‘Treatment lottery’ for mental health putting lives at risk, experts warn

Sophie Gallagher
Getty Images

Lives are at risk because of a “treatment lottery” facing patients who have self-harmed or are suicidal, according to the Royal College of Psychiatrists.

The Royal college is calling for every hospital to provide a NICE-recommended assessment for those who are found to have self-harmed. The psychosocial assessment is aimed at “identifying personal factors” that might explain an act of self-harm.

It also involves the creation of a written safety plan, made up of an agreed set of activities to support the patient, strategies to “instill hope” and people or organisations to contact for support.

The Royal College says this assessment should be carried out each time a person presents with an episode of self-harm.

Patients undergoing the assessment and creation of a safety plan at this time is shown to half the rate of repeating self-harm in the future.

But research from a 2017 health committee report on suicide prevention showed just 60 per cent of people were getting the assessments, which the college says needs to be addressed as patients continue to be “let down”.

Dr Huw Stone, chair of the Patient’s Safety Group at the Royal College of Psychiatrists, said: “Self-harming patients are being let down because many of them are not receiving an assessment that is proven to dramatically reduce repeating self-harm.

“With hospital admissions for self-harming under-30s more than doubling in the last 10 years, there has never been a more important time to ensure patients are getting the care that they need," he said.

Hospital admissions for self-harming have increased from 4,749 in 2008-09 to 10,168 in 2018-19.

The Royal College says all frontline staff who come into contact with a patient in this position should be trained to undertake the assessment and write a suitable safety plan as a result.

The college also wants there see closer ongoing work between hospitals and community mental health teams after treatment.

Simon, 49, from Derbyshire, who attempted suicide, says recovery was better after making a safety plan: “I tried to take my own life on multiple occasions and ended up in hospital each time.

“I didn’t write a Safety Plan after every attempt on my life, because they weren’t always offered. But on the occasions I did, I was better able to manage the bumps in the road which are always there when you’re recovering.

“Having a meaningful plan, one that is personal and tailored to the circumstances of the individual, is vital to reducing the risk of suicide.”

Mary, from Devon, who has a history of self-harming, said: “My Safety Plan really helped me understand my repeat self-harming by stepping back to see patterns in my thinking and behaviour.

“It’s not so much about the document itself, it’s about the care, empathy and consideration that is put into creating the Safety Plan with you. It’s what it represents.”

If you are experiencing feelings of distress and isolation, or are struggling to cope, The Samaritans offers support; you can speak to someone for free over the phone, in confidence, on 116 123 (UK and ROI), email jo@samaritans.org, or visit the Samaritans website to find details of your nearest branch.

For services local to you, the national mental health database – Hub of Hope – allows you to enter your postcode to search for organisations and charities who offer mental health advice and support in your area.

Read more

Kate Middleton encourages children to seek mental health support