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Thousands left to cope alone after leaving 
Mental Health Hospital - putting their lives at risk FIGURES released  on Thursday, 13 
April 2017, by the mental health charity 
Mind, shows that 1 in 10 people discharged 
from mental health Hospital after being admitted in crisis are not getting 
follow up within a week of leaving; which is at least 11,000 people every year. 
Mind sent Freedom of Information (FoI) requests to all 56 mental health trusts 
in England (54 trusts responded) asking for information about how quickly people 
are followed up after being discharged from Hospital. Follow up; usually a face 
to face visit or a phone call; provides continued contact and ensures that the 
right ongoing support is in place. National Institute for Health and Clinical 
Excellence (NICE) guidelines currently state that all patients should be 
followed up within seven days because people are at high risk of post discharge 
suicide in the 1st week. In fact, more recent evidence from the National 
Confidential Inquiry into Suicide and Homicide, shows of all patients who died 
in the 1st week after discharge, the highest number occurred on day 3. There is 
growing recognition of the urgent need for timelier follow up as a key suicide 
prevention measure, with both the Inquiry and the House of Commons Health Select 
Committee recently calling for earlier follow up after discharge. Current NICE 
guidelines recommend follow up within 48 hours for some patients only. Mind is 
calling for this 48 hour timeframe to extend to everyone leaving Hospital after 
a mental health crisis. Mind also sent the FOIs to Welsh Health Boards and found 
only one board could provide the data. Aneurin Bevan told Mind they were 
following up face to face with 55% within the timeframe, but couldn't provide a 
full picture. The charity is calling on the Welsh Government and Local Health 
Boards to address the lack of recorded data so that there is transparency about 
follow up and performance against Welsh Government's target. Mind has also 
conducted a survey of over 850 people about their experiences of the process 
after they left Hospital. It found that those who weren't followed up 
appropriately (after 7 days or not at all) were twice as likely to attempt 
suicide and a 3rd more likely to harm themselves compared to respondents who 
said they were followed up within 7 days of being discharged. Mind's findings 
show that the lack of appropriate follow up is also putting significant pressure 
on the NHS as people are not getting the help they need to recover. Those not 
followed up within 7 days were more than twice as likely to end up in A&E as a 
result of their mental health within the 1st week of being discharged. Data from 
the NHS shows that on average more than 1 in 20 people (6.5%) 
with mental health problems who are discharged from Hospital are readmitted 
within 30 days.
 Sophie Corlett, Director of External Relations at Mind, said:- "Thousands 
of people with mental health problems in England and Wales are not getting the 
appropriate follow up when they are 1st discharged from Hospital. This is not 
good enough. It is a tragedy that so many people so very recently leaving the 
care of Hospital are losing their lives. The Government has put suicide 
prevention as a key patient safety issue for the NHS as a whole and pledged to 
reduce suicides by 10% in the next 5 years. Timelier follow up for patients 
after they leave Hospital could help achieve this. If you don't get the right 
care after you leave, if you're left to cope alone, you can end up in a 
revolving door going straight back in to Hospital or be at risk of taking your 
own life. We are calling for NICE to update its guidance and hold local mental 
health trusts in England and Health Boards in Wales to account so that every 
person that leaves Hospital after a mental health crisis gets follow up within 
48 hours. Whether you've been in Hospital for days or for months, when you come 
out you need the right care and support to help you stay well. A vital part of 
this is having someone make early contact with you to make sure you're ok and 
getting the ongoing support you need. Seven days is simply too long to wait when 
someone's recovery is still at risk. We need to see a reduction of the follow up 
time to 48 hours now."
 
 Professor Louis Appleby, Director of National Confidential Inquiry into Suicide 
and Homicide, said:- "People leaving UK Hospitals can feel unsupported as 
they return to the problems that may have led to their admission. Those 1st few 
days are the time of highest suicide risk; follow up within 7 days has helped, 
but we now need to go further. This is probably the most important single step a 
service can take to improve patient safety."
 
 Imani is 36. She has been diagnosed with borderline personality disorder and 
post-traumatic stress disorder. She had 3 voluntary inpatient admissions when 
she was acutely suicidal. Imani said:- "When I got out, I thought: I've 
just been in Hospital, I've been suicidal; I'm sure they're going to be giving 
me 100% support. I remember coming out and thinking I wanted to go back in 
again. It's like you come out and you're a rabbit in the headlights; you're so 
vulnerable. Going back out again into the big wide world, with freedom and among 
other people, it can be overwhelming when you feel you've just had a near death 
experience. I don't remember being in contact with the Hospital once I'd come 
out; no phone call, no visit and I needed to see someone. The professional 
support was just not what I expected given what I've been through. My husband 
had to take time off work and had to be there to keep me safe."
 
 Natalie, 26, from Somerset was in Hospital after reaching crisis point and 
attempting to take her own life. Natalie said:- "When I was discharged I 
didn't get any follow up from the Hospital itself and it was a week until a 
crisis team came to visit me. When you're that unwell, it's hard getting through 
each day. Each hour is tough, so just 24 hours can feel like such a long time. I 
needed someone to talk to, to help me understand my thoughts and feelings. To 
only see someone after a week, it's not enough."
 
 Mind has a confidential information and support line, Mind Information line, 
available on:- 0300 123 3393, lines open 9am to 6pm, Monday to Friday. They also 
offer an out of hours support service on:- 07850 788 514.
 
 You can also call 
Samaritans from any phone, for free, on:- 116 123, around the 
clock, 24 hours a day, 365 days a year. You don't have to be suicidal to call 
them.
 
 Have you had issues regarding mental health care as we would like to know. 
Please email our newsroom with your comments and views of the UK Mental Health 
Care System via:- 
News24@SouthportReporter.com.
 
 Added information:- Data from Trusts and Health Boards in England and Wales
here.
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