Briefing 51: Long-stay rehabilitation services

19 June 2017

Emily Wright

19 June 2017

A small but significant proportion of people with severe and complex mental health needs access rehabilitation services. Long-stay rehabilitation services finds that some of these people are facing stays of many years in inpatient services because of a lack of community services to help them to recover.

The briefing (the 51st in our series of briefing papers) finds that while many people receive high quality care close to home from rehabilitation services, a minority spend periods of many months and sometimes years in hospital. Some are placed far from home in ‘locked wards’, and can become isolated from their families and dislocated from their local health and care services.

The briefing reviews evidence from Care Quality Commission inspection reports of inpatient rehabilitation services in England, which work with an estimated 10-20% of people with a severe mental illness who need more intensive or longer-term support than other services offer.

The paper explores the patients involved, the nature and costs of such services, and the way they have evolved over the last twenty years. It also raises concerns about long-stay rehabilitation, including the risk of isolation and lack of meaningful rehabilitation when people are kept in services of a higher intensity than is necessary, which both restricts individuals’ independence and costs more.

The briefing paper concludes that these services, and the people they help, have been ignored in mental health policy for more than a decade. As a result, local community and inpatient services have diminished, leaving some people in long-stay hospital care.

The briefing paper calls on the Government and the NHS to provide clear direction for the development and improvement of local community and hospital services for people with complex mental health needs. And it calls on NHS providers and clinical commissioning groups to ensure they offer local services to people requiring rehabilitation support and that they maintain contact with people admitted to hospitals out of their local area.

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