Children as young as 12 are having to wait more than two weeks to start treatment

Suicidal children as young as 12 are having to wait more than two weeks for beds in mental health units to start treatment, despite the risk to their lives, research reveals.

A study of under-18s with serious mental health problems found that bed and staff shortages mean NHS services for troubled young people have become dangerously “threadbare”.

Young people who have tried to end their life by self-harming or taking an overdose are facing delays of up to 15 days between first being seen and getting a place in a unit. Child and adolescent services are so stretched that even a huge area such as London, which has 10 NHS mental health trusts, sometimes runs out of beds.

In one case a very troubled child had to be taken 283 miles from the capital to Newcastle because nowhere in between had a free bed. In another, a teenage boy with psychosis who was also at risk of killing himself ended up 167 miles away in Sheffield.

The findings dramatically illustrate the crisis in NHS mental health care for under-18s, especially those whose illness is so severe that it is life-threatening, a situation Theresa May made a personal priority. They are contained in an audit – carried out by four psychiatrists including Dr Dan Poulter, a former health minister – of 71 children who ended up in A&E after experiencing a mental health crisis between late 2015 and spring 2018 and were taken into the care of the South London and Maudsley (Slam) NHS trust. Slam is the largest specialist mental health trust in England.

Norman Lamb, the former mental health minister, warned that being forced to wait for a bed could increase the risk of young people trying to end their lives. Ministers and NHS chiefs must urgently end the shameful practice of such patients being sent far from home to get care, he said.

“This audit lays bare the gap between government rhetoric and the reality for too many young, vulnerable people. We simply should not tolerate delays of this kind. We would not put cancer patients’ lives at risk. Yet this happens routinely in mental health services,” said Lamb, a Liberal Democrat MP. “For young people who are seriously unwell, there must be immediate access to beds close to home. This persistent practice of shunting very ill youngsters around the country away from friends and family is shameful and heaps more trauma on an already critical situation.”

The Slam psychiatrists who looked after the 71 patients voiced fears that being sent “out of area” risked increasing the distress of a young person in crisis and could set back their chances of recovery. Acute hospitals, where under-18s are initially cared for on a paediatric ward, are not as safe for vulnerable young people as a specialist facility, they added.

The audit shows that 38 of the 71 were deemed at risk of suicide. Despite that, the longest wait for a bed faced by any of the 14 suicidal under-18s was 15 days and 15 hours. Another waited seven days and two hours. One patient among the six who had just tried to take their own life waited six days and 22 hours and another for five days and 19 hours.

Among the 17 patients who had recently taken an overdose, one endured a delay of 12 days and 23 hours and another of six days and one hour. The one patient who was having suicidal thoughts waited five days and 21 hours. In another case a girl with eating disorders and other mental health problems, who was not suicidal, had to wait 64 days for a bed in a specialist unit to become available, which was also “out of area”.

“The longer the wait for admission to an acute mental health bed, the longer a child or young person has to wait to receive specialist treatment and care in the most appropriate setting. These delays can sometimes prolong a hospital stay for a young person, increasing their distress and sometimes delaying the initiation of the full package of mental health care they need and can only receive in a specialist setting,” said Poulter.

Slam’s ability to give proper care to growing numbers of young people with mental health problems was being hit by a lack of resources, Poulter stressed. “Both the trust and the staff do their very best for children and young people within the limits imposed by an underfunded and consequently under-resourced and under staffed mental health system.

“A crippling and long standing lack of staff and resources secondary to a lack of investment by consecutive governments is the root cause of the problem.”

The government says that more than 100 beds have been opened across the country in recent years, with plans for 40 new ones by March.

Claire Murdoch, national mental health director at NHS England, said: “This audit is now outdated, based on information from four years ago – an additional 61 beds have opened in London alone since December 2017. But we know from listening to young people and their families that they want specialist mental health support in their community, closer to home, which is why the NHS long-term plan is ramping up community care including intensive community after-care support as well as investing in earlier support through schoolsbased counselling and introducing waiting time standards for eating disorders.”