Mental health crisis house supports hundreds of people to avoid a hospital stay

Hundreds of people in Somerset who experience a mental health crisis are getting the support they need without an admission to hospital.

It’s all thanks to a crisis house, run by Rethink Mental Illness as part of Somerset’s award-winning Open Mental Health alliance, of which our trust is a key partner.

The six-bedded crisis house, located in Yeovil Town Centre, is a ‘step up care’ facility, where patients get the care they need from support staff who are present 24 hours a day, in short term non-clinical accommodation of up to seven days, instead of a longer term hospital stay.

Laura Hopkins, our operational service manager for our countywide home treatment service, first response service, and urgent care hub, explains how the crisis house works.

“It was initially set up as an alternative to an admission to a mental health ward, for those people who don’t feel safe at home or require additional support, but don’t need admission to an inpatient ward with the medical and nursing care that comes with it,” she explains.

“Colleagues in our home treatment service consider whether a patient would benefit from a stay in the crisis house, or if they require admission to an inpatient ward.

“If the crisis house is the best option, they complete a referral form for Rethink Mental Illness, who then assess the patient’s suitability for the accommodation.

“In the past those patients would have most likely ended up on a hospital ward, or they would have had to wait for a bed to become available, neither of which was ideal.

“But the good thing about the crisis house is that as a stay is limited to seven days, even if it has a full occupancy, we know when someone is due to leave and a bed will become free.”

The type of interactions that people can expect in the crisis house is purposely very different to a hospital ward, as Laura explains: “Our colleagues at Rethink run a series of one-to-one and group activities during the day that people can opt in or out of.

“They work with patients on what they would like to do, whether that’s mindfulness, crafts, or walking, or sometimes everyone comes together to cook and eat a Sunday lunch.

“It feels a bit more social, and it also lets people link into all the Open Mental Health activities that are happening on site, which doesn’t always happen on a hospital ward.

“Hot meals are provided too, and people often stay in contact with our home treatment team while they’re there, which can be reassuring for them – we’re only a phone call away.

“People can come and go freely, and the setting is quieter and more homely than a hospital ward, and they have much more autonomy, as they aren’t bound by hospital ward routines. They’re even responsible for their own medication, with a lockable box in their own room.

“It may also be that the person is using the crisis house as a trial instead of a hospital admission, and on those occasions colleagues from our Yeovil home treatment team speak to our Rethink colleagues and work together on medication reviews. We can be quite flexible with how we use the crisis house, which is great.

“We are currently seeing almost 200 people a year at the crisis house, but we actually have capacity to see almost double that.

“So if you’re caring for someone who might benefit from a stay, please contact our home treatment team – we’re very likely to be able to help.”

Two peer support mentors are based at The Foyer next door, which is run by Mind in Somerset, where they work collaboratively with Step Up colleagues and clients.

The main role of the team at The Foyer is to support clients by signposting services within Mind in Somerset and encouraging their engagement with these and other services in their local communities.

They also offer referrals into Open Mental Health referral, and can book a Crisis Safe Space appointment for the week the clients leave the Step Up service, in the hope this will relieve some anxiety and offer connection.

A person cared for at the crisis house gave some glowing feedback to the colleagues who work there.

While wishing to remain anonymous, they said: “I feel that Step Up is a really beneficial service, which provided me with increased support with different areas, all while promoting my independence in terms of self-directed support in the areas I felt I needed support.

“I have found the staff friendly, welcoming and open about personal experience, all whilst remaining professional.

“The Step-Up service provided by Rethink has enabled me to become more aware of and confident in managing my mental health. I don’t feel the service gets enough credit for the life changing support they provide!”

Katie Foulser, regional associate director (south west) for Rethink Mental Illness, says: “The crisis house provides life changing support to people when they need most need support, through our compassionate and dedicated staff in a homely environment, and we are really proud to be able to support people during these difficult points in their life.”

Kamal Ali-Merkhbi, head of contracts, delivery, and collaboration for Open Mental Health, adds: “With the current housing crisis and the strain on our healthcare system, it is great that we can reduce pressure on the NHS by offering the Step Up service to support people in Somerset on their recovery journeys

“We are working with our Open Mental Health partners and Experts by Experience to make this service and accommodation even better. Together, we are providing a safe, comfortable space that truly meets people's needs and supports their long-term recovery.”

Here’s a video where Alex, who works at the crisis house, gives a tour of the space: