网曝黑料

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The NHS has confirmed that it will be opening specialist mental health crisis centres in England over the next decade.

The plans are currently being trialled by ten hospital trusts and have been outlined in .

Responding to the proposals, Dr Lade Smith CBE, President of the 网曝黑料, said:

• Although patients with mental health problems account for less than 2% of the total attendances, one in four mental health patients wait longer than 12 hours in Emergency Departments compared to one in 10 of all other patients (RCEM QIP report).
• The Darzi report even noted a patient waited more than 18 days in an A&E department.
• Patients complain that emergency departments are often loud, noisy and overcrowded, and can make them feel worse when they are undergoing a mental health crisis.

“Estimates from the pandemic suggest that between two-thirds and three-quarters of patients in acute mental health crisis have co-existing physical conditions that must be addressed, before their mental health problems can be treated. In addition, 10% of patients initially thought to have purely mental health needs are found, during assessment, to have a serious physical health problem requiring them to be transferred to emergency physical care.

“Separating care increases the risk that a physical health need may be missed or inadequately treated. This approach could make it more difficult for people to come forward for help.

“Specially designed Mental Health A&Es co-located together with general A&E departments work well and are associated with a significant reduction in waiting times for mental health patients, as seen in Hull University Hospital.

“We are concerned however that the creation of standalone Mental Health A&Es will lead to communication breakdowns, barriers and delays as patients will have to be transferred back and forth between physical and mental health services. And of course, if these services are not on the same site, these transfers will require ambulance support. Learning from past experiences during Covid, it is clear that these services need to be co-located or linked.

“People need to be able to access mental health crisis care from fully integrated services that are able to work collaboratively with other teams to meet all their needs. There are numerous evidenced based interventions which improve emergency care, including investing in liaison psychiatry services, which specialise in providing care to children and young people, as well as adults, with both mental and physical illnesses in hospital, improves outcomes for patients.

“It is unclear whether these separate A&Es will be required to meet waiting time standards, which help prevent and reduce delays. People in crisis often face unacceptably longer waits than those with physical health problems, and only through investment across the mental health pathway will we solve this issue.

“There is also a risk that dividing physical and mental health services in this manner will reinforce the stigma surrounding mental illness and misconceptions that it is less important. This may discourage people from seeking the treatment they urgently need.

“Mental illness represents 20% of the UK’s disease burden but receives only 10% of health funding. And so, while the ?26 million allocated for these plans is welcome, it does little to address the gap in funding between physical and mental health services.

“There must also be a greater focus on earlier intervention to prevent people reaching crisis point. This requires proper support of the community mental health framework, which has been implemented patchily across the country.

“Access to timely and appropriate specialist mental health care would reduce the numbers presenting in mental health crisis as well as reduce levels of disability. The 1.7 million people waiting for non-emergency, pre-planned mental health care are not included in the UK Government’s new or , both of which are aimed at reducing waiting lists and would greatly benefit this patient group.

“If Mental Health A&Es are designed and developed using the evidence available about what works, the UK Government has a real opportunity to improve mental health care and reduce the burden on A&E.

“We want to work with policy makers to ensure any reform of crisis services, and the treatment pathway, is evidence-based, clinically-led, tailored to people’s needs and improves the availability of high-quality care.”