George Garrad, Associate Director of Health at Look Ahead
There are times when a young person recovering from a mental health crisis is better off being looked after in a community setting according to a recent report, commissioned by Look Ahead, conducted by Care Research and supported by the Wates Family Enterprise Trust. The report titled Away from hospital and into the community, made for some deeply distressing reading, but also posited optimistic, positive, and practical solutions with benefits not only for the young people, but also for the health and social care sector at large.
The report revealed that A&E has regrettably become an accidental hub for young people experiencing a mental health crisis seeking support. A young person and their family were often left without any other choice but to go to already inundated A&E departments to get the immediate help they needed.
The researchers heard from professionals, service users and their families and carers that you “had to have attempted suicide multiple times to be offered inpatient support.” In some instances a young person could be admitted to a paediatric or psychiatric ward for an extended period. In-patient psychiatric wards are well-suited to treating a person in the initial stages of a crisis, but are by design, ill-equipped to deliver the long-term recovery care that comes later. After all they were never intended for this.
This is where social care and housing comes in. Specialist community-based supported housing offers a three-pronged approach that creates better outcomes not only for customers, but also for the NHS.
Firstly, the report recommended alternative community crisis services, including supported housing away from hospital settings to reduce pressure on A&E and could reduce costs by more than 50%. Feedback from people interviewed for the report found that the earlier supported housing is made available to young people with mental health needs, the better. Meaning it may help to avert an initial crisis altogether, and ease already high pressures on the NHS by lessening admission numbers.
Where a hospital admission has already happened, supported housing offers a reliable pathway for rapid discharge. This is what we have found where I work at the supported housing and care provider Look Ahead. We are already doing this in adult mental health crisis care where supported housing services provide a comfortable and collaborative setting, where people can enjoy a homely environment backed up by support staff and continue with visits from their local specialist NHS home treatment team.
The social care side of these services also helps prevent crises from recuring. Support workers are experts in addressing many of the issues that have either caused a crisis to happen in the first place, or that could cause them to occur again in future. Support workers for example can ensure a young person can access financial support such as welfare benefits, post-placement housing, educational and career development opportunities as well as clinically informed care and support to help them manage their mental health going forward.
It should be clear now that involving supported housing gives these young people the best hope of a successful recovery, but there are also cost benefits too. Many commissioners are also keen to look into the major savings that such support models can bring in addition to the real-life personal outcomes. Our report showed that the NHS and social care commissioners could potentially make savings of around 50% by choosing supported housing alternatives instead of A&E admissions and lengthy hospital stays.
But we need more investment in new supported housing to deliver these services that help the NHS with this type of challenges. Regrettably, the Government’s recently announced scrapping of the £300m investment promised to councils to build specialist accommodation for health and care is a major blow. The sector must continue to shout our message from the roof tops. Supported housing must be a priority, thousands of young people, and the NHS are counting on it.