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Many hospital staff treating the sickest patients during the first wave of the pandemic were left traumatised by the experience, a study suggests. Researchers at King's College London asked 709 workers at nine intensive care units in England about how they were coping as the first wave eased. Nearly half reported symptoms of severe anxiety, depression, post-traumatic stress disorder or problem drinking. One in seven had thoughts of self-harming or being "better off dead". Nursing staff were more likely to report feelings of distress than doctors or other clinical staff in the anonymous web-based survey, which was carried out in June and July last year. Just over half reported good well-being. Victoria Sullivan, an intensive care nurse at Queen's Hospital in Romford, said she often can't sleep because she's thinking about what is happening at the hospital. Her worst moment was breaking the news of a death on the phone, she said, adding that the screams from the patient's relatives "will honestly stay with me forever". "Telling someone over the phone and all you can say is 'I'm really sorry', whilst they're crying their heart out, is quite traumatising," she said. "Although you're saying how sorry you are, in the back of your mind, you're also thinking: 'I've got three other patients I've got to go and see, the infusions need drawing up, and meds need to be given and a nurse needs support'. "The guilt is just too much." Lead researcher Prof Neil Greenberg said the findings should be a "wake-up call" for NHS managers. He said: "The severity of symptoms we identified are highly likely to impair some ICU staff's ability to provide high-quality care as well as negatively impacting on their quality of life." Read full story Source: BBC News, 13 January 2021

The World Health Organization’s (WHO) new Mental Health Atlas paints a disappointing picture of a worldwide failure to provide people with the mental health services they need, at a time when the COVID-19 pandemic is highlighting a growing need for mental health support. The latest edition of the Atlas, which includes data from 171 countries, provides a clear indication that the increased attention given to mental health in recent years has yet to result in a scale-up of quality mental services that is aligned with needs. Issued every three years, the Atlas is a compilation of data provided by countries around the world on mental health policies, legislation, financing, human resources, availability and utilization of services and data collection systems. It is also the mechanism for monitoring progress towards meeting the targets in WHO’s Comprehensive Mental Health Action Plan. “It is extremely concerning that, despite the evident and increasing need for mental health services, which has become even more acute during the COVID-19 pandemic, good intentions are not being met with investment,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “We must heed and act on this wake-up call and dramatically accelerate the scale-up of investment in mental health, because there is no health without mental health.” Read full story Source: WHO, 8 October 2021

One in 10 posts for consultant psychiatrists in England are vacant with growing waiting times for people needing mental health treatment, experts have warned. A census of the current situations across England by the Royal College of Psychiatrists has found there is just one psychiatrist for every 12,567 people in England. Health service bosses at NHS England have acknowledged there are an estimated 1.5 million people who are waiting for mental health support amid fears the situation will worsen as the effects of the Covid pandemic become clear. This is on top of the 5.6 million patients waiting for routine operations and treatments for physical illness. The Royal College said there was a shortage of 568 empty consultant posts in the NHS out of a total of 5,367 which it said meant patients would have to wait longer for treatment. In total there are 4,500 full time consultants working in the NHS. The highest rates of unfilled positions are in the fields of addiction, eating disorders and child and adolescent psychiatry. Read full story Source: The Independent, 6 October 2021

As part of the UK Government’s efforts to tackle health problems, including mental health, earlier in the cycle, the newly-created Office for Health Improvement and Disparities (OHID) has launched the latest Better Health – Every Mind Matters campaign to improve the general public’s mental wellbeing. The new campaign aims to empower members of the general public to look after their mental health through tips and practical advice, helping to find what works for them in reducing stress and anxiety, boosting their mood, sleeping better, and feeling in greater control of their lives. New research commissioned by OHID revealed nearly half of adults (49%) in England said the Covid-19 pandemic had a negative impact on their mental wellbeing. In the same research, more than a third of all adults in England (34%) said they did not know what to do to improve their mental wellbeing. That equated to 15.1 million people. Younger adults were the most significantly affected group with their mental health, with 57% of 18-34 year olds suggesting the pandemic had negatively impacted their mental health. Just under half (44%) reported not knowing what to do to help improve it. This is the first campaign delivered by OHID since being officially launched on October 1, 2021. They have been set up with the aim of tackling health inequalities across the country. Minister for Care and Mental Health, Gillian Keegan, said: “The public showed great resilience throughout the pandemic, but it has served as a stark reminder that we all need to look after ourselves not only physically, but mentally. “There are simple steps we can all be taking to improve our mental wellbeing and reduce feelings of stress and anxiety. For anyone who is unsure what they can do, I urge you to visit Every Mind Matters and take advantage of the expert advice and practical tips available to you.” Claire Murdoch, NHS National Director for Mental Health, added: “The last year has taken its toll on people’s mental health but NHS staff have responded rapidly to treat more people with mental health issues than ever before – rolling out 24/7 crisis lines across the country and mental health support teams in schools during the pandemic. “The NHS is here for you, so if you’re struggling with anxiety and depression our rapidly expanding talking therapy services are available, while anyone who needs urgent help can access our 24/7 NHS crisis lines – available to people of all ages. “I would encourage everyone to look after their mental health, and by answering 5 simple questions, get a tailored ‘mind plan’ which will give you tips to help boost your mood, sleep better and deal with stress and anxiety.” Over 3.4 million individual Mind Plans have already been created since the campaign was first launched in October 2019. Original source: National Health Executive

There is a mental health crisis in England, with rates of depression doubling since the COVID pandemic began. Strategies of “speaking up”, mindfulness sessions at work, and national “happiness” campaigns have been touted as an effective approach to tackling mental health at work, but therapists are unconvinced. But what of mental health services offered by the state? This has been equally unconvincing. Over the past decade or so, mental health services in England have been undergoing a process of “Uberisation”. This refers to how services are effectively treated as commodities marketed through online platforms, changing the way they are delivered as well as making the jobs of the people delivering them more precarious – similar to the effect of ride-hailing apps on taxi drivers. Specifically, this has happened through the introduction of a standardised and digitalised model of therapy called Increased Access to Psychological Therapies (IAPT). This Uberisation appears to be contributing to a mental health crisis within the therapy profession itself. IAPT, which was introduced in 2008, provides psychotherapy for depression and anxiety to over a million people each year – the largest NHS programme in England. It uses a model of cognitive behavioural therapy – made up of short-term interventions of four to 12 sessions – that use techniques, such as relaxation exercises, to encourage positive mood and behaviour. With extremely high levels of depression and anxiety among therapists, there is a genuine question about patient safety that is being overlooked. If the mental health model itself is broken, are services deepening the mental health crisis, rather than solving it? Read the full article here Source: The Conversation

Mental health patients who were discharged from or admitted to acute mental health services during the first Covid-19 lockdown experienced loneliness and social isolation, according to a new study. Published in the British Journal of Psychiatry Open the 34 patients, carers and clinical staff were interviewed by a team of researchers from The University of Manchester. Mental health service users also reported ‘working harder’ to avoid admission due to fears around environmental safety as a result of COVID-19. “Even before the pandemic, there are lots of safety concerns associated with recent discharge from inpatient mental health services, for example suicide and self-harm,“ said lead author Dr Natasha Tyler, researcher at the GM PSTRC and The University of Manchester. Dr Tyler added: ‘Our patients and carers felt that because of the national need to free-up hospital beds, the quality of discharge and admission planning was compromised at times. “That meant discharging patients from hospitals who were not ready to cope in the community or not admitting patients who needed in-patient care. “The closure of most community support services meant patients had minimal opportunities for accessing care via alternative routes. This worsened their feelings of helplessness and loneliness.” Full article here Source: Greater Manchester Patient Safety Translational Research Centre

A patient died from a serious spinal injury after emergency staff incorrectly attributed his physical condition to his mental health issues, an inquest heard. Robert Walaszkowski, who had been detained at a secure mental health unit run by North East London Foundation Trust in October 2019, suffered a serious injury after running into a door on the unit. Staff from London Ambulance Service did not suspect a spinal injury and he was taken to the emergency department at Queen’s Hospital in Romford with a suspected head injury. An inquest heard he did not receive a spinal examination and imaging of the spine, despite this being required due to the nature of his injury and presentation. He was discharged from A&E the following day, and was then placed on the floor of a private patient transport vehicle, to be transported back to the mental health unit, Goodmayes Hospital. He arrived at the hospital unresponsive. He never recovered consciousness and died of his injuries a month later. An inquest jury has recorded a narrative conclusion and found that neglect contributed to Robert’s death. Read full story (paywalled) Source: HSJ, 24 September 2021

A coroner has raised concerns about how a family was allowed to bring a restricted item that contributed to a man's death into a mental health unit. Joshua Sahota, 25, died as a result of asphyxia and psychosis in Bury St Edmunds, Suffolk, on 9 September 2019. Suffolk coroner Nigel Parsley said Mr Sahota's relatives were not told the item they brought in when visiting was on a restricted list. The NHS trust which runs the unit said it had improved its internal processes. Mr Sahota, from Kennett in Cambridgeshire, was taken to the Wedgewood Unit on the West Suffolk Hospital site three weeks before his death as his mental health had declined. Insufficient staffing levels contributed to his death, an inquest jury at Suffolk Coroner's Court concluded. Other factors 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. Read full story Source: BBC News, 21 September 2021

Record numbers of children and young people are seeking access to NHS mental health services, figures show, as the devastating toll of the pandemic is revealed in a new analysis. In just three months, nearly 200,000 young people have been referred to mental health services – almost double pre-pandemic levels, according to the report by the Royal College of Psychiatrists. Experts say the figures show the true scale of the impact of the last 18 months on children and young people across the country. “These alarming figures reflect what I and many other frontline psychiatrists are seeing in our clinics on a daily basis,” said Dr Elaine Lockhart, the college’s child and adolescent faculty chair. “The pandemic has had a devastating effect on the nation’s mental health, but it’s becoming increasingly clear that children and young people are suffering terribly.” Read full story Source: The Guardian, 23 September 2021

Leaked results from a national survey of NHS staff has revealed a sharp drop in those who believe their health and wellbeing is being supported by their employer. The People Pulse is a national, monthly survey launched in 2020. It enables provider and commissioner organisations to monitor the NHS workforce’s health and wellbeing. According to a snapshot of the results recorded between May and August seen by HSJ, there was a drop of 9.6 percentage points in “perceptions of wellbeing support”, with “positivity” sitting at 57.3%. Almost a quarter of the survey respondents reported a “negative” experience of health and wellbeing support. The survey results also revealed almost a third of respondents said they wanted to speak up about a specific issue during the pandemic, especially on issues of staff safety, health and wellbeing, but they did not because they feared repercussions or believed nothing would happen. Read full story (paywalled) Source: HSJ, 21 September 2021

A mental health hospital in Suffolk has been closed after inspectors found it was failing to protect patients from harm and abuse. St John's House in Palgrave, near Diss, was previously rated inadequate by the Care Quality Commission (CQC). A further inspection of the 49-bed hospital found the care was "unacceptable" and "insufficient progress had been made regarding patient safety". The company that runs the hospital, Partnerships in Care, part of the Priory Group, has now decided to close the site. Stuart Dunn, CQC head of inspection for mental health and community services, said: "Our latest inspection of St John's House found an unacceptable service where insufficient improvements had been made to protect patients from harm and abuse and the number of safety incidents remained high." "Staff weren't responding appropriately to patients who were self-harming, with one patient not being sent to hospital quickly enough after swallowing a foreign object, despite complaining of abdominal pain. "We reviewed CCTV footage and found staff were sometimes asleep when they should have been observing patients to make sure they were safe. This was all the more concerning as we identified this as a concern during the previous two inspections of this service, demonstrating a lack of improvement to keep patients safe. "Incidents of restraint remained high and not all staff had the right training to carry it out safely. In addition, staff were not following hospital policy when using soft handcuffs with patients during safety incidents." Read full story Source: ITV News, 17 September 2021

NHS leaders are being urged to tackle racist abuse of staff as new figures reveal that a third of black, Asian or minority ethnic workers in mental health trusts in England have experienced harassment, bullying or attacks by patients, relatives or members of the public. One in three (32.7%) BAME staff in mental health settings have experienced abuse, according to analysis by the Royal College of Psychiatrists. For BAME workers across the NHS, the rate is more than one in four (28.9%). One medical director told the Guardian that hot tea had been thrown at them “because of the colour of my skin”. A psychiatrist told how they were left traumatised after they were racially abused – then threatened with a knife. The college is calling on health leaders to take a stand against discrimination by setting up better processes in NHS trusts to record and understand data about bullying and harassment. Dr Adrian James, president of the Royal College of Psychiatrists, said the findings were deeply concerning. He said: “NHS leaders and local health bosses must tackle this head-on.” Read full story Source: The Guardian, 9 September 2021

Shortfalls in mental health services and staffing have been flagged as concerns in dozens of inquests since 2015, the Observer has revealed, with coroners issuing repeated warnings over patients facing long waiting lists or falling through gaps in service provision. The Observer has identified 56 mental health-related deaths in England and Wales from the start of 2015 to the end of 2020 where coroners identified a lack of staffing or service provision as a “matter of concern”, meaning they believed “there is a risk that future deaths could occur unless action is taken”. Coroners issue Reports to Prevent Future Deaths (PFD) when they believe action should be taken to prevent deaths occurring in future, and send them to relevant individuals or organisations, who are expected to respond. In one case, a woman referred to psychotherapy services had still not received any psychotherapy by the time she died 11 months later. In another, someone had endured a seven-month wait for a psychological assessment. Alison Cobb, senior policy and campaigns officer at the mental health charity Mind, said: “It’s shocking that so many should lose their lives because there isn’t enough capacity in mental health services to provide adequate care. These prevention of future deaths notices are meant to inform better ways of working, and it’s especially concerning that similar stories are repeating over and over again.” Read full story Source: The Guardian, 5 September 2021 Coroner's reports on the hub

A new campaign to increase awareness of life-saving treatment that can reverse drug overdoses has been launched in Scotland. The Scottish government and Scottish Drugs Forum (SDF) have joined together to help improve information about naloxone which can prevent deaths in the case of opioids overdoses. Drugs policy minister Angela Constance said: “Firstly, on International Overdose Awareness Day I want to pass on my sincere condolences to all those who have been affected by a drug-related death. That is why I am pleased to launch this joint campaign with Scottish Drugs Forum to encourage the public to get involved in our national mission and equip themselves to save a life." Read full story. Source: The Independent, 31 August 2021

According to Elizabeth Cotton, of Cardiff Metropolitan University, an expert in mental health at work, more than four in 10 – 41 per cent – of therapists working for the NHS’s talking treatments programme had been asked to manipulate data about patients’ progress. This was done in order to to improve the scheme’s apparent achievement rates, although NHS chiefs insist patients’ views are recorded when therapists are not present. Read full story. Source: The Independent, 26 August 2021

NHS leaders and experts have warned healthcare staff will leave their roles in a "mass exodus" unless exhausted doctors and nurses are given better support. This comes as reports earlier this year showed many healthcare staff are suffering from burnout. “From April onwards we’ve seen a significant rise in mental health cases, and it shows no sign of stopping,” Steve Carter, director of consulting services at FirstCare, told a panel of MPs and peers on Tuesday. “We need to address the mental health issue quickly if we are to get through the winter.” Read full story. Source: The Independent, 25 August 2021

Appletree Hospital in Durham, a unit that provides female patients needing mental health care, has received an urgent enforcement notice from the Care Quality Commission. According to a report published by the CQC today, the hospital had “ineffective leadership”, also warning staff were carrying out “inappropriate” restraint on patients and that restraint was used “as a first line intervention”. The CQC report revealed staff had also claimed managers accepted the use of “unnecessary” restrictive practices. A spokeswoman for Cygnet’s Appletree unit said: “We move forward with strengthened local leadership, including a new hospital director and safeguarding and quality improvement leads.” Read full story (paywalled). Source: HSJ, 25 August 2021

According to public health reports, there has been a sharp rise in drug overdoses, particularly heroin, over the past 10-14 days with the synthetic opioid isotonitazene implicated in some cases. In several areas of the country including five London boroughs, Hampshire, Essex, West Sussex, Dorset and Thames Valley, there has been 46 poisonings, resulting in 16 deaths, although currently, investigations are still ongoing. In a National Patient Safety alert issued on 18 August 2021, Public Health England (PHE) have instructed all NHS organisations to ensure staff are made aware of the risk of severe toxicity resulting from the synthetic opioid, and that all organisations that treat emergency cases should ensure staff are able to treat suspected cases “using naloxone and appropriate supportive care”. Roz Gittins, director of pharmacy at the charity Humankind, said "People also need to know where they can get hold of naloxone, as well as being reminded to carry it with them and to let people know where they keep it. If advice and support is required then the local substance misuse service should be contacted for specialist support. We hope that the current consultation to widen naloxone provision will be successful and that improved funding will lead to naloxone being distributed more widely to help reduce the risk of accidental opioid overdoses." Read full story. Source: The Pharmaceutical Journal, 18 August 2021

According to data shared with HSJ, the amount of NHS staff taking time off for their mental health has leapt in the past few months. The data, collected by FirstCare and covering 46,000 NHS staff from nine trusts, showed mental health absences from May to June of this year was at least 20 per cent up on April and 35 per cent up on February with more than 40 per cent up on the same months last year. “Trust leaders remain acutely aware of the impact that the pandemic, coupled with existing NHS pressures, is having on the workforce. They are deeply concerned about their staff’s mental health and wellbeing and are doing what they can to look after their staff, but they cannot do this sustainably without a fully costed and funded multi-year workforce plan.” Said NHS Providers chief executive Chris Hopson. Read full story (paywalled). Source: HSJ, 6 August 2021

The American Academy of Pediatrics (AAP) has called for in-person learning to be prioritised and for schools to prepare to address the mental health needs of their students. The AAP has also urged all who are eligible to get vaccinated, to do so, and recommends a layered approach in making schools safe for all such as wearing masks even if vaccinated. Sonja O’Leary, MD, FAAP, chair of the AAP Council on School Health has said “We need to prioritize getting children back into schools alongside their friends and their teachers -- and we all play a role in making sure it happens safely”. Read full story. Source: American Academy of Pediatrics, 19 July 2021

Analysis from leading psychiatrists found from 2020-2021 out of 47,000 women, only 3,1261 were able to get help from perinatal services. Whilst it was deemed the pandemic was not the main reason women were being denied access, it was established that due to lack of investment and funding, services were unable to provide support when needed. The Royal College of Psychiatrists is calling for funding in the next spending review. Read full story. Source: The Guardian, 1 July 2021

Chris Whitty, England's Chief Medical Officer has said the pandemic will have an impact on mental health for a considerable period to come. Speaking at the Royal College of Psychiatrists international congress, The CMO acknowledged the pandemic may have caused a lot of fear and anxiety as well as affecting people's social support and finances. Whilst Chris Whitty is optimistic that the end of the pandemic is in sight, he believes there will still continue to be some difficulties, now and in the future. Read full article. Source: BMJ, 28 June 2021

The number of children being prescribed antidepressants has increased over the past 5 years, with analysis from The Pharmaceutical Journal showing peaks have coincided with Covid lockdowns. It was found between April 2015 and April 2020, children from the ages 0-17 who were prescribed antidepressants by a GP increased by 26 per cent with an increase in prescriptions occurring more notably during lockdowns. Furthermore, the analysis found an 8 per cent increase since March 2019 showing 17,902 females and 9,855 males were found to have been prescribed antidepressants when the country was locked down in March 2020. Read full story. Source: The Independent, 24 June 2021

Margaret Evans, 86, from Nefyn, Gwynedd describes the ban on visitors as 'soul-destroying'. Ms Evans, who had been in hospital for more than 10 weeks describes her experience as like being "torn away from the world". Betsi Cadwaladr University Health Board have said they understood the impact of having no visitors and is set to make changes to the restrictions this week by allowing visits by appointment. Other hospitals around Wales have already implemented this change, including those run by Cwm Taf Morgannwg University Health Board, Powys Teaching Health Board, and Swansea Bay University Health Board. Read full story. Source: BBC News, 20 June 2021

A new survey by the BMA was conducted throughout the UK on moral distress from 18 March 2021 to 12 April 2021. It was found that those doctors who worked with Covid-19 patients and doctors who were from ethnic backgrounds, were more likely to say moral distress was a feeling they had experienced. It was also found doctors from ethnic backgrounds were also more likely to say moral injury resonated with their experiences. The results of the survey has raised concerns for staff wellbeing with the BMA asking that the government increase staffing to the NHS, and provide emotional and psychological support for healthcare workers. Read full story Source: BMJ, 16 June 2021