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Taking the crisis out of mental health crisis care

8th December 2016

Dr Emma Whicher, Clinical Lead for Healthy London Partnership’s Mental Health Crisis Care Programme and Medical Director at South West London and St George’s Mental Health NHS Trust, on how London is introducing standards for mental health crisis care across the city.

It is estimated that in any given year one in four Londoners will experience a diagnosable mental health condition.

Mental ill health affects 13 Londoners on your busy bus in the morning, more than 100 Londoners on your morning tube and three children in every school class.

London’s mental health crisis care system is under immense pressure and Londoners are suffering because of it.

In the past 12 months 4,000 Londoners were detained under section 136 of the Mental Health Act. One London A&E department saw an 82% increase in children needing an emergency assessment.

These staggering figures show we must work harder to prevent mental illness in the first place and help Londoners before they reach breaking point.

Over the past 12 months in my capacity as clinical lead I have seen how the work of Healthy London Partnership has brought together a myriad of people working in or using the mental health crisis care system.

We have passionate first-hand accounts from over 300 service users, 70 police officers and 350 front line staff in mental health and emergency services.

Together we have developed guidance around the section 136 pathway and Health Based Places of Safety that sets out new standards London’s health, care and police services will have to meet to make sure people of all ages get timely, high-quality care, in an appropriate location, wherever they are in London, 24 hours a day, seven days a week.

There are many cases that illustrate this support isn’t currently available with only half of community teams in London offering an adequate 24/7 crisis service. This results in A&E departments being the regular default, not ideal for someone having a mental breakdown.

The guidance shows what mental health crisis care needs to look like in the future in London.

In the future a suitable mental health professional will always be available for a police officer to consult with and hand over responsibility to, before they detain someone under section 136.

People in crisis will always be transported by ambulance not police car.

Right from the beginning, all professionals treating someone in crisis will treat them with care, compassion and respect.

People will be able to receive physical and mental health treatment in the same place according to the person’s needs.

Following a crisis, anyone who is discharged from an A&E or Health Based Place of Safety, will be provided with advice and support if they want it and safe transport home, especially at night.

We now have a blueprint for how crisis care needs to work — and what it needs to feel like –for Londoners in crisis.

We have transformed care in London for those who have a stroke or a heart attack and now we will do the same for our most vulnerable Londoners during a mental health crisis.

Download the new guide: Mental health crisis care for Londoners

About the author

Dr Emma Whicher is Clinical Lead for Healthy London Partnership’s Mental Health Crisis Care Programme and Medical Director at South West London and St George’s Mental Health NHS Trust. She studied medicine at Cambridge University and St Mary’s Imperial College, London. She worked as a junior doctor in Australia and was a psychiatry trainee in Leeds before moving to London. Emma has also held various regional and national roles.

For more information about our Mental Health programme contact George Howard, Senior Lead, at george.howard@nhs.net

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