A growing crisis is unfolding across England’s emergency departments, says breaking news reports. The reports allege that patients experiencing acute mental health crises have been left waiting, sometimes for up to three days, before receiving appropriate care.
According to a damning report released by the Royal College of Nursing (RCN), the number of patients waiting more than 12 hours in A&E for mental health support has increased fivefold since before the Covid-19 pandemic. This marks a dramatic escalation of a long-standing issue in the UK’s healthcare system and raises serious questions about the state’s ability to respond to the growing mental health burden.
Concerned authorities allege that the significance of this crisis cannot be overstated. They explain that mental health emergencies often involve patients in distress, at risk of self-harm, suicide, or experiencing severe psychological episodes.
The clinical standard across the NHS has traditionally been to assess and begin treatment for emergency patients as quickly as possible; usually within four hours. Yet, mental health patients are being forced to wait far beyond this threshold, sometimes languishing in busy, overstretched A&E departments for more than 72 hours before being admitted to a psychiatric ward or seen by a specialist.
Professor Nicola Ranger, the General Secretary and Chief Executive of the Royal College of Nursing (RCN), has calle the situation, ‘a scandal in plain sight’.
She explains that some of the most vulnerable people in society are being abandoned and overlooked at what might be their most critical moment.
Why the Long Wait?
There are several converging factors behind these delays. One of the primary issues is a lack of available mental health beds. Over the past decade, the UK has seen a steady reduction in psychiatric inpatient beds due to funding constraints and policy shifts toward community-based care. The community infrastructure has not expanded at the pace needed to match increasing demand.
Additionally, there is a national shortage of trained mental health professionals. The RCN report highlights that since 2010, there has been a significant shortfall in recruitment for mental health nurses. It is alleged thousands of mental health nurses will be needed to address this shortage in the area.
Patients in need of psychiatric care often have to wait in emergency departments until a specialist can assess them, and a suitable bed becomes available; sometimes hundreds of miles away.
The consequences of such delays can be devastating. For individuals experiencing psychosis, severe depression, or suicidal ideation, every hour without care increases the risk of harm to themselves and others. Emergency departments are also typically loud, chaotic, and overstimulating and are unsuitable environments for those in psychological distress.
“There’s a reason we don’t treat broken bones with painkillers and a waiting list. So why do we treat acute mental health conditions like something that can wait?” says Dr. Sarah Hughes, Chief Executive of Mind, a UK-based mental health charity.
Moreover, prolonged stays in A&E also disrupt broader emergency services. Mental health patients often require dedicated supervision, taking up space and staff attention that is already stretched. This, in turn, affects wait times for other patients and fuels a cycle of pressure and delay across the health system.
What the Numbers Show
According to NHS England data cited in the RCN report, in 2019 just over 1 000 patients waited more than 12 hours in A&E for a mental health bed. By 2024, that number had grown to more than 5 000 per year. This represents a fivefold increase. These figures likely underrepresent the true scale of the problem, as data collection on mental health emergency waits has been inconsistent.
Further, the Care Quality Commission (CQC) has flagged systemic failings in several NHS trusts for not providing safe and timely mental health services. In some trusts, patients waited over 24 hours simply for a psychiatric assessment.
A Call for Immediate Action
Experts and charities are united in calling for systemic reforms to address the growing crisis in mental health care. Among the key recommendations are rapid investment in 24/7 community mental health crisis teams, the reopening and upgrading of inpatient psychiatric units, and the expansion of mental health training for all A&E staff.
Additionally, there is a push for the introduction of mental health-specific triage systems within emergency departments to ensure more efficient and appropriate responses to psychiatric emergencies.
As of yet, ‘vulnerable individuals continue to fall through the cracks’, allege concerned authorities.
The Department of Health and Social Care has acknowledged the crisis in a statement: “We recognise the strain facing mental health services and are investing £2.3 billion per year by 2024 to expand services and recruit 27,000 additional mental health staff.”