New report Released 22/7/2024 From National Institute for Health and Care Research: “Mental Health Crisis: How to improve care”
Someone experiencing a mental health crisis needs immediate professional advice and assessment. Their mental, physical and/or social problems can be extreme, and they need appropriate care to prevent catastrophic outcomes such as suicide.
“those who do reach crisis state… should receive an appropriate level and intensity of care in a timely manner. Such care should be delivered in ways that are shown to be the most effective, making the best use of available resources and the most up to date evidence”. Getting it Right First Time report: Mental Health – Adult Crisis and Acute Care, 2021
Community services for people in mental health crisis provide an alternative to emergency departments or inpatient psychiatric admission. They include helplines, GPs, ambulance services, crisis resolution and home treatment teams, and day treatment services. They are usually delivered by a variety of agencies, including the NHS, the voluntary sector and local government. But people can find services difficult to navigate, which can delay their access to the right care.
NIHR Evidence held a webinar in May 2024 on care for adults in mental health crisis. The webinar shared research findings on:
- what works in community crisis care
- how acute day units compare to crisis resolution teams
- whether peer-supported self-management can reduce acute readmissions.
This Collection summarises the 3 research projects presented at the webinar. It includes video clips from the speakers and incorporates quotes from the day. The information will be useful for anyone involved in commissioning or delivering mental health crisis services.
Background
Recent years have seen investment in community-based crisis care to better support people experiencing mental health crises. Building on the Five Year Forward View for Mental Health, the NHS Long Term Plan aims to expand and improve access to crisis services. Recent service developments include community alternatives to hospital care, mental health ambulances, and changes to the role of police so people in mental health crises are seen by the most appropriate service.
The demand for crisis care is growing, according to the Department of Health and Social Care. Crisis resolution and home treatment teams received more than 520,000 referrals between 2018-2019, and an NHS call line dedicated to mental health crises received around 3 million calls between 2020 and 2021 (during the COVID-19 pandemic). The first presentation explored this complex landscape.
Conclusion
Care for someone experiencing a mental health crisis can mean the difference between living and dying. But the many different models of care and the resulting complex web can be difficult to navigate. People need crisis care that is easy to access and that they can trust. They need to feel safe and cared for. Staff who are well supported by leaders are more able to care compassionately for service users in the longer term. Interagency working takes effort, but it can create systems that engage staff and provide valuable services.
At the end of the webinar, presenters were asked what one thing they would do to improve services. One suggestion was a single point of access to help people find the right service for them. However, there is a lack of evidence that this approach reduces hospital admissions. They also argued for services that are values driven, and increased numbers of staff. Lastly, they called for more support for structured self-management, practical help and social support.
If you need help
Information about your local urgent NHS mental health helpline can be found on the NHS website.
If you are struggling to cope, the Samaritans website contains help and information.
Reference: NIHR Evidence; Mental health crises: how to improve care; July 2024; doi: 10.3310/nihrevidence_63937
Read the full collection and report here: https://evidence.nihr.ac.uk/collection/mental-health-crises-how-to-improve-care/?utm_source=twitter-evidence&utm_medium=social&utm_campaign=mental-health-crises
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