UK hospitals are overcrowded with people struggling with mental health problems
The U.K. National Health Service (NHS) is struggling under the strain of patient demand, as 23 hospital trusts warned that they could not cope this week. Hospital doctors have warned that the NHS “will fail” this winter unless more cash is provided. A big part of this looming problem is the pressure placed on accident and emergency (A&E) departments across the country – with figures showing the number of patients waiting on trolleys for more than 12 hours has doubled in the past two years.
In a statement issued by the President of The Royal College of Emergency Medicine, the worry about U.K. emergency rooms was made clear: “The emergency care system is on its knees, despite the huge efforts of staff who are struggling to cope with the intense demands being put upon them.” The Red Cross has called this a ‘humanitarian crisis,’ a claim described as “nonsense” by U.K. Prime Minister Theresa May.
There has been a sharp rise in demand on A&E and hospital admissions year on year. This week, the annual A&E statistics were published, giving details of emergency department attendances during 2015-2016 in England. There were 20.5 million total attendances during that time, an increase of over 4% when compared to 2014-2015.
The data also signals a worrying trend: the most recent figures show that over 165,000 people presented at A&E with psychiatric problems. Although this is a small percentage of total A&E attendances, it is a sharp rise of 47% when compared to the year 2011-2012 – and a 77% increase from 2010-2011 figures.
Even more concerning is the number of children presenting to A&E departments with mental health issues – a figure that has doubled in five years.
While there are some positive explanations for the rise in mental health problems being seen in A&E – there has been more access to psychiatric services for example – we cannot attribute such a significant rise to this alone.
The U.K. has suffered a chronic underfunding of mental health services nationally – alongside drastic cuts in social care – all of which have significantly influenced the unprecedented demand that we are seeing both in and out of a hospital setting.
Austerity measures have had devastating results for some of the most vulnerable people in society. Year on year there has been cuts to funding for housing, carers and support workers. Now key services likes child and adolescent mental health services (CAMHS) are so overstretched that they are unable to accept many referrals for children in need of help. Inevitably patients (including children and young adults) have presented to A&E as the only place that they can access in a crisis.
In a speech on mental health this week, Theresa May emphasized that her priority is to prevent mental health problems, and pledged to remove taboos and barriers to accessing help. She has promised to bolster mental health services, with nearly £1 billion ($1.2 billion) in additional funding, including more money to improve and expand children’s services, provide training to schools and fund online self-help digital therapies.
These are laudable ambitions, but it still remains unclear as to how this is going to be achievable given there are still further significant funding cuts proposed for health and social care, as well as a recruitment and retention crisis within both mental health and primary care. As the charity the King’s Fund highlighted this week: “Our concern is how these ambitions will be achieved when public health, early years provision, and other social support services are seeing their budgets cut.”
Zara Aziz is an NHS doctor in the South West of England. She trains medical students and junior doctors.
Cover: EMPPL PA Wire