Mental health cases at A&E reach crisis level – as waits get longer and specialised beds dwindle
“We’ve got two,” explains Emer Szczygiel, emergency department head of nursing at King George Hospital, as she walks inside a pastel coloured room.
“If I had my time back again, we would probably have four, five, or six because these have helped us so much in the department with the really difficult patients.”
On one wall, there’s floral wallpaper. It is scored through with a graffiti scrawl. The words must have been scratched out with fingernails.
There are no other implements in here.
Patients being held in this secure room would have been searched to make sure they are not carrying anything they can use to harm themselves – or others.
Emer Szczygiel wishes the hospital had more of the ‘ligature light’ mental health rooms
There is a plastic bed secured to the wall. No bedding though, as this room is “ligature light”, meaning nothing in here could be used for self harm.
On the ceiling, there is CCTV that feeds into a control room on another part of the Ilford hospital’s sprawling grounds.
“So this is one of two rooms that when we were undergoing our works, we recognised, about three years ago, mental health was causing us more of an issue, so we’ve had two rooms purpose built,” Emer says.
“They’re as compliant as we can get them with a mental health room – they’re ligature light, as opposed to ligature free. They’re under 24-hour CCTV surveillance.”
The rooms have a CCTV camera in the ceiling that feeds through to the main control room
There are two doors, both heavily reinforced. One can be used by staff to make an emergency escape if they are under any threat.
What is unusual about these rooms is that they are built right inside a busy accident and emergency department.
The doors are just feet away from a nurse’s station, where medical staff are trying to deal with acute ED (emergency department) attendances.
The number of mental health patients in a crisis attending A&E has reached crisis levels.
Some will be experiencing psychotic episodes and are potentially violent, presenting a threat to themselves, other patients, clinical staff and security teams deployed to de-escalate the situation.
The team were already dealing with five mental health cases when Sky News visited
Like physically-ill patients, they require the most urgent care but are now facing some of the longest waits on record.
On a fairly quiet Wednesday morning, the ED team is already managing five mental health patients.
One, a diminutive South Asian woman, is screaming hysterically.
She is clearly very agitated and becoming more distressed by the minute. Despite her size, she is surrounded by at least five security guards.
She has been here for 12 hours and wants to leave, but can’t as she’s being held under the Mental Capacity Act.
Her frustration boils over as she pushes against the chests of the security guards who encircle her.
“We see about 150 to 200 patients a day through this emergency department, but we’re getting on average about 15 to 20 mental health presentations to the department,” Emer explains.
“Some of these patients can be really difficult to manage and really complex.”
Emer Szczygiel says the department gets about 15 to 20 mental health presentations a day
“If a patient’s in crisis and wants to harm themselves, there’s lots of things in this area that you can harm yourself with,” the nurse adds.
“It’s trying to balance that risk and make sure every emergency department in the country is deemed a place of safety. But there is a lot of risk that comes with emergency departments, because they’re not purposeful for mental health patients.”
In a small side room, Ajay Kumar and his wife are waiting patiently by their son’s bedside.
He’s experienced psychotic episodes since starting university in 2018 and his father says he can become unpredictable and violent.
Ajay and his wife were watching over their son, who’s been having psychotic episodes
Ajay says his son “is under a section three order – that means six months in hospital”.
“They sectioned him,” he tells us.
“He should be secure now, he shouldn’t go out in public. Last night he ran away [from hospital] and walked all the way home. It took him four and a half hours to come home.
“I mean, he got three and a half hours away. Even though he’s totally mental, he still finds his way home and he was so tired and the police were looking for him.”
Mr Kumar said his son ran away from hospital and walked for hours to get home
Now they are all back in hospital and could be waiting “for days”, Ajay says.
“I don’t know how many. They’re not telling us anything.”
Matthew Trainer, chief executive of Barking, Havering and Redbridge University Hospitals NHS Trust, is at pains to stress nobody is blaming the patients.
“We’ve seen, particularly over the last few years, a real increase in the number of people in mental health crisis coming into A&E for support,” he says.
“And I don’t know if this is because of the pandemic or wider economic pressures, but what we’re seeing every day is more and more people coming here as their first port of call.”
‘More and more’ people in mental health crisis are showing up at A&E, says Mr Trainer
The hospital boss adds: “If you get someone who’s really distressed, someone who is perhaps experiencing psychosis etc, I’m seeing increasing numbers of complaints from other patients and their families about the environment they’ve had to wait in.
“And they’re not blaming the mental health patients for being here.
“But what they’re saying is being in a really busy accident & emergency with ambulances, with somebody highly distressed, and you’re sat there with an elderly relative or a sick child or whatever – it’s hard for everyone.
“There’s no blame in this. It’s something we’ve got to work together to try to fix.”
New Freedom of Information data gathered by the Royal College of Nursing shows that over the last five years, more than 1.3 million people in a mental health crisis presented to A&E departments.
That’s expected to be a significant underestimate however, as only around a quarter of English trusts handed over data.
For these patients, waits of 12 hours or more for a mental health bed have increased by more than 380%.
Over the last decade, the number of overnight beds in mental health units declined by almost 3,700. That’s around 17%.
The Department for Health and Social Care told Sky News: “We know people with mental health issues are not always getting the support or care they deserve and incidents like this are unacceptable.
“We are transforming mental health services – including investing £26m to support people in mental health crisis, hiring more staff, delivering more talking therapies, and getting waiting lists down through our Plan for Change.”
Claire Murdoch, NHS England’s national mental health director, also told Sky News: “While we know there is much more to do to deal with record demand including on waits, if a patient is deemed to need support in A&E, almost all emergency departments now have a psychiatric liaison team available 24/7 so people can get specialist mental health support alongside physical treatment.
“The NHS is working with local authorities to ensure that mental health patients are given support to leave hospital as soon as they are ready, so that space can be freed up across hospitals including A&Es.”
Patients in a mental health crisis and attending hospital are stuck between two failing systems.
A shortage of specialist beds means they are left untreated in a hospital not designed to help them.
And they are failed by a social care network overwhelmed by demand and unable to provide the early intervention care needed.
Migrant sex offender Hadush Kebatu has been deported to Ethiopia following his mistaken release from prison.
Footage captured from Heathrow Airport showed the moment he was escorted on to a plane on Tuesday night.
The government says he has no right to return to the UK.
Home Secretary Shabana Mahmood said she “pulled every lever” to deport Kebatu.
“I am pleased to confirm this vile child sex offender has been deported. Our streets are safer because of it,” she said.
Hadush Kebatu was arrested on Sunday after his mistaken release
Kebatu was found and arrested by the Metropolitan Police in the Finsbury Park area of north London at around 8.30am on Sunday following a manhunt.
Last month he was found guilty of sexually assaulting a schoolgirl and a woman in Epping, Essex, just over a week after arriving in the UK on a small boat.
He was expected to be deported, but instead of being handed over to immigration officials he was released from HMP Chelmsford on Friday.
He spent just under 48 hours at large before he was apprehended.
The accidental release sparked widespread alarm and questions over how a man whose crimes sparked protests in Epping over the use of asylum hotels was able to be freed.
Ms Mahmood said: “Last week’s blunder should never have happened – and I share the public’s anger that it did.”
Anti-asylum demonstrators in Epping, Essex. Pic: PA
On Sunday, Justice Secretary David Lammy said an exclusive Sky News interview will be used as part of an independent inquiry into the mistaken release.
Speaking to Sky’s national correspondent Tom Parmenter, a delivery driver who spoke to Kebatu at HMP Chelmsford described him as being “confused” as he was being guided to the railway station by prison staff.
The migrant is said to have returned to the prison reception four or five times before leaving the area on a train heading to London.
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‘My family feels massively let down’
Mr Lammy, who put Kebatu’s release down to human error, said he ordered an “urgent review” into the checks that take place when an offender is released from prison, and new safeguards have been added that amount to the “strongest release checks that have ever been in place”.
From Monday, new checks include five pages of instructions and demands that more senior prison staff sign off a release, according to documents obtained by Sky News.
“I have been clear from the outset that a mistake of this nature is unacceptable, and we must get to the bottom of what happened,” said Mr Lammy.
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Up to 8,000 holidaying British citizens are in Jamaica as it is battered by one of the strongest Atlantic hurricanes in history.
People have been ordered to stay indoors as Hurricane Melissa sweeps over the Caribbean island, which is also home to 50,000 dual nationals.
And tourists are locked down in hotels as Jamaica is hit by 185 mph winds.
Follow latest updates on Hurricane Melissa
Waves splash in Kingston, Jamaica, as Hurricane Melissa hits. Pic: AP
Andrew Tracey had been due to fly home to the UK on Monday, but his flight was cancelled.
Mr Tracey told Sky News that food packages were being delivered to guests at his hotel. Deck chairs have been removed from the beach, and the swimming pools have been drained, at the Negril hotel where he is staying.
“The balcony and walls do feel as though they are vibrating just due to the strength of the wind,” said Mr Tracey.
“I’m very nervous, it’s hard to comprehend what we are likely to expect.”
The US National Hurricane Centre in Miami said that Melissa was “one of the most powerful hurricane landfalls on record in the Atlantic basin” as it hit southwestern Jamaica near New Hope.
People walk along a road during the passing of Hurricane Melissa in Rocky Point, Jamaica, on Tuesday. Pic: AP
In a social media post, the centre warned that it is an “extremely dangerous and life-threatening situation” – and told those in the area not to leave their shelter as the eye of the storm passes over.
‘It is a bit scary, but we’ve got each other’
A British-Jamaican couple who are sheltering inside as the storm passes over the island spoke to Sky News about their ordeal.
Shantell Nova Rochester and her Jamaican fiance Denva Wray are due to get married on the island next month.
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Floods tear through parts of Jamaica
They spoke of broken windows and water coming in where they are staying, but the couple believe they are “as safe as they can possibly be” in St Elizabeth.
Mr Wray said: “Where we are is quite strong, sturdy, but you can hear a lot of wind. It is a bit scary, but we’ve got each other, so we are strong.”
Asked about the wedding, Ms Rochester said: “We’re just worried about getting through tomorrow, but that’s a worry in the back of our heads.
“Where we plan to get married is flooded at this time.”
Government action ‘too late’ – British tourist
One British man who paid £3,500 for last-minute flights so he and his family could return home before the hurricane hit the island said that he felt “completely let down” by the government’s response.
David Rowe and his family, from Hertfordshire, had spent 10 days in Jamaica before deciding to fly back to the UK on Saturday.
Mr Rowe, 47, was critical of the response of the Foreign, Commonwealth and Development Office (FCDO).
David Rowe with his wife Abby, daughter Cora, eight, and son Ethan, 12, during their holiday in Jamaica. Pic: PA/handout
Speaking to the PA news agency, IT manager Mr Rowe said: “It’s all too late, their reaction and their response to the storm has been too late – after the fact.
“The advice should have been last week, like on the Saturday – don’t travel – because a lot of the travel companies use the FCDO guidance on travel (for) all their planning and what decisions they make as an organisation.
“There should have been something done much sooner than this. A lot of the UK nationals, and people on holiday there, they are stranded.
“This could have been prevented with better action from the UK government.”
Read more:
Hurricane Melissa: What we know
‘Storm of century’ makes landfall
Mr Rowe added that he and his wife had felt “very anxious” before they flew home – and “very sad” for those left in the country.
A Foreign Office spokesperson said: “We understand how worrying developments in Jamaica are for British nationals and their families.
“Our travel advice includes information about hurricane season, which runs from June to November. Last Thursday we updated our travel advice for Jamaica to include a warning about Tropical Storm Melissa and that it was expected to intensify over the coming days.
“The safety and security of British nationals is our top priority, and that is why we are urging any British nationals in Jamaica to follow the guidance of the local authorities and register their presence with us to receive updates.”
The government’s decision to slash foreign aid will lead to unrest, further crises and threaten UK security, a group of cross-party MPs has warned.
A report by the International Development Committee found the decision in February to reduce aid to 0.3% of gross national income (GNI) by 2027/28 – coupled with the US cutting its aid budget – is having a severe impact.
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The foreign aid budget was cut to invest in defence from 0.5% of GNI, which was meant to be an interim reduction from 0.7% to cope with economic challenges caused by the pandemic.
Total aid spending is set to reduce from £14.1bn in 2024 to £9.4bn by 2028/29.
The committee, chaired by Labour MP Sarah Champion, said spending is being prioritised on humanitarian aid over development, which “builds long-term resilience and should lead to reducing the need for humanitarian aid”.
They said the international development minister, Baroness Chapman, has made it clear “the UK will remain a leading humanitarian actor”.
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Explained: Key Sudan city falls
But the committee said while they are glad those in “desperate need of aid will be prioritised, particularly in the regions of Ukraine, Gaza, and Sudan”, they are concerned about the long-term effect of pulling development aid.
“We are concerned that slashing development aid will continue to lead to unrest and further crises in the future, presenting a threat to UK security,” the MPs said.
David Lammy, when he was foreign secretary, on a visit to Chad to see how aid agencies are dealing with the humanitarian crisis. Pic: PA
Risk to UK’s national security
They said a reduction in foreign aid will have “devastating consequences across the world”.
The committee said it recognises an increase in defence spending is needed, but “to do this at the expense of the world’s most vulnerable undermines not only the UK’s soft power, but also its national security”.
They said the government must make “every effort” to return to spending 0.5% of GNI on foreign aid “at a minimum, as soon as possible”.
The committee also found long-term funding for development is “essential” to ensure value for money is achieved.
However, they accused the government of seeing value for money only in terms of the taxpayer, saying that downplays “equity and the importance of poverty reduction” and causes tension.
They agreed accountability to the taxpayer is “key to reducing poverty globally, and maximising the impact of each pound to do so, must remain the Foreign, Commonwealth and Development Office’s central tenet for official development assistance spending”.
A Foreign Office team member helping evacuees in Cyprus in 2023. File pic: Reuters
Spending on migrant hotels
Spending on migrant hotels in the UK was also criticised by the MPs, who said while international aid rules mean they can cover refugee hosting for the first 12 months in the UK, given the recent cuts, that is “incompatible with the spirit” of the UN’s OECD Development Assistance Committee rules.
“Excessive spend on hotel costs is not an effective use of development budget,” they said.
The committee recommended costs of housing refugees should be capped “at a fixed percentage” of total foreign aid spending “to protect a rapidly diminishing envelope of funding”.
Read more: Govt struggles to slash aid spent on asylum hotels
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‘Short-sighted’
Reacting to the report, Timothy Ingram, head of UK advocacy at WaterAid, said: “The UK government’s decision to cut the aid budget was one that defied both logic and humanity. Aid when delivered effectively in partnership with local communities is not charity – it’s an investment in a safer and more prosperous world.
“Undermining it, especially vital finance for water, weakens the world’s resilience to climate shocks, pandemics, and conflict – impacting the one in 10 people without access to clean water, and ultimately making us all less safe.
“This is a short-sighted political decision with long-term consequences for the UK’s stability, economy and global standing. We join with MPs in urging the government, once again, to urgently reconsider.”
Lack of transparency over private contractors’ spending
In the report, MPs said it is worried the Foreign Office has not reviewed aid spending on multilateral organisations, which allows the UK less direct influence over spending, such as the World Bank or vaccine organisation Gavi since 2016, despite spending nearly £3bn on them in 2024.
They said the use of private contractors does not offer inherently poor value for money, but a lack of transparency and data can mean under-delivering and a loss of “in-house” expertise.
Palestinians carry aid supplies that entered Gaza. Pic: Reuters
‘Tragic error’
Sarah Champion, chair of the International Development Committee, said: “Ensuring aid delivers genuine value for money has never been more important. As major donors tighten their belts, we have to ensure that every penny we spend goes to the people most in need.
“The former Department for International Development was rightly seen as a world leader in value for money; the FCDO is broadly hanging on to that reputation. But it must make some urgent improvements.
“Reducing poverty must be the central aim of the development budget. While accountability to the taxpayer is an important consideration, the FCDO’s current definition of value for money risks diverting focus away from improving the lives of the most vulnerable – the very reason the aid budget exists at all.
“The savage aid cuts announced this year are already proving to be a tragic error that will cost lives and livelihoods, undermine our international standing and ultimately threaten our national security. They must be reversed.
“Value for money is critical to making the most of a shrinking aid budget. While this report finds some positives, the government must take urgent action to wipe out waste and ensure the money we are still spending makes a genuine difference.”
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