A major international report published by NHS Clinical Commissioners and RI International, a US- based healthcare organisation outlines ten recommendations that if fulfilled would make urgent and emergency psychiatric health care ‘minimally adequate’, and calls on governmental agencies, policy makers and health and social services to take radical action to address inequalities and improve mental health crisis care.
The recommendations were agreed by delegates at an international summit in May 2018, hosted by NHS Clinical Commissioners and RI International, which brought together commissioners, providers and clinicians including GPs, paramedics and psychiatrists; service users; civil servants; and first responders such as ambulance workers and police officers from both the UK and USA. The summit found that despite cultural, system and geographic differences, the challenges faced in both countries were remarkably similar (Source: NHS Clinical Commissioners & RI International)
The ten recommendations are:
- End the current fragmentation of care through an integrated, systematic approach to behavioural health crisis care at the national level.
- Actively develop crisis service alternatives to the usual emergency measures of formal assessment and psychiatric inpatient care.
- Include special consideration to cater for armed forces veterans.
- Implement an integrated health information exchange capable technology solution to enable seamless care across organisations.
- Develop balanced scorecard dashboards that display real-time, meaningful data and outcome measures that support continuous quality improvement.
- Embed users, peers and carers should be embedded in the design and leadership of crisis systems; peer support staff should be trained and integrated in crisis service delivery.
- The zero-suicide aspiration should be owned by governmental agencies, policy makers and those implementing health and social services.
- Family and friends should be fully engaged in crisis care and inappropriate barriers created by confidentiality or privacy need to be sensitively overcome.
- Implement a single national three-digit crisis hub number that drives easy access in which all callers are welcome, the crisis is defined by the caller, and which is promoted via intelligent social media to get the word out to those who need it.
- Significant system-wide investment is needed to deliver these recommendations.The full report is available from NHS Clinical Commissioners