Shunting mentally ill round the country is ‘intolerable national scandal’

Last week, I led a debate in the House of Commons to highlight one of the most egregious examples of the institutional bias against mental illness in the NHS. This is the practice of shunting people around the country in search of a bed – sometimes hundreds of miles away from home – during a mental health crisis. 

Typically, this occurs because there is no bed available to someone locally at the time of need. Whilst the underlying reason may vary from case to case, the end result is to cause unacceptable distress during what is already a deeply traumatic experience. 

During the debate, I shared with the House  the anonymous testimony of one of my constituents in Norfolk who, following a suicide attempt, was sent more than 120 miles away from home to a hospital bed in London. His account is powerful and shocking. After being transported “like a prisoner”, spoken to just once throughout the three-hour drive, he describes how he was left isolated, frightened and disoriented in a distant unit as his family frantically tried to find out what was happening. 

Anyone would conclude that this treatment is inhumane, but there are numerous stories of this happening around the country on a regular basis. It is an utterly bizarre and outrageous way to deal with someone who is at their lowest ebb. 

The truth is that society would not tolerate this practice with someone suffering a physical health condition. It would be met with public outrage if someone who suffered a heart attack or a stroke had to be taken miles away from their family and friends to receive care. Yet this is precisely what is faced by people suffering from acute mental illness every week of the year – with  over 500 people in a non-specialist bed more than 50km away from their homes at the end of August. It is further confirmation of the total imbalance of rights of access to treatment between physical and mental health. 

This is all the more shocking when being treated out-of-area is known to increase someone’s risk of suicide. A  recent reporthighlighted that although suicides among recently discharged mental health patients have fallen in recent years, the annual number of suicides after being discharged from an out-of-area unit has increased from 68 in 2003-2008 to 109 in 2008-12. But still the number of out-of-area placements continues to rise,  increasing by 23% to 4,447 last year. 

When I investigated the problem as Minister in the Department of Health, I was told that no data is kept on what is happening around the country. We were operating in a fog. I initiated the collection of data on out of area placements - so that we now know where unacceptable practices continue. And we undertook an investigation into a number of Trusts around the country to understand better why this was happening. The conclusion from officials was that the problem is solvable. There is enormous variation around the country. So, during the debate, I challenged the Minister to set a national ambition to eradicate the practice completely within 12 months. Alistair Burt committed to report back in the New Year after considering the findings of the Mental Health Taskforce and Lord Crisp’s Commission on Acute Adult Psychiatric Care. 

People with mental illness deserve the same rights as those with physical conditions – including access to effective, timely, and local support during a crisis – and it is surely a moral imperative that we end this intolerable national scandal without delay. Much of the change that is needed can be achieved by better organisation within the health and care system. If some trusts have managed to largely eradicate the problem, then others can too. A strong political commitment is, however, essential if we are to make this happen.