Dan Parton considers the growing issues in mental health crisis care:
There was worrying news last week from Mind that NHS mental health crisis care is ‘under-resourced, understaffed and overstretched’, leading to thousands of people not getting the care they need. These problems must be addressed – and urgently.
That crisis care is struggling with a lack of funds and staff will be no surprise to anyone connected to mental health services – providers or users – but the scale of that struggle might take some people aback.
For instance, the finding that 41% of mental health trusts have staffing levels well below established benchmarks is shocking. The crucial part of that sentence is ‘well below’ – meaning that care standards will suffer, not because the staff don’t care, or aren’t good at their job, but because there is only so much a certain number of people can do.
Likewise, only a third of those who came into contact with NHS services, when in crisis, were assessed within 4 hours – as recommended by NICE. Additionally, 10% of crisis teams to not operate 24/7, again, as NICE recommends.
When people are in crisis, that’s an emergency, and emergencies don’t conveniently happen between 9 and 5, Monday to Friday. Crisis services need to be available at all times – and they need the resources to ensure that this can happen.
While Mind’s report acknowledges that there is excellent crisis care available in some parts of the country, in others it isn’t. Good services in an emergency situation can make a vast difference to the outcome for the person in crisis – and can even be life-saving. Where you live should not be a factor in whether you receive good services.
Hopefully, as commissioning powers for health services transfer to clinical commissioning groups, they will assess local crisis care responses and ensure that a range of good quality services are put in place, if they aren’t already there, and maintain them if they are.
But – and it is the usual but – funding is the problem. That crisis services are already suffering in this way is a particular worry, given that more public sector funding cuts are coming in 2013 – and succeeding years – which mean that mental health services could be squeezed even further.
If this is the case, then heavier pressure could be put on crisis services, which, in turn, could have an adverse impact on general standards of care – a lose-lose situation, if you will.
Mind’s report should act as a wake-up call for those in charge of the purse strings –from the Government to local commissioners – to ensure that crisis services are given the resources they need in terms of finance and personnel. Without those resources, crisis care faces a tough future and, more importantly, people in acute difficulty may not get the care they need, which could, in some cases, prove fatal.