28 July 2017

Out of sight and out of mind Rebecca Harrington, independent health and social care consultant.

Rebecca talks about support for people receiving mental health care outside their local area.

Rebecca Harrington social care consultant and NICE guideline chair

Some people with mental health problems will need highly specialised care for long periods of time. This may not be available where they live.

If people must leave loved ones and usual caregivers to get the care they need, it should not be a case of ‘out of sight and out of mind’.

Last year, almost 6,000 mental health patients were sent away from home so they could get much-needed care.

The Centre for Mental Health recently highlighted issues around the handling of out of area placements. It reported cases of uncoordinated care and discharge delays. With people left feeling isolated.

It can be right that people need to go elsewhere to get good quality, proactive rehabilitation. But if a move isn’t handled well, being placed at a distance from family, friends and usual professional support networks can have a detrimental impact on mental health. This is avoidable.

During my time chairing the group developing NICE’s guideline on transitions between mental health services and the community, we had several discussions about out of area placements. The result was a guideline with specific recommendations on how to protect those who have to be moved out of their local area.

The guideline says current caregivers should work closely with the distant service throughout their care. Staff should regularly review treatment plans to avoid any delays if a person’s circumstances change.

The advice set out in the guideline is based on evidence based practice. It is important that staff and providers consider the recommendations when planning each and every new out of area placement.

The guideline group also called for further research into how best to support people with complex needs such as those with dementia, learning disabilities or autism.

Moving between services can be an effective part of treatment. It should also be a positive experience for everyone no matter the situation.

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