Mental health crisis care agreement aims to improve services across London

A ‘mental health crisis care agreement’ for London has been announced which aims to improve access, patient experience and health outcomes for residents using mental health services in the region.

The overarching vision is to ensure that all Londoners experiencing mental health crisis have “equal access to timely help which is best suited to their needs.”

The agreement has been developed from a “wide range of partners” including the five integrated care systems in London, London mental health trusts, London Ambulance Service, Metropolitan Police, The Ethnicity and Mental Health Improvement Project, Thrive London, and more.

The agreement outlines four principles in key areas:

  1. Tackling inequity of access

The London-wide commitments in this area include delivering the Community Mental Health Transformation Programme, which seeks to help people to live well in their communities and address known inequalities in access; embedding “lived experience and culturally appropriate support” in delivery of mental health services; and ensuring that ‘advance choice documents’ are routinely in place to help those with a longer term diagnosis receive appropriate ongoing care.

2. Providing the right care closer to home

The collaborative will deliver the 111 First for Mental Health Programme, which will see people calling 111 with a mental health need directed to a specialist mental health service, rather than undergoing assessment using NHS pathways and algorithms.

The agreement also aims to ensure that all ICBs have “culturally competent and easily accessible front door alternatives” such as community crisis cafes and services with self-referral capacity.

In addition, the plan notes that all ICBs have committed to introducing mental health joint response cars which utilise the skills of mental health professionals and paramedics to reduce “inappropriate ambulance (or police) conveyance” to emergency departments. As a collective, the organisations involved have committed to funding mental health joint response cars to ensure that they are in operation seven days a week.

3. Timely and effective support for Emergency Department users

In this category, the agreement emphasises continued sector support to delivering the operational aspect of the London Mental Health Compact, which was developed to set out cross-agency working between London and surrounding mental health and acute trusts, local authorities, ICBs, the NHS, police services and the ambulance service.

In addition, all emergency departments in London should be compliant with the CORE24 standards for liaison psychiatry, ensuring that “people who are being treated for physical health care needs, who also have a mental health need, are provided with appropriate support for their mental health needs, and receive a holistic biopsychosocial assessment.”

4. “Purposeful” admission closer to homer

Here, commitments include delivering against plans to eliminate “inappropriate” out-of-area placements for individuals requiring inpatient admission, and ensuring that three key principles are embedded in inpatient care across London. These principles emphasise that admissions should be “purposeful”, or only occurring when the individual requires assessment, intervention or treatment that can only be provided in a hospital setting; it should deliver therapeutic benefit; and discharge should be proactively planned and effective.

The mental health crisis care agreement can be found in full here.

In other news around improving access to mental health services, in June we explored the launch of a new urgent mental health support phone line in Wales.

Last week we also shared the news of grants for community-based mental health initiatives in Mid and South Essex ICS, designed to improve support in traditionally underserved communities.