Mental health hospitals and bed space – an increase in suicides?

It was recently reported that more mental health hospital beds are needed in England, in order to stop the practice of sending patients with mental health issues to other hospitals elsewhere, often a substantial distance away from the patient’s home. The issue of mental health has been gaining media increased coverage as has the specific issue of the availability of beds for such patients.

Increased suicide rate?

In 2018 in England, the number of suicides was 5,021¹. This marks an increase of 12.8% from 2017 figures – 4,451. A possible factor in suicides is the lack of treatment, particularly from local NHS mental health trusts. It is therefore concerning NHS mental health trusts in England are lacking bed space to admit individuals who urgently need treatment.

More Inquests…

Under the Coroners and Justice Act 2009 s1, a coroner must investigate a death if the deceased died violently or unnaturally; the cause of death is unknown or the deceased died in custody or state detention². A coroner is almost always required to investigate a suicide and an increase in the number of suicides in England, will lead to an increase in the number of inquests being held. A real concern should be that the increase in the suicide rate and by extension, an increase in the volume of inquests, might stem from the lack of available beds for individuals who require urgent inpatient treatment.

Inquests are often a difficult and traumatic process for families. The fact that the death of a loved one may have been prevented if bed space had been available locally merely compounds the family’s grief.

…and Litigation?

Hodge Jones & Allen is currently instructed on a number of cases where an individual has either unsuccessfully attempted to commit suicide, leading to life changing injuries or has tragically committed suicide as a result of the failure of the local mental health hospital to admit them. While the lack of bed space in local mental health hospitals is often not the sole factor, it can play a part in the outcome. The absence of bed space can perhaps mean that an individual is not admitted in time before the individual chooses to self-harm.

A motivating factor for families pursuing clinical negligence claims against NHS mental health Trusts is to ensure that a similar situation does not happen again to other families. Sadly, the statistics appear to show that the issue is getting worse. While the statistics do not definitively show that a lack of beds as a cause of the increase, it is reasonable to infer that, a partial cause in the increase is the lack of funding for mental health services. If this issue is not addressed soon, then more individuals might harm themselves and this could lead to an increase in litigation.

Summary

Whilst the underlying causes of suicide are complex, the lack of access to treatment can be a major factor.

Early intervention and access to treatment in the local community can play a major role in ensuring that an individual remains alive, thereby potentially avoiding both an inquest and potentially, a clinical negligence claim.

It is critically important that mental health Trusts have the funds they need to provide an effective and prompt service to their local community as this will reduce distress to families and reduce the stress upon families and NHS staff having to deal with difficult inquest hearings and the often traumatic litigation that follows.

The author of this blog is Alastair Banks, Legal Assistance in our Medical Negligence team.

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¹ Office for National Statistics Age-Specific suicide rates for broad age groups, by sex, England, 1981 to 2018 registrations

² Coroners and Justice Act 2009