Urgent care for mental health in the NHS

The proposed rollout of 85 mental health emergency departments across England, backed by £120m of investment, aims to tackle the crisis in the provision of urgent and emergency mental healthcare. Six pilot sites have been proposed, with limited details regarding plans for evaluation.1

More than 80 000 people experiencing mental health crises waited over 12 hours in emergency departments in 2023-24, with 26 000 waiting more than 24 hours.2 The most common presenting mental health issues are acute psychiatric problems (eg, suicidal thoughts, hearing voices, paranoid ideas), self-harm, and alcohol and drug related problems.3

The staggering delays in care for people with mental health problems are more than an operational failure; they reflect a system that cannot meet demand. Crisis presentations to emergency departments have become the default route to care for many patients because of a lack of timely access to community services, depleted inpatient capacity, and the growing complexity of cases.456 While emergency department presentations for mental health reasons increased by over 200% between …