Bradford First Response – update

Case study summary

First Response has made a significant difference to the local management of crisis care, in particular for the emergency services. Intervening early and signposting to the right services has reduced demand on the police, ambulance services and A&E department and achieved a significant reduction in people detained under section 136 – which gives police the power to take someone to a place of safety.  The Care Trust, council, police and other partners have been national leaders in this area of work as part of the ‘Crisis Care Concordat’ multi agency partnership.

Read more about Bradford’s acute care redesign.

See how we first reported on the results of Bradford’s First Response and acute care transformation in 2016.

It is fast approaching two years since Bradford District Care NHS Foundation Trust first launched the First Response service, which offers mental health crisis support 24 hours a day, seven days a week to vulnerable people needing urgent crisis support.

Accessed through a single phone number, 01274 221181, people in crisis can ring for help from trained staff, who can identify the most appropriate course of action.

The service is operated by the trust in partnership with Bradford and Airedale Clinical Commissioning Groups, City of Bradford Metropolitan Council, West Yorkshire Police, Haven, a day-time adult mental health service developed with The Cellar Trust, and Sanctuary, a night-time service developed with mental health charity Mind.

This has resulted in people being cared for closer to home, with no out of area placements since the service launched on 6 March 2015. In 2014-15 out of area beds cost the trust £1.8 million and meant that patients often had to travel a significant distance to receive mental health care at a time when they were in crisis. Following a redesign of services, patients are getting the help they need within their own communities without having to travel long distances.

First Response has made a significant difference to the local management of crisis care, in particular for the emergency services. Intervening early and signposting to the right services has reduced demand on the police, ambulance services and A&E department and achieved a significant reduction in people detained under section 136 – which gives police the power to take someone to a place of safety.  The Care Trust, council, police and other partners have been national leaders in this area of work as part of the ‘Crisis Care Concordat’ multi agency partnership.

Building on the success of the First Response mental health crisis service and completing the mental health crisis care pathway offered across the Bradford District, urgent care service now includes: Safer space, which provides a homely and welcoming overnight place for vulnerable children and young people aged under 18 to visit in emotional distress or crisis from 10pm to 10am,  run in partnership with Creative Support. Haven, a day-time adult mental health service, which is open from 10am-6pm, based at the Cellar Trust in Shipley and the Sanctuary, a night-time adult mental health service, which is open from 6pm-11pm, based at Mind in Bradford.

Debra Gilderdale, Director of Operations and Nursing at Bradford District Care NHS Foundation Trust, said: “It is important that we are developing services together with our local communities for people requiring care and support around their mental health.  Urgent care service such as Haven, safer space and the Sanctuary demonstrate what can be achieved by working as a whole system to ensure positive experiences and outcomes.  Our local A&E departments have reported a reduction in waiting times and West Yorkshire Police have reported a 50% reduction in people sectioned under 136, of the mental health act. Officers receive immediate 24 hour access to health professionals, allowing for informed decisions to be made on how best to support people without being placed in custody and ensuring people in crisis get the help they need. ”

Haven, safer space and the Sanctuary have further reduced the number of people presenting at A&E for unnecessary admissions where more appropriate support is available.  Since the opening of Haven in August 2016, 221 vulnerable people have credited the service with providing them with a place to go as an alternative to A&E.

Nick Smith, a Governor at Bradford District Care NHS Foundation Trust has lived experience of mental health crisis and had his first suicidal thought at the age of nine. Nearly thirty years on, Nick now helps to support vulnerable people that have suffered emotionally or experienced a mental health crisis through his peer support group, which he runs through the trust’s champions Show the Way programme. Nick welcomed the opening of Haven in August, which alongside trained professionals has peer support workers and volunteers working at the centre with lived expertise of mental health crisis.

Nick said: “When I hear things about Haven I’m all for it because Bradford District Care Trust and the Cellar Trust already have a distinctive reputation in the community for helping people with mental health problems.  When they said they wanted to set up a service for people in a crisis and they wouldn’t need to go to A&E, because if you are in a crisis – which I have been many, many times, that’s where you go – I thought it was a brilliant idea.”

Haven plays a vital role in identifying crisis triggers early and preventing a crisis from escalating. People in the local area, when they reach out to services for help and support, receive the right help, with kind and compassionate staff at the times when they need them most, without having to attend A&E.

Since the launch of safer space, parents have fed back that knowing the service is available offering additional support has been extremely reassuring.

The safer space, accessed through the trust’s mental health crisis support service – First Response, provides young people in the local area, when they reach out for support, with access to the right help from kind and compassionate staff to avoid attendance to services like A&E.

Kate Wilson welcomed the launch of safer space; she knows what it’s like to live with mental ill-health. Kate first developed depression at the age of 13 after being bullied at school for being overweight and suffering from chronic fatigue, which left her bedbound for three years.  Over a decade later Kate now uses her own experience to help young people overcome mental ill-health through her work with Barnardo’s.

Kate said: “When you’re in such a low mood, severely depressed and want to end your life, having a safer space to go to for a night would have been really helpful.  It would have given me the chance to speak to someone else in a different setting.”

Young people, like Kate at 13, have helped to decide how the service will look and what should be in it.  The safer space, accessed through First Response, provides a homely and welcoming place for young people to go to when distressed.  Friendly and approachable staff and peer support workers who have personal experience of mental health issues, are on hand to work with young people to develop their plans to stay well and cope better with distress in the future.

With the aim of fulfilling the vision to becoming a national centre of excellence for mental health, the trust have been ensuring people get the right care, in the right place, with the right healthcare professional, close to home.

View further information about First Response.

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