Respond is a unique multi-agency simulation training package for professionals involved in mental health crisis care. By increasing collaboration and knowledge, it equips staff to respond quickly and appropriately to improve patient experience.
The Crisis Care Concordat has brought together relevant agencies with a shared commitment to improve the system, so that people in mental health crisis get the support they need – whatever the circumstances and whichever service they turn to first. Respond is a key step towards making that vision a reality. Using an immersive training technique, it offers a safe learning environment to explore problem solving and decision making skills, where mistakes can be made with no long-term consequences. Working alongside professionals from other agencies, participants are presented with a series of real-life situations, with constant support from a mental health professional,paramedic, police officer, psychiatric doctor, crisis nurse and, crucially, an expert by experience.
A streamlined, joined-up response depends on a clear understanding of every role, and how they fit together under the pressure of a real situation.Respond recognises that it’s simply not practical for each agency to train its staff separately, and instead creates arounded experience by bringing together the full range of relevant staff, alongside experts by experience. Some of the key participants in the initial scenario for a Respond session are set out below – with each of these specialisms also represented among the panel of experts providing advice and guidance to participants:
The AMHP decides whether or not an application should be made for detention in hospital under the Mental Health Act 1983 (amended 2007). This role includes convening the assessment, considering available information, interviewing the person with the Section 12 medical practitioner(s), consulting the nearest relative and arranging conveyance to hospital. The AMHP must ensure the person meets the criteria for detention under the Act (usually section 2 or 3) – that the person is suffering from a mental disorder, the nature/degree of which makes it necessary for them to receive assessment and/or treatment in hospital due to risk to self and/or others.
Ambulance services provide unscheduled care to patients with a range of mental health conditions who dial 111 or 999, as well as providing transportfor patients at the request of police, AMHP or medical staff to suitable locations for continued care. This includes helping individuals with an isolated mental health problem or with inter-related physical and mental health problems, often when they are feeling highly vulnerable or do not know where else to seek help. Working alongside partner agencies, their role is to provide service users with the responsive and compassionate care or to signpost them to other appropriate services, as part of a holistic and co-ordinated approach to supporting patients in crisis.
A ‘Section 12’ doctor is shorthand for a doctor who is ‘approved’ under Section 12 of the Mental Health Act on behalf of the Secretary of State (or Welsh Minister) as having special expertise in diagnosis and treatment of ‘mental disorders’. The doctor is usually a psychiatrist.The role of the doctor in a Mental Health Act Assessment is to liaise with the AMHP, interview the patient together and make recommendations for treatment. This involves making an assessment, discussing options with the AMHP and agreeing a treatment plan using the least restrictive option. This could include admission under the Act, home-based treatment or discharge to other services. For a Section 136 assessment, only one Section 12 doctor is required. For other sections of the Act, a second doctor is required and two recommendations are made. Respond-trained professionals take their learning forward with a clear understanding of each other’s roles, so that every agency in the crisis pathway can respond quickly and effectively - without the tensions and time delays that can arise from uncertainty about who should do what.
Respond was developed through the Northern England Strategic Clinical Network (SCN), and is supported by organisations including Northumberland, Tyne & Wear NHS Foundation Trust (NTW); North East Urgent and Emergency Care Network; Fulfilling Lives Newcastle Gateshead; Tees, Esk and Wear Valley NHS Foundation Trust; Northumbria Police; North East Ambulance Service; and Newcastle City Council.
Further information about Respond is available from Northumberland, Tyne and Wear NHS Foundation Trust:
To book a place on a Respond course – or to find out more about how your area could benefit from Respond, contact Amy Rafter at amy.Rafter@ntw.nhs.uk or 0191 245 6662 (ex 56662).
The project is supported by the Experts by Experience Group of Fulfilling Lives; Tees, Esk and Wear Valley NHS Foundation Trust; Northumbria Police; North East Ambulance Service; Newcastle City Council; Northern England Strategic Clinical Network; and the North East and North Cumbria Urgent and Emergency Care Network.Enrol
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Respond is a totally immersive experience. It encouraged me and my professional colleagues to leave the comfort zone of role and remit and face more honestly the considerations of a critical incident which involves mental health crisis. As a learning tool this cannot be underestimated.
I found it very helpful to better understand the roles colleagues play, and the constraints their roles put on them. Collaboration has been much more apparent since the training, making the whole process less stressful for the patient.