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Mental health service failing thousands in crisis every year

Services are understaffed, under resourced, and overstretched, says MIND

Caroline White

Wednesday, 28 November 2012

Mental health services in England are failing thousands of people in crisis every year, because they are understaffed, under resourced, and overstretched, says the charity MIND.

The charity bases its conclusions on three separate pieces of research: Freedom of Information (FOI) requests to mental health trusts; a service user survey of almost 1000 people; and preliminary research by University College London.

The findings show that four out of 10 mental health trusts (41%) in England have staffing levels that are well below established benchmarks, and access to crisis care varies widely.

One in 10 crisis teams still fails to operate services 24/7, despite recommendations by the National Institute for Health and Clinical Excellence (NICE).

Only half (56%) of crisis teams accept self-referrals from known services users and just one in five (21%) from service users that aren’t already known to them. This is despite NICE guidance that crisis teams should offer self-referral as an alternative to emergency services.

But when people in crisis did access these services, the quality of care fell short of recommended standards.

Almost one in five (18%) service users said that they were not assessed at all, while only one in three (33%) were assessed within the four hours, recommended by NICE. 

Furthermore, only 14% of those who used these services felt that they had been given all the support they needed. Less than a third (29%) of service users felt treated with dignity and respect by all staff.

Sonia Johnson, Professor of Social and Community Psychiatry at the Mental Health Sciences Unit, University College London, said that crisis teams seem to vary greatly in the amount of resource and service options.

“A particular challenge for some is being expected to deliver an increasingly wide range of services, for instance in the casualty department,” she said.

“Service users and carers often report discontinuity of care and limited therapeutic contact with staff. We need to listen to them and ensure crisis teams have clear roles in local service systems and the resources and training they need to carry these out.”

Paul Farmer, Chief Executive of MIND, said the charity was “deeply concerned” that some crisis care services were struggling to support those at a time when they most needed their help.

“We know that excellent crisis care exists, but we need it available to everyone, regardless of where they live,” he said, adding that these services could make “a huge difference,” and that a prompt response was crucial.  “An emergency is an emergency,” he said.  

The NHS Mandate, released earlier this month, emphasised that mental health should be put on a par with physical health in the NHS, and as CCGs take the helm, there was a real opportunity to do that, he said.  

“We want CCGs to use the data we are releasing today to inform how they can commission a service that addresses the needs of people in crisis,” he urged.

MIND has launched an online tool to help commissioners and service users to understand crisis care services for mental health in their area by hosting the FOI data from their local trust.

The charity is also sending a detailed briefing to all Clinical Commissioning Groups in England outlining where services are struggling and how they can be improved.

Interim director of the Mental Health Network Paddy Cooney commented: “It’s no secret that the NHS is under intense financial pressure at the moment, but for the future health of the country, it is crucial we don’t see a disproportionate impact on mental health funding or services.”

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