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Fivefold increased risk of emergency admission for those with mental ill health

Findings suggest physical health of this group is inadequately managed

Caroline White

Wednesday, 14 October 2015

People with mental health issues were five times as likely to be admitted to hospital as an emergency last year as those in good mental health, finds a new study jointly published by think tank the Nuffield Trust and the Health Foundation charity.

Most of these emergency admissions were not explicitly to support mental health needs, and many were potentially preventable, the findings show, suggesting that the physical health of this group is not being adequately managed, say the authors. 

The study is published as part of the QualityWatch programme, a joint initiative tracking the quality of care in health and social care over five years.

It draws on an analysis of over 100 million hospital records in England for each of the years between 2009-10 and 2013-14.

The analysis looked at patterns of emergency and planned hospital use over this timeframe among 536,000 people who had previously been admitted with a mental health issue and 13.1 million people whose previous admission was for other reasons.

It found that people with mental ill health were 4.9 times more likely to be admitted as an emergency, and clocked up more than triple the number of A&E attendances than people in good mental health in 2013-14.

Only one in five of the emergency admissions among this group were explicitly for mental health needs.

Furthermore, the emergency admission among those with mental health issues was more than 3.5 times as likely to be potentially preventable as it was among those in good mental health.

People with mental ill health were more likely to be admitted as an emergency rather than as an elective for some common procedures. And they were more likely to be admitted overnight and stay longer in hospital.

Some 40% of hip replacements were done as an emergency, rather than as a planned, admission; this was the case for just 8% of admissions among those in good mental health.

Commenting on the findings, Holly Dorning, Research Analyst at the Nuffield Trust said: “It is striking that people with mental ill health use so much more emergency care than people without, and that so much of this isn’t directly related to their mental health needs.

“This raises serious questions about how well their other health concerns are being managed. It is clear that if we continue to treat mental health in isolation, we will miss essential care needs for these patients.”

Felicity Dormon, Senior Policy Fellow at the Health Foundation, said: “It is deeply unfair that the physical health needs of people with mental health problems continue to be poorly met. Some areas are trialling innovative approaches to tackling this pressing issue, but these approaches are not widespread. The challenge for national policy makers and local leaders is to find the will and resource to support this innovation and improve care at scale and pace.”

Nigel Edwards, Chief Executive at the Nuffield Trust said: “The higher rates of unplanned and preventable emergency admissions experienced by people with mental ill health are of national concern. But with austerity affecting both local authority and NHS mental health services, achieving parity of esteem between mental and physical health may remain an aspiration rather than a reality.”

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