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Old Problems, New Solutions: Improving acute psychiatric care for adults in England

Final report

Urgent action is needed to improve acute psychiatric care for severely ill adult mental health patients in England.

Our report describes widespread problems with finding beds or receiving good home treatment but it also points to the improvements that can be made and gives examples where people are being well cared for in good services.

These are old problems but there are new solutions for improvement thanks to experience and learning in recent years, new technology and – very importantly – the commitment of all political parties to achieving parity between mental and physical health. This opportunity needs to be grasped.

The Commission’s focus has been only on acute care for adults but it has linked with the much wider review undertaken by the NHS England Mental Health Taskforce – the Chair and Vice-Chair of which have been members of this Commission. We very strongly welcome their proposal for new investment in Crisis Resolution and Home Treatment teams and believe that our recommendations will support the Taskforce’s strategy.

Government has important responsibilities here but so too do local organisations and leaders. Government needs to set direction, create the policy framework and secure adequate funding, while local people will need to exercise judgement and make decisions within their local context taking account of the available resources and capabilities. Both local and national leaders have the important responsibility to help change the way mental illness is perceived and to create the relationships and culture which will ensure that people receive the high quality, respectful and compassionate care they need.

We are all very grateful to the people we met or who wrote to us to tell us of their experience or offer us advice. We were both very depressed by some of what we heard and, on the other hand, deeply impressed by the care, commitment and expertise we saw in some services. We are particularly grateful to the patients, carers, policy makers and practitioners who joined our advisory groups.

The is an independent Commission but we have been very well supported by the Royal College of Psychiatrists through its Policy Unit and are, in particular, very grateful to Greg Smith and Krista Nicholson for so ably undertaking research and providing administrative support to the Commission.