Agenda item - Update on Mental Health Crisis Support

Resolved - That the Health & Wellbeing Board notes the report

41.1    Officers introduced the report. There was a high level of need for crisis support in the city. Crisis support was a system wide process with separate pathways for adults and children. There was a 24 hour helpline and 24 hour mental health team at the county hospital and there had been a reduction in the number of individuals taken into custody. However there was still an overreliance on A&E. A crisis care hub with a single point of access and community response for adults was anticipated by summer 2018. A region wide service for children was planned.

41.2    Dr Sikdar asked that the crisis support line number is kept the same for the new service to avoid undoing the outreach work which had already been done. Dr Sikdar stated that the service map in the report was incomplete as it did not reflect the role GPs played in the crisis management.

41.3    Officers responded to Councillor Penn that there was no clinical definition of crisis; it is dependent upon if an individual perceives themselves as being in crisis.

41.4    Councillor Penn expressed concerns about the rise in the number of individuals being sectioned and asked if the individuals being sectioned were generally already known to services.

41.5    Officers responded that most individuals who were sectioned were known to services but the system was very fragmented and it could be difficult to identify people.

41.6    Councillor Penn asked if there was any specific capacity to prevent children in crisis ever being taken into custody and what support was available to children after 10pm.

41.7    Officers responded that there were five section 136 suites and a sixth focused on children was planned at Chalkhill Hospital. A child who is known to services and is in crisis can be referred to an on call community team otherwise they will go to A&E.

41.8    Councillor Taylor asked if there was a plan to prevent people in crisis having to be admitted through A&E.

41.9    Officers responded that efforts were made to prevent people who only needed mental health support attending A&E but many people in crisis need physical treatment as well. The children’s model was underdeveloped and there was no a finalised model but the need was much smaller than for adults so an STP wide approach was being developed.

41.10  Mr Bartlett asked if there had been any move to introduce a permanent street triage function after a successful pilot had been run.

41.12 Officers agreed that the street triage had been successful in terms of admitting people into appropriate care and avoiding custody. However the large amount of downtime for on call staff meant in it was not an efficient use of resources.

41.13  Councillor Barford asked what follow up there was to calls which were terminated due to a person in crisis being verbally abusive.

41.14  Officers responded that clinical staff had to make judgement calls about risk. The expectation would be that the case would be referred to emergency services. The officers stated that they would investigate any specific case where Councillor Barford feels there was not an appropriate follow up.

41.15  Resolved - That the Health & Wellbeing Board notes the report