NHS: Distant Care Leads to More Suicides

Hours after being released from a secure psychiatric facility, Jeffrey Barry stabbed, mutilated and killed his neighbour, a Kurdish refugee he had met in shared support accommodation. Weeks before the murder, Barry told psychiatric staff that he wanted to hurt people, even naming his eventual victim whom he’d attacked before. And yet he was still released, resulting in Kamil Ahmad’s tragic death.

But the sad fact is that mental health patients are far more likely to harm themselves than others. New data shows that years of offering patients treatment outside their local area and overlooking mental health services has taken the ultimate toll: an increase in suicides after discharge from non-local mental health units.

Suicide Toll

These findings come just months after the Tory manifesto promised to provide mental health care closer to patients’ homes and Labour also vowed to end “out-of-area” placements.

Both pledged to give mental health care the funding it deserves. But already doctors are being forced to beg once again for mental health funding.

The research from the University of Manchester discovered that more than 200 patients committed suicide just after leaving out-of-area placements.

Out-of-area placements take mental health patients at their most vulnerable and place them far away from their home, family and support network. The result is a rather predictable increase in problems for patients, showing up most tragically in suicide shortly after discharge.

Overall the university’s annual report showed a continuing fall in the number of suicides within three months of patient discharge. However it also found that the number of suicides after discharge from out-of-area facilities had “soared”, according to the British Medical Association.

The same report from 2015 revealed a similar increase – from 85 such suicides in 2004-08 to 96 in 2009-2013, accounting for 8% and 10% of all post-discharge suicides within three months. These figures rose to 11% in 2016 and to 13% in this year’s report. The BMA stated that this “apparently persistent pattern of suicides following admission to ‘non-local beds’” followed their own research, which identified a 40% rise in the number of out-of-area admissions between 2014-15 and 2016-17.

“Unacceptable” Cost of Austerity

Following the 2015 report the Royal College of Psychiatrists launched an independent commission to address the problems in patient care, specifically the number of suicides after discharge from non-local units.

The “Old Problems, New Solutions” commission found that “in September 2015, 499 adults had to travel more than 30 miles for admission to a service which should be provided locally, such as acute care, psychiatric intensive care or rehabilitation services.”

The report said that figure suggested that thousands of people each year were travelling “unacceptably long distances” due to a shortage of beds, staff and facilities.

Apart from delaying recovery by tearing vulnerable patients from their support networks, out-of-area beds mean mental health personnel from home areas have difficulty visiting their patients and waste precious time. It also means vital information and awareness about patients can “fall between the gaps” as highlighted in the death of David Knight who committed suicide two days after being released from an out-of-area facility 150 miles from his home.

The commission noted that, aside from having fatal consequences, out-of-area beds are “very expensive”. “One Trust had spent £4.8m on out-of-area treatments for up to 70 patients at any one time in 2013-14 at an average cost of approaching £150,000 per patient per annum.” If a moral incentive won’t change the Government’s approach to mental health, perhaps a monetary one will. Out-of-area beds aren’t beneficial to patients, purses or Parliament: it’s time they were ditched before the UK has more blood on its hands.

If you’re affected by or experiencing mental health problems, please speak to your GP or contact The Samaritans by calling 116 123 free from any phone. The charity is available 24 hours a day, 365 days a year. You don’t have to be suicidal to call – whatever you’re going through, they’re here to listen.

by Jo Davey

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