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.
Black Sabbath have paid tribute to their former frontman Ozzy Osbourne after the megastar died at the age of 76.
Osbourne’s death on Tuesday morning was announced in a statement, which said he died surrounded by his family.
His death came just weeks after he reunited with his Black Sabbath bandmates – Tony Iommi, Terence “Geezer” Butler and Bill Ward – and performed a huge farewell concert for fans.
The band paid tribute to him on Instagram by sharing an image of Osbourne on stage at the farewell gig in Birmingham and writing “Ozzy Forever”.
Ozzy Osbourne’s life in pictures
Iommi, the band’s lead guitarist, said he was in disbelief at the news.
“It’s just such heartbreaking news that I can’t really find the words, there won’t ever be another like him. Geezer, Bill and myself have lost our brother.”
Please use Chrome browser for a more accessible video player
Watch: Ozzy’s last concert
Butler, Black Sabbath’s bassist and primary lyricist, thanked Osbourne for “all those years – we had some great fun”.
He said: “Four kids from Aston – who’d have thought, eh? So glad we got to do it one last time, back in Aston. Love you.”
The original drummer for Black Sabbath, Bill Ward, posted a picture of him and Osbourne on Facebook saying: “Where will I find you now? In the memories, our unspoken embraces, our missed phone calls, no, you’re forever in my heart.”
Osbourne with his wife Sharon during the 46th Annual Grammy Awards. Pic: AP
Sir Elton John described Osbourne as his “dear friend” and a “huge trailblazer” who “secured his place in the pantheon of rock gods”.
“He was also one of the funniest people I’ve ever met,” the singer wrote on Instagram.
Ronnie Wood, of The Rolling Stones, wrote: “I am so very sad to hear of the death of Ozzy Osbourne. What a lovely goodbye concert he had at Back To The Beginning in Birmingham.”
Born John Michael Osbourne on 3 December 1948 in Aston, Birmingham, he became known as the godfather of heavy metal.
The self-styled Prince of Darkness pioneered the music genre with Black Sabbath before going on to have huge success in his own right.
He was famous for hits including Iron Man, Paranoid, War Pigs, Crazy Train and Changes, both with the band and as a solo star.
Legendary American heavy metal band Metallica shared an image of them with Osbourne from 1986 along with an emoji of a broken heart.
Posting on Instagram, Sir Rod Stewart said: “Sleep well, my friend. I’ll see you up there – later rather than sooner.”
Queen guitarist Sir Brian May said he was “grateful I was able to have a few quiet words” with Osbourne after his farewell show at Villa Park three weeks ago.
He said the world will miss the singer’s “unique presence and fearless talent”.
Foo Fighters said in a social media post: “Rock and Roll would not be as loud or as fun” without Osbourne, while Led Zeppelin front man Robert Plant wrote he had “truly changed the planet of rock”.
UK
Ozzy Osbourne obituary: Heavy metal, reality TV, and biting bats – the wild life of Birmingham’s Prince Of Darkness
“You’ve no idea how I feel – thank you from the bottom of my heart,” an emotional Ozzy Osbourne told fans as he performed from a throne on stage at his beloved Villa Park, reunited with Black Sabbath, less than three weeks ago.
It was an exit on his own terms by heavy metal’s biggest character, with a supporting line-up of hard rock luminaries including Slayer, Metallica and Guns’n’Roses, all inspired by his music.
With Black Sabbath, Osbourne was at the forefront of heavy metal. As Ozzy, he was one of the biggest rock stars in the world. Nowhere was this more evident than at the Back To The Beginning in his home city, where 40,000 fans gathered to see the show billed as his “final bow”.
Please use Chrome browser for a more accessible video player
Ozzy’s final show
“Without Sabbath, there would be no Metallica,” frontman James Hetfield told the crowd in Birmingham.
It was a sentiment echoed by many of the other acts who performed on stage. Announced by his wife Sharon earlier this year, the show was a chance for the performer to reunite with Black Sabbath and say thank you and farewell to fans after years of health problems, including Parkinson’s disease, which had forced him to cancel recent tour shows.
Other celebrities, from Sir Elton John to Dolly Parton, sent video messages of support. Fans knew it would be his last performance, but could not have known his death, at the age of 76, would come so soon.
It was a truly metal goodbye.
Black Sabbath in the 1970s. Pic: Everett/Shutterstock
‘I think there’s a wild man in everybody’
John Michael Osbourne was born in Solihull in December 1948 and grew up in the Aston area of the West Midlands city.
As a teenager, he was bullied at school. Drink and drugs later became a way to escape his fears, he said in interviews, and after leaving school at 15, he worked several jobs, including labouring and in an abattoir.
It was hearing The Beatles, he said, that made him want to be a musician.
“I think there’s a wild man in everybody,” he says in a resurfaced interview clip. “Ozzy Osbourne and John Osbourne is two different people. John Osbourne is talking to you now.” His eyes widen a little manically, he grins, the voice cranks up. “But if you want to be Ozzy Osbourne, it’s like… it just takes over you.”
(L-R) Tony Iommi, Ozzy Osbourne and Geezer Butler of Black Sabbath at the Grammys in 2014
In 1967, he was recruited to the band that two years later would become Black Sabbath, inspired by a film of the same title. This was a line-up of four working-class schoolfriends – Tony Iommi, Bill Ward and Geezer Butler, alongside Ozzy – who twisted heavy blues into something darker, creating a sound and otherworldly image that felt new, exciting and rebellious.
A self-titled debut album was released in 1970 and made the Top 10 in the UK. The follow-up, Paranoid, released just seven months later, topped the charts after the single of the same name became their big breakthrough. The album also included the unforgettable Iron Man and the anti-war protest song War Pigs – its unmistakeable riff inspiring the Arctic Monkeys’ 2014 single, Arabella.
Black Sabbath went on to release six more albums with Osbourne at the helm before he was fired in 1979 due to his drinking and substance use, something he claimed was no better or worse than other members at the time.
Osbourne in 1978. Pic: Andrew Kent/Retna/Mediapunch/Shutterstock
In 1980, he returned with his debut solo album, Blizzard Of Oz, and the lead single Crazy Train. As a solo artist, he went on to release 13 studio albums – the last being Patient Number 9, in 2022 – and had hits with songs including Mr Crowley, Diary Of A Madman, No More Tears, Bark At The Moon and Shot In The Dark.
His first UK number one was a re-recording of the Black Sabbath ballad Changes, as a duet with his daughter, Kelly, in 2003, and his collaborations over the years included everyone from Alice Cooper (Hey Stoopid in 1991) and Post Malone (Take What You Want in 2019) to, in a somewhat unusual move, Hollywood star Kim Basinger for a re-recording of the dance hit Shake Your Head by Was (Not Was) in 1992.
With Black Sabbath and as a solo star, he is estimated to have sold 100 million records throughout his career – for context, this is reportedly on a par with Sir Paul McCartney’s solo sales – so the numbers speak for themselves.
With daughter Kelly Osbourne and wife Sharon in 2020. Pic: AP
Biting the bat
Osbourne was also a huge personality and played up to his hellraising image – the Prince of Darkness.
The most famous Ozzy story goes like this.
The singer was on stage in Des Moines, Iowa, 1982, when the bat appeared. He assumed it was a toy. So, like any good hellraiser would do, he bit its head off.
Pic: Chris Pizzello/Invision/AP
For more than 40 years, he found himself jokily fielding questions about bats. What do they taste like? (Salty). What happened afterwards? (Headline news, painful rabies shots). Do you have any pets? (Yes. They’re all dead).
“I get a lot of weird people at my concerts,” he told David Letterman in 1982, of how the animal came to appear in front of him. “It’s rock ‘n’ roll, y’know”.
He was sometimes irritated by the bat connection. But he also played up to the image, recounting the story in interviews, offering plush bat toys among his merch, and appearing as himself, biting a bat, in the 2000 Adam Sandler comedy Little Nicky, about the son of Satan.
Known for catapulting raw meat at fans during gigs, there were plenty of other tales of darkness and debauchery. Osbourne’s wild persona and on-stage theatrics always went hand-in-hand with the music.
From Prince of Darkness to reality TV
He was famously managed by his wife, Sharon, whom he first met when her dad, Don Arden, was managing Black Sabbath. As well as the music, Sharon and Ozzy together founded the Ozzfest festival tours in 1996 – and in 2002 came his second act.
It’s hard to imagine it now, but before the perfectly coiffed Kardashians it was a scruffy 50-something rocker from Birmingham and his family who ruled the Hollywood reality TV scene. As with his music, he was a pioneer – this time round of a new era of addictive viewing.
The Osbournes followed the lives of Ozzy and Sharon and two of their children, Kelly and Jack (their eldest daughter, Aimee, famously had nothing to do with the show), and the family fallouts and sunny California culture clash proved to be a ratings winner. The MTV series catapulted the metal star to global mainstream celebrity heights.
His marriage to Sharon was tumultuous but the pair always stayed together, and they renewed their wedding vows in 2017. Sharon was the driving force behind Ozzy’s successes, to him eventually getting clean, and behind his farewell show.
Metallica frontman James Hetfield was among those who paid tribute at his final gig earlier in July. Pic: Ross Halfin
Despite weathering the storm of drink and drug use, Osbourne’s air of indestructibility was challenged when a quad bike accident left him with a broken collar bone and ribs, as well as short-term memory loss, in 2003.
The 2020 documentary Biography: The Nine Lives Of Ozzy Osbourne, had summed up with its title the performer’s seeming ability to defy the odds. However, the health problems started to mount up. Scheduled tours were postponed, and in 2023 he told fans holding on to tickets that he had come to the realisation he was “not physically capable” of dealing with life on the road.
But there was one gig he couldn’t miss – a surprise appearance to close the Commonwealth Games in his home city in 2022, just weeks after undergoing surgery.
Now, fans will remember the shows they did get to see, the music that ushered in a new genre – and especially his most recent gig, which was said to have raised around £140m for charities. Just a few days afterwards, his new memoir, Last Rites, was announced. It will be released in October.
Ozzy Osbourne’s star on the ‘Birmingham Walk of Stars’
During his career, Osbourne was inducted into the UK Music Hall of Fame and the US Rock And Roll Hall Of Fame – twice for both, with Black Sabbath and as a solo artist. “Countless artists from many genres have credited Ozzy as a major influence, including Metallica, Lita Ford, Rage Against The Machine, and Busta Rhymes,” reads his US citation. “With his longevity, impact, and iconic persona, Ozzy Osbourne is a phenomenon unlike any other.”
He also has a star on the Hollywood Walk Of Fame – as well as in Birmingham’s Broad Street – an Ivor Novello, and five Grammy wins from 12 nominations.
But other honours, such as the NME’s Godlike Genius award, and Classic Rock’s Living Legend, also give a sense of how much his personality played a part in why he is so beloved by fans and critics alike. In the Nine Lives documentary, daughter Kelly describes him as “the most irresistible mad man you will ever meet in your life”.
Osbourne’s was an unlikely journey from Birmingham to LA. He was a working-class hero of heavy metal, a reality TV favourite – forever the Prince of Darkness.
“People say to me, if you could do it all again, knowing what you know now, would you change anything?” he once said. “I’m like, f*** no… If I’d done normal, sensible things, I wouldn’t be Ozzy.”
London and the UK’s leading status in the global financial system is “fragile”, the boss of Goldman Sachs has warned, as the government grapples with a tough economy.
Speaking ahead of a meeting with the prime minister, David Solomon – chairman and chief executive of the huge US investment bank – told Sky News presenter Wilfred Frost’s The Master Investor Podcast of several concerns related to tax and regulation.
He urged the government not to push people and business away through poor policy that would damage its primary aim of securing improved economic growth, arguing that European rivals were currently proving more attractive.
Money latest: Mortgage shake-up to save ‘time and money’
He said: “The financial industry is still driven by talent and capital formation. And those things are much more mobile than they were 25 years ago.
“London continues to be an important financial centre. But because of Brexit, because of the way the world’s evolving, the talent that was more centred here is more mobile.
“We as a firm have many more people on the continent. Policy matters, incentives matter.
“I’m encouraged by some of what the current government is talking about in terms of supporting business and trying to support a more growth oriented agenda.
“But if you don’t set a policy that keeps talent here, that encourages capital formation here, I think over time you risk that.”
He had a stark warning about the recent reversal of the “Non Dom” tax policy, which occurred across both the prior Conservative government and the current Labour government, which has played a part in some senior Goldman partners relocating away from London.
Please use Chrome browser for a more accessible video player
Chancellor will not be drawn on wealth tax
Richard Gnodde, one of the bank’s vice-chairs, left for Milan earlier this year.
“Incentives matter if you create tax policy or incentives that push people away, you harm your economy,” Mr Solomon continued.
“If you go back, you know, ten years ago, I think we probably had 80 people in Paris. You know, we have 400 people in Paris now… And so in Goldman Sachs today, if you’re in Europe, you can live in London, you can live in Paris, you can live in Germany, in Frankfurt or Munich, you can live in Italy, you can live in Switzerland.
“And we’ve got, you know, real offices. You just have to recognise talent is more mobile.”
Goldman is understood to have about 6,000 employees in the UK.
Rachel Reeves is currently seeking ways to fill a black hole in the public finances and has refused to rule out wealth taxes at the next budget.
Mr Solomon expressed sympathy for her as her tears in parliament earlier this month led to speculation about the pressure of the job.
“I have sympathy, I have empathy not just for the chancellor, but for anyone who’s serving in one of these governments,” he said, referring to the turbulent political landscape globally.
Commenting on the chancellor’s Mansion House speech last week, he added: “The chancellor spoke here about regulation, she’s talking about regulation not just for safety and soundness, but also for growth.
Please use Chrome browser for a more accessible video player
Takeaways from chancellor’s Mansion House speech
“And now we have to see the action steps that actually follow through and encourage that.”
One area he was particularly keen to see follow through from her Mansion House speech was ringfencing – the post financial crisis regulation that requires banks to separate their retail activities from their investment banking activities.
“It’s a place where the UK is an outlier, and by being an outlier, it prevents capital formation and growth.
“What’s the justification for being an outlier? Why is this so difficult to change? It’s hard to make a substantive policy argument that this is like a great policy for the UK. So why is it so hard to change?”
The Master Investor Podcast with Wilfred Frost is available across multiple podcast platforms
-
Sports3 years ago‘Storybook stuff’: Inside the night Bryce Harper sent the Phillies to the World Series
-
Sports1 year agoStory injured on diving stop, exits Red Sox game
-
Sports2 years agoGame 1 of WS least-watched in recorded history
-
Sports2 years agoMLB Rank 2023: Ranking baseball’s top 100 players
-
Sports4 years ago
Team Europe easily wins 4th straight Laver Cup
-
Sports2 years agoButton battles heat exhaustion in NASCAR debut
-
Environment2 years agoJapan and South Korea have a lot at stake in a free and open South China Sea
-
Environment2 years agoGame-changing Lectric XPedition launched as affordable electric cargo bike