Mental health care overlooked by NHS review of emergency services

A series of unsettling findings suggests the need for an agreed care pathway across the police, providers and local government, according to The Guardian.

NHS England's large scale review of all emergency services, partly driven by the premature mortality rates across hospitals, seems to have made a significant omission by overlooking mental health emergency care.

While the evidence accompanying the consultation suggests that 4,400 lives a year could be saved if weekend services were as good as those during the weekdays, there is a chance that those experiencing mental ill health could fall through the upgraded safety net.

The emergency review does not mention mental health services, the conditions leading to emergency presentations, or the role of the police, housing and mental health problems. Yet emergency mental health care plays a vital role, especially in inner city areas where demand is greater due to high levels of poverty and other social determinants of ill health and inequalities such as ethnicity, gender and age.

For example, we know there is a higher incidence of schizophrenia in inner city areas, especially among black African and Caribbean people and other ethnic minority groups, particularly in London.

The recent report by Lord Victor Adebowale on policing and mental health concluded that the presence of offending behaviour by someone experiencing mental illness, which can lead them to have contact with the police, is an emergency pathway which needs to be made safer.

Lord Adebowale's findings emphasised the failures of NHS services and police knowledge, as well as emergency communications, in meeting the needs of people with mental illness. These findings have been reinforced in the latest Care Quality Commission (CQC) reports on the emergency removal of people suspected of having a mental illness to a place of safety (under section 136 of the Mental Health Act). These reports found unacceptable emergency practices leading to deaths in police custody, mentally ill people being transported in caged ambulances and suicides on the railways and transport hubs.