Out of Area Placements

In recent reports, the Royal College of Psychiatrists, the UK body which regulates and represents psychiatrists working in this country, has highlighted the continuing national scandal of adult patients suffering with mental ill health being sent out of their local area for treatment due to a lack of inpatient psychiatric beds in the locality: a practice officially known as “out of area” placements. It is now six years since we first drew attention to this national scandal in the Speaking Out columns and little seems to have changed.

Out of area placements have now become widespread with almost half of all mental health inpatient admissions being out of area during the period 2021 to 2023 according to the medical research platform Medscape.  In fact during this time about 5,000 mental health patients were sent over 60 miles from their home for treatment.

This practice has the huge disadvantage of removing the patient from frequent and convenient contact with their families and friends and we know from experience that good support from families is an essential part of a successful recovery.  In many cases patients are admitted to mental health units hundreds of miles away from their home.  In one case a patient from Plymouth in the Westcountry was sent to a mental health unit in Darlington in the North of England some 378 miles from their home and family.

Often the cause of the inpatient bed shortages is understaffing in the local community mental health team who can often intervene early on to prevent sufferer’s conditions deteriorating into a full blown crisis.  Around one in ten of consultant psychiatrist roles in the UK are currently vacant.

Medscape reports that in 2016 the then Health Secretary, Jeremy Hunt committed to ending the practice of out of area placements in the mental health service saying “not a single patient from England with acute mental ill health should be in a bed far from home for want of one locally”.  But now seven years on patients are still being sent away from home.

In 2017 we said in this column that the practice of out of area placements was both counterproductive and inhumane and would not be acceptable in any other area of health care.  Nothing has changed now and we still stand by those comments.  We call on the government to finally end this practice immediately.  A very useful first step would be for the government to abolish the cap on the training of medical students and allow our medical schools to train all of the doctors we will need in the future.

References

Department of Health and Social Care, 2016, Out of area placements in mental health services for adults in acute inpatient care. Published 30/09/2016, viewed online 12/07/2023 at https://www.gov.uk/government/publications/oaps-in-mental-health-services-for-adults-in-acute-inpatient-care/out-of-area-placements-in-mental-health-services-for-adults-in-acute-inpatient-care

Royal College of Psychiatrists, 2023, No end in sight: over 5,000 cases of patients with mental illness being sent more than 100Km away for vital treatment.  Viewed on line 12/07/2023 at https://www.rcpsych.ac.uk/news-and-features/latest-news/detail/2023/06/21/no-end-in-sight-over-5-000-cases-of-patients-with-mental-illness-being-sent-more-than-100km-away-for-vital-treatment.

Hicks R, 2023, Mental Health Patients Sent Packing, published on Medscape and viewed on line 12/07/2023 at https://www.medscape.co.uk/viewarticle/mental-health-patients-sent-packing-2023a1000dt3

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