Crisis Care Concordat promises much – but needs funding to back it up

The launch last week of the government’s Crisis Care Concordat has promised much that could make a difference to people who are experiencing a mental health crisis, but it needs funding to ensure it delivers.

The concordat, which has already been signed by 22 organisations including NHS England, the Association of Chief Police Officers and the Royal College of Psychiatrists, sets out the standards of care people should expect if they suffer a mental health crisis and details how the emergency services should respond.

Commitments like ensuring health-based places of safety and beds are available 24/7 in case someone experiences a mental health crisis, and not using police custody as a ‘place of safety’, are very welcome – and long overdue. Reviewing mental health training programmes for the police and GPs is also a sensible move.

Change in crisis care is certainly needed. For example, figures from the BBC and online journal Community Care found last week that rising numbers of young people with a mental health crisis are being treated on adult psychiatric wards – something the Department of Health had vowed to end by 2010.

This cannot be allowed to continue. As Victoria Bleazard, associate director of campaigns at Rethink Mental Illness, said: “To place a teenager or child in an adult psychiatric ward can be traumatising and hugely damaging. If this is their first experience of the mental health system, they are much less likely to engage with services in future.”

It’s heartening to see that the concordat has been signed by various organisations, including health and the police because greater joined-up working is essential if mental health care is to be enhanced and people’s needs better met.

But, of course, the elephant in the room is funding. Mental health is still underfunded compared to physical health and that has to change. Mental health funding has declined by 2.3% in real terms in the past 2 years, again according to statistics collated by the BBC and Community Care. Specifically, crisis care funding has fallen by 1.7% in the same time, despite referrals having increased, on average, by 16%.

All the commitments in the world can be made, but unless the money is there to implement change at a national or local level – whether it is providing more training or a greater number of crisis beds – it isn’t going to happen. Shuffling existing budgets can only do so much, and ‘efficiency savings’ have been made for years, so by now they should be pretty efficient, you would think.

What cannot be allowed to happen is that the Concordat gathers dust on a shelf and the pledges are quietly forgotten while mental health services continue on as they have done – or, worse, experience further cuts – and we end up in a few years’ time welcoming another document that pledges to improve care because provision is still inadequate.