To ask the Minister of Health (i) whether any assessment has been made of the impact of waiting for an initial mental health assessment on patient safety and wellbeing, including any monitoring of adverse outcomes such as Emergency Department presentations, psychiatric admissions, self-harm incidents and deaths; and (ii) to detail any support arrangements that are in place for individuals whose condition deteriorates while waiting.

Article 10A of the Health and Social Care Act (NI) 2022 provides for Health and Social Care Trusts becoming directly responsible for social care and children’s functions directed to them under Directed Statutory Functions by the Department. The Director of Social Work Mental Health and Disability Directorate in the Strategic Planning and Performance Group has responsibility for the professional oversight, governance, performance management and accountability, and strategic oversight of Trusts in relation to the exercise of social care and children’s statutory functions. Under Directed Statutory Functions accessibility to Mental Health Services are assessed.

Trusts also have robust governance arrangements in place to ensure Mental Health Services meet expected standards in terms of support for families and carers, in line with the expressed wishes of patients. Clinical governance frameworks operate across corporate, divisional, and team levels, supported by senior oversight and multidisciplinary input.

Collectively, these arrangements ensure ongoing oversight of service delivery and support continuous improvement in access, safety, and quality of care.

For those Individuals waiting assessment who have been identified and meet the definition of an adverse incident, a clear process is in place to manage the same. This process outlines roles and responsibilities of all staff, guidance on the review process and supports for staff inclusive of reporting to the Department.

Belfast Health and Social Care Trust:

The Belfast Health and Social Care Trust acknowledge the importance of timely access to Mental Health Services and the impact that waiting times can have upon service users. Individuals whose mental health deteriorates whilst awaiting routine assessment can access a range of urgent and Crisis support services, with referrals prioritised according to clinical need.

Northern Health and Social Care Trust:

The Northern Health and Social Care Trust provides urgent Mental Health assessment through its Urgent Mental Health Service (UMHS). The service delivers community-based assessments via the Crisis Resolution and Home Treatment Team (CRHTT) within four hours of referral, and assessments within two hours of referral for patients presenting through Emergency Departments or Acute Hospital settings via the Mental Health Liaison Service (MHLS). Same day assessment is offered by CMHTs for those who experience a deterioration in their Mental Health who are known to the team

South Eastern Health and Social Care Trust:

In the South Eastern Health and Social Care Trust, a stepped care approach is in place to support individuals whose condition deteriorates. A number of measures are established;

Review via GP with potential for earlier appointment &/or a step up in referral type e.g. routine to urgent

Referral to Home Treatment Teams

Access to Emergency Departments where liaison services assess people in crisis

Escalation within services for those already known.

Southern Health and Social Care Trust:

When referrals are received in the Southern Health and Social Care Trust, they are triaged and allocated according to clinical presentation and reported risk issues. The service user will receive a letter with the triage outcome including associated useful contacts and advice on what to do should mood deteriorate while waiting. Service users referred to adult psychological therapies and waiting on assessment are provided with ‘while you wait’ resources and access to an online library of healthcare Apps.

The Trust adhere to Department of Health Integrated Elective Access Protocols in respect of managing waiting lists. If the service user experiences a change in clinical presentation while waiting initial assessment, they can contact their GP and seek additional support and advice, which may include reprioritising referral priority or referral to the Home Treatment Team. The Trust have clear processes in place for updating wait list priority should they become aware of change to risk profile for the person waiting assessment.

Western Health and Social Care Trust:

The Western Health and Social Care Trust operate a 24/7 Crisis service which can be accessed through Emergency Department attendance. Once assessment takes place, the appropriate pathway/service is identified to include inpatient admission, home treatment support in community, link/referral to appropriate community team or Community and Voluntary agency dependent on assessed need. If a patient is discharged from a community team and experiences a decline in mental health, GPs can refer back into appropriate service and grade as urgent, or the patient can access a 24/7 Crisis service.