17.03.16
Transition between services is failing mental health patients, warns NICE
Mental health patients need better support while transitioning between inpatient services, the community and care homes, NICE has warned in new guidelines that are currently open for consultation.
Problems with the transition process include delays in admission and assessment so that patients are not treated until they are in crisis, inadequate support after discharge, and patients and their families not being included in discussions.
The new guidelines have recommendations for improving the problem, including ensuring doctors respond quickly to requests for mental health assessments, allowing patients to visit the facility before they are admitted if possible, and supporting people who have had more than one admission to develop a crisis plan.
Once patients have been admitted, they should be offered access to advocacy services that take into account their language and cultural needs and protected characteristics and develop therapeutic relationships that lessen their sense of being coerced.
If a patient is admitted from outside the area where they live, practitioners from their home area and the area where they are admitted should work together.
Rebecca Harrington, an independent social care and health consultant and chair of the group that developed the guidelines, said: “Our aim is that people who need hospital treatment for their mental health needs are well supported before, during and after their time in hospital, so that they benefit from continuity of treatment and care, and avoid being isolated and stigmatised.”
The University of Manchester’s National Confidential Inquiry into Suicide and Homicide by People with Mental Illness found that, in 2002-12, 18% of patient suicides occurred within three months of discharge from hospital.
Professor Gillian Leng, deputy chief executive and director of health and social care at NICE, said of the suicide rate: “We can help reduce this number by better communication, and more joint working, between hospital and community mental health teams.”
Particularly vulnerable groups include older people, who risk being discharged to care homes when they might have been discharged to their own homes if additional support had been arranged in advance, and young people, who may lack support for reintegration into education and training.
The government recently promised £1bn additional funding for mental health services after a new report warned that they are failing patients.
The consultation is open until 27 April, with the final guideline expected in the summer. To contribute to the consultation, click here.