Reserved for those who are most unwell, many of whom are detained under the Mental Health Act.
Admission is determined by crisis resolution and home treatment teams (CRHTs) and is influenced by safety considerations, bed availability and what social support the person has.
Wards may be locked, even though not all patients are detained. People who are deemed to need closer supervision for their own or others’ safety may be admitted to a psychiatric intensive care unit (PICU).
These are documents drawn up by individuals when well to express their wishes about future care and medical treatment, when they may be unable to express those wishes themselves.
They may include advance decisions which are legally binding refusals of treatment. An advance decision does not normally have to be written down.
Smaller and less medical than a ward, these may be provided within the NHS or the voluntary sector. There is no single model, and they vary as to how they are accessed and how they are staffed.
The role of these specialist NHS teams is to respond to major mental health crisis and provide intensive support at home to people who would otherwise be admitted to hospital.
They carry out assessments and decide whether people can be treated at home or in another community setting or if they should be admitted to hospital. They can also support people when they are discharged from hospital.
These teams are part of the secondary services and people have to be referred by the GP or another health care professional, unless they are already using specialist mental health services.
The Mental Health Act 1983 provides for people with a mental disorder to be detained in hospital for assessment or treatment in the interests of their own health or safety, or with a view to the protection of others. It also provides for people to be discharged on to a community treatment order.
Used by people who have harmed themselves and need urgent physical healthcare, and others who have immediate mental health needs. People who have barriers to other healthcare, such as homeless people and vulnerable migrants are more likely to go to emergency departments.
Many, but not all, emergency departments have psychiatric liaison services to assess mental health needs, provide short-term treatment and support and link people into longer-term care if needed.
These are specialist, secure services that work with people in the criminal justice system.
From the Samaritans listening service to respite care, there is a range of support that people can access themselves or which crisis resolution and home treatment teams or other health professionals can mobilise on their behalf.