Thousands of mental health patients are being detained in locked rehabilitation wards that resemble "old-style asylums", the largest ever inspection of mental health services in England has found.

The Care Quality Commission, which inspected NHS and private care facilities and providers over a three-year period, said it was "shocked and concerned" to find around 3,500 beds in locked facilities that were "effectively institutionalised settings".

The average length of stays in such facilities in 2015-16 was 341 days, with the longest more than four years, and inspectors said many patients could be treated in less restricted settings.

"Our inspectors were concerned that some of these locked rehabilitation hospitals were in fact long stay wards that risk institutionalising patients, rather than a step on the road back to a more independent life in the person's home community," the report found.

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Sophie Corlett of mental health charity Mind said such facilities were totally inappropriate in the 21st century.


"There are people who are staying in those rehabilitation wards for an unusually long period of time, with no plans for their discharge and actually no real rehabilitation work going on," she told Sky News.

"To us that just feels like an old-style asylum under a different name and that is very concerning.

"That sort of provision has no place in a 21st century mental health system."

The report by the independent regulator of health and adult social care also highlighted other issues with a system that, with 1.8 million people seeking care last year, is under pressure from rising demand.

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The CQC found:

:: Around one in three services rated insufficiently safe, and one in four requiring improvement across the NHS and private sector

:: Long waiting times for clinics for dementia and eating disorder services

:: The number of mental health nurses had fallen by 12% in seven years to January 2017

:: Detentions under the Mental Health Act were up 26% in five years

:: "Unavailability" of in-patient care for young people with mental health problems, with vulnerable people sometimes held in police cells

While the majority of services were rated "good" or "outstanding" and most were considered "caring", the CQC said the system was under pressure.

Deputy chief inspector Paul Lelliott said: "The mental health sector is at a crossroads.

"Some services remain rooted in the past - providing care that is over-restrictive and that is not tailored to each person's individual needs.

This can leave people feeling helpless and powerless.

"But the best services are looking to the future by working in partnership with the people whose care they deliver, empowering their staff and looking for opportunities to work with other parts of the health and care system."

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Theresa May has said mental health will be a priority of her government and it is one of the NHS priorities over the next two years, but services face huge challenges arising from rising demand, falling staff levels and constrained funding.

Saffron Dordery, director of strategy at NHS Providers, which represents hospital and mental health Trusts, said the report exposed "injustices" in care.

"It is clear that core mental health services are coming under intolerable pressure," she said.

"We welcome the repeated commitments from the very top of government to address the injustices faced by people with mental health problems, and we hope this report will provide renewed impetus towards improving their experience so they receive the care they need and deserve."

Claire Murdoch, NHS England's national director for mental health, said: "We have already made huge steps forward in improving mental health care nationally, overall mental health funding is up by £1.4bn in real terms and 120,000 more people are getting specialist mental health treatment this year than three years ago.