Mental Health Emergency Treatment: A Sea of Change is Required

It's clear that a sea change is required in the way emergency treatment is delivered to people in acute mental distress. There needs to be more help and different types of help appropriate to people's levels of need, rather than the literal all or nothing that exists at the moment.

If you call 999 in an emergency, you would reasonably expect an ambulance to turn up.

When your physical health is in jeopardy, you expect your call to be taken seriously, your emergency to be treated as an emergency, and that wherever you are - day or night - help will be on its way.

If, on the other hand, you find yourself in a health crisis and you call an emergency number - the one you were given by your GP for those exact, urgent situations they told you might happen - and the phone rang and rang without an answer, you would be surprised.

If rather than being offered help, the operator told you to drink a warm drink, take a hot bath or go for a walk, you would be outraged. If you were told that the hospital was full, and that there were no teams available to visit you, you would wait as your health deteriorates, wondering what on earth you should do to get help.

As heinous as it sounds, if you need crisis care for urgent mental health problems, that's exactly what can happen to you.

Crisis care is the 999 of mental health, and deals with emergency situations where people are suicidal, immobilised by depression or intensely distressed within the changed reality of psychosis.

Mental health crises are every bit as urgent and life-threatening as physical health emergencies, but according to a new report published by mental health charity Mind today, getting help for them is far from straightforward.

The above scenarios aren't fictional. Mind's year-long investigation heard from hundreds of people who had called for help in desperate situations, some of whom who had been given advice as inadequate as staving off an emergency with a hot drink.

For many people, trying to get help was a lengthy process, involving delays of days in getting a response, fleeting visits from a community crisis team to deliver a tick-box assessment, and being told that there were no hospital beds available.

For some people who got a hospital bed, hospital was less a place of treatment, and more a place of containment, with no one to talk to, nothing to do, and not enough treatments on offer. Some patients had even been subject to abuse and taunting from staff members, and many felt unsafe.

If this was what happened when we tried to get help for our bodies, it would be unacceptable.

But it's not just about failures in processes or service provision being 'unacceptable'. For mental health, the very nature of mental and emotional distress means that it is even more important that staff are supportive, environments are safe, and that treatment is immediate, as anything less can have serious knock on effects for mental health.

Traumatic environments and circumstances are not conducive to recovery, and whether you have experience of mental heath issues or not, that much should go without question.

However, despite hearing from patients who had had truly appalling experiences, this was not the whole picture.

Mind also heard about some excellent examples of care, with warm and supportive staff, seamless allocation of the right help at the right time, and treatment that had helped change people's lives in the long term.

In addition to forward-thinking NHS care, we heard of innovative approaches from the voluntary sector, such as Leeds Survivor Led Crisis Service, which offers a safe place for one to one support after crisis teams have finished their nine to five shifts.

It's there for people who are in crisis, but don't feel they need to be in a locked hospital ward, filling the gap between community crisis teams and hospitals that exists all over the country.

Sadly, although there are other innovations elsewhere, the Leeds service is the only one of its kind in England.

It's clear from Mind's findings that a sea change is required in the way emergency treatment is delivered to people in acute mental distress.

There needs to be more help and different types of help appropriate to people's levels of need, rather than the literal all or nothing that exists at the moment. The culture needs to be improved, so that standards that we would never accept in physical health treatment are not tolerated for mental health either.

It's clear that good mental health services are achievable, but it needs to happen everywhere. An emergency is an emergency.

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