UK government announces funding for ‘mental health ambulances’ for those in crisis, but is this enough?

On Monday, the UK government announced in a press release that they are to back new ‘mental health ambulances’ as well as improvements to crisis care, with specific funding. This was announced at the same time as the draft Mental Health Bill. Announced the same week as the news breaks that two NHS mental health trusts are under scrutiny after the deaths of two young women, are these reactionary solutions doing enough? What is an alternative?

Written by Bryony Porteous-Sebouhian

Sorting out the funding: what is going where

The government press release states in it’s introduction that crisis care will be receiving a ￡150 million investment over the next three years. This includes giving people access to ‘crisis houses and safe havens’ in the community – a move that seems to tie in with the Draft Mental Health Bill’s shift away from police stations and prisons as ‘places of safety – and a specific ￡7 million dedicated to the introduction of ‘mental health ambulances’ across the country.

The aim of this, the government says, is to ease pressure on other services, improve response times and importantly, to improve outcomes for people in crisis, to save lives and ensure patients who are in crisis are being treat with ‘dignity and respect’.

Speaking to this investment and the new Draft Mental Health Bill, Health and Social Care Secretary, Sajid Javid said:

“We’re investing more money to ensure NHS patients have tailored services and support, so people in a mental health emergency get the right care at the right time. Our reforms to the outdated Mental Health Act are another important milestone in better supporting those with serious mental health issues and giving people greater control over their treatment, particularly those from ethnic minority backgrounds who are disproportionately detained under the act.”

Some of the ￡150 million will also go towards supporting local communities to invest in alternatives to hospital admission, so fewer people experiencing mental distress are admitted into inpatient facilities.

This is a crucial element of this crisis care approach, as it aims to increase local capacity, and in turn reduce inappropriate out-of-area hospital placements, which the government and NHS England has come under fire for over the past year.

Is this crisis management approach going far enough?

The Draft Mental Health Bill released on Monday the 27th of June, in large part addresses the issues surrounding the current handling of those experiencing a mental health crisis. The removal of police stations and prisons as ‘places of safety’ as well as addressing disproportionate rates of detention for marginalised people as well as those with learning disabilities and/or autism is a positive step in the right direction, as is the introduction of a ‘nominated person’ rather than ‘nearest relative’.

As Chief Executive of national mental health charity, Mind, Paul Farmer said:

“The Bill contains a number of welcome proposals. We’re particularly pleased to see measures which will give people receiving care under the Act more say over how they are treated and allow a nominated person to exercise certain rights on their behalf. Making sure people with mental health problems have more access to advocacy is particularly important.”

However, as it stands, the wider cultural and societal issues that often drive mental health crises, as well as interfering with our system’s ability to help people are not, as of yet, raised or prioritised in the Bill.

This includes issues around racial inequality, socioeconomic deprivation, gender and sexuality. Many of these also tie into other elements within our mental health legislation that are problematic, and that often come as a result of someone reaching mental health crisis, such as Community Treatment Orders (CTOs) which, in Paul Farmers words are:

“Coercive, don’t reduce admissions and are disproportionately applied to Black people.”

Earlier this month, Scotland’s Mental Health Partnership published a paper that set out proposals for a ‘radically different Mental Health and Wellbeing Strategy’. Motivation behind the paper has come especially as the previous strategy, from 2017, does not take into account the drastically different landscape of the country and of mental health services since the start of the Covid-19 pandemic.

The paper has an entirely different approach as seen, so far, by the UK government. The principles that underpin the recommendations are based firmly in prevention, with a huge focus on those wider societal and cultural issues, especially looking at poverty and the experiences of Black people and People of Colour, and how this informed people’s experiences of mental health, and indeed mental health crises.

The paper is absolutely, radically different, and has been taken on board by the Scottish government, who today announced a consultation, asking for the views of the Scottish people to inform a new strategy that seems to have responded wholeheartedly to the Partnership’s initial paper and echoes it’s priorities:

• ‘addressing the underlying reasons behind poor mental health;
• helping create the conditions for people to thrive;
• challenging the stigma around mental health and;
• providing specialist help and support for mental illness.’

Seeing these two different approaches together: preventative, whole system and whole person, and reactive: creating crisis solutions, mental health ambulances, crisis houses and safe havens etc. (the former approach is also seen in recent Welsh initiatives), it is becoming clear that England is falling behind when it comes to the journey out of the current mental health crisis we are in.?