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Thursday, 13 April 2017

Suicide risk warning over delays in follow-up treatment of mental health patients

Written by Scott D'Arcy

One in 10 mental health patients discharged from hospital after suffering a crisis has to wait more than a week for a follow-up appointment, according to new figures.

The data, obtained by mental health charity Mind from responses to a freedom of information request by 54 of the 56 NHS mental health trusts in England, showed at least 11,000 people did not get an appointment or phone call within seven days of leaving hospital in 2015/16.

Its survey of more than 850 patients also found that those who were not followed up within a week, if at all, were more than twice as likely to attempt suicide than those who had a swift follow-up - at 16% compared with 7%.

National Institute for Health and Clinical Excellence (Nice) guidelines state all patients should be followed up within seven days, or 48 hours if deemed a suicide risk.

The charity has called for all patients to be contacted after just two days, citing evidence given to a national inquiry that the highest proportion of those who take their own lives did so three days after discharge.

MPs on the Health Select Committee last month expressed disappointment that the Government had not acted on a previous recommendation calling for all patients discharged from inpatient care to receive follow-up checks within three days.

Sophie Corlett, director of external relations at Mind, said: "This is not good enough. It is a tragedy that so many people so very recently leaving the care of hospital are losing their lives.

"The Government has put suicide prevention as a key patient safety issue for the NHS as a whole and pledged to reduce suicides by 10 per cent in the next five years. Timelier follow-up for patients after they leave hospital could help achieve this.

"If you don't get the right care after you leave, if you're left to cope alone, you can end up in a revolving door going straight back in to hospital or be at risk of taking your own life.

"Seven days is simply too long to wait when someone's recovery is still at risk. We need to see a reduction of the follow-up time to 48 hours now."

Imani, 36, was diagnosed with borderline personality disorder and complex-post traumatic stress disorder and had three voluntary inpatient admissions when she was acutely suicidal.

She said: "When I got out, I thought: I've just been in hospital, I've been suicidal - I'm sure they're going to be giving me one hundred per cent support. I remember coming out and thinking I wanted to go back in again.

"I don't remember being in contact with the hospital once I'd come out - no phone call, no visit - and I needed to see someone."

Mind added just one health board in Wales replied, giving an incomplete picture, and the charity has called on the Welsh government and health service to improve transparency.

A Department of Health spokeswoman said: "We know that follow-up treatment is crucial for people with mental health conditions, which is why we have invested £400 million to improve mental health crisis care in the community, allowing more people to be treated closer to home and get the support they need following discharge from hospital.

"Any failure to meet Nice guidelines on follow-up appointments must be taken extremely seriously, and we expect trusts to take action to prevent this."

Professor Mark Baker, director of the Nice Centre for Guidelines, said: "We're prioritising a review of the Mind analysis and the recent National Confidential Inquiry report to see if we need to make any further changes to our recommendations."

Dr Paul Brown, of the Royal College of Psychiatrists said: "These figures paint an alarming picture of a system under intense and increased pressure.

"We hear reports of personnel struggling even to find the time to pick up the phone to follow up on recently discharged patients.

"It is absolutely vital that we see money promised by the Government going to the frontline."

An NHS England spokesman said: "Improved access to mental health support for people in the community where they live is part of our plans for the biggest expansion of mental health services in Europe."

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