Patients are dying and facing 'horrible tragedies' due to Manchester's mental health care crisis, staff say

Mental health services in Manchester have faced “crisis after crisis” and preventable patient deaths due to underfunding and “lack of compassion”, NHS workers have said.

A group of employees at Greater Manchester Mental Health Trust have spent months striking to demand more support, funding and staff to continue their life-saving work.

Backed by unions Unite and Unison, they have now accepted a deal of £750,000, followed by a recurrent £1 million in subsequent years, equivalent to 21 additional staff members.

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Claire Miller, a Unison representative who works in the Manchester early intervention psychosis (EIP) team said this is a “substantial investment”. 

“Without the right resources, we can’t help people recover,” Miller said. “This will make a real difference in the support we’ll be able to give families and how we’re able to respond.”

However, there remain fears that the issues within mental health services persist in Manchester and across the country – particularly as the government recently reduced the proportion of NHS funding allocated to mental health services.

Miller claimed community mental health services in Manchester are “still hugely under-resourced” and that the striking workers will continue to campaign for better funding more widely.

“We need to support collective action and come together, because that’s how we win and resist. Not only have we resisted, but we’ve actually gained investment in this climate,” Miller added. “That needs to be coordinated on a national level.”

Dr John Mulligan, a Unite union representative and clinical psychologist in the Manchester EIP team, believes problems persist. He claimed: “There’s been multiple horrible tragedies in our service and across the community mental health teams.”

“The whole secondary care services are in an absolutely diabolical situation,” he said.

Mulligan’s team works with 14- to 65-year-olds who develop the first episode of psychosis. EIP services have been found to reduce the risk of a person with psychosis attempting to take their own life from 15% to just 1%.

However, Mulligan claimed there are “thousands” of people suffering with their mental health in Greater Manchester who are not getting the support they need. 

He said the caseload “just swells and swells” – staff are meant to have 12 patients allocated to them, but instead they have 25 to 30. 

“What happens then is all the sensitive, nice stuff that we’re supposed to be doing doesn’t happen. There’s been crisis after crisis,” Mulligan said.

A Freedom of Information Request sent by striking workers to the trust and seen by the Big Issue revealed that 10 people had died while on a waiting list for mental health support as part of Greater Manchester’s ‘waiting well’ scheme since 2022, while 63 had been hospitalised.

Mulligan said he is unable to share specifics of cases while investigations are ongoing but claimed the services are in “such a diabolic state that people are dying all over the place”. “It’s horrendous. There’s a massive waitlist of people who are severely unwell. They are just neglected and left at home,” he said.

Annabel Marsh, a former community psychiatric nurse who now runs a peer support group for people suffering with severe mental health conditions in Manchester, said that people used to be allocated a care coordinator who would regularly visit them – sometimes as much as weekly – but the service is “under-resourced” and it is no longer standard practice.

When the group, Community Works, first started more than 10 years ago, each of the members had a care coordinator allocated to them, but now only three of the 35 members of the group receive this support.

“Their situations haven’t changed. They still have ongoing issues with psychotic illnesses like schizophrenia, severe bipolar, with recurrent admissions, medication which has terrible side effects and causes quite a lot of physical issues as well, including type two diabetes and weight gain. These are issues which should be monitored. That just isn’t happening,” Marsh explained.

“Some people have outpatient appointments with a psychiatrist, but that might be once or twice a year. If they go into crisis, there’s nowhere to ring for a rapid response. If people start to relapse, it’s extremely difficult to get a response quick enough to prevent hospital admissions. 

“Members of our group have had hospital admissions, almost all of which have necessitated the police getting involved because things have become so severe. People lose insight and awareness that they’re very unwell, because there’s no community services to step up support quickly.”

In one recent case, a group member who had been “extremely at risk for a long time with symptoms of relapse” was receiving no support from mental health services. She was living in “deteriorated conditions” and was unable to look after herself. Community Works provides a hot meal twice a week, because otherwise “people might not be eating at all”.

Marsh, who is in her 70s, said one of the reasons she came off the nursing register is because she does not want to be “held responsible for what’s happening to people”. 

She said: “I do my best to alert services when things are going badly, but as an ex-nurse and now as a friend to the people who come to the group, it is deeply concerning when things go wrong, and it’s just constant.”

Mulligan said he has heard “horror stories” from mental health teams across the country. Around 120 people die in England every day from preventable mental health conditions, according to the Royal College of Psychiatrists.

“There’s a misconception sometimes about striking workers, that they’re disgruntled and at odds,” Mulligan said. “But actually, we’ve got an enthusiastic and skilful team, and we’re unionised. We give a shit. We’ve managed to have a coherent group for a few years, and we can see all of the damage and destruction, heartache and death that’s occurring locally, and we just have had enough.

“Our team is fantastic, and although we’re brushed off the feet and struggling and facing lots of stress related to that, we are also motivated to fight to make things better. Most other teams don’t have that, and when we don’t, then what we are is complicit in a system that’s actually contributed towards death.”

Mulligan claimed that “many EIP patients” are gaining weight at a rate of up to 17kg in one year. 

“That’s 15 to 20 years of reduced life expectancy,” he added. “We’re the starting point for early intervention – but sadly, we’re complicit in and we’re contributing towards problems that continue in terms of physical health.”

Unison North West regional organiser Paddy Cleary said: “Early-intervention mental health services are a lifeline for many at-risk people. Getting the right support at the right time can prevent a crisis, providing help long before someone reaches breaking point. This critical work goes on day in, day out.”

He added that the “outcome of this dispute is fair and will help keep communities safe”.

Research has found that if every patient with psychosis received effective early intervention, it would save the NHS £44m every year.

A Department of Health and Social Care spokesperson said: “Too often, people experiencing mental health crises are not getting the support or care they deserve, and this government is taking action to change that.”

They claimed to be transforming mental health services backed by an extra £680m in government funding – “hiring more staff, delivering more talking therapies, and getting waiting lists down”. It has also launched one of the world’s first 24/7 mental health crisis support services via NHS 111 and announced a £26m investment in new crisis centres.

Yet there are concerns this is not enough amid cuts to NHS services and as people with mental health conditions also risk losing their financial support while the government plans to tighten the eligibility criteria for disability benefits.

Mulligan said: “If I had to say what the biggest problem is with the NHS mental health services, it would be a lack of compassion. We need staff to actually be able to do their job properly. We need staff to be skilled and comfortable, certainly.

“But ultimately, what we need is compassionate decision making. We need time. We need resources. All of that costs a lot of money, but it’ll be very well spent, and it would be money that would save not just stress and human suffering, but lives.”

He added: “Being in a system whereby we’re allowing or letting or we’re ignoring the fact that the most vulnerable in society are dying is intolerable, and it’s so unfair. So it is upsetting for all of our members. That’s one of the reasons that drove us forward to be out on strike.”

Greater Manchester Mental Health Trust and NHS England did not respond to Big Issue’s requests for comment.

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