23/08/2008
Understanding the Role of Mental Health Ambulances
In times of crisis, the immediate response and care an individual receives can significantly impact their recovery journey. For those experiencing a mental health illness, the conventional emergency services may not always be the most appropriate or comforting point of contact. This is where specialised mental health ambulances and dedicated response teams are proving to be invaluable assets, offering a more tailored and compassionate approach to care. These services are not just about transportation; they represent a fundamental shift in how we address mental health emergencies, prioritising patient dignity, expertise, and the right pathway to recovery.
The London Ambulance Service's Mental Health Initiatives
The London Ambulance Service (LAS) stands at the forefront of mental health crisis care within the UK. Recognising that the 999 and NHS 111 lines are often the initial port of call for individuals in distress, the LAS has developed robust strategies to manage these complex situations. A&E departments, while vital for physical emergencies, can be overwhelming and even re-traumatising for someone experiencing a mental health crisis. The LAS aims to divert patients from A&E where possible, understanding that their needs can often be met more effectively and sensitively in their own homes, within the community, or at alternative care settings.
To achieve this, the LAS employs a dedicated team of over 40 specialist clinicians. This multidisciplinary team includes experienced nurses, social workers, and occupational therapists. These practitioners work both remotely, providing vital clinical assessments from the emergency control room, and on the ground in specialised mental health joint response cars. This dual approach ensures that expert advice is available instantly, and that frontline teams are equipped to provide immediate, specialised support.
The Impact of Joint Response Cars
The introduction of mental health joint response cars by the LAS marked a significant advancement in patient care. These units pair a paramedic with a mental health nurse, creating a synergistic team capable of addressing both the immediate physical and mental health needs of a patient. This holistic approach provides a more comprehensive and patient-centred care model. The LAS was the pioneering ambulance service in the UK to implement such an initiative. Initially launched as a single car in South East London in November 2018, the service has expanded to six response cars operating across the capital. Since February 2020, during the challenging period of the Covid pandemic, these units have treated an impressive 28,000 patients, highlighting their critical role in the healthcare landscape.
| Service | Key Features | Expansion/Impact |
|---|---|---|
| London Ambulance Service (LAS) | Joint response cars (Paramedic + Mental Health Nurse), Remote clinical assessment, Specialist clinicians (nurses, social workers, OTs) | First in UK to introduce joint response cars. Expanded to 6 cars, treating 28,000 patients since Feb 2020. |
Scottish Ambulance Service: Enhancing Mental Health Support
The Scottish Ambulance Service (SAS) has also made substantial strides in bolstering its mental health resources, supported by a significant investment from the Scottish Government. Over the past three years, the SAS has received £1.6 million as part of the government's Mental Health Strategy. This funding has been instrumental in establishing and staffing mental health triage cars and enhancing the overall care and support offered to individuals and communities facing mental health challenges.
This investment has facilitated the recruitment of 21 new mental health professionals, including thirteen mental health paramedics, a manager, four mental health dispatchers, and three clinical effectiveness leads. These leads play a crucial role in education, refining mental health pathways, and fostering collaboration with key partners. The funding also ensures the continuation of the SAS's Mental Health Triage cars, which provide specialised care to those experiencing mental health distress who have contacted the service.
The Approach of Mental Health Triage Cars
The Mental Health Triage cars operated by the SAS offer an adaptive and approachable method for responding to individuals in mental health distress. These units typically comprise a joint response from a mental health practitioner and a paramedic, ensuring that a patient's immediate needs are met with both clinical expertise and specialised mental health understanding. Currently, three such cars are operational across Scotland – in Dundee, Glasgow, and Inverness – serving the East, West, and North regions respectively.
Beyond the triage cars, the SAS has established a broader network of support services for individuals contacting 999 with mental health concerns. Through a partnership with NHS 24 and Police Scotland, the SAS contributes to the development of a Mental Health Hub, hosted by NHS 24. This hub operates 24 hours a day and is staffed by psychological wellbeing practitioners, mental health nurse practitioners, and mental health senior charge nurses. Furthermore, in alignment with the national rollout of the Distress Brief Intervention (DBI) initiative, the SAS continues to connect individuals in distress with appropriate support following a 999 call.
Kenny Freeburn, the Scottish Ambulance Service’s Regional Director for the East region, commented on the impact of these initiatives: “This funding continues to support the expansion of our initiatives to help in how we care for people experiencing mental health distress. It's estimated that at least one in four people a year in the UK will experience mental health challenges, and the number of people contacting the emergency services about mental health concerns is also increasing. Our clinicians are often the first responders to have contact with a person experiencing mental health distress. Our ambition across all our initiatives is to connect people to the most appropriate care to meet their needs in as timely a manner as possible.”
Mental Wellbeing Minister Kevin Stewart added: “Mental wellbeing is more important than ever right now and I am pleased to see this initiative being established as part of the Scottish Government’s mental health strategy. With these three triage cars and over 20 dedicated roles within this service, it means people in need of mental health support will get it quicker and that can only be a good thing.”
West Midlands Ambulance Service's New Response Vehicles
In England, the West Midlands Ambulance Service (WMAS) has launched five brand-new Mental Health Response Vehicles (MHRVs). These vehicles are designed to provide enhanced assessment and care to patients of all ages presenting with mental health concerns. These MHRVs represent a new, first-line response service for individuals who contact 999 or 111 with a primary mental health complaint, utilising a new national specification for mental health vehicles.
The MHRVs are staffed by Specialist Mental Health Paramedics, who have undergone additional training in Mental Health Practice. They are typically accompanied by either a Student Paramedic or a Technician, providing a valuable learning opportunity to deepen their understanding and knowledge of managing mental health presentations. The five new MHRVs are strategically located at:
- Coventry
- Hollymoor
- Shrewsbury
- Stoke-on-Trent
- Worcester
It's noted that there is currently no planned MHRV provision for the Black Country hosted by WMAS, though the Black Country Integrated Care Board is expected to launch its own service in that area in due course. This development is seen as a significant step forward, with Richard Corrall, Head of Clinical Practice for Mental Health at WMAS, stating: “This is an exciting new service for responding to calls relating to mental health. We recognise there is more we can do to support these patients and direct them to the most appropriate pathways. This represents a huge opportunity for the Trust to meet their needs and establish parity of esteem between physical and mental health needs.”
It is important to note that even with the introduction of these specialised vehicles, traditional ambulances will still attend mental health cases where necessary. Furthermore, Mental Health Nurses working within the Clinical Validation Team in the Emergency Operations Centre remain available to offer crucial advice and support to frontline crews at the scene, ensuring a comprehensive safety net for patients.
Key Benefits of Mental Health Ambulance Services
The growing implementation of mental health ambulances and joint response units across the UK underscores several key benefits:
- Specialised Care: Clinicians are specifically trained in mental health, providing a higher level of understanding and appropriate response.
- Reduced A&E Attendance: By offering alternative, more suitable care settings, these services can alleviate pressure on busy A&E departments and provide a less stressful experience for patients.
- Improved Patient Experience: A patient-centred approach, focusing on dignity and compassion, leads to better outcomes and a more positive interaction during a vulnerable time.
- Holistic Approach: Joint response teams can address both physical and mental health needs concurrently, offering a more complete and effective care solution.
- Timely Intervention: Connecting individuals to the right services quickly ensures that their needs are met promptly, potentially preventing escalation of their condition.
- Parity of Esteem: These services actively work towards achieving parity of esteem between mental and physical health, recognising them as equally important aspects of overall wellbeing.
Frequently Asked Questions
Q1: Will ambulances still attend mental health emergencies?
Yes, traditional ambulances will continue to attend mental health cases when necessary. The specialised units are an addition to, not a replacement for, existing emergency services.
Q2: What kind of professionals staff these mental health ambulances?
Staff typically include mental health nurses, paramedics with specialist mental health training, social workers, and occupational therapists.
Q3: Are these services available across the entire UK?
While services like those in London, Scotland, and the West Midlands are highlighted, the implementation and availability can vary by region. However, there is a clear national trend towards expanding these specialised services.
Q4: How do these services differ from a standard ambulance response?
They differ in the specialised training of the staff, the approach to patient care which is more focused on mental health needs, and often the destination or outcome of the response, aiming for community-based solutions over A&E where appropriate.
Q5: What is the goal of a mental health joint response car?
The primary goal is to provide a combined physical and mental health assessment and care response, ensuring patients receive the most appropriate and sensitive treatment, often in their own environment, and to reduce unnecessary A&E attendances.
Conclusion
The evolution of emergency response to include specialised mental health ambulances and joint response teams represents a significant and positive development in UK healthcare. By offering expert, compassionate, and tailored care, these services are not only improving outcomes for individuals experiencing mental health crises but are also contributing to a more integrated and understanding approach to mental wellbeing across the nation. The commitment to expanding these vital resources signifies a growing recognition of the critical importance of mental health support within our communities.
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