At least 1.3 million people have presented to A&E in a mental health crisis in the last six years, an RCN Freedom of Information (FOI) request to NHS trusts in England has revealed.
Nursing staff have reported to the RCN long waits for mental health patients in emergency departments – some up to three days – with patients being cared for by security guards, others attempting suicide, and some leaving before receiving any treatment.
They also say they’re “excessively burned out” by the demands placed on them and “devastated” they can’t provide better care.
The number of people waiting more than 12 hours after a decision to be admitted to a mental health unit has risen by 383% since 2019.
In her keynote address to thousands of nursing staff attending RCN Congress in Liverpool, RCN General Secretary and Chief Executive Professor Nicola Ranger said this practice must stop. She described it as a “scandal in plain sight” and said if the “parity of esteem between mental and physical health is to mean anything, then these utterly degrading waits must end”.
Nicola also condemned cuts made to mental health beds and calls for the long-awaited Urgent and Emergency Care improvement plan in England to include specific measures to address the mental health crisis in A&E.
The demand for secondary mental health services in England has grown 106% in a decade – from 1.8 million to 3.8 million contacts and referrals between 2014/15 and 2023/24. Yet the mental health nursing workforce has not kept pace, meaning fewer nurses per patient.
Over the same period, the number of registered mental health nurses in the NHS in England has only grown 12% (from a monthly average of 36,758 to 41,100). While the number of community mental health nurses has grown by 39% (from a monthly average of 14,994 to 20,829). This lags far behind the 106% rise in demand.
Despite the entire mental health workforce growing by 23% between 2010 and 2023, the number of nurses only rose by 3% during that period. Meanwhile, therapists and support staff increased by 45%. Unlike mental health nurses, neither are trained to support people in acute distress forced to wait long periods in A&E and who require immediate and intensive help.
In her keynote, Nicola said: “Nothing less than urgent and sustained investment in community mental health nursing can ensure everybody gets timely care in the right place. That is how you turn people’s lives around and ease pressure on emergency departments.”
