Children and young people are being sent hundreds of miles away from home for mental health treatment – with sometimes deadly consequences – despite a government pledge to end these placements by the end of last year.
Two months ago, 20-year-old Lauren Bridges took her own life. She was alone in a mental health hospital 250 miles away from her family.
The move was meant to be temporary, but when she died she had been there for nine months.
“Soon as I saw the phone ring, I knew. I just knew,” said her mother, Lindsey Bridges.
“In the weeks leading up, she was very let down. She said that she could see no way out, she was going to be held in that hospital forever.”
The government pledged to end all inappropriate out-of-area mental health placements by the end of 2021, but at the end of last year, there were at least 660 active inappropriate out-of-area placements (IOAP) in England.
In total, these inappropriate placements cost the NHS more than £118m in 2021.
However, these numbers only reflect the placements we know about and do not show the full scale of the problem.
‘Lauren would still be alive’
Lauren was autistic, with a mental age much younger than 20, but was sectioned under the Mental Health Act after being diagnosed with a personality disorder.
She was being treated locally when she was sent to Manchester because of a lack of beds in her home town of Dorset.
Ms Bridges said that if the government had stuck to their plan to end all out-of-area placements, “then we would still have Lauren, and other families might still have their children”.
She said she wasn’t even warned about her daughter’s move: “I woke up to a phone call from Lauren. She was hysterical, crying her eyes out.
“She said hospital transport was on its way to pick her up and she was being sent to Manchester.”
“She was scared to death”, she said, adding that the distance was “absolutely” a factor in why Lauren took her own life.
“It broke me, it was just devastating. There was nothing I could do. I tried everything in my power to get her moved.”
A spokesperson from Dorset HealthCare, the trust which managed Lauren’s placement, said they could not comment on individual placements, but said: “Out-of-area placements are always used only as a last resort by services, either when we are at full capacity or when a person has very complex needs and requires specialist care not available within Dorset.
“We have always been committed to reducing the need for out-of-area placements, in line with the NHS Long Term Plan, and over the past few years we have undertaken an extensive programme of work to achieve this.”
Teenager ‘covered in scars’ after placement
In December, the latest available data for IOAPS, a quarter of relevant providers did not report any data.
The non-response rate is highest in the South East, where almost 40% failed to release data relating to IOAPs.
Of the out-of-area placements we know about that were still active at the end of 2021, 91% were deemed inappropriate.
Of those active during 2021 that we know about, almost half (48.4%) were a distance of 100km (66.6 miles) or more from the patient’s home, according to NHS figures.
Placements for children, however, are not recorded at all.
Among those, was Imogen Smee, who desperately needed inpatient care, but the family’s relief at being offered a bed soon changed to desperation after she was sent almost seven hours away from their home in Whitstable – to Bury.
She was just 13 years old at the time.
Claire Oliver, her mother, spent all of her savings on petrol and Airbnbs, so she could be close to her daughter: “I thought she’s never going to get better if she knows I’m not here.”
Five months later, in November 2021, Imogen was discharged, but Ms Oliver said there was no plan in place for her to return to Kent, and that she was now so ill she did not leave her room.
“She went in hardly self-harming, and she came out, and she is covered in scars. Her body looks like she’s the walking wounded,” said Ms Oliver.
‘Our life has fallen apart completely’
She has now had to resign from her job to be Imogen’s full-time carer, and called the situation the family were stuck in “inhumane”.
“And she’s still not taking any medication, and I’m like, what was the point in that?” said Ms Oliver.
“Our life has fallen apart completely.
“The impact, it’s life-changing. I don’t recognise myself, I don’t recognise my daughter.
“I don’t know whether we’re ever going to come back from this.”
Ms Oliver’s MP, Rosie Duffield, is now trying to get the issue raised in parliament.
Ms Duffield said: “It’s really become urgent, we need the health secretary to look at this and to ring-fence that mental health spending, so it is directed towards the services and not leaked to other emergency areas in the NHS.
“We really need this to be taken seriously.”
Inpatient beds cut by 70%
The Royal College of Psychiatrists (RCPsych) says the only answer is more funding – not just for community mental health services, but also to replace inpatient beds that have been cut by 70% in the last 30 years.
Dr Trudi Seneviratne, registrar of the RCPsych, told Sky News: “Sending people miles away for their treatment is simply unacceptable.
“It is devastating for their mental health, and I use the word devastating because it is truly devastating.”
Being so far away from home, even when the care is good, “hinders recovery”, she said.
“To avoid out-of-area placements where possible, the reality on the ground is that the system isn’t working.
“Even though we’re having the expansion of community services, there are so many areas across the country that don’t have enough inpatients beds. So when it’s a last resort, and somebody really does need to have treatment on an inpatient ward, the trust has no choice other than to recommend an out-of-area placement.”
Government blames pandemic for missing target
When asked, the government cited the pandemic and subsequent lockdowns as part of the reason the target for ending these placements was missed.
However, the RCPsych disputes this, and claims progress had stalled pre-pandemic.
A Department of Health and Social Care spokesperson said: “Everyone should have access to safe, appropriate mental health care and we recognise the impact that receiving care far away from loved ones can have.
“That’s why we are investing an extra £2.3bn per year to transform NHS mental health services by 2024, meaning more people will be able to receive care as close to home as possible.
“To address the impacts of the pandemic, we have provided an additional £500m through our Mental Health Recovery Action Plan, to make sure support is in place this financial year.”
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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