This is the story ‘Sally’ wanted us to tell:
There has been a lot of press coverage about the lack of beds, but this usually refers to beds needed in a crisis or following a Mental Health Act assessment.
My colleagues and I in community teams have been dealing with another, almost hidden, consequence of there not being enough beds.
Clozapine is the NICE guideline recommended treatment for persistent “treatment resistant” psychotic symptoms. Treatment can only be started in hospital, as the side effects can be dangerous and careful monitoring of bloods and physical health is needed. Hospital admission to start clozapine is usually planned, rather than an emergency. Consequently I’ve been trying to arrange a planned admission for a couple of people under the care of our team. Each time I think we’ve got a bed it gets cancelled, as emergencies and detained patients are understandably always given priority. This goes on for weeks and weeks. What this means though is that people are either having treatment delayed or denied, and ethically this feels wrong. I feel like I’m not living up to my professional code of conduct. We did manage to get one person admitted, but they were discharged so rapidly clozapine treatment wasn’t even started. It feels like people will only get treatment if they end up being sectioned but that goes against all the principles of the Mental Health Act.