Mental health sufferers face long stays in rehab

A new report has highlighted how people in rehab for serious mental health problems are more likely to face lengthy stays far from home and local support.

The Care Quality Commission (CQC) has found that 63 per cent of placements in residential-based mental health rehabilitation services are ‘out of area’, which means they are in different areas to the CCGs that arranged them and are far more expensive for the NHS.

With 78 per cent of ‘out of area’ placements are with independent sector providers rather than the NHS, the CQC discovered that the quality of care in residential mental health rehabilitation services is very similar between NHS and independent sector providers.

However, people in residential mental health rehabilitation services provided by the independent sector are more likely to be further from their homes than those staying in NHS services – 49km compared to 14km. Additionally, they are more likely to stay there for longer – 14.5 months on their current ward compared to 7.5 months on their current ward in a NHS service.

Furthermore, although the daily cost for residential mental health rehabilitation is similar between the sectors, because of the longer stays, independent services can end up costing twice as much as NHS services. The average cost of current is stay £162,000 in comparison to £81,000. CQC estimates that £535 million is spent on residential mental health rehabilitation annually, with ‘out of area’ placements accounting for around two thirds of this expenditure.

Paul Lelliott, lead for mental health at the CQC, said: “Inpatient rehabilitation services have a vital role to play in supporting people with severe mental health problems to recover and return home. Collectively, the independent sector and the NHS make a valuable contribution to the delivery of mental health rehabilitation and in helping people to step back on the road to living more independently.

“However, we are concerned about the high number of beds in mental health rehabilitation wards that are situated a long way from the patient’s home. This dislocation can mean that people can become isolated from their friends, from their families and from the services that will provide care once they have been discharged. Also, we are concerned that our evidence shows that on average, people in ‘out of area’ placements can end up staying in residential rehabilitation for twice as long as they would have done in a local NHS bed, which can increase their sense of institutionalisation, affect their onward recovery, and can be very costly. The attention now must be on developing services that are focused on people’s recovery and that are not ‘long-stay’ wards in disguise, that are closer to where people live, and that are well-connected to the wider local system including services that will provide aftercare.”