Pitfalls and phone calls: understanding access to mental health services

Tuesday, 16 May 2017 - 4:01pm

How can frontline teams work more effectively with statutory mental health services, to ensure clients get the right help, at the right time, from the right people?

Man being counselled

It sounds like a simple question, but having worked for many years as a Senior Practitioner in a mental health access team, I know only too well how difficult it can be to get clients seen by the right person – and I was on the inside!

For people referring in, it can be a frustrating experience: being left holding the proverbial baby, with little idea of how to navigate a complicated organisation. I wrote the ‘Working with Statutory Mental Health Services’ guidance to help workers to navigate those systems, and avoid the pitfalls that delay support for the people who need these services the most.

Often, these pitfalls are about how we communicate with each other. When complaints arrived on my desk, I was struck by how often both sides had the best interests of the client at heart. Unfortunately, in our over-worked, over-stretched, under-resourced world, things had gone wrong along the way. I would mourn the loss of conversation, where each party could explain themselves, say what they need, and come to an agreement. Instead, there were flurries of misunderstood emails and letters that never quite got the point across. The loser in all of this is, of course - the client.

There is much to be gained from picking up the phone and asking the mental health team: what it is that you need from me? Finding the time to have a conversation can save many hours of unnecessary work and frustration on both sides.

In developing the guidance, I reflected on how little credit frontline workers in homelessness services give themselves for the work they do. They spend a lot of time with the people they support, and know them well. They gain insight into a person’s mental health that someone in a mental health team wouldn’t necessarily pick up on, in the time available for a first assessment. This kind of information can be like gold dust to a mental health worker.

I remember many conversations with workers disappointed because the mental health team had decided not to offer a service to their client, and hadn’t explained the decision properly. This left people concerned that their client was not going to get what they needed. A conversation to explain our reasons fully often left workers feeling happier about the decision, as they understood our reasoning. This also helped to set realistic expectations on both sides, about what each other’s service was able to offer.

I often found myself thinking about all the great mental health work that was being done with clients outside of statutory services, and this is one of the key messages of our guidance. Not everybody with a mental health problem needs, or benefits from, mental health services. In some cases, it is better not to receive a statutory service. This doesn’t mean that there is no support, because they are already receiving high quality, supportive, relationship-based therapeutic work from you – their homelessness worker. We need to remind frontline teams how significant their support can be - even in non-specialist roles, so that they recognise their impact, as well as knowing when it’s time to seek statutory intervention.

Support workers should use the guidance to improve communication and relationships with statutory services, and to get their clients seen when needed. But, just as importantly, frontline homelessness teams need to stop hiding their light, and start celebrating their own therapeutic value to the people they work with. 

Working with Statutory Mental Health Services

Guidance for housing and homelessness teams on referrals to, and support from, statutory mental health services.

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Helen Kelsall

EASL Mental Health Assessor

Helen was until recently a Senior Practitioner Social Worker and Approved Mental Health Professional in an inner London mental health assessment service. She now works for EASL part time carrying out mental health assessments and doing some writing work. She is also an independent Best Interests Assessor under the Deprivation of Liberty Safeguards, and an independent trainer on the Mental Capacity Act.