Mental Health Services Under-Resourced ? Yes ! Suicide Prevention Minister And Related Reports Covering The Meltdown

For issues specific to caring for someone with mental ill health.
NHS cancellations of child mental health sessions jump 25%.

Staff shortages and growing demand reported to be behind annual rise in England.

Growing numbers of troubled children are having appointments with NHS mental health services cancelled, the organisation’s data show.

Figures obtained by the mental health charity Mind reveal that CAMHS (child and adolescent mental health services) in England cancelled 175,094 appointments with vulnerable patients between August 2018 and July 2019.

That was 25% more than the 140,327 which were cancelled during the same period in 2017-18.

Experts think staff shortages and the growing demand from young people for help with anxiety, depression and other conditions, lie behind the trend.

Although under-18s with mental health problems can pull out of planned sessions, the proportion of appointments cancelled by a CAMHS provider rose as a percentage of all appointments year-on-year, from 3.3% in 2017-18 to 3.7% last year – one in 27 of all consultations.

Mind called the upward trend deeply concerning, especially as some appointments were with young people who were self harming or having suicidal thoughts.

“We know services are struggling to cope with the increasing numbers of people needing help. But no young person should face being stood up by the NHS,” said Vicki Nash, the charity’s head of policy and campaigns. She added that a cancellation could set back both the young person’s relationship with CAMHS staff at and potentially their mental health.

Nash said: “Having a mental health appointment cancelled can break a young person’s trust in the health service. People are often at their most vulnerable at the point they receive professional support for issues as complex as eating disorders, self-harm and psychosis, let alone children who may be interacting with services for the first time in their lives.

“No young person should have to worry about whether their next appointment will happen. Once someone enters the mental health system they deserve timely and consistent support that gives them the best possible chance of recovery.

“It is deeply concerning that the number of cancelled appointments continues to rise, even in proportion to the increase in appointments. As demand grows under-supported staff are leaving in droves, and this can impact the gaps between appointments and chances of cancellation.”

The figures underline the difficulties facing NHS England in honouring its ambitious pledges to transform access to specialist care for children and young people facing mental health challenges, and especially in reducing what are often long waits for care. Experts say the continuing fall in the number of mental health nurses and vacancies for specialist child psychiatrists in many CAMHS teams threaten delivery of the plans.

The number of under-18s in England referred to CAMHS has risen fast. It increased from 343,386 in 2017-18 to 405,479 last year – an 18% jump from the year before. Exam pressure, online bullying, pressure to look good, difficulties within families and dysfunctional backgrounds, as well as a greater openness among young people in acknowledging their condition and seeking help, have all been cited as explanations for the soaring demand.

GPs revealed last week that many of the young people struggling mentally who were referred to CAMHS were rejected for being not ill enough. Sometimes the youngs people faced delays lasting months before they first saw a mental health professional.

Under-18s and their families cancelled about four times as many appointments as CAMHSproviders, the figures obtained by Mind also showed. During 2018 a total of 798,010 appointments were cancelled because the young person called off the meeting or did not attend. Overall, CAMHS services provided 3,734,000 appointments in 2018-19 where the patient did attend.

Emma Thomas, the chief executive of the charity YoungMinds, urged ministers and NHS chiefs to ensure more help for young people as soon as they develop problems, and to go beyond just concentrating on improving access to CAMHS once patients become more ill.

Thomas said: “The next government must ensure service improvements through investment in the NHS, but also make sure that young people can get help when they first need it, whether that’s through youth clubs, drop-in centres, local charities, schools, or online. We urgently need a new strategy that makes prevention and early intervention a priority.”

The Guardian approached Matt Hancock, the health and social care secretary, for a comment but have yet to receive a reply.
New inpatients banned at mental health unit rated unsafe.

Damning CQC report on private Cygnet Acer clinic where patients could self harm and one died by hanging.

A privately run mental health unit has been banned from admitting new patients after inspectors found numerous safety failings, one of which led to a resident dying by hanging.

The Care Quality Commission (CQC) has stopped the Cygnet Acer Clinic, in Chesterfield, Derbyshire, from accepting new inpatients. It declared that the facility was “not safe” for people to use.

Inspectors found that clinic patients had opportunities to hang themselves, and the unit had soaring levels of patient self harm, and a huge shortage of trained staff.

The CQC’s report is one of the most damning it has issued about poor and unsafe care affecting vulnerable and potentially suicidal patients in a mental health facility.

It is the 33rd time since the start of 2017 that the CQC has rated a mental health inpatient unit in England run by a profit-driven firm as inadequate, and the eighth time that has involved Cygnet.

The Cygnet Acer looks after a maximum of 28 women, at a time; they might have personality disorder and also another mental illness, learning disability or substance misuse problem.

Inspectors uncovered a series of lapses in safety, including the risk that patients could be able to try to end their life.

“In 2019 there had been two serious incidents, one of which led to a patient death by using a ligature,” the inspectors said. One in five staff had not been trained to understand most types of patient safety incidents, despite the highly vulnerable inpatient group.

Kevin Cleary, the regulator’s deputy chief inspector of hospitals, said: “The care provided at Cygnet Acer Clinic fell well below the standard that people should expect to receive. We found that the service was not ensuring the safety of those in its care.

“The number of incidents of self harm by patients had increased in the three months leading up to our inspection [in August] and almost half of the incidents involved patients using a ligature.”

The CQC also found that in one of the hospital’s two wards, Upper House, the number of incidents of self harm had more than trebled from 156 in May to 577 in July; that managers and staff were leaving patients at risk of being able to hang themselves by not getting rid of all potential ligature points; and that “75% of staff were not qualified for the roles they were doing”.

During their visit in August inspectors watched as patients gathered in the unit’s reception and banged on windows to get help from staff nowhere to be seen.

Wendy Burn, president of the Royal College of Psychiatrists, said: “We are deeply concerned by the appalling findings in the report, which has found that another hospital has failed to provide the necessary care for a vulnerable group of patients. Action must be taken to understand why patients in inpatient settings are being repeatedly let down.”

Sophie Corlett, director of external relations at the mental health charity Mind, said: “Many women in mental health services have experienced abuse or violence and their need for compassion and a safe haven is even more acute. And yet, shockingly, we hear about services set up specifically to support women that totally fail to deliver appropriate care.

“Across the board, long-neglected mental health hospitals and other buildings are putting people at risk of slower recovery, of self harming or even taking their own lives. We should not expect people with mental health problems to use inadequate and dangerous services, nor should we expect mental health staff to work in them.”

Luciana Berger, the Liberal Democrats’ shadow health secretary, said: “It is shocking that vulnerable female mental health patients were abandoned instead of receiving the care they need. There are serious questions to answer about why so many privately run mental health units have been deemed inadequate by the CQC in the last three years.”

The CQC, as well as rating Cygnet Acer inadequate, also placed it into special measures, and banned new admissions for six months.

A spokesperson for the clinic called the CQC’s findings inaccurate, adding: “This CQC report is in fact from an inspection in the summer. Since then there has been a further inspection in October and the CQC has recognised the progress made and given us positive feedback.”

The clinic said it had made “substantial improvements” as a result of the CQC’s visit, including extra training for staff and review of risk assessments. “We provide more than 140 services across the UK, the majority of which are rated good or outstanding. Where recently we have seen a relatively low proportion rated inadequate, we have rapidly invested the required resource to improve so they can meet the high standards we expect.”
Mental health : young people in crisis waiting hours for A&E help.

Figures show thousands of under-18s seeking care in England not seen in four hours.

Thousands of young people undergoing a mental health crisis, including those who are potentially suicidal, are having to wait more than four hours for A&E care, NHS figures show.

Almost a fifth of the under-18s who seek A&E help in England for psychiatric problems such as depression and self-harm are not seen within the supposed maximum of four hours.

Figures released by hospital trusts to Labour under freedom of information laws showed that while 82.2% of such patients are seen within four hours, 17.8% are not. Across the 65 acute trusts that supplied data, 11,210 of the 13,205 under-18s with a mental health problem were seen within four hours but 2,357 waited longer.

In all, 26,593 children and young people aged 17 or under attended A&E last year as a result of mental health issues. If the 17.8% of them who had to wait beyond four hours at the 65 trusts was replicated across that entire cohort, that would mean as many as 4,733 waited that long.

The disclosure prompted warnings that troubled young people might harm themselves while waiting for delayed care and calls for under-18s suffering a deterioration in their mental health to be able to access help quicker so they did not have to turn to an A&E.

“Young people should have the support they need for their mental health to prevent them from reaching crisis point and no child should be faced with long waits for help in a crisis”, said Barbara Keeley, Labour’s shadow minister for mental health and social care, who obtained the figures.

Emma Thomas, the chief executive of the charity YoungMinds, warned that long waits could make things worse for a young person in crisis.

“We work with young people who have waited months for mental health support and who have started to self-harm or become suicidal, who then go to A&E because they don’t know where else to turn.

“But despite the best efforts of staff, it’s often a stressful and frightening environment, and not somewhere a desperate child or teenager should have to wait for hours before getting help.”

Thomas added that the “worrying figures” showed that, despite progress by the NHS in extending patients’ access to mental health crisis care, more services in schools and community settings were needed.

“If young people do reach crisis point, there need to be places they can go instead of A&E, where they can get the help they need in a space that feels safe”, she said.

NHS England has pledged in its Long Term Plan to ensure that everyone in England – children, young people and adults – can access mental health crisis services around the clock by 2023-24 by calling the 111 telephone helpline.

It plans to create “24/7 provision for children and young people that combines crisis assessment, brief response and intensive home treatment functions” and set up crisis resolution home treatment services for adults.

It also plans “a range of complementary and alternative crisis services to A&E and admission within all local mental health crisis pathways”.

The Conservatives did not respond directly to Labour’s findings. A spokesperson said: “One of the great changes of our age is to treat mental health on a par with our physical health. Demand for mental health services is rising and the stigma of the past being taken away.

“As a result, the NHS is treating twice as many people with mental health conditions than in 2010 and is delivering the biggest expansion of mental health services in a generation – backed by an additional £2.3bn in real terms by 2023-24.”
Shrewsbury and Telford Hospitals : Concerns over mental health treatment.

Inspectors have taken further action against a hospital trust because of concerns over the treatment of mental health patients, the BBC understands.

It comes as a Care Quality Commission report said maternity care has improved at Shrewsbury and Telford Hospital NHS Trust, but emergency services still require urgent action. ... e-50679381