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Ground-Level

So often, we hear of people in desperate need of support but with no knowledge of how to get it. Even when they ask people who work in the system, they don't seem to know either. It's often only when someone reaches the point of requiring inpatient services that community support is then offered. This page gives an overview of what kind of support you can get from the Health and Social Care system, how to get it, and where to look.

Mental Health

The NHS England National plan: Building the right support, initially published in 2015 and part of a wider NHS Long Term Plan, was actioned alongside partners in July 2022 to make systemic and organisational framework changes to reduce the reliance on mental health inpatient care and strengthen the support that people, including autistic individuals or those with learning disabilities and mental ill-health, can receive in the community.

 

Within this plan, and the introduction of Integrated Care Systems (ICSs), there have been a number of changes to the way that services are structured, funded and how people can access appropriate and timely care that meets their individual needs. This is an overall breakdown of how mental healthcare is now organised, and where you can access it.

The NHS mental health system is structured in 3 tiers:

Primary Care

Primary care is essentially the entry-level of mental health care in the NHS. To access this, you usually start by going through your GP, local authority, or a mental health charity, who make referrals based on what you’re struggling with.

Click here to read more.

Secondary Care

Secondary care consists of both general hospital and community care, and you generally need a formal referral to access it.

Click here to read more.

Tertiary Care

Tertiary care is highly specialised care that includes secure forensic psychiatric units, where people are usually detained under the sections of the Mental Health Act (1983) because they have been ordered by a criminal court to receive treatment in hospital.

Primary care

Primary care

Within the primary care category, you might  be referred to social prescribing, where you’ll be signposted to a range of community-based activities and support. You may also be allocated a link worker, who may help in connecting you to such community-based activities and support. 

 

GPs, charities or local authorities may also refer you to talking therapies as part of the NHS’s Improving Access to Psychological Therapies (IAPT) service. You can self-refer to either social prescribing or your local IAPT service.

2nd Care

Secondary Care

Secondary Care includes both community and inpatient care for mental ill-health and usually requires a referral generated by a GP, local authority or general hospital.

 

Community care

 

Community care includes support and treatment from Mental Health Teams (MHTs). These can look like: 

  • Child and Adolescent Mental Health Services (CAMHS): community support and treatment for children and young people under the age of 18.

  • Older Adult Mental Health Teams for people over the age of 65. 

  • Community Mental Health Teams (CMHTs): CMHTs give short and long term support and treatment in the community, and are for people aged between 18 and 65.

  • Specialist Mental Health Teams: community teams, such as eating disorder services, where it is deemed a more specialist level of expertise and treatment is required. 

Crisis Teams

Crisis teams offer short term support if you are experiencing acute distress and crises. Generally, crisis teams act to prevent hospital admissions but they can arrange for you to be admitted into hospital if they feel you will be unwell for longer. You can contact crisis teams yourself, or be referred by A&E, your GP or as part of your care plan if you are already with a mental health team.

 

Crisis teams are sometimes called:

• home treatment teams

• crisis resolution teams

• intensive teams

• crisis and assessment teams

• rapid response teams

You can read more about Crisis Teams and other crisis services here.

Early Intervention Team

EITs work with people when they are experiencing psychosis for the first time, and often when it is drug-related psychosis. Referrals to EITs happen in various ways, but should happen immediately and alongside a crisis team. 

Inpatient care

 

Inpatient care is when you or your loved one is admitted into a mental health hospital on a voluntary basis, or detained there under the Mental Health Act (1983) or a Deprivation of Liberty Safeguards (DoLS) order. 


Inpatient hospitals can be directly owned by the NHS, or the NHS will commission private providers from the independent sector (like The Priory Group, Huntercombe/Active Care Group, Elysium Healthcare and Cygnet Healthcare). Types of mental health wards and hospitals include:

  • Acute wards

  • Psychiatric Intensive Care Units (PICUs)

  • Assessment and Treatment Units (ATUs)

  • Recovery and rehabilitation units

  • Forensic mental health wards

  • Specialist wards (eating disorder, personality disorder, mother and baby, and young person units.

 

Most psychiatric hospitals are ‘locked wards’, meaning you will have to ask permission to leave the unit and outdoor space is secure. You can read more about what each unit can do and what a length of stay looks like here.

Sectioning and the Mental Health Act (1983)

Sectioning means that you are detained under different sections in the Mental Health Act (1983), that are all used for slightly different purposes and have differing rights depending on which particular section you have been detained under. You can read more about the types of sections under the Mental Health Act (1983) and what to expect when being sectioned here.

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