A huge shake up of A & E provision was announced this week by Professor Bruce Keogh, the top doctor in the NHS. Will these proposed changes be any more effective than a sticking plaster in terms of the actual benefit for mental health service users?
Given that rapid decline of a person’s mental health should be recognised as a mental health emergency, what of emergency mental health services? It is hard enough for people in mental health crisis to know where and how to access urgent healthcare, without this proposed tiered system adding to the confusion. How will patients who are mentally unwell know where to turn for help if they are unable to access out of hours mental health services? New super A & E, standard A & E, evening/night GP surgery, 111, paramedic? The list of options is mind boggling. I ask myself the question,if I were psychotic, paranoid, manic or deeply depressed, would I be able to adequately access urgent help when I may need it most?
The solution is to improve access to specialist support, to lessen distress and prevent crises; by this I mean 24/7 crisis resolution and home treatment teams in all parts of the country. In particular, rural communities and areas where the demand stretches existing resources such as inner cities, and at weekends and public holidays. Improvement need to be made to existing services such as A & E to provide a seamless net to ensure immediate access is available. Really, we need to be looking at improvements to the urgent care system for both physical and mental health, for young and old alike.
I do hope that thought is given to this sector of the public and their specialist needs. I really do not want to see mental health relegated to a “bolt on” or simply a sector that will have to “fit in.” Any redesigning of the infrastructure of the NHS ought to be reconfigured to meet the needs of this often overlooked and vulnerable sector of our society.
Your thoughts and comments on this subject would be most welcome.
According to Steve Duggan, Chief executive at the centre for Mental Health, the quality of care that mentally ill people receive when they are at their most vulnerable is “unacceptable”.A report from four national inspectorates found that police cells were used under section 136 of the mental health act, some 9.000 times as a “place of safety.” Surely, they are only meant to be used as a last resort?
When it comes down to accessing care; The Health and Social Care Information Centre estimate that mental health service users attended A & E departments at twice the average rate, compared to the general population. So where are the dedicated psychiatric A & E departments?
Until Next time, Steve Clifford, Cognitive Behavioural Psychotherapist
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*Duggan, S (2013) Leadership in Mental Health, Health Service Journal. June. www.hsj.co.uk/opinion/blogs/leadership-in-mental-health/2007653.bloglead [Accessed 13/11/13]