Suicidal children are being sent home because hospitals are busy – but there is another way

“I felt lonely and just petrified that I was going to lose my son in the worst possible way.” This was a harrowing testimony from a teenager’s mother, as she described to a roomful of health and social care professionals what happened when an A&E department sent her son home, aged 16, despite his clear spoken intention to take his own life.

The story is – in equal measure – deeply sad and alarmingly common. The research we launched this week drew on a series of in-depth interviews with young people, parents, carers, and more than 20 NHS and social care staff from a range of different NHS Trusts and health organisations across England.

Our findings show that, with nowhere else to turn, accident and emergency departments have become the go-to point for young people suffering mental health crises. Their parents arrive at hospital, hoping upon hope that someone will “scoop-up” their child and help them get better.

But the reality is very different. According to the majority of the people that were interviewed as part of our research, the pressure on NHS services today is such that the threshold for intensive support is so high that only once your son or daughter has attempted suicide on multiple occasions will they get any in-patient care. Reaching that point of crisis is every parent’s worst nightmare, but even then, an inpatient bed is far from guaranteed.

One of the parents we interviewed, Miriam, has seen her eldest daughter – now aged 18 – attempt suicide several times. She says, “it feels to me and my family that they have to be dead before they get some help. If your daughter is saying they want to end their life and they’ve got no hope, then she needs intensive help. I really feel that she needs some sort of intensive supported living and therapy that continues beyond a few days or sessions.”

Sending suicidal young people home is plainly wrong for the patient and puts a terrible strain on the families concerned. The impact on Miriam’s younger children has been acute, with one sibling aged 16 – who is herself diagnosed with autism – now very scared of the police, since they have visited the house on so many occasions in traumatic circumstances. Meanwhile a four year old sibling considers it “normal” to have police and ambulance services turn up at the door.

There is no blame to be passed anywhere here, it is just about doing things differently. With NHS budgets under significant strain, and the number of children and young people needing mental healthcare skyrocketing since the pandemic, there is an urgent need for change.

Instead of discharging young people to their family homes, our research showed there is a need and appetite for community residential settings away from hospital. It demonstrated that these are needed so the young people involved can be afforded the time, space and therapy which is essential to a sustained recovery.

Our report, “Away from hospital and into the community”, examines the huge potential for improved care that could come from redirecting funds towards support of this kind. Offered within intensive supported housing, community services can help young people at crisis point, and stop more of them from getting there in the first place.

A great example is The Hope Service, run by the Surrey and Borders Partnership NHS Foundation Trust. CQC and Ofsted registered, Hope is staffed by psychiatrists, psychologists, social workers, nurses, teachers, art and drama therapists, family therapists and activity workers. The teams work with young people to stop the escalation of mental ill health, both in a residential setting and outside.

Financial modelling undertaken as part of our research demonstrates that specialised health and housing services of this sort costs some 52 per cent less than equivalent stays in hospital, at £2,000 per week instead of £4,200. That means ministers could be making more of this care available to more young people right now by redirecting funds.

This is just the beginning. Our ambition is to see all the political parties come together to recognise the power of residential treatment for young people suffering mental ill-health. Only by doing so can we defuse what is already a ticking timebomb under adult mental health, stopping unwell young people becoming very vulnerable and resentful adults.

Just as we expect treatments for cancer to be fast and comprehensive, we should expect to live in a country where no parent is told, “your child wants to end their own life, but the best thing you can do is take them home.”

Chris Hampson is chief executive of Look Ahead Care and Support, a charitable housing association. The organisation launched “Away from hospital and into the community“ this week, following research funded by the Wates Family Enterprise Trust and undertaken by Care Research