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Improving the Assessment and Management of People Experiencing Mental Health Crisis in Emergency Care

Friday 12 July 2019
De Vere West One Conference Centre, London

Improving the Assessment and Management of People Experiencing Mental Health Crisis in Emergency Care
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Follow the conference on Twitter #MHEmergencyCare

“A&E is often not the best place for people in need of urgent mental health care, however in some cases it will be unavoidable.” Clinically-led Review of NHS Access Standards, NHS England March 2019

People who arrive at A&E experiencing a mental health crisis will receive emergency care within one hour under NHS pilot schemes aimed at improving care and saving more lives. The new standard, a significant step towards parity of esteem for mental health, is among a raft of proposed clinical improvements that aim to deliver rapid assessment and treatment for patients with the most serious conditions, and expand short waits for millions more NHS patients.” NHS England 11 March 2019

“People now expect that the NHS will help someone with mental health problems with the same timeliness as for their physical health. We know that too often, people with mental health problems find that isn’t the case... we are pleased to see tangible improvements now being proposed, including making sure people who end up in A&E in a mental health emergency receive care within one hour.” Paul Farmer, Chief Executive of mental health charity Mind, 11 March 2019

“The guarantee of a timely response for mental health crises means people with the most acute need will have assurance that their mental health emergency will be responded to with the same speed and tailored care as life-threatening physical conditions.” Clinically-led Review of NHS Access Standards, NHS England March 2019

The national review of NHS clinical standards has said patients presenting in A&E with an emergency mental health need should receive a response from the liaison psychiatry team within one hour of being referred, and within 24 hours for an urgent referral. This conference focuses on improving the emergency response to people experiencing mental health crisis who arrive in A&E services. Ideally people experiencing mental health crisis will be supported by mental health crisis service and therefore not have to attend A&E. However many people experiencing mental health crisis are not aware of, or do not have easily accessible alternative options therefore the only option is to either not access help, to dial 999 or go to A&E. Historic design of A&E datasets mean it is not possible to reliably and routinely count the number of A&E mental health attendances which  has made it challenging to systematically understand the extent of mental health demand on A&E or to assess impact. The NHS Long Term plan states that the new targets would be introduced by 2020.

“We will ensure that no acute hospital is without a mental health liaison service in A&E departments and inpatient wards. By 2020/21, at least 50% of these services will meet the ‘core 24’ service standard as a minimum, working towards 70% by 2023/24, and 100% coverage thereafter…  Those coming to A&E will receive a response from a 24/7 liaison psychiatry team (or equivalent children’s and young people’s service) within the first hour of their referral, and will receive the appropriate, timely support to meet their needs and an evidence-based package of care. These standards will support our ambition for the NHS to be able to meet as many needs as possible in the community, and that when people do attend A&E, it is equipped to be responsive to their needs.” Clinically-led Review of NHS Access Standards, NHS England March 2019

The conference will include a presentation on managing young people experiencing mental health crisis in an A&E Setting following the findings that “in 2017-18, there were 27,487 attendances in A&E by young people aged 18 or under with a recorded diagnosis of a psychiatric condition.” Young Minds 2018

"One of the main reasons that crisis services are overstretched is that young people who are struggling don't get help soon enough, which means that problems often escalate. We often hear from young people who’ve gone to A&E because they don’t know where else to turn.The problem is that A&E can be a crowded and stressful environment, and is often not the most appropriate place for children and young people to go in a crisis.” Emma Thomas, Chief Executive, Young Minds

This conference will enable you to:

  • Network with colleagues who are working to improve the response to people in mental health crisis attending emergency departments
  • Understand the implications of the new NHS clinical standard: patients presenting in A&E with an emergency mental health need should receive a response from the liaison psychiatry team within one hour of being referred, and within 24 hours for an urgent referral
  • Learn from outstanding practice in psychiatric liaison services
  • Reflect on national developments and learning including the findings of the November 2018 HSIB investigation into the provision of mental health care to patients presenting at the emergency department
  • Improve the way you provide high quality mental health crisis care in the emergency department
  • Develop your skills in assessment & psychiatric decision making
  • Understand how you can improve discharge or diversion to a more appropriate setting
  • Identify key strategies for managing self harm
  • Improve how you work with frequent A&E attenders
  • Self assess and reflect on your own practice
  • Gain cpd accreditation points contributing to professional development and revalidation evidence

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