Crisis care and liaison mental health services (adult services)

Liaison psychiatry is one form of crisis mental health care available. The mental health charity Mind describes a crisis as when a person’s mental health is at ‘breaking point’, and they are experiencing symptoms such as suicidal feelings, self-harm, and extreme anxiety. Liaison mental health services provide assessment and mental health care 24 hours a day, 7 days a week, to people with urgent needs arriving in A&E, and to those who need mental health treatment alongside their physical treatment on an in-patient ward in hospital.

Why this matters

Liaison mental health services play a valuable role in supporting people in a crisis, as well as adults and older adults who have both mental and physical health problems in a general hospital setting. They can help people to avoid lengthy stays in hospital and can speed up discharge.

Our aims

  • Making sure thousands more people can get support where and when they need it, with the ambition that ultimately no one who needs mental health support will be turned away
  • Making sure that no-one in a mental health crisis ends up in a police cell – Reducing the numbers of people in police custody needing a place of safety during a mental health crisis remains a priority and at 1%, our rate is 5 times lower than the rest of England & Wales. We have a police control room triage service which employs mental health nurses is supporting frontline police officers.
  • People presenting with a mental health need in A&E departments and on physical health wards will have access to a swift and compassionate assessment of their mental health needs and high-quality National Institute for Health and Care Excellence recommended care, any time of the day or night, every day of the week, in whichever general hospital they attend in Greater Manchester, with their mental health needs identified and treated during the hospital admission or during follow-up in community mental health services
  • General hospital staff will be able to better support people with mental health problems, through training, support and formal and informal networks

What’s next

There’s a national directive that no acute hospital is without an all-age liaison mental health service in A&E departments and inpatient wards by 2021 and that:

  • At least 50% of these services meet the core-24 service standard as a minimum.
  • 70% of these liaison services will meet the core-24 service standard by 2023/24 working towards 100% coverage thereafter

The Core-24 standard is where team:

  • operate as an on-site, distinct 24/7 service
  • are resourced in line with (or close to) the recommended staffing numbers and skill mix which enable them to operate on a 24/7 basis including access to older adult clinical expertise
  • meet recommended response times (1hr for emergencies, 24hrs for urgent ward referrals)

In Greater Manchester we have a more ambitious target – to attain a core-24 standard liaison mental health service in all 10 Greater Manchester acute hospitals with a type 1 A&E by the end of 2020/21. A Type 1 A&E is a consultant-led 24-hour service with full resuscitation facilities and designated accommodation A&E patients.