‘More Need Crisis Care’

Hundreds of mental health patients are being denied emergency care because NHS managers will not give them access to crisis help. Carers have complained to an NHS watchdog that Oxfordshire and Buckinghamshire Mental Healthcare Trust (OBMHT) should allow more people the 24-hour support provided by the county’s two crisis teams.

At the moment only patients formally referred to the scheme can use it, but Dennis Preece, chairman of the trust’s carer reference group, claims many more people would benefit from its care in an out-of-hours emergency.

The problem is increasing as more people are discharged from hospital to be treated in the community. The crisis teams work from 9am to 9pm and the 22-strong workforce – due to increase to 32 from April – look after between 20 to 30 people at any one time.

Patients with acute mental illness are referred by their GPs or community mental health teams, and can then use the on-call emergency service from 9pm to 9am and at weekends. But many people with mental illness who seem well most of the time are overlooked, failing to get a referral to the service, which costs £800,000 a year.

Mr Preece said: “Crisis comes sometimes almost overnight and it’s important people can get to the crisis team without too many problems. People get into crisis for different reasons. Suddenly they’re in crisis, it’s Saturday night and they don’t know where to turn. They can’t get hold of their regular community health team nurses or their own GP so what do they do?

“It certainly doesn’t do anything for their mental health condition. They need help then and there. They can’t wait until Monday morning. People with schizophrenia can go into crisis if they fail to take their medication or something increases their paranoia. Another group not given access is those with bi-polar disorder, who for large parts of the time appear to be OK. There is more suicide in that group of people than among schizophrenics.

“We want these people to have access to the crisis team, but the trust won’t have it because they say they’d be swamped with cases that should be dealt with by community health teams during the week.”

The concerns have now been raised with the Healthcare Commission, the national NHS watchdog which can investigate trusts. In a statement, an OBMHT spokesman said: “A referral is required because the service is for people with acute mental health problems and the teams must have the relevant information to make safe interventions. It is also important that a person’s GP is aware of the crisis service involvement and we need to ensure that we are offering the right service to people.”

The Healthcare Commission confirmed it had been told of carers’ concerns.