Urgent adult mental health crisis referrals in England have more than doubled between 2023 and 2024, highlighting the growing strain on mental health services, according to a recent report by the Care Quality Commission (CQC). The surge in referrals, especially to crisis teams, has placed considerable pressure on already overstretched services, with many patients becoming more unwell while awaiting help.
In March 2024, the number of very urgent adult referrals to crisis teams rose to 3,063, up from just 1,400 the previous April. The CQC report also raised concerns over insufficient resources, including a shortage of beds and staff, forcing ward managers to discharge the “least unwell” patients earlier than necessary. As a result, many individuals are not receiving the timely, appropriate care they need.
Disproportionate Impact on Black People
The report also highlighted troubling racial disparities, noting that black people are 3.5 times more likely to be detained under the Mental Health Act than their white counterparts. Dr. Sarah Hughes, CEO of Mind, called these statistics a “source of national shame.” She noted that black men, in particular, have been disproportionately represented in mental health crisis data for years and are seven times more likely to be placed on community treatment orders—measures that she argues are both intrusive and ineffective.
“The statistics are unacceptable and reflect that England’s mental health system is light years away from delivering compassionate care,” Hughes said.
Challenges in Accessing Mental Health Care
The report also found that people living in the most deprived areas of England are 3.5 times more likely to attend A&E for mental health care than those from less deprived areas. Many mental health services reported that patients who were detained for treatment appeared to be more unwell than in previous years, but the pressure on inpatient beds meant that these patients were discharged too soon, often before they were stable.
In nearly half of the cases involving children or young people detained under the Mental Health Act, they were readmitted within a year, indicating a failure to address their needs adequately during the initial stay.
A Damaging Cycle of Care
Jenny Wilkes, the interim director of mental health at the CQC, stated that the report revealed a “damaging cycle” of ineffective treatment. She explained, “Without timely access to necessary mental health support, people are being bounced from service to service without ever receiving the level of care they need.”
Wilkes acknowledged that while the forthcoming mental health bill aims to reduce detentions and improve care, resources—including staffing and beds—are the key factors that need urgent attention. The bill, if passed, would give patients more control over their care, include families in treatment discussions, and introduce limits on the length of time people with learning difficulties or autism can be detained.
Concerns Over Bed Shortages and Out-of-Area Placements
The CQC report found a significant 25% increase in inappropriate out-of-area placements for mental health patients, with 5,500 patients being treated in facilities far from home, making it harder for them to receive support from their families and local care teams.
The quality of ward environments was also a major concern, with reports of bed shortages causing patients to be placed in unsuitable rooms. Some wards were overcrowded, with one ward having 16 patients assigned to a 12-bed ward, leaving four patients without a bed upon their return.
Calls for System Reform
Mental health charity leaders, including Marjorie Wallace, the chief executive of Sane, criticized the system’s failure to provide adequate care. Wallace noted that people detained under the Mental Health Act are being moved around the country like “unwanted parcels” due to a lack of available beds and overwhelmed crisis teams. She added, “Callers to our helpline report they are told there are no beds available locally.”
Dr. Hughes and other advocates are calling for reform to address the fundamental issues in the mental health system, such as staffing, bed availability, and the quality of facilities. Brian Dow, deputy chief executive of Rethink Mental Illness, argued that the report further highlights how England’s mental health system is at breaking point. He called for a clear plan from the government to ensure that mental health services receive the necessary funding and staff to deliver timely and effective support.
Conclusion
The CQC’s report paints a grim picture of England’s mental health services, with overcrowded wards, staff shortages, and racial disparities worsening an already fragile system. As urgent referrals continue to rise, experts warn that the lack of resources is putting the most vulnerable at greater risk, further emphasizing the need for urgent reform in mental health care in the UK.
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