A mental health trust has ordered a review into the reasons behind a spike in unexpected deaths in Norfolk after 20 patients in their care died during a five-month spell.

New figures show that 38 serious incidents have been reported to Norfolk and Suffolk NHS Foundation Trust in the five months since April, of which 20 related to the deaths of patients using the trust's services in Norfolk. A Norfolk MP last night described the news as 'extremely troublesome' at a time when the mental health trust is cutting more than 400 jobs and reducing bed numbers by 20pc as part of a restructure.

Officials from the NHS trust said they were monitoring closely the number of deaths of patients using their community services, but a rise in suicide rates was in line with national figures. Bosses have also commissioned a review to work out if the deaths followed a particular pattern.

Figures show that between April and August, there were eight unexpected deaths in West Norfolk, three in North Norfolk, three in South Norfolk, three in Great Yarmouth and Waveney, and three in the Norwich area.

Reports into the circumstances of many of the 20 unexpected deaths have not yet been completed.

Peter Jefferys, non-executive director of the mental health trust and psychiatrist, said he was reviewing the circumstances surrounding the 20 deaths to see if there was a trend. He is set to report back to the NHS trust later this year.

'There has been a bit of a spike in the last six months and we sometimes get clusters where this happens. I will report on whether there is a pattern and whether there are issues. Does it relate to the training of staff on risk management and is our clinical supervision up to standard and are people being left in limbo?'

Between April 2012 and March 2013, a total of 161 serious incidents were reported to Norfolk and Suffolk NHS Foundation Trust, 53 of which were unexpected deaths across the two counties. The trust does not hold Norfolk-only figures for unexpected deaths in 2012/13.

Amanda Hedley, chief executive of mental health charity Norwich and Central Norfolk Mind, said there was evidence that stress about people's debt, jobs and housing situations impacted on people's mental health and wellbeing.

'Where there are social problems with the economy and people losing their jobs, we are likely to see an increase in depression and probably suicide.

'It is good they [Norfolk and Suffolk NHS Foundation Trust] is reviewing what the spike is about because it seems quite an increase in the number of unexpected deaths in a short space of time. People need to feel able to ask for help and there are a range of services that provide help if people know where to go to and people should not be feeling alone if they are dealing with these issues,' she said.

The other serious incidents reported to Norfolk and Suffolk NHS Foundation Trust between April and August included three cases where an under 18 was admitted to an adult mental health ward, three falls, one pressure ulcer, one drug incident, one self harm case and an assault by an inpatient.

Norman Lamb, health minister and North Norfolk MP, said he took concerns surrounding the mental health trust 'extremely seriously.'

'On the face of it, they are extremely troublesome and I want to understand better the long-term trend. It has been established that there is a clear government priority to reduce suicide rates and there are steps that can be taken to reduce suicide rates and we need to understand better the statistics,' he said.

Roz Brooks, director of nursing and patient safety at the mental health trust, said a serious incident (SI) was recorded when a patient died unexpectedly up to six months from discharge.

'Our board has been reviewing all SIs and in particular the number of community deaths. The recent publication of the national confidential inquiry into suicides and homicides has demonstrated that there is an increased prevalence of suicide in the community, the prevalence of community deaths in Norfolk is in keeping with what is happening both regionally and nationally.

'The board is monitoring our SIs closely for all trends or themes. The SI reporting criteria changed in April 2013 and as a result, it is difficult to look at this year's information comparatively.'

The mental health trust is in the process of reducing its budget by 20pc by 2016, which will result in the loss of around 400 jobs.

Bob Blizzard, prospective parliamentary candidate, who has been campaigning against mental health cuts in the Waveney area, said the number of unexpected deaths were 'alarming'. 'I am in no doubt that staff in Great Yarmouth and Waveney are incredibly overstretched and struggling to cope with high demand. These are unacceptably high figures and I would like to see how they are going to get figures down at a time when they are cutting back on staff.'

'When they are overstretched, there will be more incidents like this. Our mental health services have always been a cinderella service and to take 20pc out of an area that has never been well funded is unacceptable,' he said.