09 April 2026
Responding to the Health Services Safety Investigation Body (HSSIB) interim investigation report on mental health crisis care: legislative challenges in EDs, published today (09 April 2026) President of the Royal College of Emergency Medicine Dr Ian Higginson said: “We welcome the Health Services Safety Investigations Body’s (HSSIB) interim report into mental health crisis care including its focus on legislative gaps affecting patients in crisis in the Emergency Department.
“For many years RCEM highlighted significant gaps in both service provision and legislation which in combination leave patients experiencing a mental health crisis at risk of harm. These risks include prolonged stays in emergency departments – often lasting many days and in rare cases weeks – in environments that are often loud, bright and unsuitable for therapeutic care. Patients may also experience limited access to appropriate mental health interventions during their stays. The lack of appropriate powers leave patients at risk: the potential for the patient to leave and harm themselves further, balanced against the risk of them being kept in the ED without any specific legal powers to do so. RCEM is also concerned about the consequences of Right Care Right Person which increases these risks to patients.
“Emergency Departments should only be used as a place of safety where there is a clear medical need. However, recent updates to the Mental Health Act have not adequately addressed the legal gaps previously highlighted by RCEM including those presented during the House of Commons review and outlined in its 2022 report. The consequences of these gaps have been underscored by several coroners following tragic cases in which patients have left the emergency department after seeking help and have subsequently come to harm.
“While RCEM welcomes the report’s recommendations that the government should address these legislative shortcomings it emphasises that reform must go hand in hand with increased capacity in mental health services. In particular, the shortage of acute mental health beds and designated places of safety must be urgently addressed. Improved capacity would reduce the time patients spend in an inappropriate environment such as emergency departments, and enable healthcare professionals to use the powers available under the Mental Health Act more effectively to protect vulnerable patients.
“RCEM recognises that further findings will be presented in the final HSSIB report and looks forward to continued engagement on this critical issue.”