Our emergency services personnel deal with a range of challenges and stressful situations often on a daily basis and it’s more important now than ever that they are offered the support to deal with the situations they face every day. It’s not surprising that, the mental health charity Mind recently reported that mental health continues to be an issue across all of the emergency services.
As we begin to understand the pressures, triggers and stress that working within a control room brings – we can start to arm our frontline 999 call takers and dispatchers with better tools to cope and deal with the daily pressures of making life and death decisions, sometimes in split seconds.
Mind found that call handlers sometimes felt overwhelmed and ill-equipped to carry out their role and that this can impact their own wellbeing.
Their research indicated that call handlers often felt ill prepared in dealing with callers experiencing mental health problems, describing this as one of the biggest challenges of the role. Call handlers sometimes must stay on the line with callers experiencing suicidal thoughts or feelings for long periods of time, while waiting for a frontline response to arrive, and the research found that staff worried about making things worse by saying the wrong thing.
One of the techniques for balancing demand across the emergency services, especially in the cases where mental health issues can be identified is better integration and collaboration of urgent care services.
Integrating and sharing contact history of repeat callers who suffer with mental health helps as a warning flag to the control room that alternative methods could be used instead of dispatching a vehicle.
The collaboration between professions is also increasing – having a mental health triage nurse placed within the control room is becoming more and more common. This allows the person showing signs of distress or mental health issues to be treated by a trained professional.
Emergency services and health trusts throughout the UK are coping with rising demand from people requiring urgent mental health treatment.
London Ambulance Service NHS Trust
According to recent data, the London Ambulance Service NHS trust control room takes 13,000 calls a month related to mental health – about 10% of all calls.
Four years ago, it recruited mental health nurses in the control room to provide immediate expert help to callers.
“If someone is very upset, or distressed in any way, a senior mental health nurse is there delivering psychological interventions to help soothe and calm the patient,” says Trust Mental Health Lead Carly Lynch.
“They’ll talk to them about what their difficulties might be and who’s best placed to help them.”
The patient receives the appropriate help, and, in some cases, an ambulance visit is avoided.
More recently, in south-east London, mental health nurses have been accompanying paramedics to patients experiencing a mental health emergency to offer immediate help. Nurses rotate between the call centre and the response car.
Since the service launched last November, it has seen patients with severe problems, including suicidal feelings or a psychotic relapse. The proportion taken to A&E has dropped from 54% to 19%. The trust now plans to roll out the service across London and predicts annual mental health hospital admissions could be almost halved– from 58,000 to 30,000.
Norfolk and Suffolk NHS Foundation Trust
Following a pilot project with the Norfolk and Suffolk NHS Foundation Trust five years ago, which placed mental health specialists in the police control room for the first time. Funding from the Norfolk PCC, Constabulary, health partners and district councils has helped fund the continued growth of the Norfolk Police Integrated Mental Health Team.
Funding from the PCC for 2017/18 enabled the force to add two new nurses to the team which, now with seven members, has gone far beyond its initial brief of helping improve the police response to vulnerable callers.
As well as supporting and training police to identify, assess and respond to potential risk and harm at the earliest opportunity, the team also provides advice to those in mental health crisis, diverting individuals to appropriate services.
With the addition of the two new posts funded by the PCC, the team has been able to increase the number of joint visits to vulnerable members of the community its nurses attend with police officers. It has also enabled, on occasion, nurses to be deployed from the control room to support frontline officers at the scene of incidents.
However, where many different providers are working together on the case, all too often there can be governance gaps between the services, placing patients at risk as they move from one to the other, so this is an area that needs to be improved and monitored. So, whilst there has been significant progress in the last few years in dealing with the volume of mental health-related calls and improvement in mental health training and awareness across the emergency services, there is room still for further enhancement in these areas.
Mental health and wellbeing from the control rooms perspective
Given these growing pressures, we embarked on a research project between April and June 2019 to discover in more detail what challenges are facing control room personnel in dealing with calls relating to mental health, as well as the support they receive in managing their own wellbeing.
The results are published in our whitepaper, were we analyse the results of the survey and explore other recent insights and initiatives from industry and government sources.
Respondents to the survey comprised individuals from police forces, fire authorities, ambulance trusts, and search and rescue teams with representation from all parts of the UK and the Republic of Ireland. Respondents’ (94%) roles spanned the full spectrum within the control room environment from operators and dispatchers through to supervisors, managers and senior management. In all, 225 emergency services’ personnel completed the survey. Their collective responses form the results and insights contained in our paper.