Urgent Adult Mental Health Crisis Referrals in England Double in a Year
Care Quality Commission Report Highlights Overstretched Services and Increased Demand
Urgent adult referrals to mental health crisis teams in England more than doubled between 2023 and 2024, according to a healthcare watchdog, which found that people were becoming more unwell while waiting for help from overstretched services.
The report, from the Care Quality Commission (CQC), found there were not enough beds or staff, and ward managers felt pressed to discharge the "least unwell" patients.
Very urgent adult referrals to crisis teams increased to 3,063 in March 2024, from 1,400 the previous April.
The report, published on Thursday, also found that people from the most deprived areas of England attended A&E for their mental health 3.5 times more than those from the least deprived areas did.
Many services told the CQC that on admission, detained patients seemed to be more unwell than in the past – but that the increased demand for inpatient beds meant they were being discharged too soon. In nearly half of cases where a child or young person was detained under the act, they had to be admitted again within a year.
Jenny Wilkes, the interim director of mental health at the CQC, said the report showed a “damaging cycle” of ineffective treatment. “Without timely access to necessary mental health support, people may find themselves being bounced from service to service without ever receiving the level of care that they need,” she said.
She also noted that while forthcoming legislation aimed to improve mental health care, "this can’t be addressed by legislation alone as there simply aren’t the resources to fix these issues.”
The new laws, if passed, would give patients more power over their care, ensure relatives are included in discussions, and introduce shorter limits to the length of time people with learning difficulties or autism can be detained.
The CQC report also found inappropriate out-of-area placements, where patients were admitted to services far from home for treatment, increased by 25% on the previous year, up to 5,500.
The report highlighted concerns about the quality of ward environments, noting that there were often not enough beds available. In some cases, bed shortages meant patients were placed in seclusion rooms—sparse spaces with limited furnishings not designed for long-term use. In another service, 16 patients were allocated to a 12-bed ward, meaning that four – who were either being treated voluntarily or were on overnight leave – did not have a bed to return to.
Marjorie Wallace, the chief executive of the mental health charity Sane, said sectioned people were “still being shunted around the country like unwanted parcels.”
“Callers to our helpline, SANEline, report they are told there are no beds available locally and crisis and intervention teams are full to capacity,” she said.
Dr. Sarah Hughes, CEO of Mind, stated that fundamental issues in staffing levels, bed capacity, and hospital conditions were severely impacting recovery. “Isolating people and holding them in crumbling, outdated facilities is the very opposite of dignified, humane care,” she said. “In some cases, people with mental health problems can’t even get outside to a monitored courtyard for fresh air due to such low staffing levels.”
Brian Dow, the deputy chief executive of the charity Rethink Mental Illness, said the report provided “yet more evidence that our mental health system is at breaking point.”
With demand for mental health services continuing to rise, many experts stress the need for increased investment in staffing, facilities, and community-based support to ensure timely and effective care for those in crisis.
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