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Wednesday, 13 October, 1999, 17:02 GMT 18:02 UK
Crisis in mental health
Patients may get poorer treatment due to staff shortages
Staffing levels in all areas of mental health are at crisis levels, with more than 70% of trusts reporting problems recruiting doctors and nurses.

And government plans for psychopaths could make things worse, says the Sainsbury Centre for Mental Health, which has launched a review into staffing levels.

Mental Health
It says the recruitment problem is worst in inner city areas.

But across the country 71% of trusts report problems recruiting and retaining psychiatrists while 85% have difficulty recruiting nursing staff.

Some regions and specialisms are worse-hit than others. Merseyside has the highest vacancy levels with all specialisms short by 13%.

The highest proportion of vacancies is in forensic psychiatry, which is short of 200 practitioners.

Psychopath warning

The Sainsbury Centre is also worried about the impact the government's new plans for psychopaths could have on mental health services.

Andrew McCulloch, the Centre's policy officer, said the plans could mean more forensic psychiatrists are needed.

They are likely to assess people with severe personality disorder for the government's new detention centres for psychopaths.

The government is said to believe these people are untreatable, according to current mental health legislation, and need to be locked up to protect the public.

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Mr McCulloch said: "It is hard to analyse the implications. It could draw people away from existing forensic psychiatry services, particularly if more resources are provided, and that could mean we would not be able to staff mental secure units."

Alternatively, if the plans are not properly funded and if the detention centres do not include treatment programmes, there could be problems staffing them, he added.

"People go into psychiatry to make people better or ameliorate their condition. But if these people are seen as untreatable what will mental health services do with them? It is ill thought-out."

Low morale

The Sainsbury Centre wants to find out what the extent of the staffing problem is and to identify examples of good practice for recruiting and retaining workers.

It estimates the review will take a year. The results could be used to decide how to spend the 700m announced last year for mental health services for the next three years.

"We have to look at how we are going to invest the money and how to attract more people into the profession. Then we can spend it.

"It is not simply a question of more cash. If the government gave us half a billion now we would not be able to spend it," said Mr McCulloch.

Some campaigners believe the research should have been done by the Department of Health before the extra cash was announced.

They blame low morale, poor pay and poor working conditions for the staffing shortage.

Tougher conditions

Mr McCulloch says media reports of community care failures have added to low morale.

"It is not good for any service if they feel they are branded a failure. With limited resources invested what do you expect anyway?" he asked.

Staffing shortages can lead to a vicious circle, with higher caseloads and more stress for those who remain and more chance of patients slipping through the net.

Another result is that only the most disturbed patients get admitted to hospital, meaning a tougher working environment for mental health staff.

Violent attacks

The Royal College of Nursing and the Institute of Psychiatry have long called for more mental health nurses and better training of staff.

They say psychiatric units in areas like London are severely over-stretched and make it more likely that nurses could be subjected to violent attacks.

A 1998 study in London found an average of three vacant nursing posts on every mental health unit.

This led to a heavy reliance on agency and bank staff.

See also:

23 Sep 98 | Health
Luring nurses back into the NHS
13 Oct 99 | Health
510m boost for mental health care
05 Feb 99 | Health
GPs threaten mass resignation
16 Feb 99 | UK Politics
Psychopaths lock-up plan under attack
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