Designing better mental healthcare facilities

CQC report: attitude to those 'in crisis' variable

Right here, right now, a report published in June by the Care Quality Commission highlighting people's experiences of help, care, and support, during a mental health crisis, says one in 12 of those questioned reported coming into contact with between six and 10 different services.

Alongside presenting feedback from almost 1,800 individuals with experience of such a crisis, the report reflects the findings of local area inspections ‘looking at how services work together’, surveys of service-providers, and a review of national data.

The CQC said: “We found the quality of care experienced by a person in crisis can vary greatly depending on where they are, and what help they require. Many people also experienced problems getting help when they needed it, and found healthcare professionals sometimes lacked compassion and warmth.”

Other findings included:

  • The use of police cells as a ‘place of safety’ for people in crisis has ‘fallen significantly’, but those under 18 can ‘have problems’ accessing suitable places of safety. In 2013/14, nearly a third of people under 18 who were detained were taken into police custody.
  • Fewer than four in 10 who had visited ‘A&E’ while in crisis felt listened to and taken seriously, or treated ‘with warmth and compassion’. Those coming into contact with specialist mental health services ‘were only slightly more positive’.
  • GPs, ambulance staff, and the police, were all perceived as being more empathetic.
  • 42% said the care they received failed to help them while ‘in crisis’.
  • 23% had not agreed to the care they received, while 32% were unsure about who to contact when ‘in crisis’. • Access to, and the quality of services, after 5 pm were ‘not good enough’.
  • Just under 13 per cent of section 136 detentions in 2012/2013 were of people detained under the Act in the previous 90 days. In local authority areas piloting ‘street triage’ schemes, where mental health nurses accompany officers to incidents where the police believe people need immediate mental health support, there has been a ‘substantial reduction’ in the use of Section 136 of the Mental Health Act.
  • Once in a place of safety, most services are conducting assessments under the Act within three hours of arrival.  

The CQC says that overall, ‘there is cause for optimism’, with inspectors finding ‘examples of very good practice’. However, it maintains that ‘there is still too much variation across the country and even within the same local authority areas’. Interestingly, the findings point to people in crisis ‘having a much more positive experience of voluntary sector services than with services from the statutory health sector’.

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