More than one in three (38%) people who have been in hospital after experiencing a mental health crisis feel they were discharged too early, a charity has warned.
A mental health crisis is defined as any situation in which a person feels they need urgent help relating to their mental health, such as having suicidal thoughts or attempting to harm themselves or others.
The new survey from mental health charity Mind also uncovered one in five (21%) said they were given no notice at all that they were going home.
This even happens when people have been an inpatient for a long time, with one in three people (33%) in hospital for more than a month saying they were given less than 48 hours’ notice that they were being discharged or no notice at all.
Worryingly, two out of five people (37%) surveyed said there was no plan for their further care and support after leaving hospital, contrary to official guidelines.
According to Mind, the days and weeks after leaving hospital after a mental health crisis are critical.
People are at high risk of suicide in the first week after leaving hospital and if they are unsupported they could become unwell again and end up back in hospital. Therefore, is important that care plans for ongoing support are made before people leave.
But the survey of more than 1,200 people who have previously been in hospital after a mental health crisis found less than half (44%) said managing their mental health or self-care was considered in plans for leaving hospital.
In addition, only half of people (51%) said their accommodation needs were considered in any plans and less than a third (29%) said money and benefits were considered.
This is something Phillipa, 34, experienced. She has been diagnosed with both emotionally unstable personality disorder and a long-standing eating disorder, and was hospitalised in January 2016.
“I’d been in my local mental health unit for a week, when one morning I woke up to be told that there was a taxi waiting for me downstairs and to get ready,” she said.
“Dazed and confused, still half asleep, I didn’t understand. Did I have an appointment? Was I visiting somewhere? Did they have the right person?
“Within minutes I found myself in the taxi, with all my belongings shoved into four bin liners. Handed not enough medication to get me through the weekend, I was now off suicide watch and, with a staff member, apparently headed for my local Community Mental Health Team (CMHT).
“I didn’t know the time, if I had my door key, if I had money on me or if I had my bus pass. No one could explain what had just happened.”
Phillipa had a whole host of answered questions, such as how she would get the medication she needed, whether she had money on her electricity metre and how she would get home from the CMHT appointment.
“My brain froze. I went into a state of shock,” she said.
“Was I even awake? I cannot do this. I don’t think most people could have coped, and in my already fragile state of mind, I really had no chance.”
According to NICE (National Institute for Health and Care Excellence) guidelines, experiences like Phillipa’s shouldn’t happen.
The guidelines state plans should be made for people’s ongoing care from admission or as early as possible from when they go into hospital.
There should be a written plan put together in collaboration with the person receiving care. Yet nearly two in three people (66%) in the survey said they were not given a written care plan and one in four (23%) said they were unaware of any plan at all.
As well as ongoing mental health care, planning for additional support with housing and finances should be included when people leave hospital.
But around half of respondents said that these things were not well considered or, in some cases, considered at all.
Paul Farmer, chief executive of Mind, called the findings “shocking” “not good enough”.
“It is a tragedy that so many people so very recently leaving the care of hospital are being left to cope alone, and are at risk of losing their lives,” he said.
“Whether you’ve been in hospital for days or for months, when you come out you need the right care and support to help you stay well.
“Leaving hospital and coming home can be daunting. You need to feel prepared and confident you will get the support and services you need to help pick up the pieces and continue getting better. Providers must urgently make the improvements needed for everyone in their care.”
In light of the findings, Mind has produced a booklet to help people plan for their care when they leave hospital after a mental health crisis and a briefing to show what can be done to support people.
In response to the Mind survey an NHS England spokesperson said: “Good care doesn’t end when someone leaves hospital which is why all mental health patients should receive a follow-up consultation with an appropriate NHS professional as needed following discharge.”
Useful websites and helplines:
- Mind, open Monday to Friday, 9am-6pm on 0300 123 3393
- Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI - this number is FREE to call and will not appear on your phone bill.)
- Get Connected is a free advice service for people under 25. Call 0808 808 4994 or email: help@getconnected.org.uk