Thousands of patients are being readmitted to NHS mental health units in England every year soon after being discharged, raising concerns about poor care, bed shortages and increased risk of suicide.
Experts say being discharged prematurely can be upsetting, set back the patient’s chances of making a full recovery and be “disastrous” for their health.
Figures from NHS mental health trusts in England show that last year almost 5,000 people – children and adults – were readmitted to a mental health facility within a month of leaving.
The Labour MP Dr Rosena Allin-Khan said the “alarming” data, which she obtained under freedom of information laws, showed too many patients were not receiving enough help to recover.
In all 3,381 patients were readmitted within 30 days of their discharge by 35 of the 54 specialist mental trusts in England during 2022-23, according to responses Allin-Khan received. Extrapolating those figures to all 54 trusts suggested an estimated 4,927 people were readmitted within a month, she said.
Also in 2022-23, 1,972 people were readmitted by 36 trusts within a week of discharge – something NHS mental health services accept should never happen. Extrapolation of those figures to the 54 care providers shows that an estimated 2,794 people returned as an inpatient within seven days, according to the MP’s research.
Allin-Khan said: “With record waiting lists and mental health beds in short supply, it is alarming that many patients are being discharged only to be readmitted within days. Every patient expects to receive full and appropriate mental health support, so it is concerning that in many cases patients are being discharged prematurely.
“Being discharged too soon can have a disastrous impact, stunting progress towards a full recovery, ultimately causing further damage to a patient’s mental health.”
The figures show that both seven- and 30-day readmissions are declining. Confirmed seven-day readmissions were down from 2,336 in 2017-18 and confirmed 30-day readmissions were down from 4,338 over the same period.
But experts said any early return to hospital after discharge could be highly damaging for patients who remained mentally fragile and could heighten the risk that they could kill themselves.
Last year, Mersey Care trust had the highest number of 30-day readmissions, with 321, followed by the East London (298) and Sussex Partnership (278) trusts. The highest number of seven-day readmissions were at the Barnet, Enfield and Haringey (191), Lancashire and South Cumbria (185) and East London (159) trusts.
Marjorie Wallace, the chief executive of the mental health charity Sane, said she was shocked by the figures. Too many readmissions occurred because vulnerable patients received inadequate help from community-based mental health teams after their discharge, she said. That lack of support can be so significant that “in some tragic cases” patients kill themselves.
“Recent reports of the number of patients who, after discharge, experience ‘unexpected’ deaths are becoming a cause of concern,” Wallace said. “The highest risk of suicide can be within the first 48 hours following discharge, yet we still know patients who are left to go home alone to a flat or unsupported accommodation with nowhere to turn for help.”
To improve the situation “needs the time of a mental health worker to escort a patient who has been at risk and visit after discharge. Yet people who contact us say this doesn’t happen. The team may take days to arrive and are sometimes too late,” she said.
Almost 100,000 people a year spend time as an inpatient in mental health, autism and learning disability services in England, NHS figures show. Just over half have been detained under the Mental Health Act.
Andy Bell, the chief executive of the Centre for Mental Health thinktank, said he welcomed the fact that seven- and 30-day readmissions had declined. But, he added: “It’s worrying that so many people are still needing to go back to hospital within seven days or a month of leaving. While the numbers are falling, going back to hospital so soon after being discharged can be a distressing experience for anyone to go through.”
The NHS’s stock of mental health beds has fallen dramatically over the last 30 years.
NHS England said Allin-Khan was wrong to extrapolate the figures she received to all 54 trusts. But it did not explain why readmissions happened or respond directly to the findings.
A spokesperson said: “It is misleading to scale up data in this way without full responses. NHS mental health teams work to discharge patients at the appropriate time, and under the NHS long-term plan we are increasing funding for mental health services by £2.3bn a year.
“This included nearly £1bn a year to transform community mental health services, which are supporting people to stay well after discharge.”
