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Patients at risk in ‘crumbling’ mental health wards, NHS leaders warn

Patient safety is at risk in “crumbling” NHS mental health hospitals starved of the money needed to improve dilapidated buildings, new data has revealed.

Hundreds of vulnerable mentally ill patients are still being cared for in 350 old dormitory-style wards, 20 years after the NHS was told to provide all patients with en-suite rooms. A lack of funding to refurbish hospitals has also meant too many wards still have ligature points that patients can use to try to harm themselves.

NHS leaders said the lack of cash from the government meant they could not deal with warnings issued by the Care Quality Commission (CQC), the sector’s watchdog.

A survey of mental health trust leaders by NHS Providers has now found bosses are worried the state of psychiatric wards is undermining their ability to keep patients safe.

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Source: The Independent, 20 February 2020

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Senior trust medics complain of ‘excessively authoritarian’ management

Senior doctors in the radiology services at the University Hospitals North Midlands Trust have reported a ‘toxic’ culture and feelings that managers had been ‘excessively authoritarian’.

In a letter sent by medical director John Oxtoby on 13 July, consultants who had been interviewed as part of an external review, have reported the culture within the department was “unhealthy and even toxic, and that this was impacting to some degree nearly all of the consultants interviewed”

“It is clear from this work that as well as the need to tackle working relationships and some behaviours in the department, there is a huge amount of collective pride in the services delivered by the department.” Said Mr Oxtoby. 

Read full story (paywalled).

Source: HSJ, 3 August 2021

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Patients don’t feel safe in A&E, research finds

Visiting A&E or relatives is considered much riskier than attending hospital for other reasons, according to the first in-depth piece of research into the subject. 

The research, authored by the University of Leicester and NIHR Leicester Biomedical Research Centre Bioinformatics Hub, asked 400 participants how they felt about attending hospital across a range of scenarios during the pandemic. It also revealed that consistent staff use of PPE is seen as a top priority by patients, with staff testing receiving significant but much less support. 

Participants in the Leicester research were asked to rank how ”safe and confident” they felt coming into hospital for a number of reasons on a scale 1-100. The median score given to “visiting a friend or family member” was 49. The score for attending accident and emergency was 50.

Attendance at A&E’s fell sharply during the pandemic peak. It is now rising, but has not reached pre-covid levels. The research suggests that fear could still be playing a significant part in the drop off.

Attending hospital for elective care received a median score of 61. Participants were most confident in visiting hospital for essential surgery (median score 78), and clinical scans or x-ray (77).

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Source: HSJ, 3 September 2020

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£52 million investment to fast track online maternity records

England's Chief Nurse has announced every pregnant woman will be able to access their maternity records from their smart phone. 

The move has been made so that pregnant women will be able to have more control over their pregnancy and will be able to see all the decisions and information made via a smart phone. 

GPs and health professionals will also be able to access this information, it is hoped that by doing so, it will mean pregnant women will no longer have to repeat information to different clinicians they see whilst pregnant, which may also help improve safety.  

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Source: NHS England, 17 June 2021

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NHSE funding policy risks ‘levelling down’ maternity safety, warns hospital chief

 

Glen Burley, an acute trust chief executive has said NHS England risks ‘levelling down’ safety in some maternity services by ‘disproportionately’ directing additional funding to struggling trusts.

This comes after NHS England said the funding prioritised the trusts which needed the most support to meet the essential actions in the Ockenden Report, where in March, NHSE invited trusts to bid for a share of £96m extra funding for maternity services. 

A spokeswoman for NHS England has said: “The NHS made an additional £96m investment in maternity services following the Ockenden Review, the majority of which will bolster the workforce by funding an additional 1,200 midwives and 100 obstetricians. While the funding for additional workforce is for all NHS trusts, it is right that those who most need the support are prioritised.”

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Source: HSJ, 02 September 2021

 

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GMC tackles bullying and sexual harassment for doctors

New responsibilities for doctors regarding their use of social media and tackling toxic workplace behaviours and sexual harassment are among key proposals in the General Medical Council’s (GMC) planned update to its core ethical guidance.

The regulator has launched a 12-week consultation on the draft new content of 'Good medical practice', which outlines the professional values, knowledge and behaviours expected of doctors working in the UK. This represents the first major update of the guidance since it first came into effect in April 2013, with the review process launched last year.

The GMC said the draft new update follows months of working with doctor, employer, and patient representatives, as well as other stakeholders, and reflects the issues faced in modern-day healthcare workplaces.

Included for the first time in the draft new guidance is a duty for doctors to act, or support others to act, if they become aware of workplace bullying, harassment, or discrimination, as well as zero tolerance of sexual harassment.

For the first time, the GMC's ethical guidance proposes 12 commitments, including:

  • Make the care of patients my first concern.
  • Demonstrate leadership within my role, and work with others to make healthcare environments more supportive, inclusive, and fair.
  • Provide a good standard of practice and care, and be honest and open when things go wrong.
  • Ensure my conduct justifies my patients’ trust in me and the public's trust in my profession.

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Source: Medscape, 27 April 2022

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GPs giving antidepressants to children against guidelines

GPs are breaching medical guidelines by prescribing antidepressants for children as young as 11 who cannot get other help for their mental health problems, NHS-funded research reveals.

Official guidance says that under-18s should only be given the drugs in conjunction with talking therapies and after being assessed by a psychiatrist.

But family doctors in England are “often” writing prescriptions for antidepressants for that age group even though such youngsters have not yet seen a psychiatrist, according to a report by the National Institute for Health and Care Research (NIHR), the NHS research body.

The report linked the prescriptions to the long wait many young people, some self-harming or suicidal, face before starting treatment with NHS child and adolescent mental health services (CAMHS). Under-18s are prescribed the drugs for anxiety, depression, pain and bedwetting.

The guidance on antidepressants has been issued by the National Institute for Health and Care Excellence (NICE), which advises the NHS on which treatments are effective.

Referencing NICE’s recommendation of a two-step approval process, the NIHR study said “this often” did not happen. “No antidepressants are licensed in the UK for anxiety in children and teenagers under 18 years, except for obsessive compulsive disorder. Yet both specialists [psychiatrists] and GPs prescribe them. Thousands of children and teenagers in the UK are taking antidepressants for depression and anxiety. The numbers continue to rise and many have not seen a specialist.”

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Source: The Guardian, 4 November 2022

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Chronic UTI sufferers face mental health crises after being ‘dismissed and gaslighted’ for years

Women suffering from chronic urinary tract infections (UTIs) are facing mental health crises after being “dismissed and gaslighted” by health professionals for years, according to a leading specialist.

Daily debilitating pain has left patients feeling suicidal, with those in recovery describing lingering mental health problems “akin to post-traumatic stress disorder (PTSD)”, said Dr Rajvinder Khasriya, an NHS consultant urogynaecologist at the Whittington Hospital in London.

Patients have said they feel crippling anxiety over planning ahead to ensure there is always a toilet around, even after their condition has been controlled with treatment. 

Vicky Matthews, who searched for a diagnosis for three years after a recurrent UTI became chronic, said the condition caused a “gradual decline” in her mental health as medical professionals were unable to pinpoint what was causing her pain.

"I questioned my pain. I questioned what was going on. I questioned whether it was actually real and that was a pretty awful thing to be dealing with on top of having physical pain,” the 43-year-old said, describing what she felt was “mental torture”.

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Source: I News, 12 February 

Further reading on the hub

The clinical implications of bacterial pathogenesis and mucosal immunity in chronic urinary track infection

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New FFP3 respirators may cut infection risk

New FFP3 masks may reduce likelihood of infection rates, a new study finds. After healthcare workers used the masks when on Covid-19 wards, the rate of SARS-CoV-2 infections was found to be lowered by a significant amount. 

Since the study, Public Health England have updated its guidance which now requires NHS organisations to provide FFP3 respirators where appropriate. 

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Source: BMJ, 29 June 2021

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CQC brings in whistleblowing gurus to boost ‘independence and credibility’

The Care Quality Commission (CQC) has hired two independent whistleblowing champions, Joy Warmington and Arpita Dutt, to oversee a major review of how it listens to concerns.

The CQC previously announced it had appointed Zoe Leventhal KC, of Matrix Chambers, to lead the first phase of the review, which is considering how the CQC handled protected disclosures made by Shyam Kumar, an orthopaedic surgeon at University Hospitals of Morecambe Bay Foundation Trust, and whether ethnicity “played any part in the management of those disclosures”.

On Friday it issued details of the second phase of the work, including that it had brought in two outside experts, and long-time champions of whistleblowers, to “help to ensure the independence and credibility of the review”.

This was launched amid wider concerns about how it responds to whistleblowing concerns in the service and among its own staff, including potential discrimination and also comes as the CQC itself seeks to begin a major restructure.

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Source: HSJ, 22 November 2022

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Coroner slams scandal-hit NHS hospital for serious failings after mother bled to death when medic refused vital blood clotting drugs after C-section following long labour

A coroner has today slammed a hospital for a series of serious failings after a mother bled to death when a medic refused to allow her vital clotting products.

Gabriela Pintilie, 36, from Grays, Essex, gave birth to her healthy baby girl, Stefania, in February last year following a C-section after a long labour. But she suffered a major haemorrhage and died from a cardiac arrest hours later.

Basildon University Hospital, in Essex, came under fire after it emerged a locum haematologist refused to give Mrs Pintilie the blood after he followed the wrong set of guidelines. The fresh frozen plasma, which could have saved her life, remained outside the theatre after senior staff were not told it was available.

Essex Coroner Caroline Beasley-Murray today slammed the hospital for a lack of clear leadership and teamwork during the crucial minutes and hours when Mrs Pintilie suffered a massive haemorrhage.

The court heard how the on-call haematologist Dr Asad Omran, who was at home,  was called but refused to give permission for vital blood-clotting drugs to be issued until further tests were run. 

An expert witness said she believed the use of clotting drugs in the 'extreme situation' would have 'significantly increased' the chances of a different outcome. Dr Omran did not initially issue blood-clotting drugs because he followed the wrong protocol. He was following protocol for a normal adult, instead of a woman in labour, which was 'completely at odds with clinical guidelines'.

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Source: Mail Online, 20 January 2020

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Mum of tragic Jaxon McVey hits out at second baby death four years after her son’s ‘preventable’ stillbirth

A maternity unit criticised for the preventable stillbirth of a baby is under investigation after the unexpected death of a second baby.

The newborn baby died in December last year after her birth at the standalone midwifery-led unit (MLU) at Lagan Valley Hospital in Lisburn.

Despite this, the unit continued to operate as normal for another three months when the South Eastern Trust temporarily paused births at the MLU.

The second tragedy came four years after Jaxon McVey was stillborn when his delivery at the unit went catastrophically wrong.

A post-mortem found he died as a result of shoulder dystocia – an obstetric emergency where the head is born but the shoulder becomes trapped behind the pubic bone.

Jaxon’s mum, Christine McCleery, has hit out at the South Eastern Trust and raised concerns over the measures put in place following his stillbirth on Mother’s Day 2017.

“I feel like they didn’t learn from Jaxon,” she said.

“I don’t know if any other babies died before Jaxon, but I know one died afterwards.

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Source: The Independent, 23 November 2022

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The millions of people stuck in pandemic limbo

When the coronavirus pandemic began, Emily Landon thought about her own risk only in rare quiet moments. An infectious-disease doctor at the University of Chicago Medicine, she was cramming months of work into days, preparing her institution for the virus’s arrival in the United States. But Landon had also recently developed rheumatoid arthritis—a disease in which a person’s immune system attacks their own joints—and was taking two drugs that, by suppressing said immune system, made her more vulnerable to pathogens.

Normally, she’d be confident about avoiding infections, even in a hospital setting. This felt different. “We didn’t have enough tests, it was probably around us everywhere, and I’m walking around every day with insufficient antibodies and hamstrung T-cells,” she said.

Two years later, Covid-19 is still all around us, everywhere, and millions of people like Landon are walking around with a compromised immune system. A significant proportion of them don’t respond to Covid vaccines, so despite being vaccinated, many are still unsure whether they’re actually protected—and some know that they aren’t. Much of the United States dropped COVID restrictions long ago; many more cities and states are now following. That means policies that protected Landon and other immunocompromised people, including mask mandates and vaccination requirements, are disappearing, while accommodations that benefited them, such as flexible working options, are being rolled back.

This isn’t a small group. Close to 3% of US adults take immunosuppressive drugs, either to treat cancers or autoimmune disorders or to stop their body from rejecting transplanted organs or stem cells. That makes at least 7 million immunocompromised people.

In the past, immunocompromised people lived with their higher risk of infection, but COVID represents a new threat that, for many, has further jeopardised their ability to be part of the world. From the very start of the pandemic, some commentators have floated the idea “that we can protect the vulnerable and everyone else can go on with their lives.” Seth Trueger, who is on immunosuppressants for an autoimmune complication of cancer, said. “How’s that supposed to work?”

He is an emergency doctor at Northwestern Medicine; he can neither work from home nor protect himself by avoiding public spaces. “How am I supposed to provide for my family or live my life if there’s a pandemic raging?” he said. 

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Source: The Atlantic, 16 February 2022

Further reading

Read further Covid-19 blogs and stories from staff on the frontline

 

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Doctor shortages pushing Scottish NHS to ‘breaking point’

Doctor shortages are jeopardising patient safety and rota gaps are pushing the NHS to “breaking point”, Scottish physicians have warned.

A lack of doctors in NHS Scotland due to unfilled vacancies, sick leave and a shortage of staff is often putting patients’ welfare at risk, a survey of consultants has found. More than a third of Scottish doctors (34%) reported, in the Royal Colleges’ annual census, that trainee rota gaps occurred at least daily, while 16% warned they are causing “significant patient safety problems”.

A further 78% of those who responded said rota gaps potentially cause patient safety problems, but that there are solutions in place.

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Source: The Scotsman, 14 October 2019

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Patient Safety Learning calls for the NHS to publish details of post-COVID clinics

PSL-logo-for-web.png.1127867a65f62c33e7b9acb24862c578.pngPRESS RELEASE

(London, UK, 11 September) – The charity Patient Safety Learning are calling on the NHS to publish details of post-COVID support clinics and clarify how these can be accessed by thousands of ‘Long COVID’ patients.

Patient Safety Learning has written to Sir Simon Stevens, Chief Executive of the NHS, calling on him to take steps to publicise the locations and details of these services. This follows Matt Hancock MP, Secretary of State for Health and Social Care, expressing concerns in the Health and Social Care Select Committee on Tuesday that not all GPs know how to access these services.

Helen Hughes, Chief Executive of Patient Safety Learning, said: “We have heard from many Long COVID patients that they are not clear on the location of these clinics, what services they offer and who is eligible for support. Some patients have been advised by their GP that there are no post-COVID clinics available within their area. Though the NHS launched the ‘Your COVID Recovery’ online portal for patients recovering from COVID, there is no clear indication of how the clinics fit into this and how patients can access the support they need.”

Long COVID patients are those with confirmed or suspected COVID-19 who continue to struggle with prolonged, debilitating and sometimes severe symptoms months later. In their letter, the charity has identified a series of steps needed to provide greater clarity for these patients, including:

  • Publishing a list of all existing post-COVID clinics and contact details.
  • Confirming whether these clinics are accessed by referral from your GP or self-referral. If by GP referral, publish the guidance issued to GPs on this process.
  • Confirming who is eligible for these services, whether they are restricted to those hospitalised by COVID-19 or open to those who are managing their symptoms at home.
  • Confirm what services are available from these clinics. Specifically, whether they can help patients access clinical investigations, as well as treatment and rehabilitation.
  • Clarify whether these services are available to all patients or only those who have had a confirmed positive test for COVID-19.

Notes to editors:

  1. Patient Safety Learning is a charity, which helps transform safety in health and social care, creating a world where patients are free from harm. We identify the critical factors that affect patient safety and analyse the systemic reasons they fail. We use what we learn to envision safer care. We recommend how to get there. Then we act to help make it happen. For more information: www.patientsafetylearning.org
  2. In the Health and Social Care Select Committee on Tuesday 8 September 2020, Matt Hancock commented that “The NHS set up Long COVID clinics and announced them in July. I am concerned by reports this morning from the Royal College of GPs that not all GPs know how to ensure that people can get into those services. That is something I will take up with the NHS and that I am sure we will be able to resolve.” The full transcript can be found here.
  3. Patient Safety Learning’s full letter to Sir Simon Stevens can be found here.
  4. Patient Safety Learning have previously set out patient safety concerns for Long COVID patients, outlining these issues in more detail. Read more here.

 

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Women aged 50-60 at greatest risk of ‘long Covid’, experts suggest

Women aged 50-60 are at greatest risk of developing “long Covid”, analysis suggests. Older age and experiencing five or more symptoms within the first week of illness were also associated with a heightened risk of lasting health problems.

The study, led by Dr Claire Steves and Prof Tim Spector at King’s College London, analysed data from 4,182 COVID Symptom Study app users who had been consistently logging their health and had tested positive for the virus.

In general, women were twice as likely to suffer from Covid symptoms that lasted longer than a month, compared with men – but only until around the age of 60, when their risk level became more similar.

Covid vaccine tracker: when will a cor

Increasing age was also associated with a heightened risk of long Covid, with about 22% of people aged over 70 suffering for four weeks or more, compared with 10% of people aged between 18 and 49.

For women in the 50-60 age bracket, these two risk factors appeared to combine: They were eight times more likely to experience lasting symptoms of Covid-19 compared with 18- to 30-year-olds. However, the greatest difference between men and women was seen among those aged between 40 and 50, where women’s risk of developing long Covid was double that of men’s.

“This is a similar pattern to what you see in autoimmune diseases,” said Spector. “Things like rheumatoid arthritis, thyroid disease and lupus are two to three times more common in women until just before menopause, and then it becomes more similar.” His guess is that gender differences in the way the immune system responds to coronavirus may account for this difference."

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Source: The Guardian, 21 September 2020

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Mental health unit 'failed' man who took own life

The father of a man who took his own life said the mental health unit where he was staying "failed him completely".

Joshua Sahota, 25, died as a result of asphyxia and psychosis at the Wedgewood Unit in Bury St Edmunds, Suffolk, on 9 September 2019.

Insufficient staffing levels at the unit contributed to his death, an inquest jury found.

Mr Sahota, from Kennett in Cambridgeshire, was taken to the unit three weeks before his death as his mental health had declined.

There was no psychologist in post and the jury at Suffolk Coroner's Court recorded this as having contributed to his death.

It also found that a plastic bag which contributed to his death was on a restricted items list, but this was "unclear" and there were "inconsistencies of understanding this" by staff and visitors.

Other factors that the jury said contributed to his death included insufficient observations and one-to-one processes, no clear and concise risk assessments, being slow to develop a care plan and the absence of a documented crisis plan.

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Source: BBC News, 10 September 2021

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Pregnant women should be asked how much they drink

Pregnant women should be asked how much alcohol they are drinking and the answer recorded in their medical notes, new "priority advice" for the NHS says.

The advice, from the National Institute for Health and Care Excellence (NICE), is designed to help spot problem drinking that can harm babies.

Infants with foetal alcohol spectrum disorder (FASD) can be left with lifelong problems. The safest approach during pregnancy is to abstain from alcohol completely.

The more someone drinks while pregnant, the higher the chance of FASD - and there is no proven "safe" level of alcohol.

But the risk of harming the baby is "likely to be low if you have drunk only small amounts of alcohol before you knew you were pregnant or during pregnancy", the Department of Health says.

An earlier draft of the recommendations for NHS staff in England and Wales suggested transferring data on a woman's alcohol intake to her child's medical notes - but this has now been dropped, following concern women who needed help might hide their drinking.

The Royal College of Midwives spokeswoman Lia Brigante said: "As there is no known safe level of alcohol consumption during pregnancy, the RCM believes it is appropriate and important to advise women that the safest approach is to avoid drinking alcohol during pregnancy and advocates for this.

"We are pleased to see that the recommendation to record alcohol consumption and to then transfer this to a child's record has been reconsidered.

"This had the potential to disrupt or prevent the development of a trusting relationship between a woman and her midwife."

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Source: BBC News, 16 March 2022

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Covid: Vulnerable NHS patients to be offered new drug

A new Covid drug designed to reduce the risk of vulnerable patients needing hospital treatment will be available on the NHS from today.

Sotrovimab is a monoclonal antibody given as a transfusion to transplant recipients, cancer patients and other high-risk groups. If given quickly after symptoms develop it is should help prevent people from falling seriously ill with the disease.

Initial tests suggest it should still work against the Omicron variant.

"These new drugs have an important role to play," said Prof Steven Powis, the national medical director of NHS England.

"If you test positive and are at high risk then we will be contacting you, and, if eligible, you will be able to get access to these new treatments."

Around 1.3 million of the highest risk NHS patients are eligible to receive Sotrovimab, along with other new Covid treatments as they become available.

The drug is most effective if taken in the first five days after infection and is likely to be given in clinics or to outpatients in hospital.

It has been approved for use in vulnerable groups - such as those with cancer, diabetes or heart disease.

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Source: BBC News, 20 December 2021

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Surge in serious incidents caused by ambulance delays

Ambulance trusts are seeing rising numbers of serious incidents resulting from delays in reaching patients, research by HSJ has uncovered.

Serious incidents are defined by the NHS as a patient safety failure “where the consequences to patients, families and carers, staff or organisations are so significant or the potential for learning is so great, that a heightened level of response is justified.”

East Midlands Ambulance Service Trust saw 71 serious incidents in 2021-22 compared with 38 in the financial year before. The trust’s board papers attribute the increase in SIs related to delayed responses since June 2021 to “sustained pressure on the service” and the resulting growing handover times at accident and emergency departments. Of 14 SIs reported in February and the first half of March 2022, seven were due to “prolonged waits for an ambulance response”.

West Midlands University Ambulance Service Foundation Trust has also seen an increase in SIs. Its board papers report that half of the SIs are due to “delays in reaching patients resulting in harm, serious harm, and deaths”. It has given the issue of “hospitals, breaches, delays and turnaround times” the maximum rating of 25 on its risk register.

Long delays – especially for category two patients, where average performance last month was above an hour – are causing increasing concern. Stroke Association chief executive Juliet Bouverie said the organisation was hearing “shocking accounts from stroke survivors who have waited hours for an ambulance… We are extremely worried that stroke survivors’ lives and recoveries are being put at extreme risk.”

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Source: HSJ, 20 April 2022

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"They don’t hide from the coronavirus, they confront it"

As the world writhes in the grip of Covid-19, the epidemic has revealed something majestic and inspiring: millions of health care workers running to where they are needed, on duty, sometimes risking their own lives. In his article in the New York Times, Don Berwick says he has never before seen such an extensive, voluntary outpouring of medical help at such a global scale. Millions of health care workers are running to where they are needed, sometimes risking their lives.

Intensive care doctors in Seattle connect with intensive care doctors in Wuhan to gather specific intelligence on what the Chinese have learned: details of diagnostic strategies, the physiology of the disease, approaches to managing lung failure, and more. 

City by city, hospitals mobilise creatively to get ready for the possible deluge: bring in retired staff members, train nurses and doctors in real time, share data on supplies around the region, set up special isolation units and scale up capacity by a factor of 100 or 1000.

"We are witnessing professionalism in its highest form, skilled people putting the interests of those they serve above their own interests."

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Source: New York Times, 23 March 2020

 

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CQC steps in at troubled trust over covid infections

The Care Quality Commission (CQC) has taken immediate enforcement action at East Kent Hospitals University Foundation Trust citing “serious concerns” over patient safety.

The regulator confirmed it was taking action today after inspectors visited on 12 August following concerns being raised about the standard of care and risk to patients.

The CQC confirmed the action had been taken, but it said it could not comment further due to legal restrictions and the trust’s right to appeal the decision.

HSJ understands the enforcement action was taken due to concerns over infection prevention control and the number of patients who have contracted COVID-19 in hospital. It is believed to be the first such action against a trust.

Read full story (paywalled)

Source: HSJ, 27 August 2020

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On the edge of exhaustion in the NHS

"I still have nightmares most nights about being completely out of my depth."

Gemma, a ward nurse in Northern Ireland, was redeployed to a critical care unit at the end of March when the first wave of coronavirus struck.

"I had never looked after a critically ill intensive care patient in my life," she says.

"I just thought, I'm coming in here and I'm going to die. I'm going to catch Covid and I'm going to be one of those patients in the beds."

As the second wave of the pandemic takes deep root across parts of the UK, thousands of NHS workers are struggling to recover from what they have already been through.

"We were all in PPE all the time," recalls Nathan, a senior intensive care nurse at a hospital in the Midlands. "All you can see is people's eyes, you can't see anything else."

He describes trying to help junior members of staff survive long and difficult days.

"And I'd see these eyes as big as saucers saying help me, do something. Make this right. Fix this."

"The pressure was insane, and the anxiety just got me," he says. "I couldn't sleep, and I couldn't eat, I was sick before work, I was shaking before I got into my car in the morning."

Nathan ended up having time off with severe anxiety, but he is now back at the hospital, waiting for the beds to fill up again.

The BBC has spoken to a number of nurses and doctors across the UK who are deeply apprehensive about what lies ahead this winter.

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Source: BBC News, 24 October 2020

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Survey of Americans who attempted suicide finds many aren’t getting care

The number of people who try suicide has risen steadily in the U.S. But despite gains in health coverage, nearly half are not getting mental health treatment.

Suicide attempts in the United States showed a “substantial and alarming increase” over the last decade, but one number remained the same, a new study has found: Year in and year out, about 40% of people who had recently tried suicide said they were not receiving mental health services.

The study, published in JAMA Psychiatry, traces a rise in the incidence of suicide attempts, defined as “self-reported attempts to kill one’s self in the last 12 months,” from 2008 to 2019. During that period, the incidence rose to 564 in every 100,000 adults from 481.

The researchers drew on data from 484,732 responses to the federal government’s annual National Survey on Drug Use and Health, which includes people who lack insurance and have little contact with the health care system. They found the largest increase in suicide attempts among women; young adults between 18 and 25; unmarried people; people with less education; and people who regularly use substances like alcohol or cannabis. Only one group, adults 50 to 64 years old, saw a significant decrease in suicide attempts during that time.

Among the major findings was that there was no significant change in the use of mental health services by people who had tried suicide, despite the passage of the Affordable Care Act in 2010 and receding stigma around mental health care.

Over the 11-year period, a steady rate of about 40%t of people who tried suicide in the previous year said they were not receiving mental health care, said Greg Rhee, an assistant professor of psychiatry at the Yale School of Medicine and one of the authors of the study.

The Affordable Care Act, which took effect fully in 2014, required all health plans to cover mental health and substance abuse services, and also sharply reduced the number of uninsured people in the U.S. However, many respondents to the survey in the new report said the cost of mental health care was prohibitive; others said they were uncertain where to go for treatment or had no transportation.

“It is a huge public health problem,” Dr. Rhee said. “We know that mental health care in the U.S. is really fragmented and complicated, and we also know not everybody has equal access to mental health care. So, it’s somewhat not surprising.”

Read full story (paywalled)

Source: New York Times,19 January 2022

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Patient Safety Learning is registered as a charity with the Charity Commission Registration number 1180689.

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