Spike in mental health patient deaths shows NHS 'struggling to cope'

MP Norman Lamb likens rise of over 20% in the unexpected deaths of mentally ill people in NHS care to Mid Staffs scandal and calls for investigation

A sudden spike in the number of mental health patients dying unexpectedly in NHS care has prompted calls for a wide-ranging investigation into “threadbare” services that are “struggling to cope”.

New NHS figures show that the number of deaths annually among mental health patients in England has risen 21% over the last three years from 1,412 to 1,713.

The number of those killing themselves or trying to do so has also increased, by 26% from 595 in 2012-13 to 751 in 2014-15. It covers both those being treated as inpatients for serious mental health problems and also those who are being cared for while still living at home.

Figures obtained by Norman Lamb, the Liberal Democrat MP, show that the overall number of “serious incidents” – involving unexpected or avoidable deaths, serious harm, injury and abuse – has climbed 34% to 8,139 a year. They have become so common that one trust, North East London foundation trust, had a total of 633 last year – almost two a day.

Lamb, the mental health minister in the coalition until last May, made the comparison with the Mid Staffordshire scandal in which patients died as a result of poor care.

“Significant numbers of unexpected deaths at the Mid Staffs NHS trust caused an outcry and these figures should cause the same because they show a dramatic increase in the number of people losing their lives,” Lamb said.

“NHS England and the government should set up an investigation into the causes of this as these figures involve tragedies for families around the country and the human impact is intense.”

Underfunding of sometimes threadbare mental health services which are struggling to cope with rising demand for care is to blame, Lamb claimed.

The way the NHS collects such figures has changed since 2014-15. But figures for the first six months of 2015-16 show a continued upward trend, with 1,132 serious incidents recorded as involving an unexpected or potentially avoidable death.

Paul Farmer, chief executive of the charity Mind and also the chair of NHS England’s mental health taskforce, said that even if better reporting partly explained the rises, “the figures give us real cause for concern”.

“We know, for example, that suicides among people in touch with crisis resolution and home treatment teams – which are there to support people in crisis to stay in their own homes rather than be admitted to hospital – have increased significantly.

“These teams have in recent years been starved of funding and in some cases have been disbanded altogether or else merged into community teams, losing their specialist function, at a time of rising demand,” Farmer added.

Every unexpected death should be investigated so that lessons can be learned to prevent future loss of life, he urged.

But Prof Sir Simon Wessely, president of the Royal College of Psychiatrists, said the apparent dramatic increases were due primarily to staff and trusts reporting more such events when they happen.

By almost every metric, the number of people with mental health problems in the UK has surged in recent years, leaving NHS services simply unable to deal with the volumes. The numbers of people in contact with mental health services has jumped by more than 40% over the past decade, while the number of antidepressant prescriptions have surged by more than 100% in the same period.

Rise and fall

But the government has been accused of cutting millions of pounds from mental health funding. An attempt to concentrate efforts on talking therapies by increasing the numbers of psychotherapists has produced mixed results.

Many long-term patients describe a byzantine system of long waiting times, lack of psychiatrists, overreliance on pills as an easy solution and a sense of limbo for all but the most severe cases.

Matters have not been helped by the fact that limited staffing numbers have fallen even further in recent years. The number of specialist mental health nurses has fallen more than 10% over the past five years, the Guardian has learned.

The loss of one in 10 of the entire mental health nursing workforce in England has occurred mainly in hospitals and mental health units treating some of the sickest patients, official NHS figures show.

Figures from the NHS’s health and social care information centre, obtained through a parliamentary question, show that the number of qualified nurses working in psychiatry dropped by 10.8% from 41,320 in 2010 to 36,870 in 2015.

While the number working in community psychiatry services has fallen only slightly from 15,986 to 15,826, those listed as working in “other psychiatry” – mainly hospital units – went down from 25,334 to 21,044.

“These shocking figures raise serious concerns about the future of our mental health services,” said Luciana Berger,the shadow minister for mental health. “At a time when there is growing demand and staff are being asked to do more for less, cuts to the number of nurses working in mental health are completely unacceptable.”

The National Health Service explained

NHS England declined to comment directly on Lamb’s figures. A spokeswoman said: “Reporting of incidents is intentionally up right across the NHS, including mental health, as part of our national effort to encourage transparency and a culture of learning.

“That’s the lesson from the airlines - openness is a precondition for safety and improvement. That’s as true for mental health services as it is for maternity care or surgical operations.”

In the UK, the Samaritans can be contacted on 116 123
In the US, the National Suicide Prevention Hotline is 1-800-273-8255
In Australia, the crisis support service Lifeline is on 13 11 14

• This article was amended on 26 January 2016. Because of an editing error, an earlier version said hundreds of patients had died as a result of poor care by Mid Staffordshire NHS trust. Sir Robert Francis QC concluded in his reports on care at the trust that it would be unsafe to infer from mortality statistics, on which the figures were based, that there was any particular number of avoidable or unnecessary deaths at the trust.


Denis Campbell Health policy editor

The GuardianTramp

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