The Care Quality Commission (CQC)’s “Right here, right now” report examines people’s experiences of the quality of help, care and support provided during mental health crises. This national review concludes that people in need of urgent mental health care in England frequently receive inadequate support.
This review is based on surveys of patients’ experiences, analysis of national data and inspections of services. It indicates that 42% of patients may not get the help required. Only 14% of survey respondents thought the care they received was appropriate or helped resolve their crisis. A&E staff are sometimes unsympathetic. Patients are sometimes passed between three or more different services; over 10% of patients come into contact with between six to ten services.
“Except for people with dementia, most people with a mental health condition are admitted to hospital via A&E in the evenings (outside of 9am and 5pm). In particular, the peak hours for self-harm admissions are between 11pm and 5am when it accounts for 6% of all people admitted via A&E. This may indicate that there are problems with other services providing support out of hours, so that people turn to A&E for help because other support is not available”. (p.9)
Triggle, N. (2015). Mental health crisis care ‘struggling to cope’. London: BBC Health News, June 12th 2015.
This relates to:
Right here, right now: people’s experiences of help, care and support during a mental health crisis. London: Care Quality Commission (CQC), June 12th 2015.
There is also an Executive Summary.
Race Equality Foundation’s Companion Report on Mental Health Crisis Care
The Race Equality Foundation’s parallel report discusses how black and minority ethnic patients experience discrimination and poor service in mental crisis care. The issues covered include:
- Experience of discrimination on the basis of race or other characteristics.
- Emergency and urgent care services failing to address cultural needs.
- Limited understanding / appreciation of faith and cultural sensitivity in the mental health system.
- The attitude that mental health is a lower priority.
- The impact of cuts to local services on specialist BAME mental health services.
Examples of good practice are mentioned, such as provision of specialist supported housing, work with service-users (and their carers) to develop care plans, and services working together to support people and prevent repeated crises.
Jeraj, S. Shoham, T. [and] Islam-Barrett, F. (2015). Mental health crisis review: experiences of black and minority ethnic communities. London: Race Equality Foundation, June 2015.
Steps at NHS England Towards Transformation of Mental Health Crisis Care
NHS England’s National Clinical Director for Mental Health, Dr Geraldine Strathdee, has written about innovations in mental health crisis care:
Transforming mental health crisis care – Dr Geraldine Strathdee. London: NHS England, June 15th 2015.
Working to deliver the care mental health patients deserve – Dr Geraldine Strathdee. London: NHS England, June 22nd 2015.
As a further step towards minimising the stigma of mental health problems, new guidelines are to be issued concerning factors to be considered for Disclosure and Barring Service (formerly CRB) checks. Mental health crises – which are not crimes – need not always be disclosed to employers in background checks.
Home Office to issue mental health disclosure advice. London: BBC Health News, August 9th 2015.