Britain's Victorian mental health wards can't cope with coronavirus – violence is inevitable

Our psychiatric services are ill-equipped at the best of times. This pandemic will tip them over the edge, writes Ian Hamilton

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You have to be extremely ill to justify admission to a mental health ward here in Britain. Compare the 18,000 beds available on such units today with the 67,000 in the 1980s. This rapid reduction doesn’t reflect an improvement in the nation’s mental health, but an ongoing attempt to replace expensive inpatient care with community treatment, which is significantly cheaper.

In normal times this dwindling mental health hospital capacity was a constant struggle for staff, who would have to decide who was the least ill, to be discharged or sent on leave, to make way for a new acutely ill person who could no longer be cared for in the community.

Prior to the coronavirus outbreak, bed occupancy was running at over 100 per cent. Covid-19 has amplified the problems that were already visible in the way care is provided for those with the most acute mental health problems. But now, crucially, the ability to send some patients on leave and immediately fill the empty bed has all but gone.