COVID-19 exposed the danger of years of under-investment in unsafe and not fit-for-purpose mental health buildings as “a disaster waiting to happen”, says the Royal College of Psychiatrists. Old and overcrowded mental health wards increase the risk of infection and have contributed to the deterioration of patients' mental health.
New research by the College reveals that a third (32.9 per cent) of clinicians in England feel that the quality of mental health buildings has compromised care for patients during the pandemic. It is essential that patients with the virus are isolated away from other patients – but 38 per cent of psychiatrists report that mental health buildings are unsuitable for safely separating patients with suspected or confirmed COVID-19.
A senior source at a hospital trust said: “Old and overcrowded buildings are simply not fit for infection control and the danger of cross infection is very high. Our patients are seriously mentally ill people who need to be treated in hospital, yet we were constantly having to make the judgement – where would it be safer for them to be? On a ward struggling to manage COVID cross infection or back at home where their mental state might get worse?
“Time and time again mental health has been completely left out of the hospital rebuilding programme. We can’t keep treating people with mental illness as second-class citizens. If government is serious about addressing the needs of those with mental health problems, we need investment for our estates. We simply can’t go on for much longer without it.”
Funding for mental health facilities is long overdue but is more urgent in the face of the COVID-19 pandemic and the threat of a second wave. COVID-19 is not the only danger faced by patients and staff because of the years of systematic neglect of mental health buildings. Mental health providers often receive a disproportionately lower amount of capital funding compared to other providers.
Analysis published in a new report from the Royal College of Psychiatrists reveals that trusts are struggling even to complete very high-risk repairs where there is a danger of catastrophic failure of care or serious injury. In 2018/19 almost £13 million worth of outstanding high-risk repairs in mental health and learning disability sites were reported – an increase of over 150 per cent on two years earlier.
Dr Adrian James, President of the Royal College of Psychiatrists, said: “COVID-19 brutally exposed the years of neglect that left some mental health services struggling to control infection. The Prime Minister’s recent announcement of investment is timely, but we need an urgent and immediate injection of cash to prepare buildings for the next COVID-19 wave – followed by substantial long-term investment. This devastating pandemic presents us with an opportunity to learn and invest to make our mental health facilities the best in the world.”
The Royal College of Psychiatrists is calling for immediate action to reduce the risks posed by a second wave of coronavirus this winter as well as to ensure high-quality and safe mental health services into the future. Specifically, among other proposed investments, the College is calling for:
- £376 million (25 per cent) of the Prime Minister’s recently announced £1.5 billion of NHS capital funding for 2020/21 to be ring-fenced for mental health NHS trusts. This includes the £250 million confirmed funding as a significant and welcome step on the road to eradicating dormitory wards and at least £126 million to support mental health services in the immediate term.
- A £1 billion building and redevelopment programme to enable 12 major mental health projects to be completed by 2030.
- £950 million to improve the therapeutic environment of mental health and learning disability/autism inpatient services by completing the elimination of dormitory wards; eliminating mixed sex accommodation; procuring en-suite facilities for all existing single rooms; minimising the risks of harm through innovative safety improvement projects, and making the estate more suitable for people with disabilities.
- £450 million for new building and redevelopment schemes for community mental health facilities as part of the significant expansion of services outlined in the NHS Long Term Plan.
* Read Next steps for funding mental healthcare in England here
* Royal College of Psychiatrists https://www.rcpsych.ac.uk/
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