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05-Apr-2018

 

The Safe Haven – working together and improving out of hours mental health crisis service

Nick Parkin – Senior Commissioning Manager, Mental Health and Learning Disabilities at NHS North East Hampshire and Farnham CCG, describes The Safe Haven at the Wellbeing Centre, a pioneering out-of-hours mental health crisis service.

“When we started in April 2014, there was nothing like the Safe Haven in the country.  It’s an out-of-hours mental health crisis service which is open seven days a week, including bank holidays - 6pm until 11pm in the evenings and 12pm until 11pm at weekends.  What’s great about this service is that it was co-designed with local people who use the services. 

People told us what they wanted when they’re experiencing a mental health crisis.   We took a gamble.  We developed a partnership with a third sector organisation called MCCH, a mental health secondary care provider called Surrey and Borders Partnership NHS Foundation Trust and Hampshire County Council.  It is a system that’s unique because it is open to anybody.  You don’t have to have a GP referral.  Anybody can go.  It doesn’t matter where you live.  It doesn’t matter where your GP is.  If you have a mental health crisis, the service is available to you.

Since the service opened, in April 2014 it has had over 4,000 attendances. It has been widely praised by the police and ambulance service, who also take people there as an alternative to A&E. People who are suffering a mental health crisis are also using the Safe Haven as an alternative to going to A&E. 

In its first year of operation it reduced acute psychiatric admissions by 33% and that was independently validated by Mental Health Strategies.  But, that in terms of cost, represents about a £500,000 saving across our footprint, in terms of those reduced admissions.  It is an award-winning service.  It won a health service journal award.   We noticed that A&E attendances for North East Hampshire and Farnham where the diagnoses in a psychiatric category show a rising trend from April 2013 – February 2015.  But since that point, since the Safe Haven opened, it appears to have plateaued.  And a forecast of activity for that later period, based on previous trends indicates that the attendances that time, are less than would have been expected.  The plateau in A&E attendance numbers coincides with a rapid increase in the number of attendance at the Safe Haven.

We have also done a comparison with other clinical commissioning groups, to support that figure and it clearly shows that A&E attendances for psychiatric diagnosis per thousand of the population are continuing to rise for other CCGs who don’t have access to a safe haven.

We have some wonderful stories from people who use the service, who said it’s changed their lives and that it has helped them to manage their mental health crisis.  They don’t feel that there is any pressure on them to attend their community services, it is a safe place to go.  They get support there.  There is secondary mental health specialist support there if they need it but also professional third sector mental professionals who can support them. 

Most critically, the people who use the Safe Havens have increasingly reported that their attendance at the service stopped them attending A&E . So, where they would perhaps end up in liaison psychiatry or self-harming or taking an overdose, they are going to the Safe Haven and they are able to manage their mental health crisis better without having to resort to other coping strategies.”

Watch Nick’s presentation on The Safe Haven, which he delivered at The King’s Fund Annual Conference 2016.

 
 
 

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