Suicidal children of 12 years have to wait more than two weeks for beds in mental health units to start treatment, despite the risk to their lives, reveals the research.
A study of 18-year-olds with severe mental health problems found that the lack of beds and staff means that NHS services for young people in difficulty have become dangerously "worn out".
Young people who have tried to end their lives self-harming or taking an overdose have to face delays of up to 15 days between being first seen and getting a place in a unit. Child and adolescent services are so large that even an enormous area like London, which has ten NHS mental health funds, sometimes runs out of beds.
In one case a very traumatized child had to be taken 283 miles from the capital in Newcastle because nowhere had a free bed. In another, a teenager with psychosis who was also at risk of killing himself ended up 167 miles away in Sheffield.
The findings dramatically illustrate the crisis in the NHS's mental health system for children under 18, particularly those whose illness is so serious that it is life-threatening, a situation that Theresa May has made a personal priority. They are contained in an audit – conducted by four psychiatrists including Dr. Dan Poulter, former health minister – of 71 children who ended up in A & E after having had a mental health crisis between the end of 2015 and the spring of 2018 and were entrusted with the care of the South London Trust and Maudsley ( Slam). Slam is the largest trust specializing in mental health in England.
Norman Lamb, the former minister of mental health, warned that being forced to wait for a bed could increase the risk that young people try to end their lives. NHS ministers and leaders must urgently end the shameful practice of those patients who are sent away from home to take care, he said.
"This audit exposes the gap between government rhetoric and reality for too many young and vulnerable people, we simply should not tolerate such delays, we would not put cancer patients' lives at risk, but this happens routinely in health services. mental, "said Lamb, Liberal Democrat MP. "For young people who are not well, there must be immediate access to beds close to home.This persistent practice of sorting very sick young people across the country, far from friends and family, is shameful and generates more traumas in a situation already critical ".
The Slam psychiatrists who treated the 71 patients expressed the fear that sending "out of area" could increase the anguish of a young man in crisis and could reduce their chances of recovery. Acute hospitals, in which children under 18 are initially treated in a pediatric ward, are not as safe for vulnerable young people as specialized facilities, they added.
The audit shows that 38 of the 71 were considered suicide-threatening. Despite this, the longest wait for a bed in front of one of the 14 under-18 suicides was 15 days and 15 hours. Another waited seven days and two hours. One of the six patients who had just tried to take their own lives waited six days and 22 hours and another for five days and 19 hours.
Among the 17 patients who had recently taken an overdose, one was delayed 12 days and 23 hours and another six days and one hour. The only patient who was having suicidal thoughts waited five days and 21 hours. In another case a girl with eating disorders and other mental health problems, who was not suicidal, had to wait 64 days for a bed in a specialist unit to become available, which was also "out of area".
"The longer the wait for admission to an acute mental health bed, the longer a child or young person has to wait to receive specialist care and treatment in the most appropriate context." These delays can sometimes prolong a hospital stay for a young person, increasing their discomfort and sometimes delaying the start of the complete package of mental health care they need and can only receive in a specialized setting, "Poulter said.
The ability of Slam to pay proper attention to the growing number of young people with mental health problems has been affected by the lack of resources, Poulter pointed out. "Both trust and staff do their best for children and young people within the limits imposed by an under-funded mental health system and, consequently, with insufficient resources and staff.
"A paralyzing and long-term lack of personnel and secondary resources due to the lack of investment by successive governments is the root cause of the problem".
The government says that over 100 beds have been opened across the country in recent years, with plans for 40 new by March.
Claire Murdoch, national director of mental health at NHS England, said: "This audit is now outdated, based on information from four years ago: another 61 beds have been opened in London since December 2017. But we know from # 39 listening to young people and their families who want specialist mental health support in their community, closer to home, which is why the NHS long-term plan is increasing community care by including intensive support for the care of the community as well as investing in previous aid through counseling and the introduction of schools standard waiting times for eating disorders. "