Responding to the briefing, Rebecca Gray, NHS Confederation mental health director, said: “This briefing shines a welcome light on the challenges currently facing crisis and inpatient mental health services and support.
“NHS and voluntary, charity and social enterprise (VCSE) providers have worked together to significantly expand crisis provision, including crisis houses and assessment centres, psychiatric liaison services in acute hospitals and phone lines.
“The commitments in the government’s Ten-Year Health Plan such as new Mental Health Emergency Departments, expansion of 24/7 neighbourhood mental health care centres and assertive outreach teams, can also build on existing work to provide more proactive care and keep people well and out of hospital.
“But we know that due to demand outstripping capacity the needs of many individuals such as children and young people, people with learning disabilities and autism as well as minoritised communities are not being met.
“All parts of the system – including ICBs as strategic commissioners, providers in mental health, ambulance and acute services – must work together to support the development and expansion of the most effective, evidence-based pathways for crisis support, including VCSE provision.”
The briefing’s recommendations are:
- The NHS in England should invest in mental health crisis care, addressing gaps in provision and updating estates which are no longer fit for purpose, with decisions about investment priorities being led by the available evidence of what is safe and effective.
- Integrated care boards and NHS mental health service providers should review whether their crisis and acute care provision is sufficient to meet the needs of their populations, and whether it is based on currently available evidence of safety and effectiveness.
- Mental health service providers and commissioners should work in partnership with a wide range of service users, carers, and community- and user-led organisations to co-design crisis and acute mental health services.
- Mental health service providers should not routinely use surveillance technology except as part of robust trials of its safety, acceptability, and effectiveness.
- Research funders should prioritise evaluations and trials of community-based crisis care, of ways to avoid compulsory admissions, of ways to make hospitals safer and more therapeutic, and of alternatives to hospital admission.