Excellent crisis care exists. It can save lives. And that’s why we need it available for everyone.

A mental health crisis is frightening and can be life-threatening. Yet you told us you couldn't always get help when you desperately needed it. Some of you were left isolated, frightened and unsupported. You told us physical restraint was being used too often. That's not acceptable.

 

When you are in crisis we want you to be treated with humanity and compassion, get help when you need it, and have a choice and control over the kind of treatment and support you receive.

 

We've been campaigning for better crisis care for three years and finally it's being seen as a national priority. We are currently focusing on the use of physical restraint in mental health hospitals.

 

If you or someone you know is in crisis now, read our information and advice about the places you can turn to for help.

 

Listening to experience

Our independent inquiry (2010-11) found that excellent crisis care exists, but that too often people are turned away and struggle to get help.

Access to crisis care

Our investigations in 2012 found huge variations in rates of access to crisis care between mental health trusts. Crisis teams in four out of ten trusts were understaffed and trusts had limited crisis care options beyond home treatment and hospital.

Physical restraint

Our investigations in 2013 found shockingly high levels of physical restraint in mental health hospitals.

Read more about our findings and recommendations to ensure people in crisis get help not harm.

Crisis care inquiry

Between Autumn 2010 and Summer 2011, Mind's independent inquiry team listened to evidence from 400 people with experience of crisis, professionals and providers from across England and Wales to find out how well mental health units and crisis teams were meeting people's needs.

Excellent crisis care exists. We heard about:

  • innovative services that were easy for people to access
  • courteous and helpful staff
  • well designed, therapeutic environments
  • teams with a can-do spirit and approach.

But many of you told us about poor and even traumatic experiences - unable to get help from the crisis team, waiting for hours in A&E, or being left isolated and frightened in impersonal hospital settings with staff too stretched to spend time with you. People from some Black and minority ethnic groups still seem to be being treated more neglectfully or coercively than others.

Our vision and recommendations

For you to have the crisis care you need, when you need it, we need to campaign for change in four areas:

Humanity - so that you are treated in a warm, caring and respectful way.

Commissioning for people's needs - so that services meet the needs we all share such as for care, safety, respect and someone to talk to, and also recognise the diversity of our needs and circumstances.

Choice and control - so that you are trusted to understand your own needs and have more choice and more say over treatment and support.

A shared approach to healing and recovery - so that the skills of everyone involved in crisis care are used to best effect - professionals, support workers and peer workers who have themselves experienced mental health problems.

I needed a safe place - somewhere I could not seriously harm myself until I recovered emotionally.

Crisis services across the country

In 2012 we asked mental health trusts to tell us about their crisis services. We found:

Huge variations between trusts in the rates of access to their crisis care services.

  • Crisis teams - referrals ranged from 42 to 430 people per 10,000 population
  • Home treatment - new episodes of home treatment range from 8 to 104 per 10,000 population
  • Hospital treatment - admissions ranged from 5 to 56 per 10,000 population.

Under-staffing - many crisis care teams are under-resourced and over-stretched; in fact, 4 in 10 truats had staffing levels well below established benchmarks.

Limited options - having a range of options can give you a choice and meet your needs better but only 12 trusts had more than one option on top of hospital and home treatment. Only seven said they had a crisis house.

Barriers to care

Our findings suggested different ethnic groups may face different barriers to crisis care:

  • Indian, Bangladeshi and Chinese people had consistently low rates of referral to crisis teams
  • once assessed by a crisis team, BME groups were more likely to be admitted to hospital, especially Black Caribbean people.

Physical restraint in hospitals in England

When you are experiencing a mental health crisis, you may become frustrated, frightened and extremely distressed. Healthcare staff have to deal with challenging situations and make quick decisions to ensure the safety of patients and staff. Sometimes they use physical restraint to control someone's behaviour which means holding them against their will. It can be humiliating, dangerous and even life-threatening.

Physical restraint should only be used as the last resort, when there's no other way of stopping someone from doing themselves or others immediate harm. But many of you told us physical restraint is being used too often.

We're calling for national standards on the use of restraint, accredited training and an end to face down restraint.

The Government is taking notice and developing guidance but we need to keep it a top priority.

Take action

What we found out about physical restraint in England

We asked mental health trusts about their use of physical restraint in the year 2011-12 and found huge variation across England.

  • One trust reported 38 incidents while another reported over 3,000 incidents.
  • There were almost 1,000 incidents of physical injury following restraint.
  • Face down restraint, which is dangerous and can be life-threatening, was used over 3,000 times. Yet some trusts have worked hard to eliminate face down restraint and reported no incidents.
Check your local data and take action

Physical restraint: download our resources

Our report sets out the background to physical restraint, our findings on it use and impact, and our recommendations. You will find personal experiences and some great examples of trusts that have radically reduced physical restraint and worked hard to eliminate face down restraint.

  • Read our full report
  • Read our briefing for healthcare staff
  • Read our briefing for MPs

Learning from experience

Nadine blogs about her experience of being physically restrained in hospital and how staff could have managed her care differently. Grace shares her experience of how restraint can be done in the right way. More real life stories about crisis care.

Read how one small group of service users helped to fundamentally reshape the approach of Sheffield's mental health services - and how the trust undertook the long process of making changes for the benefit of patients and staff. More real life stories about crisis care.

Coming out of a psychotic episode is always scary, but the staff were always sure to inform me of what was going on so that I was not confused as to why somebody was holding my arms.

Real life stories

Personal stories are the most compelling way of highlighting why we need excellent crisis care. Many of our supporters have spoken out and shared their own experiences of crisis care and physical restraint.

Experiences of restraint

Read Rosemary's story

Read Connor's experience as a nurse

Listen to Rachel's story

Rachel talks about being restrained in hospital, sometimes quite unnecessarily she believes. Before you listen, please be aware that Rachel is honest and explicit about her restraint experience. Some listeners may find her account upsetting and triggering.

Listen to Pat's story

Pat talks about training healthcare staff in respect-based support techniques that are used as an alternative to physical restraint. Before you listen, please be aware that Pat is honest and open about his experience of restraining people. Some listeners may find his account upsetting and triggering.

Experiences of crisis care

Check out the latest crisis care videos we've received from our wonderful supporters. Please watch carefully and be aware that some videos include fictional demonstrations of people being restrained and you may find this content triggering.

Read people's blogs on crisis care.

Share your story

We're always interested in hearing from our supporters about your crisis care experiences. Find out how you can share your story.

Mental Health A-Z

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