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NHS health in crisis as NHS beds availability falls

Published date: 28 April 2014 |
Published by: Staff reporter
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A STUDY by the University of Chester has shown that the number of beds for mental health patients in England has fallen by 39 per cent since 1998 causing a mental health “crisis”.

And, according to the new research, the numbers are still falling with little evidence that healthcare needs for serious mental illnesses are being met outside of hospital.

In the paper, Hospital Admissions and Community Treatment of Mental Disorders in England from 1998 to 2012, published in General Hospital Psychiatry, Professor Ben Green, from the University of Chester, and Dr Emily Griffiths, of North Carolina State University, explored recent national NHS England data published online, mainly analysing hospital episode statistics.

The research found that mental health bed numbers fell 39 per cent from 37,000 in 1998 to 22,300 in 2012.

Admissions for various diagnoses, such as depression, bipolar disorder, schizophrenia, dementia and obsessive compulsive disorder, all fell, in line with declining bed numbers but they found that more patients were being sectioned under the Mental Health Act to force admission.

They also found the numbers of admissions for alcoholism and cirrhosis rose significantly across the rest of the NHS in association with increased affordability of alcohol.

Outside of the hospital environment researchers found the data on the activity of community mental health teams was patchy and has not been collected in a consistent manner or for a long enough time to enable useful comparisons.

The best available data was for crisis intervention teams over a span of six years, and this data did not show a significant rise in community activity to support those with mental health needs who could no longer be treated in hospital because there were fewer beds.

The researchers found admissions were declining for key major mental disorders like depression. By 2012, the annual admissions rates for depression fell by 50 per cent compared to 1998 meaning that now every year 15,000 “hospital grade” cases of depression are not being admitted which would have been in 1998.

Prof Green, professor of postgraduate medical education and psychiatry, said: “Our findings suggest there is a crisis in psychiatric beds in England that is squeezing out severely depressed patients. Evidence for where these patients are being treated is not clear. GPs may be picking up the extra cases, or maybe not.

“Despite this trend there are concerning patterns of certain mental illnesses being on the rise. Admissions for alcohol-related disorders, physical or mental, increased significantly and this was linked to a rise in patients being admitted with severe liver cirrhosis. This rise in alcohol-related admissions seems linked to the increased affordability of alcohol.

“Hospital admissions for other mental illnesses like eating disorders and post traumatic stress disorder have also been on the rise. Reasons for this are not clear.”

Prof Green made an urgent call for further research to examine how the change in hospital admissions affects the general public and primary care providers.

He said: “Pressures caused by having fewer and fewer mental health beds could have resulted in a rise in demand for care for mental illness placed on GPs – particularly for cases of severe depression, with primary care carrying associated risks of suicide, self-harm and so on.

“It could also have increased the burden of care for patients on their friends and families. Especially concerning is that there may be more unmet mental health needs where patients are not being treated, particularly those with ‘hospital grade’ depression.

“We urgently need more studies on the patterns, causes and effects of unmet mental health needs. Public release of NHS data should continue and be strengthened. In particular, we need consistent publication of community mental health team activity by diagnosis. This would determine if additional staff, resources or training are needed for those working in the frontline of primary care.”

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