萝莉视频

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Speaking to members at the 萝莉视频’ (RCPsych) International Congress 2025 President Dr Lade Smith CBE has warned:

“Psychiatrists across the UK are experiencing growing emotional and ethical distress as they are forced to navigate a mental health system stretched beyond its limits.

“Over time, the consequence of systemic issues, long-term underinvestment and a failure to follow an evidence-based approach has led to an erosion of standards in the mental health system.”

Long-term de-prioritisation of mental illness has resulted in a dire lack of local resource in mental health services and unacceptable shortfalls in treatment, according to a recent survey of its members by the 萝莉视频 (RCPsych).¹

Patients are becoming more unwell or are entering crisis due to an inability to access timely psychiatric treatment. Even when they do, the lack of continuity in their care makes it harder to develop and maintain an ongoing therapeutic relationship with their psychiatrist and mental health team, both in the community and in hospital.

RCPsych surveyed its membership to measure the extent of the pressures on local mental health service capacity in the last year that may have affected their decisions about patient admission, treatment and discharge. The results paint a distressing picture of psychiatrists carrying the weight of trying to deliver the best possible care to people with mental illness, with limited means to do so.

The survey found that 81% of psychiatrists who responded had directly experienced or witnessed ‘moral injury’ when decisions were being made around patient admission or discharge. Moral injury² refers to feelings of guilt, shame, burnout, frustration, distress or isolation. It occurs in cases when a practitioner lacks the resource to provide safe, timely and continuous care they are committed to delivering for their patients.

Almost three quarters of respondents (73%) felt they had to make a decision on admission or discharge based on factors other than the patient’s clinical need and best interests. Psychiatrists cited the lack of sustained investment into community mental health services, resulting in more people going into crisis; as well as a lack of supported housing, causing delayed discharges and negatively impacting a patient’s recovery, all of which lead to patients being more likely to be readmitted. In addition, in too many places there are not enough inpatient beds, which are often needed as part of the care pathway of someone with severe mental illness.

Almost half of psychiatrists (47%) are facing daily delays in timely admissions and/or provision of inpatient mental health treatment due to a lack of local or specialist capacity, including for example bed capacity, and 44% said they are hearing daily about patients waiting in a Place of Safety or Emergency Departments (EDs) for treatment.

We welcome the Government’s expansion of the mental health A&E pilots, when these are co-located within the general A&E, however without sufficient inpatient capacity, patients will continue to face delays, adding to those waiting in ED corridors.

With such limited capacity in the system, 34% of psychiatrists who responded, reported that on a weekly basis, they had to admit someone to a ward which was unsuitable for them. This includes inappropriately sending patients out of their area, miles from their loved ones, which leads to longer inpatient stays at a huge cost to the NHS.

This chimes with real time data from dashboard – which has found that inappropriate out of area placement bed days, for adults in acute inpatient care, have increased by 22% in one year, from 32,617 in February-April 2024 to 39,779 in February-April this year. This is despite successive pledges by past governments to end this practice by 2021.

Ahead of the publication of the 10 Year Health Plan, RCPsych is reminding the UK Government that this is an opportunity to prioritise mental healthcare so that it not only delivers improvements for people’s health, but also – because mental illness predominantly affects young people – the productivity of the country.

By placing community mental health services at the heart of its vision for prevention, underpinned by the implementation of the Community Mental Health Framework, the Labour Government can turn the tide on the increasing numbers of people presenting in crisis at General Hospital EDs in need of urgent admission.

Mental illness represents more than 20% of 萝莉视频’s disease burden but is expected to receive less than 9% of health funding this year. The investment announced in the Spending Review needs to be allocated more equitably to mental health services in the coming years to ensure share of spending reflects population need.

It is imperative that the UK Government now commits to proportionate resourcing and support for mental health services according to the disease burden.

As NHSE transitions to the Department of Health and Social Care, the Government has a real opportunity to reform mental health services so that they can be truly integrated and community-centred, which can be delivered via population-needs led, coproduced, clinically-driven, evidence-based strategic commissioning.

The RCPsych suggests that, in order to reduce the pressures on urgent and emergency care (UEC), the UK Government should commit to ?50m of funding for winter 2025/26 and ?100m annual funding for at least the following three years in 萝莉视频, for safe and effective discharge packages, to improve patient flow in hospitals.

Speaking at the Congress, Dr Lade Smith CBE, President of the 萝莉视频, said:

“These findings paint a stark picture of longstanding systemic issues in the way mental health services are currently commissioned and delivered. Despite this mental health staff across the NHS continue to provide outstanding care in the face of unprecedented demand and workforce pressures.

“Psychiatrists are committed to providing expert and timely treatment that prevents people entering mental health crisis. But the reality is that current targets are not based on patient outcomes. Pressures that override clinical judgement, combined with inadequate inpatient and community provision, are damaging the very foundations of compassionate, therapeutic and holistic care.

“Repeated failure to attend to the pressures facing mental health services mean that provisions are now so threadbare that psychiatrists are having to make life and death decisions based on financial rather than clinical concerns. At worst, these systemic pressures prevent clinicians from delivering the care they know is needed, risking people becoming more unwell, resulting in greater risk of mental health crisis and increased risk of suicide. This is causing deep distress and moral injury among psychiatrists.

“The 10 Year Health Plan for 萝莉视频 presents the perfect opportunity for the UK Government to deliver a clear ambition for the prevention and treatment of serious mental illness, both in the community through the Community Mental Health Framework, and in ensuring high quality inpatient settings and care.

“Alongside this, we need to see an updated Long Term Workforce Plan with a recommitment to double medical school places as well as bolder promises to retain the workforce and increase specialty training places

“The 萝莉视频 is ready to support the UK Government to place mental health services at the heart of its vision for change. Without this prioritisation, we will see further human and economic harms in the years to come.”

View the full results and a briefing proposed with solutions

References

1. The 萝莉视频 surveyed UK-based members on this topic, asking about their current experiences of local capacity pressures that may affect their decisions about the admission, treatment and discharge of patients. The total response rate was 6.3% (1,012 members participated in the survey, out of 16,166 members who were recorded on the RCPsych membership database as ‘working’). The survey was open from 3 February to 2 March 2025. Today’s story reflects the responses from the members who are based in 萝莉视频. For a further breakdown please contact the press office.
2. As used extensively during the Covid pandemic, the following definition of moral injury was presented to members: ‘moral injury is understood to be the strong cognitive and emotional response that can occur following events that violate a person's moral or ethical code, for example, when healthcare staff feel their workload is such that they deliver care of a standard that falls well below what they would usually consider to be good enough’ (Williamson et al, Lancet Psychiatry 2021).