Mental health services across the UK are under unprecedented strain, with a steep fall in nurse numbers and available beds at a time of rising demand, the Royal College of Nursing has warned.
A report, published today by the RCN, also warns that the loss of early intervention services means patients experiencing serious mental health problems are unable to access local treatment, leading to increasing numbers being sectioned.
“We are running the serious risk of turning back the clock and undoing all the good work that has gone before”
The last four years have seen a drop of more than 3,300 posts in mental health nursing across the UK, with more experienced nurses disproportionately lost and the expectation of more to come as older nurses retire.
This is despite pledges to improve mental health care, and in particular move towards more community services, the RCN said in its latest Frontline First report on nursing workforce trends – titled Turning Back the Clock? (see PDF top-right).
Meanwhile, around 1,500 beds have been lost from the system in England since 2010, representing a 6% reduction at a time when demand rose by 30%.
Admissions to inpatient units have risen over the same period, with the RCN suggesting it is linked to the loss of early intervention and crisis resolution services.
“Our nursing workforce is increasingly ill-equipped to give people with mental illness the specialist, recovery-driven care they need”
The loss of these vital services means many people experiencing symptoms of psychosis and serious mental illness have to wait until they are ill enough to be detained under the Mental Health Act before they can access treatment as an inpatient.
There has been a rise in detentions under the Mental Health Act of 13% between 2009-10 and 2012-13.
Despite stated commitments from governments and healthcare providers to establish “parity of esteem” between physical and mental illness, the RCN claimed there was a “gulf between the rhetoric and reality”.
Peter Carter, chief executive and general secretary of the RCN, said: “The fact that mental health services are now facing staff cuts and bed shortages is a shocking tragedy which is having a real and lasting impact on those who desperately need the right care and support.
“We are running the serious risk of turning back the clock and undoing all the good work that has gone before,” he said. “The establishment of early intervention services was a great leap forward, and has helped many people live well who may once have been written off.
“If staffing levels and services are cut back further, then services will continue to crumble which would be a tragedy for us all to say nothing of all the thousands of private tragedies that could result,” said Mr Carter.
He added: “Our report makes for sobering reading but with the right resources and funding, and commitment from all levels of government, we can ensure that this important arm of nursing is protected.”
Mark Winstanley, chief executive of the charity Rethink Mental Illness, said: “Our nursing workforce is increasingly ill-equipped to give people with mental illness the specialist, recovery-driven care they need. Nurses are being forced to take a risk-averse approach to care which prioritises keeping people safe, rather than helping them get better.
“Reducing nursing staff levels and skill-sets will result in more people needing long-term support, including expensive hospital treatment,” he said. “The costs to the NHS in the long-run will far outweigh any short-term savings it gains.”
The RCN is calling on the government and employers to ensure they have enough staff with the right level of skill to deliver the care needed at the point at which help is sought.
In particular, with almost of third of mental health nurses aged over 50, many of whom can retire at 55, a long term strategy is needed to recruit and train mental health nurses in order to deliver care in the community and inpatient units.