What do service users and carers want?

Access and availability
Services in primary or secondary care that are readily accessible and available to them 24 hours a day, 7 days a week when in crisis.

To enable people and their carers to get help without lengthy procedural delays especially important for people from BME communities

A service culture and environment that empowers them and involves them in decision making, building on prior experience of crises where possible.

Holistic approaches
That take account of the context of their lives and in which the crisis occurs and support plans that focus on their strengths and existing support structures. Services that provide social interventions as well as clinical support.

For many service users it is important to have support that helps them to remain at home, retaining accommodation where in jeopardy, and to cope with the stresses in their daily lives.

Active help in self-management especially from peers, who have had similar experiences, can inspire them and instil hope for their own future.

Staff/service user relationships
Services in which there is less staff/patient distance and staff respect users as equals is viewed as a key factor in aiding recovery.

At times service users as well as their family members/carers express wishes for a place of respite where they feel safe; crisis houses may be appropriate for this purpose 3 4 5 8 9. Family members such as children need a period of respite from a parent who is experiencing serious mental health problems.

Carer involvement/family orientated practice
Carrying the burden of care for someone who is in crisis can be very stressful and carers often feel ignored and unsupported in their caring role with confidentiality used inappropriately to exclude them from giving and receiving relevant information 37 10