Dumped in A&E and left untreated for 5 days or more: Shameful plight of some of our most vulnerable patients

Exclusive: Experts warn of ‘dire’ state of emergency care for mental health patients as ‘alarming’ figures highlight ‘unacceptable delays’

Doctors have sent a stark warning over the dire state of emergency care for mental health patients after half of A&Es revealed patients were waiting more than five days in hospital before getting the treatment they need.

The “truly alarming” figures, shared exclusively with The Independent, show vulnerable patients are being let down by “unacceptable delays” to their treatment, with one campaigner warning the issue has become a national emergency.

The data, collated by the Royal College of Emergency Medicine (RCEM), prompted a bleak verdict from top doctor Dr Adrian Boyle who said the system – which sees patients being cared for by A&E staff who are not specifically trained for their needs – was failing the most “fragile” patients.

Warning that mental health patients are being hit the hardest by long waits in A&E, Dr Boyle, the RCEM president, added: “These patients need effective and efficient care, they deserve compassionate care – crucially, they deserve better.”

The shocking statistics come after The Independent published a series of exposés highlighting the poor treatment of mental health patients across the country, prompting the government to launch national reviews into mental health care.

It comes as:

• 46 per cent of A&E departments surveyed admitted adult mental health patients had waited more than five days before their treatment was decided
• 12 per cent of the units said they also had child mental health patients waiting for this length of time
• Mental health patients reported being kept unlawfully and restrained in A&Es, including by untrained security guards
• One mental health patient told The Independent she was held on a mattress for eight days as she waited to be treated

Data also shows that 20 per cent of mental health patients – equating to thousands a month – are waiting more than 12 hours to be seen, treated or admitted after going to A&E, compared to 10 per cent of all other patients. Mental health patients make up three per cent of attendances and around five to six per cent of those waiting 12 hours overall.

Metropolitan Police commissioner Sir Mark Rowley’s officers will no longer attend emergency calls if they are linked to mental health incidents (PA Wire)

Dr Lade Smith, president of the Royal College of Psychiatrists, said patients struggling with a mental health crisis should be seen within “hours, not days”.

“They are being let down by unacceptable delays to their treatment, which have the potential to put them at even greater risk. NHS staff on the front line are doing their best to provide people with effective care but they simply cannot meet the rising levels of demand,” she added.

Paul Spencer, head of health policy and campaigns at Mind, said the figures were “truly alarming” and provided more evidence for the government the UK is in the “middle of a mental health crisis” which needs action.

Former health secretary Steve Barclay announced a national mental health inquiry in June (BBC)

He added: “While it’s clear that more emergency beds are needed for people in mental health crisis, that alone will not solve this problem. The lack of services for people with mental health problems means that not enough help is available to prevent people from reaching crisis point.

“We desperately need more timely, easy-to-access support right across the country. This is a national emergency.”

In February 2022, NHS England launched pilots across England to test one-hour waiting times for assessment of mental health patients in A&E. But no official targets have been applied since.

Dr Boyle said to The Independent: “This poll highlights the dire state of mental health emergency care. These are vulnerable patients, from children up to adults, who are fragile and seeking emergency mental health support.

‘Shocking and unacceptable’: Abena Oppong-Asare, shadow minister for women’s health and mental health (Getty)

“But sadly, the system is failing them, with the majority of these vulnerable patients left waiting in A&Es for hours and hours, many for days.

“It is wrong and must be met with meaningful action.”

The RCEM survey, the first of its kind, had responses from 68 hospitals – one-third of those in the UK – with half warning that assessment spaces in A&E are “always” occupied with mental health patients needing admission. Thirty-one hospitals said they had mental health patients on the A&E ward for five days or more.

More than 92 per cent of respondents called for increased mental health bed capacity to help delayed admissions, while 32 per cent said quicker assessments under the Mental Health Act were needed.

Dr Boyle said: “There must be equitable care for all – at present this is not the case. Mental health patients are one group that faces the longest waits and suffer the most.”

‘They deserve better’: Dr Adrian Boyle (RCEM)

The most recent NHS data shows that at the end of 2022-23, 1.3 million patients were waiting for a follow-up appointment from their community mental health service – up 10 per cent on the year.

One A&E lead also said in the survey that a lack of social care support for mental health patients was a major issue, with 25 per cent of patients able to go home but unable to get support.

The NHS began publishing hidden waiting time data for all patients waiting more than 12 hours from arrival in A&E, following reports by The Independent. Although it also collects data on 12-hour waits for mental health patients, this is not routinely published.

However last year, The Independent revealed internal NHS data which showed 5,000 patients in August 2022 – almost four times as many – were waiting more than 12 hours in emergency departments as two years ago. A further story revealed the thousands of mental health patients being admitted to general hospital wards due to a lack of preventative care.

Abena Oppong-Asare, shadow minister for women’s health and mental health, said: “It is shocking and unacceptable for any mental health patient, but especially children, to be left to wait days in A&E before they are treated. Labour will tackle the mental health crisis head-on and get people the help they need when they need it.”

The Department for Health and Social Care said it had invested an additional £2.3bn in mental health services until 2024 and for those experiencing a crisis it had established 24/7 mental health helplines, taking 200,000 calls a month.

An NHS England spokesperson said: “There is no doubt mental health services are under significant pressure, with community crisis services seeing a 30 per cent increase in referrals compared to before the pandemic, and NHS urgent and emergency care also treating record numbers.”