A Cavendish Square Group publication 23 Helping our most unwell patients get better quicker Two crisis houses in Camden are treating hundreds of people a year as an alternative to acute hospital admissions By Katie Clayton, Operational Manager for Camden Acute Services, Camden and Islington NHS Foundation Trust The population of north London has some of the highest levels of mental ill-health in the UK. Camden and Islington NHS Foundation Trust has developed a service designed to help some of our most unwell patients by keeping them out of hospital and setting them on the journey to recovery. The Trust operates crisis houses in both Camden and Islington, but in this case study we focus on Camden. The Camden Crisis Houses are an alternative to acute inpatient hospital admissions. The first, North Camden Crisis House, opened in 2008 and the second, Rivers Crisis House, opened in 2014. Both Crisis Houses have an average occupancy rate of 93%, and have treated 366 people between April 2013 and March 2014. The majority of people who use the service are single, live alone, are unemployed and have had previous contact with mental health services. The service has proved very popular with patients, many of whom say if they are unwell they would prefer to go to a Crisis House rather than anywhere else, such as a hospital ward. The North Camden Crisis House is a six bed unit which opened as a result of a 10 year campaign by mental health service users in Camden. Service users and an art psychotherapist collaborated to create a modern and non-clinical look for the House itself in order to achieve a space where service users feel valued and self-empowered. The Crisis Houses consist of three multi-disciplinary teams which offer flexible and seamless support seven days a week. The teams include a consultant psychiatrist, pharmacists, nurses, clinical support workers (mostly with backgrounds in psychology or psychotherapy and occupational therapy), art therapists, students and volunteers. A mix of clinical and non-clinical workers – with access to a clinical psychologist and consultant psychiatrist during weekdays – work on each shift to offer a comprehensive package of care to people using the service. People can be referred to the Crisis Houses by their GPs or community mental health teams via the Crisis Teams, or they can self-refer. People who use Camden’s Crisis Houses live with severe and enduring mental health conditions with common diagnoses of psychoses, personality disorders, bipolar affective disorders as well as long term physical health issues such as diabetes, hypertension and chronic pain. They are among the most unwell patients treated by the Trust. A recent evaluation of the Rivers Crisis House revealed that people using the service were living with multiple stressful situations including recent job losses, debt, bereavements and social isolation. On admission, more than 80% of people present with self-harm and plans to end their lives. People stay on average 11 days and, on discharge most people (77% – 83%) return to their homes, supported by a wide range of community mental health services. Since the first crisis house opened in 2008, we have found our Crisis Houses to be a cost-effective alternative to an inpatient hospital stay. The patients who use them have an improved mental state and report high levels of satisfaction with the service they receive. Much of the debate around mental health care and mental health funding focuses too closely on inpatient beds. Camden’s Crisis Houses offer a compelling and cost effective alternative to inpatient care for seriously unwell patients – an alternative that should be more widely explored by the healthcare community.
London Mental Health Fact Bbook
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