‘Desperate’

Parents tell of ordeal as daughter waited for treatment

David and Angela, the parents of the 18-year-old woman who endured an eight-and-a-half-day spell in A&E waiting for a mental health bed, describe her and their ordeal.

“Louise [not her real name] has been experiencing mental health difficulties since October 2021. She was diagnosed soon after with ADHD and EUPD – emotionally unstable personality disorder. Since then she’s been admitted to hospital five times, each time for four to six weeks. Each admission came after Louise had left home, threatened to harm herself and been picked up by the police under a section 136 order, which lets the police take you to be assessed at a ‘place of safety’, which is either a section 136 suite or an A&E unit. We can’t praise the police highly enough for their speedy response and caring attitude when they are called.

On Thursday 16 June Louise went from our home in Surrey to

Sutton to see her sister. But she rang us saying that she had ‘had enough’ and was going to ‘end it all’. The police found her, assessed that she was at risk of harming herself, put her under a section 136 and took her to the A&E in St Helier, the local hospital. Someone undergoing a mental health crisis should be taken to a ‘place of safety’, which is ideally a section 136 suite at a psychiatric hospital. But these are few and far between, so the police often have no choice but to take the person to an A&E, which is a totally unsuitable environment for someone with serious mental health needs.

Louise spent her first night in A&E sitting in a chair in a very small room with a curtain for a door, as there was no bed available, with two police officers standing over her. We cannot imagine a more inappropriate way of supporting someone undergoing a mental health crisis. A ‘place of safety’ should be welcoming and therapeutic. She spent the next three nights on a thin mattress in a bare room with a chair and little else. The section 136 ended after 24 hours so she was placed into the hands of security guards to monitor her 24/7 alongside A&E staff.

On her first day the A&E psychiatric liaison team judged that she needed compulsory admission to a mental health unit to be assessed and treated. That’s called a section two. That order, made under the Mental Health Act, can last for 28 days and is the most common way people with mental health problems are detained or ‘sectioned’. However, the problem for Louise was that a section two can’t be enacted in an A&E because you aren’t classed as an inpatient there; you are merely waiting for a bed. You are therefore in limbo.

And so the waiting game – the search for a bed for Louise in a mental health unit – began. However, both the psychiatric liaison team and the A&E staff told Louise and us that there was no bed available, not just locally but anywhere in England.

As the days ticked by Louise became more and more dejected, despairing and desperate. She was confused and uncertain about when she might get a bed and where it might be. Her time in A&E was having a damaging effect on her already poor state of mind.

One complication in the search for a bed was that Louise experienced her mental health crisis in the ‘wrong’ area, apparently. She was found in Sutton but we live in Surrey. Surrey

residents’ mental health needs are supported by Surrey and Borders Partnership NHS healthcare trust – they usually provided Louise’s care – while residents of Sutton, where the St Helier is, have their needs met by South West London and St George’s mental health NHS trust.

It was the Surrey and Borders trust’s responsibility to find Louise a bed. I was given the phone number and email address for their bed management team. However, you cannot speak to anyone when you phone, so I left messages asking them to call me and also emailed them. I got no response.

Louise became so agitated by her long stay in A&E that she began to bang her head against the wall in her room. That resulted in her being restrained and sedated, which was traumatic and distressing for her. Had she been found an acute bed much earlier this may not have happened. She also absconded twice from the A&E, each time being brought back by the police. Both times we were terrified that she would come to harm. The second time it happened, CCTV picked her up near Sutton railway station, which was worrying.

Louise should never have been put in a position to place herself at risk of harm or worse. This was a young woman who was experiencing a mental health crisis and was in need of specialist treatment, who believed that she won’t get the help she needed and was feeling desperate. I never want us or any other parents and carers to have to go through what we did. The mental health system as it is at present is letting Louise and others down badly and placing them at great risk of harm.

Eventually she did get a place in an acute ward of an NHS mental health hospital in Guildford, and finally left St Helier at 1.30am on Saturday 25 June – eight and a half days after she had first arrived.”