New data shows that one in 10 people who attended an A&E department in England last month with a mental health need remained there for more than 24 hours. In some departments, the proportion exceeded one in three. The figures highlight the scale of pressure on emergency services and the continued reliance on A&E for people experiencing psychological distress.
Long waits for mental health patients in emergency departments are not a new challenge, but the persistence of 24 hour stays indicates ongoing system constraints. Many departments are managing demand that exceeds their design and capacity. A&E spaces that are configured for acute physical health needs are increasingly acting as holding areas while patients wait for mental health assessment or an available bed elsewhere.
Drivers of Prolonged Mental Health Stays
Several factors are contributing to the length of these stays. Inpatient mental health bed capacity remains limited, particularly for people who require specialist support or detention under the Mental Health Act. Community and crisis teams, which are intended to divert people away from acute care, often face staffing gaps and high caseloads. Availability varies between regions, leading some patients to seek help at A&E as the most accessible option.
These pressures mean that patients can wait extended periods before appropriate onward care is identified. Liaison psychiatry teams may be present on site but cannot always progress assessments without a clear destination for continued treatment or support.
Operational Impact on Emergency Departments
Long stays create operational challenges for emergency departments. Patients who remain for 24 hours or more often require one to one observation, designated space and repeated clinical checks. This can reduce the number of cubicles and beds available for other emergency presentations, creating delays that affect the wider flow of the department.
Ambulance handovers, waiting times for treatment and the movement of patients through A&E can all be affected. Some departments report increasing numbers of young people and individuals with complex social needs arriving in crisis, adding further pressure to teams already working at capacity.
A System Capacity Issue
The data reflects a broader pattern across urgent and emergency care. Trust leaders frequently cite limited mental health bed availability, variation in crisis services and challenges accessing social care as key factors behind prolonged stays. These constraints affect the ability of emergency departments to move patients efficiently through the system, even when clinical assessment has taken place.
Potential Areas for Improvement
Several regions are testing alternative pathways intended to reduce A&E reliance. Crisis hubs located near emergency departments, expanded 24 hour community teams and earlier involvement of mental health specialists at triage are among the approaches being trialled. Early evidence suggests these models can shorten waits and reduce pressure on emergency departments.
Further progress will depend on increased capacity in inpatient and community mental health services, clearer crisis pathways, and stronger coordination between NHS providers, local authorities and voluntary sector organisations.
The latest figures underline the need for a coordinated response. Emergency departments cannot resolve these waits alone and require broader system support to ensure timely access to mental health care.
