David and Angela, the parents of the 18-year-old woman who endured an eight-and-a-half day-long spell in A&E waiting for a mental health bed, describe her and their ordeal.
“Louise (name has been changed) 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 had come after Louise has 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 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, who lives there. 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 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 then 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, two at a time, 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 to be found. You are therefore in limbo.
And so the waiting game – the search for a bed for Louise in a mental health unit – began. However, no bed could be found. 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 and no bed was found, 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. She said things like ‘no one is helping me’ and ‘I’ll never get better’. 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. This opened up a whole other can of worms. 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. Whether these two trusts were talking to each other to organise the care that my daughter needed is hard to know for sure. But we were told that organising a bed would have been more straightforward had she been sectioned in the area that she resides. I don’t think young people experiencing mental health crises plan their hospital admissions with the foresight that the current ‘system’ demands.
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 picked up and brought back by the police. Both times we were terrified that she would come to harm. The second time it happened, on he evening of 23 June, CCTV picked her up walking near Sutton railway station, which was worrying.
The main point here is that 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 as parents 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 in a similar situation down badly and in doing so placing them at great risk of harm.
Eventually she finally 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.”
• In the UK, Samaritans can be contacted on 116 123 or email jo@samaritans.org. You can contact the mental health charity Mind by calling 0300 123 3393 or visiting mind.org.uk
