6:00 AM July 28, 2022
A specific emergency department for mental health patients could be the key to easing the region’s care crisis.
This is the view of Zoe Billingham, the new chairman of the Norfolk and Suffolk NHS Foundation Trust, who has placed the ambitious concept at the top of her wish list.
The concept would see walk-in mental health support from psychiatrists, allowing people in crisis to get immediate care and avoid the need to be referred to specialist services.
It was one of a host of measures Ms Billingham, who took over as the struggling trust’s chairman in January, said she would love to see brought in at some point in the future – although it is still very much a hypothetical concept.
Ms Billingham said: “We have a real gap in our services. When people have physical emergencies, they can go to A&E and see a doctor.
“Why do we not have A&E for mental health. We have got to think of different ways to provide our services and that would be one of those ways. It would be a dream for me.”
Currently, some accident and emergency departments do offer some access to mental health practitioners – although merely as one of many functions it provides.
The goal of a specific A&E for mental health would be to take away one group of patients placing demand on departments across the county – while also easing strain on other emergency services such as the police.
The vision is one of a number of things previous inspector of police Ms Billingham has on her wish list for the region’s mental health services, which was placed into special measures earlier this year by the Care Quality Commission.
She said that she was desperate to see more forms of community care on offer locally to drive down the number of referrals to NSFT’s specialist services are tasked with.
Currently, more people are referred to specialist mental health services in Norfolk than anywhere else in the country.
Ms Billingham said this was not due to there being more people needing referrals, but instead limited alternatives – something she is keen to see addressed.
She said: “We are a specialist mental health trust – when you are referred to us it is because you have a serious degree of alarm.
“If you are able to get help earlier on things can be nipped in the bud and you may not require referrals.
“In other parts of the country, there are more ways for people to get care before they need to be referred for specialist treatment.
“What I want to see is mental health practitioners available to every school and every member of the public, every day of the week.
“I want to see community cafés and hubs on every corner – I want there to be as much access to that sort of facility as possible.”
Emma Corlett, from the Campaign to Save Mental Health Servicessaid that the concept was something the campaign’s late founder Terry Skyrme had called for in the past, having seen similar models work well in London.
But she said she did see some issues with it which would need to be addressed should the vision ever become a reality.
She said: “There is always a tricky balance between specialist bespoke services and ensuring those with mental illness aren’t discriminated against and excluded from NHS services they are already entitled to access.
“You cannot always separate out the mental and the physical – for example in older people what looks like psychosis might be toxic confusion due to urinary tract infection.
“Underlying physical causes of many presentations need to be ruled out.
“Following a suicide attempt, some people will need both physical and mental health – which A&E would they be sent to?”
The concept of a specific A&E for mental health patients is certainly an interesting one, writes health correspond David Hannant.
It is not, by any means, a perfect idea but it does show that there are people in key roles at NSFT who are looking to think outside the box to address its many challenges.
It is clearly evidenced by the sheer amount of people being referred to NSFT that there are not enough options available to people before they reach the point of crisis.
There absolutely needs to be more investment in caring for people’s mental health early, before they deteriorate into serious issues.
Preventing mental illness from deteriorating has a much wider impact that simply helping the individual in question.
Minimizing the number of people who reach crisis point will help services across the health system, trim waiting lists and free up resources across the emergency services.
Clearly, we are in the midst of a crisis and it will take innovation to come out of it – so this kind of thinking is pleasing to hear.