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Sky News
an hour ago
- Business
- Sky News
Mental health cases at A&E reach crisis level - as waits get longer and specialised beds dwindle
"We've got two," explains Emer Szczygiel, emergency department head of nursing at King George Hospital, as she walks inside a pastel coloured room. "If I had my time back again, we would probably have four, five, or six because these have helped us so much in the department with the really difficult patients." On one wall, there's floral wallpaper. It is scored through with a graffiti scrawl. The words must have been scratched out with fingernails. There are no other implements in here. Patients being held in this secure room would have been searched to make sure they are not carrying anything they can use to harm themselves - or others. There is a plastic bed secured to the wall. No bedding though, as this room is "ligature light", meaning nothing in here could be used for self harm. On the ceiling, there is CCTV that feeds into a control room on another part of the Ilford hospital's sprawling grounds. "So this is one of two rooms that when we were undergoing our works, we recognised, about three years ago, mental health was causing us more of an issue, so we've had two rooms purpose built," Emer says. "They're as compliant as we can get them with a mental health room - they're ligature light, as opposed to ligature free. They're under 24-hour CCTV surveillance." There are two doors, both heavily reinforced. One can be used by staff to make an emergency escape if they are under any threat. What is unusual about these rooms is that they are built right inside a busy accident and emergency department. The doors are just feet away from a nurse's station, where medical staff are trying to deal with acute ED (emergency department) attendances. The number of mental health patients in a crisis attending A&E has reached crisis levels. Some will be experiencing psychotic episodes and are potentially violent, presenting a threat to themselves, other patients, clinical staff and security teams deployed to de-escalate the situation. Like physically-ill patients, they require the most urgent care but are now facing some of the longest waits on record. On a fairly quiet Wednesday morning, the ED team is already managing five mental health patients. One, a diminutive South Asian woman, is screaming hysterically. She is clearly very agitated and becoming more distressed by the minute. Despite her size, she is surrounded by at least five security guards. She has been here for 12 hours and wants to leave, but can't as she's being held under the Mental Capacity Act. Her frustration boils over as she pushes against the chests of the security guards who encircle her. "We see about 150 to 200 patients a day through this emergency department, but we're getting on average about 15 to 20 mental health presentations to the department," Emer explains. "Some of these patients can be really difficult to manage and really complex." "If a patient's in crisis and wants to harm themselves, there's lots of things in this area that you can harm yourself with," the nurse adds. "It's trying to balance that risk and make sure every emergency department in the country is deemed a place of safety. But there is a lot of risk that comes with emergency departments, because they're not purposeful for mental health patients." In a small side room, Ajay Kumar and his wife are waiting patiently by their son's bedside. He's experienced psychotic episodes since starting university in 2018 and his father says he can become unpredictable and violent. Ajay says his son "is under a section three order - that means six months in hospital". "They sectioned him," he tells us. "He should be secure now, he shouldn't go out in public. Last night he ran away [from hospital] and walked all the way home. It took him four and a half hours to come home. "I mean, he got three and a half hours away. Even though he's totally mental, he still finds his way home and he was so tired and the police were looking for him." Now they are all back in hospital and could be waiting "for days", Ajay says. "I don't know how many. They're not telling us anything." Matthew Trainer, chief executive of Barking, Havering and Redbridge University Hospitals NHS Trust, is at pains to stress nobody is blaming the patients. "We've seen, particularly over the last few years, a real increase in the number of people in mental health crisis coming into A&E for support," he says. "And I don't know if this is because of the pandemic or wider economic pressures, but what we're seeing every day is more and more people coming here as their first port of call." The hospital boss adds: "If you get someone who's really distressed, someone who is perhaps experiencing psychosis etc, I'm seeing increasing numbers of complaints from other patients and their families about the environment they've had to wait in. "And they're not blaming the mental health patients for being here. "But what they're saying is being in a really busy accident & emergency with ambulances, with somebody highly distressed, and you're sat there with an elderly relative or a sick child or whatever - it's hard for everyone. "There's no blame in this. It's something we've got to work together to try to fix." New Freedom of Information data gathered by the Royal College of Nursing shows that over the last five years, more than 1.3 million people in a mental health crisis presented to A&E departments. That's expected to be a significant underestimate however, as only around a quarter of English trusts handed over data. For these patients, waits of 12 hours or more for a mental health bed have increased by more than 380%. Over the last decade, the number of overnight beds in mental health units declined by almost 3,700. That's around 17%. The Department for Health and Social Care told Sky News: "We know people with mental health issues are not always getting the support or care they deserve and incidents like this are unacceptable. "We are transforming mental health services - including investing £26m to support people in mental health crisis, hiring more staff, delivering more talking therapies, and getting waiting lists down through our Plan for Change." Claire Murdoch, NHS England's national mental health director, also told Sky News: "While we know there is much more to do to deal with record demand including on waits, if a patient is deemed to need support in A&E, almost all emergency departments now have a psychiatric liaison team available 24/7 so people can get specialist mental health support alongside physical treatment. "The NHS is working with local authorities to ensure that mental health patients are given support to leave hospital as soon as they are ready, so that space can be freed up across hospitals including A&Es." Patients in a mental health crisis and attending hospital are stuck between two failing systems. A shortage of specialist beds means they are left untreated in a hospital not designed to help them. And they are failed by a social care network overwhelmed by demand and unable to provide the early intervention care needed.
The Hindu
09-05-2025
- General
- The Hindu
Simhachalam temple wall collapse: Missed writing on the wall
When Umamaheswara Rao and wife Sailaja set out to the Simhachalam hills in Visakhapatnam from their home at Chandrampalem at 2.30 a.m. on April 30, they were probably thinking of the moment they would finally fulfil a long-cherished dream: to witness the 'nijaroopa darshan' of Sri Varaha Lakshmi Narasimha Swamy, a rare sight available only once a year during the temple's 'Chandanotsavam'. The couple were just three years into their marriage, and life seemed good. The two software professionals, both 30 years old, were ambitious as well as deeply spiritual. They reached the temple after short trip of 25 km and joined a sea of devotees hailing from across Andhra Pradesh, Telangana, Odisha and beyond. Many of them had reached the hill the previous evening (April 29) itself to avoid the rush after midnight. All had one objective: to catch a glimpse of the original form of the idol, which remains covered in sandalwood paste throughout the year except this occasion. From around midnight, devotees began taking their place in their respective queues [sarva (free) darshan; ₹300, ₹1,000 and ₹1,500 ticket darshans]. Umamaheswara Rao, Sailaja, her mother P. Venkata Ratnam (50) and his aunt G. Mahalakshmi (55) took up their spot in the ₹300 queue, located close to Rajagopuram and the bus terminus atop the hill. Above them, on a higher elevation, a massive new brick and concrete wall towered. The festival began with 'Suprabhatam' at 1 a.m. on April 30, followed by a few other rituals. The hereditary trustee Pusapati Ashok Gajapathi Raju had the first darshan of the deity at 3 a.m., followed by some ministers and other VVIPs, who entered the main temple through the Rajagopuram. The darshan for common devotees was to begin from 4 a.m. Shortly after, however, the weather took a drastic turn and heavy downpour, accompanied by gales, began pummelling the region. Naresh, a volunteer present at the site, recalls what happened next. 'There was a loud thud, and people began screaming. At first, we thought nobody was hurt, but when we reached the spot, we saw the wall had collapsed onto the queue line, and many were trapped under the debris; it was a horrifying sight.' The hilltop, the divine abode, began echoing with wails of ambulance sirens and the screams of the injured. Seven people lost their lives that day, including Umamaheswara Rao, Sailaja, Mahalakshmi and Venkata Ratnam. While the bodies were taken to King George Hospital (KGH), the injured were shifted to Visakha Institute of Medical Sciences (VIMS) near Hanumanthawaka. Outside the KGH mortuary, heartbroken relatives wept inconsolably; some were stunned into stillness by what had just happened. 'We received a WhatsApp message early in the morning about the accident. I checked Mahesh's [Umamaheswara Rao] message; he had left a voice note saying he was heading to Chandanotsavam. It's hard to accept that someone so full of life is no longer with us,' says a devastated family member. Kin demand answers Anger and grief seized the families of the victims in the aftermath of the tragedy. The grieving kin questioned how a new wall could collapse so easily and why the devotees were allowed to line up so close to an area that was still under construction. Many point fingers at what they call gross negligence in festival arrangements and allege that despite reviews by a group of ministers over the few weeks prior to the festival's commencement, the authorities utterly failed to ensure basic safety measures. Some family members, reflecting on past festivals, say that while there had been instances of inconvenience and crowd management issues, they had never heard of incidents leading to deaths at the temple. 'My son was a god-fearing man. He visited many temples, but never in my worst nightmares did I imagine he would lose his life at one,' says P.V.V. Satyanarayana, father of Durga Swamy Naidu, another victim. He sits on the floor of the mortuary,face slick with tears. He had come all the way from Machavaram in East Godavari district upon hearing the news. Accident waiting to happen According to sources,the wall's construction was completed just five days before the festival began. Residents near the temple cannot recall a precedent to the incident at the temple. The impressive rock pillars and stone walls of the nearly 1,000-year-old temple stood the test of time and continue to inspire awe among devotees. Shortly after the incident, the government formed a three-member committee to inquire into the issue. Deposing before the committee, the contractor had this to say: 'I was under pressure from officials to complete the work though I was against the construction of the wall, which was not part of the original plan.' The engineer tasked with supervising the construction told the panel that he was not present at the site when the wall was constructed. 'I was on camp in Vijayawada,' he had said. The inconsistencies in the statements of the contractor and the engineering officials were not lost on the panel, though. Its chairperson opined that proper quality checks might have been given the go-by during the wall's construction and that other infrastructure works taken up on the hilltop and on the foothills under the Centre's Pilgrimage Rejuvenation and Spiritual, Heritage Augmentation Drive (PRASHAD) scheme, also need to be inspected. People familiar with the functioning of the temple said on condition of anonymity that the wall was on a higher ground while queue lines with an iron mesh were on a lower plane along the hill slope. The construction of the wall, about 15 ft. long and 10 ft. high, was taken up under the PRASHAD scheme. It was completed in haste ahead of the annual festival and the concrete curing was not done properly. According to sources, the wall gave way owing reportedly to the incessant flow of water from the upper areas. It collapsed on the wire mesh around the queue lines and then slid down the slope along with the mesh upon the devotees, trapping eight under bricks and soil. Personnel of the AP State Disaster Response Force (APSDRF), Police, the Fire Department and NDRF had a tough time rescuing the injured and extricating the bodies. A few roof sheets and iron supporting pillars, too, fell to the ground. A power cable was reportedly snapped, electrifying one of the iron poles. An electrician was brought in to rectify the problem. 'We managed to rescue two injured from under the debris. We retrieved seven bodies from the rubble during the operation, which lasted for nearly two-and-a-half hours,' T. Ramakrishna, RI of SDRF told The Hindu at the accident spot on the day. 'We were initially posted at the temple pushkarini (tank), which is at the foothill, as officials anticipated that a number of devotees would have a dip there before having darshan in the early hours. However, we were asked to come to the hilltop as most of the devotees were directly going to the hilltop,' said Ramana, one of the team members of SDRF 16 Battalion Visakhapatnam. Wall without permission Pasarla Prasad, a former member of the Simhachalam Temple Trust Board and former corporator, says the wall was constructed without authorisation. Another former member of the temple trust board Dadi Devi says that the infrastructure works at the temple had been neglected by the Endowments Department as well as the Tourism Department, which executes the PRASHAD scheme. 'There was no inspection of works by officials, and political interference compounded the problem. The construction of Kalyana Mandapams was taken up at Srinivasa Nagar on the foothills about six years ago, but they are yet to be completed,' Dadi Devi says. 'There is no internal Vigilance Wing in the temple. Works below ₹5 lakh do not require the permission of the Endowments Commissioner. On completion of infra works, third party inspection is needed. The work has to be tested at some places randomly to ensure quality of the construction,' says Pasarla Prasad. A devotee, seeking anonymity, says that a viewpoint built on the way to the hilltop was done in a hurry and has not been provided with a railing or protection wall. 'Many devotees go to this point to take selfies,' the devotee adds. Tragedies at temples The Simhachalam incident is the second major temple tragedy in the State this year. In January, a stampede during the distribution of tokens for the Vaikunta Dwara Darshan at Tirumala left six dead and several others injured. Lack of proper crowd management and sudden opening of gates were said to have contributed to the tragedy. There were also allegations of lack of coordination between TTD Trust Board and officials. It may also be recalled that Deputy Chief Minister K. Pawan Kalyan had sought a public apology from the TTD Board and the officials.
Hans India
27-04-2025
- Business
- Hans India
Vizag to be developed as financial capital of AP: CM
Visakhapatnam: King George Hospital (KGH) will be developed on a par with AIIMS in Delhi, assured Chief Minister N Chandrababu Naidu. Inaugurating the Centenary Alumni Building (CAB) near Panigal block of the Andhra Medical College and unveiling the plaque of Dr. Babasaheb Ambedkar Auditorium in Visakhapatnam on April 26 (Saturday), the Chief Minister expressed concern over how medical expenses continue to touch roof for the common man and underlined the need to bring them down as it would be a gamechanger. 'Patients should get admitted to a hospital to get cured rather than ending up in the premises for days. Doctors should treat patients and cure them as soon as they get admitted to the hospital,' Naidu emphasised. The state government is working towards achieving zero poverty by 2029, Naidu reiterated. For this to become a reality, the CM said people are considered as capital. 'Efforts are taken to ensure that Telugus gain the top position in various fields they have embarked upon by 2047. Apart from achieving the highest per capita, measures are also taken to achieve a happy, healthy and wealthy society,' the CM stressed. Terming the doctors profession as the most dedicated and committed one, Naidu said, 'Even as knowledge is important for the doctors, it is also equally imperative for them to embrace technology and students should consider technology upgradation as an effective tool to keep themselves updated,' the Chief Minister underlined. In the YSRCP's tenure, a matching grant was not provided by the state government for the establishment of the CAB. 'Despite the challenges faced, the AMC alumni were able to build the CAB with commitment and determination,' he appreciated. With Bhogapuram International Greenfield Airport, Visakhapatnam Steel Plant, steel plant of ArcelorMittal Nippon Steel India, TCS, Cognizant and Google coming up, Naidu said, the landscape of Visakhapatnam is set to transform completely. In the days to come, Visakhapatnam is going to be the financial capital of Andhra Pradesh, the CM expressed confidence. Speaking on the occasion, Health Minister Satya Kumar Yadav highlighted that the Chief Minister focuses more on the health sector. This apart, the CM is also keen on implementing advanced technology like AI, Machine Learning and Centre of Excellence. Terming the CAB as an architectural tribute which is made possible by the alumni of the AMC, the college's Principal Dr. Sandhya Devi said the old students contributed Rs 50 crore to mark the centenary milestone.
