For a young girl, trapped in a spiral of despair, it is terrifying to be taken into care. But it is torture too, her mother says, to walk away and leave her little girl far from home.
Maisie Shaw from Hull is 15 years old. Suffering from autism, depression, and with a history of self-harm, she has been in and out of hospital since the age of 12.
In that time, she has been an in-patient 10 times. And because of a shortage of beds, she has been sent more than a 100 miles to Manchester, to Birmingham, and now Leeds, sometimes for months at a time. It is holding her back, her mother says, to be stuck in this damaging cycle at a time when she is at her most vulnerable and needs more than ever to have the support of her family.
“She’s lost her childhood,” said Sally Burke, who has campaigned tirelessly for change and met with government ministers to highlight Maisie’s plight. “We’re going round in circles and Maisie is bouncing from place to place, there just isn’t enough in the local area to make her feel safe.
“The whole family is tortured by the process. There’s no quality of life here, we are struggling to exist in this system.”
Maisie’s battle with her mental health became increasingly apparent from the age of 12. Diagnosed with autism, she struggles to regulate big emotions, and having spent much of the past few years as an in-patient, often feels safest when she is in hospital.
It is hard to break this structure, her mother says, as her daughter has become so used to the constant routine.
“Maisie feels like she has to go into a unit when she is in crisis, as that’s the only way she feels safe,” said Mrs Burke, who is working with local services on projects to promote home care. “And because we haven’t got a unit nearby, it’s pot luck where she’s sent to. There’s a need for that emergency bed for anybody in crisis, be it for a child or an adult, although they should be used on a short term basis. But there are children that have been in this cycle for years.”
Maisie’s first placement was in Birmingham, at the age of 12. Soon after she was sent to Sheffield, then Greater Manchester. In all, she was away from home for more than six months.
“That was a massive battle for Maisie, and for us as a family as it was so far to travel,” said Mrs Burke. “I tried to visit Maisie every other day, or two or three times a week. Maisie was sobbing that she didn’t want to be left and it’s really difficult to leave your child in that state and then drive all that way home, having to deal with those emotions. It’s just an horrendous ordeal to have to try and cope with that as a parent.”
There is no comparison to care for a physical illness, Mrs Burke says. When Maisie had her appendix out, her mother slept next to her on the ward, yet she has to travel more than 100 miles to visit when it’s a mental illness.
“It’s a reactive system, not a proactive one,” she said. “When your child is so unwell, it’s the worst feeling ever. Mental health care is in crisis. It’s appalling that in this country, in 2017, people are suffering like this. If we don’t get the right provision locally, where she feels that she’s safe, how can Maisie ever fight to have a future? Mental health issues are curable, it is something you can live with. But sometimes we have to wait two weeks for a bed. She almost has to self destruct before they listen to her.”
A procurement process is now underway to commission an 11-bed unit in the Humber area, the Humber NHS Foundation Trust has said, adding that there is a national shortage of beds within children and adolescent mental health services.
“This has happened in the context of pressures on funding for mental health services,” a spokesman said, adding that NHS England is addressing the issue nationally and in Yorkshire and Humber. “As a result, there are inevitably periods of very high demand for beds which can lead to patients receiving out-of-area care.
“This is always a last resort for the trust.”
The government has said eliminating out-of-area placements for mental health patients is a “national ambition”.
In a speech in January, Prime Minister Theresa May pledged to tackle mental illness in young people, saying: “If you suffer from mental health problems, there’s not enough help to hand.”
Reducing out-of-area placements is also included in England’s Sustainability and Transformation Plans (STP), the five-year blueprint for the future of health and social care in 44 areas of the country.
The West Yorkshire and Harrogate STP, designed to tackle a £1bn funding gap in five years’ time, aims to cease out-of-area placements by the end of 2017.
The Humber, Coast and Vale STP, which covers Hull, sets out mental health improvements including: “Reducing the amount of people cared for out of area.”
A spokeswoman for the West Yorkshire STP said: “Our collective ambition is to ensure that nobody within West Yorkshire and Harrogate goes out of area for treatment.
“This is better for people and their families and better for the local health and care economy.”
“We are determined to share best practice across the region and quickly reduce out of area placements for non-specialist hospital care over the next 12 months.
“We are already achieving this in some areas across the STP.
“We aim to keep people as close to home as possible when in crisis or in need of high quality specialist support.
“This is something that will form part of our delivery of the Mental Health Five Year Forward View, backed by real investment from CCGs and NHS England.“
The Department of Health said it provided £7m for 56 new specialist Children and Adult Mental Health Services (CAMHS) beds, raising the total to 1,442, the highest ever.
Patients sent away for beds after York’s mental health hospital was shut down
The sudden closure of York’s psychiatric hospital led to mental health patients being sent to beds elsewhere.
NHS bosses reportedly began sending patients to places including Middlesborough, around 50 miles away, after Bootham Park Hospital was shut down by inspectors in October 2015.
Latest figures show there were around 80 occasions in four months when patients from the Vale of York Clinical Commissioning Group (CCG) area were sent away for treatment, the highest in Yorkshire. A CCG spokeswoman said: “The sudden closure of Bootham Park Hospital in October 2015 led to in-patients requiring to receive their care out of the local area.
“Financial support has been made available for family members of individuals who are placed out of area for the costs of their travel.” The CCG pointed out that there were other reasons of out-of-area placements, including court orders preventing people from being treated locally. A new mental health hospital for York is planned for 2019.
Wakefield NHS bosses said recruitment problems and a fire which closed a ward at the city’s Fieldhead Hospital caused problems in mental health services.
Wakefield had Yorkshire’s second highest figure for out-of-area placements. People were sent away for treatment on around 55 occasions between mid-October and January 31. After the fire last November alternative beds were swiftly found for patients on the ward, said NHS bosses.
A new £16m in-patient facility is being built by South West Yorkshire Partnership NHS Foundation Trust. A spokesman added: “Service demand remains high, and this has resulted in a small number of patients accessing in-patient care outside of Wakefield.
“While this is sometimes appropriate if specialist care is needed, the trust has been working with other local NHS organisations to minimise the distance patients need to travel.”