Improving mental health urgent and emergency care services
We're making some changes to crisis support services so that people in Sussex can get the right help at the right time with their mental health. This is in response to the significant need in our communities following the Covid-19 pandemic.
The impact of the pandemic on our mental health
Many people who lost family members to Covid-19 had to grieve alone during periods of lockdown, others lost their jobs or were isolated with an abusive partner and young people were cut off from their friends and social networks, missing out on significant periods of their education, when the schools closed.
Nationally, it is forecast that 10 million people in England will need support for their mental health over the next five years as a direct result of the pandemic.
The situation in Sussex
In Sussex, there has been a 15% increase in the number of people referred by A&E departments to the Mental Health Liaison Teams (MHLTs) for assessment from 2019 to 2023.
People who need to be admitted to hospital are having to wait longer in A&E, or in the community, for a hospital bed to become available. There are also delays in patients being discharged from hospital because they need ongoing support in the community.
And the number of calls to NHS 111 'select the mental health option' - a 24-hour crisis mental health line - from people who need help with their mental health - has more than doubled in the past year.
As a county, Sussex has a higher prevalence of patients with a mental illness compared to the average for England. Brighton & Hove, East Sussex and West Sussex's recorded prevalence of a diagnosed serious mental health illness is 1.12% compared to 1.05% for England for 2022/20223.
The increase in need in our community is having a knock-on effect on the emergency services in Sussex. For example, the police are often called to A&E to support people in a mental health crisis and the ambulance service is responding to a higher number of calls to help people in mental distress.
Improving mental health urgent and emergency care services
Our aim is to make sure that people can access timely and appropriate help with their mental health. This will improve outcomes for individuals and help to reduce the current pressure on A&E, the police, ambulance and other services.
This requires a collaborative approach between partner organisations, including Sussex Partnership, Sussex Police, SECAMBs, acute hospitals, voluntary, community and social enterprise (VCSE) as well as service users and their families, carers and supporters.
What we've already done
To better support people who are experiencing a mental health crisis, we have:
- Established mental health liaison teams within the A&E departments at the Royal Sussex County Hospital in Brighton, Conquest Hospital in Hastings, Princess Royal in Haywards Heath, Worthing Hospital and Eastbourne General Hospital and St Richard's Hospital in Chichester.
- Established a range of services as alternatives to A&E, including five Havens across Sussex. These are dedicated mental health crisis assessment facilities for adults over 18 in East Sussex, West Sussex and Brighton & Hove.
- Delivered a pilot for the Blue Light Triage Service in North West Sussex which provides a single point of contact for the police and ambulance service to receive advice, information and support to triage people to the most appropriate service or place or safety. The pilot resulted in a 20% reduction in the number of people in North West Sussex transported by the ambulance service to A&E. As a result of the success of the pilot, there are plans to roll out an enhanced version across the county following consultation with staff, people who use services and partner organisations.
- Implemented 'NHS 111, select mental health option' in Sussex in November 2022 as a first line of support for people experiencing a self-defined mental health crisis.
- Launched 'Text SUSSEX to 85258' in July 2022 to provide a digital way for people to get help with their mental health. In the first year, there have 805 text-based conversations with 131 people using the service more than once.
- In partnership with Sussex Police, we are delivering a six-month pilot in Eastbourne and Brighton, working with an external provider to transport and supervise patients detained by the police under section 136 of the Mental Health Act 1983.
Our focus for the next 12 months
We are working with our Voluntary Community and Social Enterprise Sector (VCSE) partners - Southdown, Richmond Fellowship and West Sussex Mind - to re-model Staying Well as a walk-in service, removing the need for people to have to first make an appointment. Staying Well is a community-based service that people can attend to get support with and advice about their mental health.
The plan is for all five Staying Well services - in Brighton, Crawley Eastbourne, Hastings and Worthing - to be fully open access by Summer 2024.
We will continue to increase awareness and use of 'Text Sussex' to enable people to get timely support with their mental health.
We are undertaking research amongst service users, carers and families about how best we can enable people who need support and help with their mental health to find and access appropriate mental health services.
We are continuing to expand the Blue Light Line to provide a pan-Sussex single point of contact for the police and ambulance service to receive advice, information and support to triage people to the most appropriate service or place or safety.
With funding from NHS England, we are in the process of procuring two mental health response vehicles to be in operation across Sussex in 2024 and then three more in 2024/25, subject to national procurement. Located across Sussex and staffed by clinical staff, the vehicles will provide a rapid response to patients experiencing a mental health crisis.
We are working with the Crisis Resolution Home Treatment Teams to establish a new clinical model across Sussex, which includes rapid assessment and therapeutic home treatment both to prevent the need for a hospital admission and support patients to be discharged from hospital.
We are continuing to optimise the five Havens across Sussex to provide urgent crisis care, including as an alternative to hospital admission. We are also working with partners to develop their use as health-based places of safety as alternatives to A&E for people who are awaiting a mental health assessment having been detained by the police under S136 of the Mental Health Act 1983.
Building on the success of the Recovery House in East Sussex, our focus is to support the increase of Recovery Bed capacity across the county. In West Sussex this includes working alongside the VCSE provider to establish dedicated short-term beds for step-up and step-down support to prevent the need for admission to hospital and support people discharged from hospital in their recovery journey.
We are working with local authorities and other partners to identify solutions for improving housing for people with mental health needs as this is often a contributor to someone experiencing a mental health crisis and can also prevent timely discharge from hospital. This is part of the new mental health Discharge to Assess (D2A) initiative to provide supported housing services for people who are ready to leave hospital but need ongoing assessment and support.
Do you need help with your mental health?
If you are feeling at 'breaking point' and need help with your mental health, there's lots of ways you can get support. Find out about how to get help with your mental health in Sussex.