Children and young people in England with serious mental health problems are still being sent for treatment many miles away from their homes because bed shortages in some areas remain so severe, despite a pledge to end such practices eight years ago.
NHS England promised in 2017 to stop forcing highly troubled under-18s to leave family and friends after some received care more than 300 miles from where they lived.
“We are committed to ending the need for children and young people travelling long distances for the right care,” Claire Murdoch, NHS England’s national director for mental health, said at the time.
However, the latest data shows the practice continues. Between December 2023 and November 2024, 319 children and adolescents were admitted to non-local beds.
In total, the children spent 35,845 days away from home – classified as inappropriate out of area placement bed days – as a result of care being unavailable locally, according to a data analysis by the Royal College of Psychiatrists (RCP).
Experts say sending seriously mentally unwell children to units far from home can be distressing for them, reduces their chances of recovery and increases their risk of self-harm.
Some have complex mental health problems that already involve a heightened risk of self-harm or suicide, such as severe depression, eating disorders, psychosis or personality disorders.
Dr Guy Northover, the deputy chair of the RCP’s child and adolescent faculty, said: “It is unacceptable that sick and extremely vulnerable children and young people with mental illness are still being sent miles away from their family and friends, sometimes for months on end, simply because they need treatment that is either not available as community care or within a local inpatient setting.
“One child being sent away from home almost every day is simply unacceptable. At a time when these children are having to cope with a mental illness, the last thing they need is to be left isolated, lonely and unsupported. It is also counterproductive as it will take longer for them to recover, lengthening their stay out of area and putting more pressure on overstretched services. This practice can also put parents and carers under immense pressure when they will already be overwhelmed with worry.”
Rachel Bannister’s daughter, who was diagnosed with an eating disorder in 2014, was sent to several hospitals far from her home in Nottingham, including one in Scotland, 315 miles away, where she stayed for six months, including over Christmas.
“The whole family were devastated when she went away,” Bannister said. “I felt as if my heart had been ripped out and I had failed her. We are all still processing the trauma of it all many years later.”
While they were apart, telephone conversations revealed the 15-year-old’s longing for simple gestures such as a hug or a shared walk in the park. “It was heart-wrenching for us to be unable to fulfil those basic needs,” Bannister said.
The lack of consistency in her care “hugely impacted” her recovery, Bannister said. “Years later, the challenges persist. It is essential to move away from inappropriate and distressing placements and instead embrace compassionate approaches within communities.”
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Olly Parker, the head of external affairs at YoungMinds, a children’s mental healthy charity, said: “Out of area placements are expensive for the NHS, costing more money than if support was available in the young person’s local community. It’s unacceptable that this is still happening, especially following years of pledges to stop it, and a sign that the system is straining under the pressure.
“The government needs to increase mental health support capacity in the community and make sure young people can access support much earlier, to prevent them becoming more unwell. This will provide better care for young people closer to home, as well as save the NHS money.”
An NHS England spokesperson said: “It is unacceptable for patients to be treated away from home – NHS England has committed to eliminating out-of-area placements and is supporting systems across the country to meet this ambition.”
The NHS was treating record numbers of children, they added, and had published plans on how mental health was being prioritised.
A Department of Health and Social Care spokesperson said: “Young people with mental health issues are not getting the care they need where they need it.”
Long waits had become normalised, the spokesperson added, and the government was working to give children the support they needed earlier.