Mental health crisis services rolled out across england

Mental health crisis teams will be strengthened and new alternative forms of provision such as safe havens and crisis cafes will open across the country as part of the NHS Long Term Plan.

More than £200 million of national funding has been allocated to local areas to transform urgent and emergency mental health care through a network of services over the next two years.

Just under half of NHS mental health crisis teams currently operate on a 24/7 basis but under the plans, every single one will offer round the clock support, making access to care much easier for people in need of urgent mental health support.

The money will also boost the roll out of new or expanded crisis services such as safe havens, crisis cafes and crisis houses in every region.

These services are usually provided by the voluntary sector or NHS and tend to be rated highly by patients – helping people whose needs might be escalating to crisis point. Another £140 million will bolster these services further from 2021 onwards.

While the crisis teams offer urgent and emergency mental health support in the community or intensive mental health treatment at home, studies have also shown that when fully staffed and operating 24/7, they improve patient experience and free up resources by providing an alternative to A&E or inpatient admission.

Sir Simon Stevens, NHS chief executive said: “The NHS is delivering on its pledge to improve mental health support, with every local health service now signed up to providing a round-the-clock community mental health crisis service by 2021. This means people will be able to self-refer in the same way they can for urgent physical health care. And it will also help relieve pressure on other emergency services including A&Es, the police and ambulances.”

Every local health service has signed up to having a round the clock community mental health crisis service by 2021 – with people able to self-refer to in the same way they can for urgent physical health care – mostly over the phone but also online or by simply dropping in.

Friends, families and other professionals who may be supporting people experiencing a mental health crisis, such as police and ambulance staff will also be able to access the teams 24 hours a day, 7 days a week.

NHS crisis teams include mental health professionals, nurses, social workers, pharmacists and support workers. They provide care at home for people experiencing a mental health crisis who might otherwise be hospitalised for example due to psychosis, self-harm or suicidal feelings.

The teams can administer medication, provide practical support, for example with money or housing and or help plan care prevent a crisis happening in the future.

Claire Murdoch, national mental health director for the NHS said: “Specialist NHS mental health crisis teams working with the voluntary sector on alternative forms of provision such as crisis cafes and safe havens, can often be a better way of meeting needs of people experiencing a mental health crisis than A&E or an inpatient psychiatric admission. Rolling these services out in every part of the country will help to address some of the most pressing inequalities in access to urgent care that people with mental health needs have experienced.

“This investment in life changing services will also pave the way for the flagship long-term plan ambition to make NHS 111 the single universal point of access for urgent mental health care by 2024.

Sophie Corlett, Director of External Relations at Mind, the mental health charity, said: “It is very encouraging to see this much-needed investment in crisis care services. For too long people with mental health problems have struggled to get access to appropriate services when they reach crisis point. Routinely, people find that in their area ‘crisis’ phone lines are only open during office hours and, when they do get through, are required to wait hours or even days before they can access help. When you are in crisis, when you can no longer cope, you need access to support right away, whether that is specialist mental health support that comes to where you are, or the option of more informal support in a sanctuary or evening ‘crisis café’, a safe space where you can be supported to recover. It is particularly positive to see a focus on peer support workers and addressing inequalities experienced by particular groups when accessing services, such as young black men.”

National Police Chiefs’ Council lead for Mental Health, Chief Constable Mark Collins said: “The police service is responding to increased levels of demand caused by incidents related to mental health, which are not crime related. Any strengthening for mental health provision, enabling practitioners to offer appropriate care and support to those in mental health crisis is welcome. This should ease the pressure on our people and ensure those in mental health crisis have more direct access to treatment in line with their care needs.

“There is a well-established, and growing dialogue between partners to build lasting support networks between emergency services and we will work closely with the NHS and others to ensure this continues at pace.”

Some local examples of the type of transformation happening include:

£3 million to Hampshire and Isle of Wight STP:

  • 24/7 access to mental health crisis care through NHS 111 for everyone across Hampshire, Isle of Wight, Southampton and Portsmouth
  • Safe havens across Portsmouth and SE Hampshire with substance misuse specialists and peer support workers
  • Respite house where people can stay for up to four weeks when needs escalating to crisis point
  • More staff in crisis teams across the region.

£1.6 million to Northamptonshire STP:

  • A new crisis house in the north of the county, building on the success of the one south of the patch. The houses provide a homely environment where people can stay for two-five days as an alternative to admission to a psychiatric inpatient ward
  • Increasing staffing and opening hours of the crisis cafés across Northamptonshire. These are a drop in without the need to book appointments
  • Creation of a 24/7 clear single point of access for all mental health care in the county, which will include access to crisis care staff, social care, psychological therapies and voluntary sector support.

£3.6 million to North Central London STP:

  • Services that are designed with young black men, to be more suitable to meet their mental health needs in the community in view of the disproportionate number of young black men who end up detained under the Mental Health Act
  • Specific mental health crisis services tailored to older people and their carers, building on success of the leading service in Camden and Islington.

 £5.7 million to Cheshire and Merseyside STP: highlights include:

  • Everyone will be able to access mental health crisis care by calling 111 and selecting option 2
  • Staffing to increase in all crisis teams across the region so that everywhere has 24/7 access and intensive support at home to people who would otherwise need an admission.

The new investment in crisis alternative services will mean employment of thousands more peer support workers with lived experience of using mental health services.

They will also require a focus on addressing historical inequalities in experience of mental health care such as those faced by young black men or people with substance use problems.

The NHS Long Term Plan creates a new fund for local mental health services worth at least £2.3 billion each year by 2023/24.