London improving mental health crisis

Topics covered: Ridouts professional advice

This year there has been an increased focus on mental health following the government’s mental health action plan ‘Closing the Gap’. Waiting time targets have been introduced with the aim of improving treatment and standards for people with mental health problems.

Chief Executive of South London and Maudsley NHS foundation trust, Matthew Patrick who directs the mental health crisis care concordat believes there is still a way to go before patients experience true “parity of esteem”. One initiative is to bridge what remains as one of the biggest gaps between the treatment of mental and physical health: emergency care.

Matthew Patrick said that physical traumas are considered to be emergencies, but in the case of a mental health crisis, the care is far more variable. It can involve any one of 14 different places to get help, including accident and emergency, the transport police or homecare. Or a person could be taken to a police cell as a place of safety for a mental health assessment.

In 2012-13, police made nearly 22,000 detentions under section 136 of the Mental Health Act. Across the country, two-thirds of these people were taken to hospital but a third were taken to police cells, an inappropriate and distressing environment for someone experiencing a mental health crisis.

Mr Patrick said that: “It’s time to rethink how we respond to individuals in crisis. We need to improve the system to provide people with the rapid and effective support and care that they deserve – whatever the circumstances in which they first need help and from whichever service they turn to first.”

Mr Patrick said that to make improvements, a whole system view was required with an integrated strategy that extends to social care, housing and employment support as well as substance abuse. This approach delivered the Strategic Clinical Network’s commissioning standards which are a set of recommendations for commissioning mental health crisis services across London. Representatives from 22 organisations including Mind, the Metropolitan Police, NHS, social care, housing and local councils met a few weeks ago to agree an action plan for implementation.

Recommendations include a round-the-clock telephone helpline; 24-hour psychiatric services in accident emergency departments across London, and mental health crisis care training for GPs, practice nurses and community staff.

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