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.
Two senior Labour MPs have suggested the prime minister may have to go within months if the government continues to perform poorly.
Sky News’ deputy political editor Sam Coates said his sources – a member of the government and a prominent politician – have “put Sir Keir Starmer on notice”.
Both warned that, if Labour performs badly in next May’s elections across Wales, Scotland and London, it could mark the end of his time in Downing Street.
Coates added: “The level of unhappiness and despair in parts of the Labour Party is so striking that right now, on the first anniversary, I am hearing from ministers in government that Starmer might have to go in months.”
Reform UK is surging in the polls in Wales, while Labour faces a threat from left-wing parties such as the Greens in London.
It comes as the prime minister made it clear that Rachel Reeves has his “complete support” as chancellor and remains integral to his project, Sky News’s political editor Beth Rigby understands.
She looked visibly upset during Prime Minister’s Questions, with a spokesperson claiming she had been affected by a “personal matter”.
A day earlier, Sir Keir’s controversial welfare bill was passed despite a sizeable rebellion from Labour MPs, with major U-turns meaning a new £5bn black hole has appeared in the country’s finances.
One senior figure told Rigby that the pair were as “as close politically” as any chancellor and prime minister have ever been.
“She is going absolutely nowhere,” they added.
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Welfare vote ‘a blow to the prime minister’
Ms Reeves’s tears sent markets spiralling, with the value of the pound and long-term government bonds falling sharply.
Later in the day Sir Keir, said Ms Reeves will be chancellor for a “very long time to come”.
The prime minister said it was “absolutely wrong” to suggest her tearful appearance in the Commons related to the welfare U-turn.
“It’s got nothing to do with politics, nothing to do with what’s happened this week. It was a personal matter for her,” he said while speaking to the BBC’s podcast Political Thinking with Nick Robinson.
“I’m not going to intrude on her privacy by talking to you about that. It is a personal matter.”
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Asked if she will remain in post, he said: “She will be chancellor by the time this is broadcast, she will be chancellor for a very long time to come, because this project that we’ve been working on to change the Labour party, to win the election, change the country, that is a project which the chancellor and I’ve been working on together.”
He said Ms Reeves has done a “fantastic job” and added: “She and I work together, we think together. In the past, there have been examples – I won’t give any specific – of chancellors and prime ministers who weren’t in lockstep. We’re in lockstep.”
Wes Streeting, the health secretary, also offered a strong defence for the prime minister and chancellor.
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Health Secretary: Reeves is ‘resilient’
He told Sky News this morning that Sir Keir has been “consistently underestimated” and was “of course” safe as prime minister.
And he said Ms Reeves was a “tough character” who was ” resilient” and “here to stay”.
Despite making “significant improvements”, Greater Manchester Police (GMP) has lost the “trust and confidence” of some victims of grooming gangs, according to a report by the police watchdog.
Michelle Skeer, His Majesty’s Inspector of Constabulary, said that since 2019, when GMP started to review its non-recent child sexual exploitation investigations, “the force has improved its understanding and approach to investigating allegations of child criminal and sexual exploitation”.
The document, published today, said police have live investigations into “multi-victim, multi-offender” child sexual exploitation inquiries, involving 714 victims and survivors, and 1,099 suspects.
Grooming gangs scandal timeline
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‘Our chance for justice’
But despite recording improvements, a report by His Majesty’s Inspectorate of Constabulary and Fire & Rescue Services (HMICFRS) also identified:
• Various training gaps within the investigation team
• Lack of consistency in evaluating case files between social care, health and police
• Failures to initially support victims meant they had “lost trust and confidence” in police
The report was commissioned by the Mayor of Greater Manchester Andy Burnham in 2024 to evaluate whether police, councils and health services can protect children from sexual exploitation in the future.
Its release comes days after Sir Keir Starmer announced he was launching a new national inquiry into grooming gangs after previously arguing one was not necessary,
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Starmer to launch new grooming gang inquiry
The findings were issued as the final part of the CSE (child sexual exploitation) Assurance Review process which started in 2017. The first three reports examined non-recent child sexual exploitation in Manchester, Oldham and Rochdale.
Mr Skeer said that the force has been trying to improve its service to those who have experienced sexual exploitation, but previous failings have badly affected trust in GMP.
He said: “For some, trust and confidence in the police had been lost, and the force would not be able to rectify their experiences.
“It is vital that improvements are led by victims’ experiences, and if they do come forward, they are supported, protected and taken seriously.”
A recent report by Baroness Casey found a significant over-representation of Asian men who are suspects in grooming gangs in Greater Manchester, adding though authorities are in “denial” more needs to be done to understand why this is the case.
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Teen caught in child sex exploitation
Inspectors also said there were “training gaps” in some investigation teams and issues with data sharing, with local councils sometimes not willing to provide detectives with information, leading to “significant delays in investigations” into grooming gangs.
It cites problems with intelligence provided by Manchester City Council, which took months to arrive and “was so heavily redacted that some pages contained only a few words”, the report said.
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GMP is the only force in the country to set up a dedicated team to investigate grooming gangs. Called the Child Sexual Exploitation Major Investigation Team (CSE MIT) it has about 100 staff and a ringfenced budget.
In October 2024, the force told inspectors there were 59 live multi-victim, multi-offender child sexual exploitation investigations, of which 13 were being managed by the CSE MIT.
The report adds: “The force fully accepts that it made mistakes in the past.
“It has taken positive and effective steps to learn from these mistakes and improve how it investigates recent and non-recent child sexual exploitation.”
Separately, the Baird Inquiry published in July 2024 found officers at GMP were abusing their power – making unlawful arrests, unlawful and demeaning strip searches, sometimes treating victims as perpetrators, and traumatising those who have suffered sexual abuse or domestic violence.
The health secretary has offered a strong defence of the prime minister and chancellor – ahead of Sir Keir Starmer setting out his 10-year vision for the NHS.
PM ‘might have to go in months’ – politics latest
Wes Streeting dismissed suggestions the prime minister could be forced out in months following the toughest week of his premiership yet, and described Rachel Reeves as “resilient” and would “bounce back” following her tearful appearance in the Commons on Wednesday.
Overnight, two senior sources – a member of the government and a prominent politician – told Sky News’ deputy political editor Sam Coates that they had “put Sir Keir Starmer on notice”.
The health secretary, who was speaking as Sir Keir prepares to set out his 10-year vision for the NHS, said the prime minister had been “consistently underestimated”.
Asked by Kamali Melbourne on Sky News Breakfast whether Sir Keir was “safe”, Mr Streeting said: “Of course.
“Keir Starmer has been consistently underestimated. I wonder when people will learn.
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Reeves has ‘complete support’
“They said he couldn’t win the Labour leadership, but he did. They said he couldn’t change the Labour Party, but he did.
“They said he couldn’t take the Labour Party from its worst defeat since the 1930s to election victory last year. And he did and now the cynics say he can’t change the country, but he will.”
As for Ms Reeves – whose tearful appearance in the Commons spooked markets after the prime minister initially failed to back her, Mr Streeting said the chancellor was a “tough character” who was “resilient and she will bounce back”.
The health secretary declined to expand on why Ms Reeves was in the chamber at all yesterday, repeating that it was a personal matter.
“Rachel Reeves as chancellor is here to stay,” he continued.
“We need her to get the economy from strength to strength, to make sure that family finances are in better health than we were when we came into office.”
Speculation about the futures of the two most senior members of the government threaten to overshadow the announcement today, which the government says is “one of the most seismic shifts” in the health service’s history.
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Why has Starmer axed NHS England?
Sir Keir will pledge three main facets of the plan: moving care into the community, digitising the NHS, and a focus on sickness prevention.
The prime minister will announce neighbourhood health services will be rolled out across England to improve access to the NHS and to shift care out of overstrained hospitals.
Sir Keir has already promised thousands more GPs will be trained, and to end the 8am “scramble” for an appointment.
He also previously said his government will bring the NHS into the digital age, with “groundbreaking” new tools to support GPs rolled out over the next two years – including AI to take notes, draft letters and enter data.
And he will promise new contracts that will encourage and allow GP practices to cover a wider geographical area, so small practices will get more support.
Unite, one of the UK’s largest healthcare unions, welcomed the plan cautiously but said staff need to be the focus to ensure people are better looked after.
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‘Reform or die’
Sir Keir said: “The NHS should be there for everyone, whenever they need it.
“But we inherited a health system in crisis, addicted to a sticking plaster approach, and unable to face up to the challenges we face now, let alone in the future.
“That ends now. Because it’s reform or die.”
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Neighbourhood health services
The newly announced neighbourhood health services will provide “pioneering teams” in local communities, so patients can more conveniently access a full range of healthcare services close to home.
Local areas will be encouraged to trial innovative schemes like community outreach door-to-door to detect early signs of illness and reduce pressure on GPs and A&E.
The aim is to eventually have new health centres open 12 hours a day, six days a week to offer GP services as well as diagnostics, post-operative care and rehab.
They will also offer services like debt advice, employment support, stop smoking help or weight management.
More NHS dentists
Dentists will also be part of the plan, with dental care professionals part of the neighbourhood teams.
Dental “therapists” will carry out check-ups, treatments and referrals, while dental nurses could give education and advice to parents or work with schools and community groups.
Newly qualified dentists will be required to practice in the NHS for a minimum period, which they have said will be three years.
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