"crisis care and no hospital beds"

About: Camden and Islington NHS Foundation Trust

(as a friend),

My friend who I support has had very bad mental health problems for over 20 years. He has psychosis and often doesn't take his medicine so gets ill. The police often go to his home and when they are there, they ring the crisis teams and ask for him to be assessed. The police then have to call me because in Camden they say they don't come and assess people or you have to wait a few days. They also told the police and the GP that there was no point assessing him as there were no beds. This has happened lots of times and to everyone I know who has to deal with the mental health trust. They always say they cant come out and the person has to go to A&E. But when the police come for a welfare check when he is ill he gets much more worse and has to be taken away in handcuffs because he is then frightened. This is wrong. He is not a criminal, he is a very ill man and they refuse to help him. He has been sectioned lots of times for many months sometimes so they know he is not well and even his psychiatrist at Peckwater Centre, said they could not get beds. It is terrible. he can't go to a crisis house as they don't take psychosis patients.

The Mental Health Trust know this. I have complained, his elderly mother complained and his social worker in a meeting said there were no beds any more. If you make a written complaint then everyone knows that the patient will suffer and he can't go anywhere else for help can he? I don't know anyone who thinks the crisis teams and the section team in Camden are any good. What is the point of them? They also refuse to work with him at home anyway, so he has to go to hospital. The person who writes responses here and tells people to e mail sounds like an admin person or manager who doesnt know what really goes on. Someone told me that it would be a very good idea to undercover film or record the crisis team when people try ring them. I think it would be a good idea as well

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Response from Camden and Islington NHS Foundation Trust

Dear Peter

Thank you very much for getting in touch. Just so you know, I am Head of Communications at the Trust and I monitor the Patient Opinion website. You are right - I am a manager. We think it's sensible that someone like me reads the postings and then passes them on to the right clinical team. This means front line staff time isn't wasted reading emails which may not be relevant to them. You are also right that I can't know in depth everything that is going on at every level of the Trust, but I know who does know. It is those relevant teams I contact for an answer and response which will be posted up in the coming weeks.

My role in responding to you is not to give you the answer you seek but to let you know that I WILL get an appropriate person to get back in touch with you and to know that your opinion has been heard and I hope then acted upon.

The important thing here is your friend, and it is fantastic that you are looking out for them in this way.

Can I ask that you get in touch with our feedback team on feedback@candi.nhs.uk

We need a bit more information to further help you and your friend so we can ensure that the right care is being given.

There are a number of things you mention including lack of beds. Our policy is that anyone who needs a bed will get one, however, in this case I do not know what the issues are which you say are stopping this happening. That is why it's so important that you get in touch with us on feedback@candi.nhs.uk.

Meanwhile I will send your email to the relevant team and make sure they get an answer for you, but we will have to be fairly general in our response unless you get in touch with us - so please do.

Once again - thanks for getting in touch

Response from Camden and Islington NHS Foundation Trust

Dear Peter

You still haven't got in touch and it is many months later. We had been hoping you would have wanted to help your friend further and can't understand why you haven't wanted to follow this up?

Have you got in touch with us already? Please contact feedback@candi.nhs.uk and mention this posting so we know you have responded.

Thank you

Response from Camden and Islington NHS Foundation Trust

Dear Peter SJ

Thank you very much for taking the time to put in writing your concerns regarding the care of your friend who has had mental health difficulties for the last twenty years. As we do not have the details of your friend’s identity, we can only respond to the issues you mention on a general level and are unable to feedback to you as detailed a response as we would normally provide.

In order to address your concerns the response below has been written by the Operational Service Managers for both the Crisis Resolution Teams and the Crisis Houses within the Trust – Debbie May and Katie Clayton.

To address each point as follows:

You initially state that the Police often go to your friends home but that when they then summon the Crisis Team they do not attend to assess him.

First and foremost the Crisis Teams do accept referrals from the Emergency Services; we cannot examine the exact details of this incident without sufficient information from you however I am sorry that this seems to have happened on this occasion. In your complaint you also mention that there was no point in referring as there were no beds. You state this has been reiterated to you by your friend’s psychiatrist and also their social worker. Again it would be useful to have more detail on this so we can pass these concerns on to those in directly involved in his day to day care.

All service users in mental health crisis should be offered an assessment to ascertain their level of need – if a hospital admission is indicated then a bed will be provided for them.

We cannot emphasize enough – no resident of Camden or Islington will be denied a hospital bed if one is required. It must be worrying for you to think this is the case.

It is important to convey to you, the Crisis Team also considers people for the Crisis Houses before thinking about an in-patient acute admission. There are two houses in Camden both of which also take self-referrals for patients with all diagnoses. Other services, including the Mental Health Liaison teams and the Community mental health teams can also refer directly to the houses.

Ultimately, the Crisis Teams primary objective is to offer support and care in the least restrictive environment and so are keen whenever possible to care for service users in the comfort of their own homes. In the case of your friend – we cannot comment on how the police have behaved or what they may have said, but please be clear that we will raise this with our police colleagues at the next formal meeting.

In relation to your comment about use of recording equipment to monitor services such as the Crisis Team, we would like to thank you for this as we are always looking for ways of how we can develop and improve upon our services. A telephone recording system is an idea which we will be happy to consider as a means of training staff and offering additional security and safety for external callers.

I would like to thank you for taking the trouble to contact us. We value complaints as an important source of feedback and feel this process helps staff to be more aware of service areas that can be improved. If you would like to discuss this matter further or need clarification please do not hesitate to contact;

Katie Clayton (Operational Services Manager – Camden Crisis Houses/Acute Day Programmes & Drayton Park Women’s Crisis House) Katie.clayton@candi.nhs.uk

Yours sincerely

Debbie May (Interim Operational Services Manager)

Crisis Resolution Teams