London shuts down at least 18 mental health wards in three years

At least 18 mental health units in London public hospitals were shut down over the last three years, according to information released after a Freedom of Information request carried out by DatAddicts.

This number could be even higher, since only three out of 11 NHS Foundation Trusts had replied to this request, at the time of writing.

Up to ten mental health wards were shut down last year in hospitals linked to South London and Maudsley NHS Foundation Trust, which did not specify the institutions these units belonged too. In 2012, another four mental wards were closed in this area, following the closure of a ward in 2011.

May 2013 saw the closure of the acute unit of Naseberry Court, in Waltham Forest, according to data released by North East London Foundation Trust.

Central and North West London NHS Foundation Trust reported the closure of the Belgrave mental health unit at the Gordon Hospital in Pimlico during 2012, as well as the Mulberry North Ward at the South Kensington & Chelsea Mental Health Centre last year.

The reduction of mental health units reflects a ten-years trend by which the NHS is investing in developing community services to reduce dependence on hospital based care for people suffering from mental illness, explains a communication officer of Central and North West London NHS Foundation Trust.

This Trust argues that it has put in place four Home Treatment teams in the boroughs of Westminster and Kensington & Chelsea, which provide an alternative to admission for acutely unwell patients, who would have previously been admitted to hospital. The Trust says that this transformation is backed by the Clinical Commissioning Groups, which have stated their desire to see “a greater use of community services and reduced dependence on inpatients beds”.

But budget cuts are driving this restructuring, with acute services obliged to deliver savings of around 20 per cent between 2011 and 2014, which equates to approximately £7.6million, according to that same Trust.

“In order to remain financially viable and maintain the community services that offer greater choice for patients and promote recovery, savings must be delivered by reducing the demand for and subsequently provision of inpatient beds,” writes the Trust in a document sent as a response to DatAddicts’ enquiry. By closing two of their units, the Trust has removed 25 beds, and plans to reduce the total amount even further, by removing 15 acute beds at St Charles Hospital in Westminster.

A spokesperson of South London and Maudsley NHS Foundation Trust said: “Work is constantly being undertaken to ensure beds are used effectively. Reducing inpatient beds allows an increasing number of patients to be treated at home with the support of GPs and healthcare professionals in the community. It means there is less requirement for inpatient treatment and it reduces lengths of stay when admission is required”.

North East London Foundation Trust is yet to respond at the time of writing, and the Royal College of Psychiatrists refused to comment on this issue.

According to Graham Thornicroft, Professor of Community Psychiatry at the Institute of Psychiatry -part of King’s College London-, the disappearance of mental health wards is definitely due to NHS budget cuts.

“The main reason are the reductions in investment by Clinical Commissioning Groups for the provision of specialist mental healthcare,” he explains to DatAddicts.

Thornicroft is concerned that if support provided to patients by community mental health teams is also reduced, this may lead to an increased pressure on inpatient beds. Patients in need for urgent care might then have fewer places to go.

One out of each six people in Britain suffers from a diagnosable mental disorder today, and one out of four will experience a mental health problem in any given year, according to the charity Time-to-Change. Some of these illnesses, such as schizophrenia, are slightly more common in the more socially deprived areas of England.

On average, women with mental illness die 15 years younger than their non-mentally ill counterparts, while men die 20 years earlier. However, experts have not yet found any evidence of a link between the number of beds and this premature mortality, says Thornicroft.

Mental health wards in England lost in total 2,085 beds in the last three years, falling from 23,016 to 21,931, according to information released by NHS England. The NHS Foundation Trusts that lost most beds were Black Country Partnership (-18,68 per cent), South London and Maudsley (-15,15 per cent), and Cornwall Partnership (-14,86 per cent).

Julia Kerry* had a psychotic episode earlier this year, after suffering from severe depression for years. She knew something serious was happening to her when she started hearing the voices of dead members of her family. Julia complains that the public health system should not save money at the expense of patients who require special care.

“It has been probably the worst experience of my life. My mother rapidly took me to the hospital. I don’t know what we would have done if we had not been able to find help,” she says. “It is just not fair to reduce the quality of help provided to people like me. We rely on these services”.

(*Name changed at the request of the interviewee).

Psychiatric beds shortage


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