Thousands of patients are readmitted to NHS mental health units in England each year shortly after discharge, raising concerns about poor care, bed shortages and an increased risk of suicide.
Experts say premature discharge from hospital can be distressing, reduce a patient’s chances of full recovery and be “disastrous” for their health.
Figures from England’s NHS mental health trusts show that last year almost 5,000 people – children and adults – were readmitted to a mental health facility within a month of leaving.
The Labor MP Dr. Rosena Allin-Khan said the “alarming” data, obtained under freedom of information laws, showed too many patients were not receiving enough help to recover.
A total of 3,381 patients were readmitted within 30 days of their discharge by 35 of England’s 54 specialist mental trusts in the period 2022-2023, according to responses Allin-Khan received. Extrapolating these figures to all 54 trusts suggested an estimated 4,927 people were readmitted within a month, she said.
Also in 2022-2023, 1,972 people were readmitted by 36 trusts within a week of discharge – something the NHS mental health service accepts should never happen. Extrapolating those figures to the 54 healthcare providers shows that an estimated 2,794 people returned to hospital within seven days, according to the MP’s research.
Allin-Khan said: “With record waiting lists and a shortage of mental health beds, it is alarming that many patients are being discharged only to be readmitted within days. Every patient expects full and appropriate mental health support. It is therefore worrying that in many cases patients are discharged prematurely.
“Discharged too early can have disastrous consequences, hindering progress towards a full recovery and ultimately causing further damage to a patient’s mental health.”
The figures show that both the number of seven- and thirty-day readmissions are decreasing. The number of confirmed seven-day readmissions decreased from 2,336 in 2017-2018, and the number of confirmed 30-day readmissions decreased from 4,338 during the same period.
But experts said an early return to hospital after discharge could be very harmful for patients who remain mentally vulnerable and could increase the risk that they would commit suicide.
Last year the 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 numbers of seven-day readmissions occurred in the Barnet, Enfield and Haringey trusts (191), Lancashire and South Cumbria (185) and East London (159).
Marjorie Wallace, the chief executive of mental health charity Sane, said she was shocked by the figures. Too many readmissions were happening because vulnerable patients did not receive enough help from community-based mental health teams after discharge, she said. This lack of support can be so great that “in some tragic cases” patients commit suicide.
“Recent reports of the number of patients experiencing ‘unexpected’ death after discharge are becoming a cause for concern,” Wallace said. “The greatest risk of suicide may occur within the first 48 hours of discharge, yet we still know patients who go home alone, to a flat or unsupported accommodation, with nowhere to turn for help.”
To improve the situation “the time of a mental health professional is needed to guide a patient at risk and visit him after discharge. Yet people who contact us say this doesn’t happen. It can take days for the team to arrive and sometimes it is too late,” she said.
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Nearly 100,000 people a year spend time in mental health, autism and learning disability services in England. NHS figures show. Just over half are detained under the Mental Health Act.
Andy Bell, the chief executive of the Center for Mental Health think tank, said he welcomed the fact that the number of thirty-seven day readmissions had fallen. But he added: “It is worrying that so many people are still having to return to hospital within seven days or a month of leaving. Although numbers are falling, returning to hospital so soon after discharge can be a painful experience for anyone.”
The NHS's stock of mental health beds has fallen dramatically in the past thirty years.
NHS England said Allin-Khan was wrong to extrapolate the figures it received to all 54 trusts. But it did not explain why readmissions occurred and did not respond directly to the findings.
A spokesperson said: “It is misleading to scale up data in this way without complete answers. NHS mental health teams work to discharge patients at the right time and on conditions NHS Long Term Plan we are increasing funding for mental health by £2.3 billion per year.
“This included almost £1 billion a year to transform community mental health care, which supports people to stay well after discharge.”