Practice nurses, GPs and other community staff in London should be provided with training to assess and manage mental health crisis, new regional standards have recommended.
This training should include understanding the potential causes of crises, such as the role of substance misuse and social factors, to ensure early identification and intervention, said the guidelines.
The London Mental Health Crisis Commissioning Standards – the first in the capital – have been published by the London Mental Health Strategic Clinical Network and feature 12 new recommendations to improve services.
The recommendations include a round-the-clock telephone helpline and 24-hour psychiatric services in accident and emergency departments.
Immediate access to psychotropic medications routinely used to manage mental crisis patients, including intramuscular preparations, should be available and administered in emergency departments when necessary, the recommendations add.
The guidelines also state that a person should be assessed under the Mental Health Act within four hours of presenting to an emergency department to ensure parity of esteem.
“Excellent crisis care exists in London, but it’s not consistent”
The same timeframe is recommended within the community for urgent assessments. To ensure this target is met, the number of mental health professionals should be increased and sector-wide rotas should be developed, states the guidance.
Other standards include 24-hour clinical support for police answering mental health-related calls, the provision of crisis houses with psychiatric care and support, and closer relationships between local authorities, health services, the police and voluntary organisations.
The standards are in response to the Mental Health Crisis Care Concordat – a national agreement supported by mental health charity Mind and the Department of Health – to help bring urgent mental health care in line with emergency health care for physical illness.
Experts from 22 organisations including Mind, the Metropolitan Police, the NHS, social care, housing and local councils will now discuss the implementation of the new standards.
Dr Nick Broughton, chair of urgent and crisis care at the London Mental Health Strategic Clinical Network, said: “If a person suffers a heart attack, they know what health care to expect, but in the case of a mental health emergency, the care is far more variable.
“It can involve the police and very often ends in people not receiving the care they need when they need it and in the right place,” he said.
Dr Broughton, who is also medical director of West London Mental Health NHS Trust, added: “Excellent crisis care exists in London, but it’s not consistent. These standards are about increasing the accessibility and consistency of services across the capital.”
Welcoming the new standards, NHS England (London) regional director Anne Rainsberry said: “This is an important step towards ending years of imbalance between mental and physical health services.”