The mental health crisis among children and young people in the UK continues to raise deep concerns, especially as vulnerable individuals are being sent far from home to receive treatment. Despite a government pledge to put an end to these out-of-area mental health placements by the end of 2021, the reality remains grim, with hundreds of young people still being sent hundreds of miles away from their families, often with devastating consequences. In some cases, these distant placements have even led to tragic outcomes, such as the untimely death of 20-year-old Lauren Bridges.
Lauren, who was autistic and diagnosed with a personality disorder, died after spending nine months in a mental health facility 250 miles away from her home in Dorset. Her story highlights not just the immense emotional strain caused by these placements but also the systemic failings within the UK’s mental health care system.
The Promises Broken and the Ongoing Crisis
In 2021, the UK government set a firm goal: to end inappropriate out-of-area mental health placements by the end of the year. This was part of an effort to prevent young people from being sent far away from their homes for treatment, which is known to significantly hinder recovery. But as 2022 began, the figures painted a much bleaker picture. At the close of last year, there were at least 660 active inappropriate out-of-area placements in England, despite the government’s commitment.
These placements come at an enormous financial cost. In 2021 alone, the National Health Service (NHS) spent over £118 million on inappropriate out-of-area mental health care. However, this figure likely underestimates the scale of the issue, as it only accounts for placements that have been reported. Disturbingly, the true number of placements—and the human cost associated with them—may be far higher.
Lauren Bridges: A Tragic Story of Isolation and Loss
Lauren Bridges’ tragic story illustrates the severe consequences of these placements. At the age of 20, Lauren was placed in a mental health hospital in Manchester, a staggering 250 miles away from her family in Dorset. This was supposed to be a temporary solution, but nine months later, she was still there. Her mother, Lindsey Bridges, has spoken openly about the heartbreak she felt when her daughter died.
“As soon as I saw the phone ring, I knew. I just knew,” Lindsey recalls. The weeks leading up to Lauren’s death were filled with increasing despair. Lauren expressed feelings of hopelessness, convinced she would be stuck in the hospital forever. “She said that she could see no way out,” her mother explained, describing the deep sense of helplessness Lauren felt.
Lindsey believes that if the government had stuck to its plan to eliminate out-of-area placements, Lauren might still be alive today. “We would still have Lauren, and other families might still have their children,” she said. The sense of injustice is compounded by the fact that Lindsey wasn’t even informed of Lauren’s transfer to Manchester until after it had been arranged. “She was hysterical, crying her eyes out,” Lindsey recalls of the moment Lauren told her she was being sent to Manchester.
Lauren’s story is just one of many that underline the mental and emotional toll of being sent far from home. The isolation, distance from loved ones, and the feeling of being forgotten can exacerbate an already fragile mental state. For Lauren, the distance from her family was “absolutely” a factor in her decision to take her own life. “It broke me, it was just devastating,” Lindsey said. Despite her best efforts, she could not secure her daughter’s transfer back to a local facility.
Dorset HealthCare, the trust responsible for managing Lauren’s placement, has declined to comment on individual cases but stated that out-of-area placements are used only as a last resort. They claim such decisions are made either due to a lack of local capacity or because a patient has highly complex needs requiring specialist care. However, these explanations provide little comfort to families like the Bridges, who are left grieving the loss of their children.
Widespread Failures in Data Reporting
Lauren’s story is not an isolated incident. The broader issue of out-of-area placements continues to affect hundreds of young people across the country. In December 2021, the latest data available, a quarter of providers involved in mental health care failed to report any information on inappropriate out-of-area placements. In the South East of England, nearly 40% of relevant providers did not provide data, meaning the true scale of the issue is likely even more widespread.
Among the cases reported, 91% of the out-of-area placements active at the end of 2021 were deemed inappropriate. Of these, nearly half involved distances of more than 100 kilometres from the patient’s home. However, this only represents the cases we know about, and crucially, placements for children are not recorded at all, leaving the situation for the youngest and most vulnerable patients even murkier.
The Case of 13-Year-Old Imogen Smee
Another tragic example is that of 13-year-old Imogen Smee, who was sent almost seven hours away from her home in Whitstable, Kent, to a mental health facility in Bury. Her family was initially relieved when she was finally offered a bed after desperately seeking inpatient care. However, that relief quickly turned to despair as they realised how far away she would be sent.
Imogen’s mother, Claire Oliver, did everything she could to be near her daughter, spending her entire savings on petrol and temporary accommodation so that she could visit Imogen regularly. “I thought she’s never going to get better if she knows I’m not here,” Claire said.
Five months later, Imogen was discharged, but there was no plan for her to receive local support upon her return to Kent. The impact of her time in distant care was severe. Claire describes how her daughter’s mental health had deteriorated while she was away, saying that Imogen had gone into the hospital with minimal self-harming behaviours, but came out covered in scars. “Her body looks like she’s the walking wounded,” Claire says, illustrating the devastating effects of being far from home and in a system that failed her.
The Toll on Families
For families like Claire Oliver’s, the consequences of these distant placements extend far beyond the individual in treatment. Claire has had to resign from her job to become Imogen’s full-time carer, and she describes their life now as “inhumane.” With her daughter still not receiving the right medication or treatment, Claire questions the point of the placement at all. “Our life has fallen apart completely. The impact, it’s life-changing,” she said. The emotional and financial toll on the family has been immense, and Claire is uncertain whether they will ever recover from the trauma of the experience.
Claire’s MP, Rosie Duffield, is now working to raise the issue in Parliament, calling on the government to ring-fence mental health funding so that it is directed towards the right services. “It’s really become urgent,” Ms Duffield said, emphasising the need for immediate action to address the crisis.
The Loss of Inpatient Beds: A System Under Strain
The Royal College of Psychiatrists (RCPsych) has long called for more funding for mental health services, warning that the system is overstretched and unable to meet the growing demand. Over the past 30 years, inpatient mental health beds have been cut by 70%, leaving many trusts with no choice but to send patients out of area when local facilities are full.
Dr Trudi Seneviratne, the registrar of the RCPsych, has been outspoken about the dangers of sending people far from home for mental health treatment. “It is devastating for their mental health,” she said. Even when the care provided is good, being far from family and familiar surroundings hinders recovery. “To avoid out-of-area placements where possible, the reality on the ground is that the system isn’t working,” Dr Seneviratne explained.
Despite recent efforts to expand community mental health services, many areas of the country still lack sufficient inpatient beds. When faced with this reality, trusts often have no option but to recommend an out-of-area placement, even though it is acknowledged that such moves are far from ideal.
The Government’s Response: Blame on the Pandemic
When questioned about the missed target for ending inappropriate out-of-area placements, the government has cited the COVID-19 pandemic as a significant factor. The disruptions caused by lockdowns and the increased demand for mental health services are seen as contributing to the failure to meet the 2021 deadline.
However, the RCPsych disputes this claim, arguing that progress had already stalled before the pandemic began. They contend that while the pandemic has exacerbated existing challenges, the underlying issues within the system were present long before COVID-19.
In response to the ongoing crisis, the government has committed an additional £2.3 billion per year to transform NHS mental health services by 2024. They have also provided an extra £500 million through the Mental Health Recovery Action Plan, aimed at addressing the immediate impacts of the pandemic. Yet, for families like the Bridges and the Olivers, these promises come too late.
Conclusion: A System in Need of Urgent Reform
The tragic stories of Lauren Bridges and Imogen Smee are stark reminders of the human cost of inappropriate out-of-area mental health placements. While the government has pledged to improve the system and invest more in mental health services, the reality on the ground is that young people continue to be sent far from their families, with devastating consequences.
To prevent further tragedies, there is an urgent need for systemic reform. This must include not only increased funding for community and inpatient mental health services but also a commitment to transparency and accountability in reporting placements. Without these changes, more families may be forced to endure the heartbreak of losing a loved one to a system that should be designed to protect and care for the most vulnerable in society.
Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email [email protected] in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK
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