What is the problem?

  • Severe mental health problems such as psychosis are often episodic in nature, with periods of stability and less intense symptomatology interrupted by periods of crisis.
  • For many people these periods of crisis result in an admission to an acute inpatient setting.  Community based crisis services have been developed to create alternatives to hospital.
  • A key role for community services such as Crisis Resolution and Home Treatment teams is to act as gatekeepers determining the safest and most beneficial form of support, taking account of patient and carer needs and wishes, in the community or hospital.4
  • Rates of admission and acute bed numbers are falling but rates of those detained continue to rise5.

There are inequities in services that adversely affect people from Black and Minority Ethnic communities5 who are more likely to experience:

  • Problems in accessing services
  • Cultural and language barriers in assessments
  • Lower GP involvement in care;
  • Inadequate community-based crisis care
  • Lower involvement of service users, family and carers
  • An aversive pathway into mental health services:
    • higher compulsory admission rates to hospital
    • higher involvement in legal system and forensic settings
  • Higher rates of transfer to medium and high secure facilities
  • Higher voluntary admission rates to hospital
  • Lower effectiveness of hospital treatment and satisfaction with care
  • Longer stays in hospital and higher rates of readmission to hospital
  • Less likelihood of having social care/psychological needs addressed within care
  • Planning/treatments processes
  • More severe and coercive treatments
  • Lower access to talking treatments6