News Release, 27 February 2002
There should be UK-wide investment to help establish community-based crisis services for people with severe mental health problems to use wherever and whenever they need them, according to two leading mental health research charities.
The recommendation is made in a new report, Being there in a crisis, produced by the Mental Health Foundation in association with the Sainsbury Centre for Mental Health to be launched at a London conference on Thursday 28 February 2002.
"It is time we took a fundamental look at the services available for people experiencing mental health crisis," said Ruth Lesirge, chief executive, Mental Health Foundation. "Existing hospital-based services can be unpopular with both staff and service users, who often report feeling punished for their mental distress. We need to build on the positive experiences of the small number of innovative community-based crisis services, frequently run by the voluntary sector, which focus not only on medication and containment but on supporting people to recover. We will always need hospital care, which needs to be of good quality, but providing alternative community-based services but providing alternative community-based services will help to meet needs more effectively and flexibly."
The report is based on the Mental Health Foundation's crisis programme which supported the development over three years of seven different alternative and complementary crisis services run by voluntary sector and service user organisations. These crisis services included crisis houses, helplines and drop-in services. In addition the report incorporates the evaluation of three crisis houses (two funded and supported by the Mental Health Foundation) by the Sainsbury Centre for Mental Health.
The report reveals that, in addition to providing a service that is highly valued by service users, community based crisis services may often prevent people needing hospital care and have similar readmission rates to those for inpatient wards. Although it is difficult to make a direct comparison of costs between inpatient and community-crisis services, as the services are so different, services by the crisis houses evaluated in the report varied from £66.88 to £113.81, which contrasts with an average daily cost of providing hospital care to somebody experiencing a mental health crisis of between £144.00 and £210.00.
It is estimated that up to 1.5% of the adult population experiences severe mental health problems (including long term clinical depression, manic depression, psychosis, schizophrenia and severe eating disorders). In the year to 31 March 2001 there were over 100,000 admissions to hospital for severe mental health problems - admissions which are often precipitated by a crisis.
Sainsbury Centre for Mental Health director of research, Richard Ford, said: "This report provides evidence that these alternative crisis services can work in practice as effective parts of a range of crisis service provision and most importantly that these services are highly valued by service users. With current Government policy endorsing the development of alternative crisis service provision combined with this evidence, there should now be wider development of these types of services on a national scale."
Users of the crisis services overwhelmingly felt that they could not have got the same kind of help from other services:
"It is completely different compared to the hospital. I was in hospital for seven months, the staff sit and read newspapers and dish medication, you are not allowed out. It really does not compare, you get your own life back, people help to pick up pieces."
Being There in a Crisis recommends:
- Service commissioners and providers should ensure that existing services are audited on how well they are meeting individual needs and consider greater access to alternative and complementary provision to meet needs more flexibly
- The programme of increased investment in mental health services should continue but with a broader focus across the full range of crisis provision
- Specific mental health crisis support should be available for women and minority ethnic communities for example
- Crisis services should ensure that staff are trained and have the time to talk with and listen to those experiencing distress
- The future development and improvement of inpatient acute care should be influenced by the lessons from this report
- Community-based crisis services, developed with voluntary sector services and service user groups, should establish good links and take referrals from statutory services but continue to have equal usage through self-referral to ensure continued independence
Return to news releases 2002
For further information and interview requests contact please contact the press office on 020 7803 1105 / 1128 or email the press office
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