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Evidence case study: evidence for an out-of-hours service in mental health to support people in emotional distress

What was the aim of the evidence review?

Following a consultation with service users and carers of mental health services a need was raised for an out of hours service for people to go when emotionally very distressed and close to a crisis. The aim of the evidence review was to look at what had been shown to help people in mental health distress and whether there was evidence in favour of mental health ‘sanctuaries’.

Who completed the evidence review?

The evidence review was completed by Elizabeth Williams, Senior Project Manager at Bristol Clinical Commissioning Group.

What did they do?

Elizabeth searched for evidence via websites and databases and involved an information specialist from public health to check that nothing was missed.

How long did it take?

The evidence review took one week. The work started in November 2013.

What did they find?

Initially no evidence was found about mental health ‘sanctuaries’ but the search did identify information about four places that provided something similar in the UK. There were no comprehensive evaluations of these services but there were details of their existence suggesting they may be a source of evidence about this kind of service. As a result, a set of questions was devised and the four places were contacted to find out more about the services they provided.

Two of the houses were places where people can stay to help them manage a mental health crisis. Bristol already commissions a male and female crisis house, so this was not what was being searched for. However, the other two services were very similar to what local service users and carers had described as needed and so contact was made with these to establish if any evidence had been generated from an evaluation or other source.

Who was the evidence shared with and why?

The results were shared with the modernising mental health project team and project board at Bristol Clinical Commissioning Group. A large event was organised to present the findings to all key stakeholders, including service users and carer. This was also used as an opportunity to get feedback on areas where there was difference between the services being delivered around the UK to find out what people wanted for Bristol.

How were the findings used in local decision-making?

Whilst completing the evidence review, contact was made with the manager of Dial House in Leeds, which led to a very fruitful relationship. Dial House is a sanctuary for those in crisis and has been operating for over 10 years. The manager of this service provided information about a recent evaluation that had been done by a local university to measure the added value of the service. As soon as it was published a copy was obtained to inform local plans.

At the stakeholder event lots of questions and issues were raised, which were then discussed with the manager of the Leeds service to find out how they had dealt with these.

Following the event a service specification was written, which was used as part of a procurement exercise to find a provider for the Bristol Sanctuary. The Leeds service manager agreed to be the external expert on the evaluation panel for the procurement and was such an asset as she knew, from an operational perspective, what questions to ask.

What has changed as a result?

The contract for the Bristol Sanctuary was awarded to St Mungo’s Broadway in September 2014. The service opened on 1 April 2015, running on Friday, Saturday, Sunday and Monday, 10.00pm to 2.00am where previously no out of hours provision existed.

An evaluation of the new service is in process, as at April 2017.