Better care for mental health crisis

Emergency support for people in mental health crises is set to dramatically improve as part of a far-reaching new agreement between police, mental health trusts and paramedics.

The agreement – called the Crisis Care Concordat – has been signed by more than 20 national organisations in a bid to drive up standards of care for people experiencing crisis and help cut the numbers of people detained inappropriately in police cells and iron out the variation in standards across the country.

There are stark inequalities in the acute sector of mental health care for people from some BME groups who continue to be over-represented in hospital and as detained patients and in crisis care overall.

Deputy Prime Minister Nick Clegg said: “A mental health crisis can already be distressing for individuals and all those involved, but when people aren’t getting the right support or care it can have very serious consequences. It’s unacceptable that there are incidents where young people and even children can end up in a police cell because the right mental health service isn’t available to them.

“That’s why we’re taking action across the country and across organisations to make sure those with mental health problems are receiving the emergency care they need.

“We want to build a fairer society – one where mental health is as important as physical health – and the Crisis Care Concordat is an important step towards addressing this disparity.”

Norman Lamb, Care and Support Minister, said: “When someone has a mental health crisis, it is distressing and frightening for them as well as the people around them. Urgent and compassionate care in a safe place is essential – a police cell should never need to be used because mental health services are not available. For me, crisis care is the most stark example of the lack of equality between mental and physical health.

“The NHS and police already work well together in some areas, but it is totally unacceptable that crisis mental health care is so variable across the country. It is imperative that all areas seek to implement the principles of the Concordat as quickly as possible to ensure consistent care, no matter where you live.”

Local areas will now sign their own regional and local agreements to commit to working together across services to improve care and potentially save lives and is expected to have agreed a Mental Health Crisis Declaration by December 2014.


People from BME groups are more likely to present in crisis with A&E often the first point of contact. The Concordat  acknowledges that this needs to be addressed and sets out that work will begin before March to look at inequalities in access to mental health services for BME communities with the aim of improving care.

• In areas where black and minority ethnic groups have a higher risk of being detained under the Mental Health Act, this must be addressed by local services in consultation with these groups; and

• A 24-hour helpline should be available for people with mental health problems and the crisis resolution team should be accessible 24 hours a day, 7 days a week.

• Health-based places of safety and beds are available 24/7 in case someone experiences a mental health crisis;

• Police custody should not be used because mental health services are not available and police vehicles should also not be used to transfer patients. We want to see the number of occasions police cells are used as a place of safety for people in mental health crisis halved compared 2011/12;

• Timescales are put in place so police responding to mental health crisis know how long they have to wait for a response from health and social care workers. This will make sure patients get suitable care as soon as possible;

• People in crisis should expect that services will share essential ‘need to know’ information about them so they can receive the best care possible. This may include any history of physical violence, self-harm or drink or drug history.


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