Gareth Price: Treating mental health patients closer to home

As a trust we regularly talk about the importance of providing care for people with mental health problems closer to home and helping people to live well in their communities. Whilst the majority of our patients will continue to live well at home, with support from specialist mental health services, there are occasions where more help may be needed short term to support someone through a crisis in their wellbeing.

It is well reported in the media that finding hospital beds for adults with severe mental health problems is increasingly difficult. This is a national problem, made worse by an ever increasing demand on mental health services, as people’s lives become more complex and more people are finding that they need this type of support.

We recognise that it is always better for people to stay as close to home as possible and avoid hospital altogether if it is safe to do so. We know that being away from family and friends, as well as the professionals that people are used to receiving support from, can have a detrimental effect on their recovery and can sometimes prolong their stay in hospital.

We have been working closely as a health and care community over the last few years to see how we can increase the range of help available to people in Lincolnshire. In January 2018 we opened a new psychiatric clinical decisions unit (PCDU) and expanded our home treatment and bed manager teams, to better support patients in crisis.

These services have enabled us to provide enhanced assessments and intensive home support and after six months, we are already seeing reductions in the number of people needing hospital care, and fewer people having to travel out of the area.

The PCDU cares for up to six people at a time, for up to 48 hours. It has enabled professionals to spend more time with patients to better assess their needs and put support packages together.

This is supported by additional staff in the trust’s community home treatment teams, who are then able to provide an increased level of intensive support at home and avoid hospital admission in many cases.

To date we have received around 450 referrals to the PCDU, and managed to avoid hospital admission in around 70% of these patients. Having this extra time is giving people the time to think through the nature of their crisis and what help they need to recover. It also gives clinicians time to do a more thorough assessment, enabling us to tailor what care we can provide.

The number of people needing to travel out of the area for hospital care has also reduced considerably and if admission has been needed, on many occasions a local bed has been found as people have been able to wait in a safe and therapeutic environment until one becomes available.

Our bed managers also play a key role, keeping in daily contact with all wards in and out of the county and regularly visiting hospitals where Lincolnshire patients are admitted to ensure they can be discharged as soon as possible. As a consequence we have also seen a positive reduction in the number of days people have to stay in hospital.

Work continues with our commissioners and other partners ensure the support we provide is the best it can be. It is great to see that these services are already having a positive impact and are providing more timely and appropriate support for people in their time of need.

Gareth Price, is the service lead for the urgent care pathway at Lincolnshire Partnership NHS Foundation Trust