The case of the missing 'Out of Hours' service

The manager of the Emergency Duty Team rang me this morning. He has been trying to get hold of me for a while but due to neither of us being available at the same time (and me sometimes disconnecting my phone for some peace)it has proved difficult.

However, we finally touched base and discussed the problems people with mental illness come across when they hit crisis, out of hours. That's not to say there aren't problems trying to get a service during 'normal' working hours but the particular area we discussed was when Community Mental Health Teams have shut up shop for the day.

The manager was very concerned about the gaps in service and that the team he manages are not 'trained' or have a specific remit to deal with people with mental illness.

Following our convo, they copied me into a letter they were sending to a MH Trust Director and the Director of Social Services. Below is my response:



Thanks for copying me into the email and responding so promptly, following our telephone conversation this morning.

I have experience of contacting the EDT on 3 occasions (once for myself) as you so rightly put, they can offer a brief chat to discuss the issues but then advise the person to ring the locum GP service or go to A&E. Speaking for myself and my father, and most probably many other people with mental illness who live alone and don’t posess a car, it is very difficult or impossible to get to A&E when crisis arise.

I don’t want to ramble on and lose the plot so need to be clear that there is a gap between contacting an out of hours service and then appropriate response/action being taken by support services.

My view is that a specific out of hours service, for people with mentail illness, is what is needed. Where the people manning the phone understand the complications and diversity of illnesses as well as the isolation people often find themselves in, which becomes more acute when someone hits crisis point. The out of hours service could have a direct link to the crisis team (as a referral service), it could even become an extention of the Crisis Team (as part of its core remit).

If I remember rightly the MH Director was going to look at the problems in regards to out of hours access to support services, with a view to putting a proposal to the Commissioner/Funder. I am not sure if that is an on going project or what the outcomes on any research done are. I would very much appreciate knowing what the outcomes were.

I would also be willing to contact the Commissioner/Funder to seek their views on how progress can be made in regards to this on-going problem.

I will be contacting my GP practise to find out how much is known about the crisis team and how GPs and Locum GPs refer their patients on when necessary although I fear that, again from my experience, dealing with people with mental illness is seen as the remit of Beds and Luton Partnership Trust. I think, being objective, there is a problem with communications in regards to professionals being aware of what MH services are available and how they can access them on their patients’ behalves but I will be finding out for myself how my GP practise goes about dealing with patients in crisis.

I look forward to hearing from you and anyone else involved in running, or making decisions about, services which respond to people in crisis and hearing their views and what action can be taken to improve service provision.

Interesting (should read frustrating) that I was raising these issues when I was part of NIMHE Eastern Region forum and the local SU rep group. I have subsequently raised the same issues with the MH Director responsible for 'Crisis and Acute Care' and was involved in a resolution meeting (last year) to see how the problems could be resolved....and still nothing has changed!!!