Partners across the Hampshire and Isle of Wight Integrated Care System have been working with people with lived experience of mental health challenges to develop a more straightforward, simple way of contacting the NHS to receive mental health crisis support.
Getting help involves accessing both the mental health and our urgent and emergency care systems. Both are complex systems, which do not always work in an integrated way.
Mental health nurses working in NHS 111 provide easy access to support for patients, taking pressure off the rest of the system by reducing attendance at Emergency Departments and enabling people to get mental health support before a problem becomes a crisis.
The nurses help to ensure that people with mental health concerns and conditions using the service can be appropriately triaged and given support. This could mean supporting them directly or referring them on to other services in the community.
The service is driven by people’s needs and service users are at its heart, ensuring they have easy access to support at the right time and in the right place for them, including enabling people to get help mental health support before a problem becomes a crisis.
The work to set up the mental health triage service was co-produced by patients, ambulance services and 111 providers, police, GPs, Emergency Departments, voluntary sector organisations, mental health services, and other community services such as pharmacies. Policy drivers such as the NHS Long Term Plan and funding helped them move forward with developing this service.
This project highlights what systems can do when you work together, with funding, on a common purpose for the benefit of patients.
Evidence shows that the triage service has reduced pressures on other parts of the health and care system.
In one year alone there were 21,697 contacts with the service. Of those, almost 19,000 people (87 per cent) were supported with home management/self-care, and fewer than 500 (1.9 per cent) needed an emergency ambulance response. 10 per cent were asked to see their GP and 0.3 per cent were recommended to attend an Emergency Department.
When the service first started, over two thirds of patients were referred to primary care, compared to 10 per cent now. This would cause patients unnecessary delay in receiving the support they needed.
Mental health contacts to 999 have reduced by 26 per cent.
In total 88 per cent of calls are supported with self-care and home management, compared to 11 per cent when the service was provided by a clinician from NHS 111 with little or no mental health experience and minimal access to patients’ care management plans or crisis plans, which were held in the mental health trust.
It was essential to get the message out to people in the local area about the new service in a user-friendly way and how they can access it. A YouTube video and other user-friendly materials have been produced.