Scores of mental health patients in 'acute distress' were sent out of Norfolk and Suffolk for care - despite five years of promises that the practice would end.
With services bursting at the seams, 82 people from the two counties were shipped away from their homes and loved ones in January - spending a total of 1,359 nights out of the counties.
It is the highest number since October 2016, and has been strongly condemned by campaigners who have been relentlessly warning of the scandal since 2014.
The shocking figures were revealed in board papers released ahead of a meeting on Thursday where bosses at Norfolk and Suffolk Foundation Trust (NSFT) will discuss the data.
MORE: You're killing people: how I was carted out of county just for treatment
The trust refused to comment before the information had been discussed in public, but previously chief operating officer Stuart Richardson said just one out of area placement was one too many.
The vast majority of out of area patients in January came from Norfolk, with 73 being sent away from the county, and nine from Suffolk.
That is despite repeated promises from NSFT to end the practice.
In January 2014, NSFT bosses said they would stop sending patients out of the area for treatment within four months.
This was not achieved and more recently the trust set itself the goal of to October 2017, before being adjusted to the 'more realistic' date of March 2018. This was again missed but now national targets have demanded all mental health services stop sending patients out of the area by 2021.
Terry Skyrme, from the Campaign to Save Mental Health Services in Norfolk and Suffolk, said he had been trying to stop it for five years, back to when he worked in the trust's crisis team.
He said: 'I was raising concerns about this back then, the whole team was absolutely fed up. As an AMHP [approved mental health professional] I had to take people across the country.
'A lot of people would say 'I'm not going to hospital if it's 100 miles away from home' but if there was a bed locally and they knew their family could visit they would.
'They say we're investing in community care but it's got worse and worse.'
The NSFT board papers put the high January numbers down, in part, to a delay in opening a wellbeing hub in Norwich.
They said: 'In Norfolk and Waveney the delay in implementing the wellbeing hub and internal flow issues linked to delayed transfers of care and length of stay is impacting negatively.'
While in Suffolk there had been changes in wards and staffing issues.
Between September 1 and November 30 last year dozens of people were still being sent to hospitals at least 200km (124 miles) away – and five at least 300km (186 miles) away.
Data also revealed there were 36 deaths of people under the trust's care in January, which was up slightly from December but down from a high of 70 in December 2017. This number includes those who died from physical health complaints.
A spokesman for the Campaign to Save Mental Health Services in Norfolk and Suffolk said: 'Inflicting acute distress on people in crisis and wasting three quarters of a million pounds on transporting people out of Norfolk and Suffolk in January alone is disgraceful. The money could be invested in improving community mental health services and reopening some of the 140 mental health beds that have been closed by NSFT. Instead, the money is wasted on private hospital beds nationwide.'
Last month NSFT's chief operating officer Stuart Richardson said: 'We consider one out of area placement as one too many and whenever this is unavoidable, we always strive to ensure that patients are treated as close to home as possible, and aim to repatriate them at the first available opportunity.
'A large number of out of area placements are for less than one week and in the past two months no patient has been cared for outside of Norfolk and Suffolk for longer than 28 days.'
He also said he was confident they would eliminate out of area placements by 2021.
He added: 'In addition, we're working on a number of initiatives to use our inpatient beds more efficiently, which will reduce length of stay and free up beds.'
'We know it's avoidable'
North Norfolk MP Norman Lamb, who has long campaigned on mental health, said the situation was 'wholly unacceptable'.
He said: 'We know that putting patients out of area is associated with a higher risk of suicide, there's clear evidence of that.'
Mr Lamb said when he was health minister he had sought to abolish the practice.
He said: 'There are many trusts around the country which have managed to end out of area placements, so this is a significant failure with massive human cost.
'We know it's avoidable through better organisation of your resources, it's unacceptable and deeply disturbing.'
He also added there was a high cost to out of area placements, and questioned why this money could not just be used to open more beds in Norfolk and Suffolk.
Between September and November last year alone out of area placements cost £1.27m.
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