Founder and CEO of the Suicide Crisis Centre, Joy Hibbins, considers how her charity is becoming a replacement crisis service for an understaffed NHS
“Up until now, I’ve tried to avoid direct criticism of the operational aspects of our mental health crisis services.
I’ve spoken more generally about how I feel changes and reform are needed. But I think the issues are now so serious that the current situation has to be highlighted.
I run a Suicide Crisis Centre. We’re a registered charity, totally independent of NHS services. Increasingly, we have become a replacement crisis service for people who are under community mental health services. Last month 77% of our clients were under secondary psychiatric services which are for people with more severe and enduring mental health conditions such as schizophrenia, bipolar disorder and personality disorder.
If you’re under that service, you have access to the Crisis Resolution and Home Treatment Team. If you are at risk of suicide, they are the team you contact.
What’s happening is that people under the service are contacting us instead when they are in crisis. Increasingly, it’s because the crisis team isn’t getting back to them quickly enough – or at all.
Clients in need
A client under secondary psychiatric services who contacted us last week told us that she had left a voicemail message for the crisis team to call her and they didn’t return her call at all that night. She was left unsupported. She was the second client to inform us of this kind of occurrence in that week.
When a BBC news crew filmed our work last autumn, they saw us trying to contact the crisis team for a client we went out to visit. The cameraman captured on film the moment where the 24-hour crisis team was “closed”. That was just before 10pm. We were assured that they would phone us later. They didn’t. We stayed with Sarah until 5am and they didn’t call during that time.
High demand and understaffing
We cannot simply dismiss that as a one-off. It is still happening. My impression is that the local mental health teams cannot meet the demand for their services, and are chronically understaffed at times.
Staff shortages put lives at risk. A young woman who we have supported in the past contacted us shortly after midday on Tuesday. She was at risk of suicide. Her presentation concerned me and I felt she needed psychiatric assessment. She is under secondary mental health services and had tried to contact her regular team but no one was available, she said.
I contacted the mental health service which supports her - the Recovery Team. There should always be a member of the triage staff available within that team to talk to patients. They had no one on triage that day, their receptionist told me.
I called the crisis team. I told the crisis team member who answered that there was no one on triage in Recovery – no one to help to or assess our client. Despite this, he insisted that until 5pm she must be supported by Recovery. After 5pm the crisis team would be available to her, he said. I explained that she was at risk of suicide. Despite this, he insisted she must call the Recovery Team. He actually put the phone down on me at this point.
If we had not been there, she would have been totally unsupported and at risk, at a time when she needed psychiatric assessment.
Later that day I was contacted by a young woman in her twenties who is also under secondary mental health services. She is well-known to the crisis team. She was stating an intention to harm herself but would not give me her location. For the next five hours I communicated with the local police force as we tried to locate her and ensure her safety. I don’t know if she tried to contact the crisis team at any stage but they certainly weren’t involved that evening.
She was found by the police and is safe and well.
As a result of all this, I worked a seventeen-hour day. I wasn’t forced to do it. It was my choice. We care about our clients and I couldn’t have just gone home knowing one of them was at risk. But I am left feeling that if we had a properly-staffed mental health crisis service, I wouldn’t have needed to do all that last Tuesday.
An unofficial replacement for the NHS crisis team
We are far too regularly an unofficial replacement for the crisis team, because they are either unable to meet demand or they are understaffed.
I know that NHS staff are also affected by the current situation. Mental health staff work beyond their allocated shift, too, because they are concerned about a patient.
The Suicide Crisis Centre was set up predominantly to help people at risk of suicide who were not accessing any other service and people who had disengaged from other services. It was set up to reach people who are unlikely to ask for help from anyone else.
As we are supporting so many people who should be able to access the crisis team but can’t, we are concerned that there are times when the people who are not under services are unable to access us because we are so inundated with clients.
We need the crisis team to be sufficiently staffed so that they can respond to people under the care of mental health services who are at risk of suicide. The current situation places lives at risk."
Joy Hibbins is Founder and CEO of the Suicide Crisis Centre