New study reveals ‘striking’ disparity in emergency care use for people with mental ill health

A new studypublished by the Nuffield Trust and Health Foundation suggests that people inEngland with mental ill health are not having their physical health adequatelymanaged, despite being known to the NHS for their mental health needs. 

People withmental ill health in England had almost five times more emergency hospitaladmissions last year relative to people without; yet the vast majority of theseemergency admissions were not explicitly to support mental health needs, and aproportion of them were potentially preventable.

People withmental ill health experienced 4.9 times more emergency hospital admissions.

Drawing onanalysis of over 100 million hospital records per year, the research compareshospital use between two patient groups: people who have previously been tohospital for their mental health and people whose previous hospital use doesnot relate to mental health. The analysis looks at patterns of emergency andplanned hospital use between 2009/10 and 2013/14.

It finds that:

  • People with mental ill health experienced 4.9 times more emergency hospital admissions and 3.2 times more A&E attendances than people without mental ill health in 2013/14.
  • Despite previous experience of mental ill health, only a fifth of the emergency hospital admissions this group experienced in 2013/14 were explicitly for mental health needs.
  • People with mental ill health had 3.6 times more potentially preventable emergency admissions than those without but slightly fewer planned inpatient admissions.
  • For some common physical health procedures, people with mental ill health were more likely to have an emergency rather than planned admission, stay longer in hospital or be admitted overnight. For example, for people with mental ill health who had a hip replacement, 40% experienced an emergency rather than planned admission; whereas for people without mental ill health, just 8% of these admissions were an emergency.

Commenting onthe findings, Holly Dorning, Research Analyst at the Nuffield Trust said: “It is striking that people with mentalill health use so much more emergency care than people without, and that somuch of this isn’t directly related to their mental health needs. This raisesserious 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 willmiss essential care needs for these patients.”

FelicityDormon, Senior Policy Fellow at the Health Foundation said: “It is deeply unfair that the physicalhealth 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 policymakers and local leaders is to find the will and resource to support thisinnovation and improve care at scale and pace.”

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

The NuffieldTrust and Heath Foundation study is published as part of their five-yearQualityWatch programme. It offers a new way to measure progress towards parityof esteem between mental and physical health, a policy goal of all majorpolitical parties.

To read the fullreport, clickhere.