Developing the emergency response for mental health patients

I have been privileged to work with the London Ambulance Service (LAS) since 2015. I am the current Consultant Nurse for Mental Health and am honoured to have been named Mental Health Nurse of the Year in the BJN Awards 2024.

Mental health calls account for at least 10% of our call volume, with patients or their relatives often dialing 999 during a crisis. When I first joined the service, mental health clinicians had recently been introduced into our Emergency Operations Centre, which is where 999 calls are taken. Introducing mental health clinicians into the service enabled patients calling 999 to receive enhanced assessments from mental health specialists, and provided crew advice to staff on the scene with patients.

Building on this success, I was eager to explore what a specialised face-to-face response for our patients might look like. In 2017, using quality improvement (QI) methodology, I began conducting test shifts with a paramedic colleague. We responded to mental health crisis calls as deemed appropriate by the ambulance dispatcher. Using plan-do-study-act (PDSA) cycles, we completed 10 test shifts and then presented our findings to the trust. Simultaneously, the trust was developing its next 5-year strategy, and mental health was identified as a ‘pioneer service’. This led to the creation of a pilot for a mental health joint response car.