Introduction

Welcome to the Mental Health Crisis Care Profile. This profile has been produced to support an intelligence driven approach to mental health crisis care planning.   It collates and analyses a wide range of publically available data on associated prevalence of mental health crisis, risk factors, access to care, treatment, and outcomes. It offers planners, providers and stakeholders the means to profile their area and benchmark against similar populations.

This profile is part of a system-wide drive towards using data to support the commissioning and delivery of effective mental health crisis care. The profile supports delivery of the action set out in the Crisis Care Concordat to provide information to assess the level of local need for crisis care, develop baseline assessments of current provision, perform gap analysis and monitor the effectiveness of responses to people who experience a mental health crisis.

We will continue to develop and expand the profile; future versions will include more data on crisis care as this becomes available. The first part of an update has taken place in March 2019 and a number of indicators have been removed. 

Profile structure - data are presented under the domains of Risk factors, Pre-existing mental health condition, Access to support before crisis point, Urgent and emergency access to crisis care, Quality of treatment and care when in crisis, and Recovery and staying well.  Domains group data by geography (Clinical Commissioning Group, Sustainability and Transformation Plan, Local Authority, Region, Mental Health, or Ambulance trust) and then order data by topic (e.g. primary care followed by secondary care). Where an indicator is available at ‘STP’ geography, these are the STPs as at April 2018. 

Profile content - data are drawn from many sources and vary by time period, population and presentation of values. Care should be taken with interpretation. Detailed metadata and any caveats are set out in the Definitions section.

Data quality - data items are included if viewed as robust, of sufficient quality, or offer an important element that could not be otherwise gained.  Each indicator has been assessed and labelled with its quality rank.

Indicators 91454 and 91455 - rates of adults in treatment at specialist drug/alcohol services - it has come to our notice that data for these indicators may be unreliable. They will be reviewed as part of the full review of this profile taking place in Spring 2019. In the meanwhile, please use the versions in the 'related service contacts' domain of the Suicide Prevention Profile.

Supporting Documents

Recent updates

August 2019

The following indicators were updated:

Risk factors domain

  • First time entrants to the youth justice system: rate per 100,000 population aged 10-17

Quality of treatment domain

  • Gate kept admissions: % (quarterly) admissions to acute wards that were gate kept by the CRHT teams

Recovery and staying well domain

  • Follow up after discharge: % of patients on CPA who were followed up within 7 days after discharge from psychiatric inpatient care (in quarter)

July 2019

The following indicators were updated:

Risk factors domain

  • Children in need: Rate per 10,000 children aged <18

Access to support domain

  • People on Care Programme Approach (CPA): rate per 100,000 population aged 18+ (end of quarter snapshot)
  • Contact with specialist mental health services: rate per 100,000 population aged 18+ (end of quarter snapshot)
  • Mental health service users on Care Programme Approach: % of mental health service users (end of quarter snapshot)
  • Access to IAPT services: People entering IAPT as % of those estimated to have anxiety/depression (in month)
  • IAPT waiting times < 6 weeks from referral to first treatment: % of referrals (in month)
  • IAPT waiting times < 18 weeks from referral to first treatment: % of referrals (in month)
  • IAPT referrals for BME patients: % of referrals (in quarter)

Urgent and emergency care domain

  • People subject to Mental Health Act: rate per 100,000 population aged 18+ (end of quarter snapshot)

Quality of treatment domain

  • Service users with crisis plans: % of people in contact with mental health services (end of quarter snapshot)
  • IAPT DNAs: % of IAPT appointments (in month)
  • Diagnosis coding: % of people in contact with mental health services with a diagnosis or provisional diagnosis recorded (end of quarter snapshot)
  • Recording of employment status: % of people in contact with mental health and learning disability services with employment status recorded (end of quarter snapshot)
  • Recording of accommodation status: Percentage of people in contact with mental health services with accommodation status recorded (end of quarter snapshot)

Recovery and staying well domain

  • IAPT reliable improvement: % of people (in quarter) who have completed IAPT treatment who achieved "reliable improvement"
  • IAPT recovery: % of people (in month) who have completed IAPT treatment who are "moving to recovery"
  • CPA adults in employment: % of people on CPA (aged 18-69) (end of quarter snapshot)
  • Stable and appropriate accommodation: % of people on CPA (aged 18-69) (end of quarter snapshot)

June 2019

The following indicators were updated:

Risk factors domain

  • Cause for concern - Looked after children where there is cause for concern: % of looked after children
  • Under 18s conception rate / 1,000 (PHOF indicator 2.04)

Pre-existing mental health condition domain

  • Long-term mental health problems (GP Patient Survey): % of respondents aged 18+
  • Estimated prevalence of opiate and/or crack cocaine use

Access to support domain

  • People on Care Programme Approach (CPA): rate per 100,000 population aged 18+ (end of quarter snapshot)
  • Contact with specialist mental health services: rate per 100,000 population aged 18+ (end of quarter snapshot)
  • Mental health service users on Care Programme Approach: % of mental health service users (end of quarter snapshot)
  • Access to IAPT services: People entering IAPT as % of those estimated to have anxiety/depression (in month)
  • IAPT waiting times < 6 weeks from referral to first treatment: % of referrals (in month)
  • IAPT waiting times < 18 weeks from referral to first treatment: % of referrals (in month)
  • IAPT referrals for BME patients: % of referrals (in quarter)
  • Proportion waiting more than 3 weeks for drug treatment
  • Proportion waiting more than 3 weeks for alcohol treatment

Urgent and emergency care domain

  • People subject to Mental Health Act: rate per 100,000 population aged 18+ (end of quarter snapshot)

Quality of treatment domain

  • Gate kept admissions: % (quarterly) admissions to acute wards that were gate kept by the CRHT teams
  • Service users with crisis plans: % of people in contact with mental health services (end of quarter snapshot)
  • IAPT DNAs: % of IAPT appointments (in month)
  • Recording of employment status: % of people in contact with mental health and learning disability services with employment status recorded (end of quarter snapshot)
  • Diagnosis coding: % of people in contact with mental health services with a diagnosis or provisional diagnosis recorded (end of quarter snapshot)
  • Recording of accommodation status: Percentage of people in contact with mental health services with accommodation status recorded (end of quarter snapshot)
  • Satisfaction with social care support: % service users extremely satisfied or very satisfied with their care and support
  • Satisfaction with social care protection: % of service users

Recovery and staying well domain

  • IAPT recovery: % of people (in month) who have completed IAPT treatment who are "moving to recovery"
  • IAPT reliable improvement: % of people (in quarter) who have completed IAPT treatment who achieved "reliable improvement"
  • Follow up after discharge: % of patients on CPA who were followed up within 7 days after discharge from psychiatric inpatient care (in quarter)
  • CPA adults in employment: % of people on CPA (aged 18-69) (end of quarter snapshot)
  • Stable and appropriate accommodation: % of people on CPA (aged 18-69) (end of quarter snapshot)

 

The following indicators were added:

Risk factors domain

  • Children in low income families (all dependent children under 20)
  • Children in care
  • Percentage of children where there is a cause for concern
  • Percentage ethnic minorities
  • Domestic abuse-related incidents and crimes - current method
  • Long term claimants of Jobseeker's Allowance

Access to support domain

  • Adults in treatment at specialist drug misuse services: rate per 1000 population (indicator 92454)
  • Adults in treatment at specialist alcohol misuse services: rate per 1000 population (indicator 92455)

Quality of treatment domain

  • Service users with crisis plans: % of people in contact with mental health services (end of quarter snapshot)
  • Diagnosis coding: % of people in contact with mental health services with a diagnosis or provisional diagnosis recorded (end of quarter snapshot)
  • Recording of employment status: % of people in contact with mental health and learning disability services with employment status recorded (end of quarter snapshot)
  • Recording of accommodation status: Percentage of people in contact with mental health services with accommodation status recorded (end of quarter snapshot)

 

The following indicators were removed:

Risk factors domain

  • Children under 16 in poverty: % of children aged 0-15
  • Emotional and behavioural health outcome for looked after children: % eligible children considered 'of concern'
  • White ethnic group: % of population
  • Mixed/Multiple ethnic group: % of population
  • Asian or Asian British ethnic group: % of population
  • Black or Black British ethnic group: % of population
  • Other ethnic group: % of population
  • Domestic abuse incidents recorded by the police: rate per 1,000 population

Pre-existing mental health condition domain

  • Contact with mental health or learning disability services: rate per 1,000 patients on GP practice list aged 18+

Access to support domain

  • Adults in treatment at specialist drug misuse services: rate per 1000 population (indicator 91454)
  • Adults in treatment at specialist alcohol misuse services: rate per 1000 population (indicator 91455)
  • Primary care assessment of depression: % of adults with a new diagnosis of depression who had a bio-psychosocial assessment

Urgent and emergency care domain

  • Attendances at A&E for a psychiatric disorder: Rate per 100,000 population
  • Emergency admissions: % of (quarterly) mental health admissions which were emergency

Quality of treatment domain

  • Mental Health Service users with crisis plans: % of people in contact with services (end of quarter snapshot)
  • Diagnosis coding: % of people in contact with mental health services with a diagnosis recorded (end of quarter snapshot)
  • Recording of employment status: % of people in contact with mental health services with employment status recorded (end of quarter snapshot)
  • Recording of accommodation status: % of people in contact with mental health services with accommodation status recorded (end of quarter snapshot)
  • Assessments for carers of adult mental health clients: rate per 100,000 population aged 18+

Recovery and staying well domain

  • Social care mental health clients aged 18-64 years receiving home care during the year: rate per 100,000 population

 

The following indicator was moved from the ‘re-existing mental health condition’ domain to the ‘access to support’ domain:

  • Contact with mental health or learning disability services: rate per 1,000 population

April 2019

The following indicators were updated:

Risk factors domain

  • Dementia recorded prevalence (aged 65+): % of practice register

The following indicators were removed

Risk factors domain

  • Children under 16 in poverty: % of children aged 0-15
  • Looked after children: rate per 10,000 population aged under 18 – this will be replaced by a rate of children in care, once the pre-election period is over
  • Parents in alcohol treatment: rate per 100,000 children aged 0 – 15
  • Parents in drug treatment: rate per 100,000 children aged 0 – 15
  • Long-term unemployment: % of working age population – this will be replaced by a more up-to-date indicator, once the pre-election period is over
  • Insolvency: rate per 10,000 population
  • Likely to seek help form GP if they have a mental health problem: % of respondents
  • Uncomfortable talking to friends or family about their mental health: % of respondents
  • Uncomfortable talking to employer about their mental health: % of respondents

Pre-existing mental health condition domain

  • Estimated prevalence of mental health disorders in children and young people: % population aged 5-16
  • Social care mental health clients receiving services: rate per 100,000 population
  • Mixed anxiety and depressive disorder: estimated % of population aged 16-74

Access to support domain

  • Leadership (Digital Maturity Assessment): score
  • Medicines Management Optimisation (Digital Maturity Assessment): score
  • Transfers of Care (Digital Maturity Assessment): score
  • Exception rate for severe mental illness (SMI) QOF indicators: % of patients excluded from mental health quality indicators
  • Exception rate for dementia: % of patients on dementia register excluded from quality indicators
  • NHS 111 calls regarding mental health - persons: Rate per 100,000 population
  • NHS 111 calls regarding mental health - female: Rate per 100,000 population
  • NHS 111 calls regarding mental health - male: Rate per 100,000 population
  • NHS 111 calls regarding mental health made by those <18 years old: % of mental health calls
  • NHS 111 calls regarding mental health made by those 18 to 64 years old: % of mental health calls
  • NHS 111 calls regarding mental health made by those 65+ years old: % of mental health calls
  • NHS 111 calls regarding mental health received Mon-Fri: Daily rate per 100,000 population
  • NHS 111 calls regarding mental health received Sat-Sun: Daily rate per 100,000 population
  • NHS 111 calls received regarding mental health from midnight to 9am: % of mental health calls
  • NHS 111 calls received regarding mental health from 9am to 5pm: % of mental health calls
  • NHS 111 calls received regarding mental health from 5pm to midnight: % of mental health calls
  • NHS 111 calls received regarding mental health coded as Worsening known mental health problem: % of mental health calls
  • Health assessments for looked after children: % who had an annual assessment
  • Emotional and behavioural health assessment of looked after children: % eligible children assessed
  • Development assessments for young looked after children: % aged <5 whose development assessments were up-to-date
  • Social care assessments for mental health clients: rate per 100,000 population aged 18-64

Urgent and emergency care domain

  • Ambulance requests to attend section 136 incidents: rate per 100,000 population
  • Ambulance attendance to Section 136 incidents where attendance was requested by the police: rate per 100,000 population
  • Ambulance attendance to Section 136 incidents requested by Police: rate per 1000 requests from Police
  • Prompt ambulance attendance to Section 136 incidents: % attended within 30 minutes
  • Prompt ambulance attendance to Section 136 incidents after request from police: % attended within 30 minutes
  • Child hospital admissions for mental health conditions: rate per 100,000 aged 0 -17 years
  • Self-Harm (10-24 year): Hospital admissions - directly standardised rate per 100,000 of the population
  • Detentions under the Mental Health Act: annual rate per 100,000 population
  • People subject to short-term orders under Mental Health Act during year: rate per 100,000 population
  • NHS 111 mental health calls where caller was advised to attend primary care as a matter of routine: % mental health calls
  • NHS 111 mental health calls where caller was advised to attend primary care urgently: % mental health calls
  • NHS 111 mental health calls where caller was advised to attend primary care as an emergency: % mental health calls
  • NHS 111 mental health calls where caller was advised to attend the emergency department: % mental health calls
  • Emergency admissions for neuroses: Indirectly age and sex standardised rate per 100,000 population
  • Adult acute mental health bed days: rate per 100,000 population aged 16-64

Quality of treatment domain

  • Repeat detentions under Mental Health Act during year: average detentions per person
  • Repeat short-term orders under Mental Health Act during year: average orders per person
  • Serious incidents: rate per 100,000 occupied bed days
  • Complaints: rate per 100,000 occupied bed days
  • Physical Assaults on staff: rate per 1,000 staff
  • Assaults on trust staff resulting in a criminal sanction: rate per 1,000 assaults

March 2019

Crisis profile 6 indicators updated

Risk factors domain

  • Children under 16 in poverty: % of children aged 0-15
  • Unaccompanied Asylum Seeking Children looked after: count
  • Statutory homelessness: rate per 1,000 households

Urgent and emergency care domain

  • Child hospital admissions for mental health conditions: rate per 100,000 aged 0 -17 years
  • Young people hospital admissions due to substance misuse: rate per 100,000 aged 15 – 24
  • Self-Harm (10-24 year): Hospital admissions - directly standardised rate per 100,000 of the population

February 2019

Indicators 91454 and 91455 - rates of adults in treatment at specialist drug/alcohol services - it has come to our notice that data for these indicators may be unreliable. They will be reviewed as part of the full review of this profile taking place in Spring 2019. In the meanwhile, please use the versions in the 'related service contacts' domain of the Suicide Prevention Profile.

Crisis profile 14 indicators updated

Risk factors domain

  • Long-term unemployment: % of working age population
  • Supported asylum seekers: rate per 10,000 population

Access to support domain

  • Contact with specialist mental health services: rate per 100,000 population aged 18+ (end of quarter snapshot)
  • People on Care Programme Approach (CPA): rate per 100,000 population aged 18+ (end of quarter snapshot)
  • Mental health service users on Care Programme Approach: % of mental health service users (end of quarter snapshot)

Urgent and emergency care domain

  • People subject to Mental Health Act: rate per 100,000 population aged 18+ (end of quarter snapshot)
  • Admission episodes for alcohol-specific conditions - Under 18s
  • Admission for mental and behavioural disorders due to use of alcohol condition: rate per 100,000 population

Quality of treatment domain

  • Gate kept admissions: % (quarterly) admissions to acute wards that were gate kept by the CRHT teams
  • Suicide: age-standardised rate per 100,000 population (3 year average)

Recovery and staying well domain

  • Follow up after discharge: % (quarterly) of patients on CPA
  • CPA adults in employment: % of people on CPA (aged 18-69) (end of quarter snapshot)
  • Stable and appropriate accommodation: % of people on CPA (aged 18-69) (end of quarter snapshot)
  • Gap in the employment rate for those in contact with secondary mental health services and the overall employment rate: percentage point difference

January 2019

7 indicators updated with new data:

   Access to support domain

  •    Access to IAPT services: people entering IAPT (in month) as % of those estimated to have anxiety/depression
  •    IAPT referrals for BME patients: % of referrals (in quarter)
  •    IAPT waiting times < 6 weeks from referral to first treatment: % of referrals (in month)
  •    IAPT waiting times < 18 weeks from referral to first treatment: % of referrals (in month)

   Quality of treatment domain

  •    IAPT DNAs: % of IAPT appointments (in month)

   Recovery and staying well domain

  •    IAPT reliable improvement: % of people (in quarter) who have completed IAPT treatment who achieved "reliable improvement"
  •    IAPT recovery: % of people (in month) who have completed IAPT treatment who are "moving to recovery"

December 2018

21 indicators updated with new data:

   Risk factors domain

  •    Number of people with learning disabilities known to GPs: % on register
  •    Number of adults with dementia known to GPs: % on register
  •    Primary school fixed period exclusions: rate per 100 pupils
  •    Secondary school fixed period exclusions: rate per 100 pupils

   Pre-existing mental health factors domain

  •    Depression recorded prevalence (QOF): % of practice register aged 18+
  •    Antidepressant prescribing: Average Daily Quantities per STAR-PU
  •    Hypnotics prescribing: average daily quantities (ADQs) per STAR-PU
  •    Severe mental illness recorded prevalence (QOF): % of practice register (all ages)

   Access to support domain

  •    Exception rate for dementia: % of patients on dementia register excluded from quality indicators
  •    People on Care Programme Approach (CPA): rate per 100,000 population aged 18+ (end of quarter snapshot)
  •    Contact with specialist mental health services: rate per 100,000 population aged 18+ (end of quarter snapshot)
  •    Depression recorded incidence (QOF): % of practice register aged 18+
  •    IAPT referrals for BME patients: % of referrals (in quarter)
  •    Mental health service users on Care Programme Approach: % of mental health service users (end of quarter snapshot)
  •    Exception rate for severe mental illness (SMI) QOF indicators: % of patients excluded from mental health quality indicators
  •    Exception rate for depression: % of patients on depression register

   Urgent and emergency care domain

  •    People subject to Mental Health Act: rate per 100,000 population aged 18+ (end of quarter snapshot)

   Quality of treatment domain

  •    Patients with SMI who have comprehensive care plan: % with plan

   Recovery and staying well

  •    CPA adults in employment: % of people on CPA (aged 18-69) (end of quarter snapshot)
  •    Stable and appropriate accommodation: % of people on CPA (aged 18-69) (end of quarter snapshot)
  •    IAPT reliable improvement: % of people (in quarter) who have completed IAPT treatment who achieved "reliable improvement"

77 indicators updated to use 2017/18 CCGs:

   Risk factors domain 

  •    Children under 16 in poverty: % of children aged 0-15
  •    Long-term health problem or disability: % of population
  •    Number of people with learning disabilities known to GPs: % on register
  •    Socioeconomic deprivation: overall IMD score (2015)
  •    Number of adults with dementia known to GPs: % on register
  •    Dementia recorded prevalence (aged 65+): % of practice register

   Pre-existing mental health condition domain 

  •   Estimated prevalence of any mental health disorder: % GP registered population aged 5-16 
  •   Estimated prevalence of common mental health disorders: % of population aged 16-74 
  •   Long-term mental health problems (GP Patient Survey): % of respondents (aged 18+) 
  •   Depression and anxiety prevalence (GP Patient Survey): % of respondents aged 18+ 
  •   Depression recorded prevalence (QOF): % of practice register aged 18+ 
  •   Severe mental illness recorded prevalence (QOF): % of practice register (all ages) 
  •   GP prescribing for psychoses and related disorders: Items (quarterly) per 1,000 population 
  •   Antidepressant prescribing: Average Daily Quantities per STAR-PU 
  •   Hypnotics prescribing: average daily quantities (ADQs) per STAR-PU 
  •   New cases of psychosis: estimated incidence rate per 100,000 population aged 16-64 
  •   Contact with mental health or learning disability services: rate per 1,000 population Female 18+ yrs 
  •   Contact with mental health or learning disability services: rate per 1,000 population Male 18+ yrs 
  •   Contact with mental health or learning disability services: rate per 1,000 population Persons 65+ yrs 
  •   Contact with mental health or learning disability services: rate per 1,000 population Persons 18+ yrs 
  •   Contact with mental health or learning disability services: rate per 1,000 population 

  Access to support domain

  •   Depression recorded incidence (QOF): % of practice register aged 18+ 
  •   Biopsychosocial assessment at the time of diagnosis of depression: % of newly diagnosed patients (aged 18+) 
  •   Exception rate for severe mental illness (SMI) QOF indicators: % of patients excluded from mental health quality indicators 
  •   Exception rate for depression: % of patients on depression register 
  •   Exception rate for dementia: % of patients on dementia register excluded from quality indicators 
  •   Access to IAPT services: people entering IAPT (in month) as % of those estimated to have anxiety/depression 
  •   IAPT referrals for BME patients: % of referrals (in quarter) 
  •   IAPT waiting times < 6 weeks from referral to first treatment: % of referrals (in month) 
  •   IAPT waiting times < 18 weeks from referral to first treatment: % of referrals (in month) 
  •   Contact with specialist mental health services: rate per 100,000 population aged 18+ (end of quarter snapshot) 
  •   Receipt of assertive outreach services: rate per 100,000 population aged 18+ (end of quarter snapshot) 
  •   People on Care Programme Approach (CPA): rate per 100,000 population aged 18+ (end of quarter snapshot) 
  •   Mental health service users on Care Programme Approach: % of mental health service users (end of quarter snapshot) 
  •   Treatment by Early Intervention Teams: rate per 100,000 population aged 18+ (end of quarter snapshot) 
  •   New cases of psychosis served by Early Intervention Teams: rate (annual) per 100,000 population aged 18+ 
  •   BME mental health service users: % of mental health service users 
  •   NHS 111 calls regarding mental health - persons: Rate per 100,000 population 
  •   NHS 111 calls regarding mental health - female: Rate per 100,000 population 
  •   NHS 111 calls regarding mental health - male: Rate per 100,000 population 
  •   NHS 111 calls regarding mental health made by those <18 years old: % of mental health calls 
  •   NHS 111 calls regarding mental health made by those 18 to 64 years old: % of mental health calls 
  •   NHS 111 calls regarding mental health made by those 65+ years old: % of mental health calls 
  •   NHS 111 calls regarding mental health received Mon-Fri: Daily rate per 100,000 population 
  •   NHS 111 calls regarding mental health received Sat-Sun: Daily rate per 100,000 population 
  •   NHS 111 calls received regarding mental health from midnight to 9am: % of mental health calls 
  •   NHS 111 calls received regarding mental health from 9am to 5pm: % of mental health calls 
  •   NHS 111 calls received regarding mental health from 5pm to midnight: % of mental health calls 
  •   NHS 111 calls received regarding mental health coded as Worsening known mental health problem: % of mental health calls 

   Urgent and emergency care domain

  •   Child hospital admissions for mental health conditions: rate per 100,000 aged 0 -17 years 
  •   Self-Harm (10-24 year): Hospital admissions - directly standardised rate per 100,000 of the population 
  •   Attendances at A&E for a psychiatric disorder: rate per 100,000 population 
  •   Emergency admissions: % of (quarterly) mental health admissions which were emergency 
  •   People subject to Mental Health Act: rate per 100,000 population aged 18+ (end of quarter snapshot) 
  •   Detentions under the Mental Health Act: annual rate per 100,000 population 
  •   People subject to short-term orders under Mental Health Act during year: rate per 100,000 population 
  •   NHS 111 mental health calls where caller was advised to attend primary care as a matter of routine: % mental health calls 
  •   NHS 111 mental health calls where caller was advised to attend primary care urgently: % mental health calls 
  •   NHS 111 mental health calls where caller was advised to attend primary care as an emergency: % mental health calls 
  •   NHS 111 mental health calls where caller was advised to attend the emergency department: % mental health calls 

   Quality of treatment domain

  •   Children on adult wards: Number of bed days (in quarter) on adult mental health wards for patients under the age of 18 
  •   IAPT DNAs: % of IAPT appointments (in month) 
  •   Mental Health Service users with crisis plans: % of people in contact with services (end of quarter snapshot) 
  •   Diagnosis coding: % of people in contact with mental health services with a diagnosis recorded (end of quarter snapshot) 
  •   Recording of employment status: % of people in contact with mental health services with employment status recorded (end of quarter snapshot) 
  •   Recording of accommodation status: % of people in contact with mental health services with accommodation status recorded (end of quarter snapshot) 
  •   Gate kept admissions: % (quarterly) admissions to acute wards that were gate kept by the CRHT teams 
  •   Emergency readmissions: % of (quarterly) mental health admissions which were emergency readmissions 
  •   Repeat detentions under Mental Health Act during year: average detentions per person 
  •   Repeat short-term orders under Mental Health Act during year: average orders per person 
  •   Patients with SMI who have received the complete list of physical health checks: % of patients with SMI 
  •   Patients with SMI who have comprehensive care plan: % with plan 

   Recovery and staying well domain

  •   IAPT recovery: % of people (in month) who have completed IAPT treatment who are "moving to recovery" 
  •   IAPT reliable improvement: % of people (in quarter) who have completed IAPT treatment who achieved "reliable improvement" 
  •   Follow up after discharge: % (quarterly) of patients on CPA 
  •   CPA adults in employment: % of people on CPA (aged 18-69) (end of quarter snapshot) 
  •   Stable and appropriate accommodation: % of people on CPA (aged 18-69) (end of quarter snapshot) 

November 2018

Crisis profile 26 indicators updated

Risk factors domain

      • First time entrants to the youth justice system: rate per 100,000 population aged 10 – 17
      • Adult social care users who have as much social contact as they would like: % of adult social care users
      • First time offenders: rate per 100,000 population
      • Violent crime (including sexual violence) - violence offences: rate per 1,000 population

Pre-existing MH condition domain

      • Long-term mental health problems (GP Patient Survey): % of respondents (aged 18+)
      • GP prescribing for psychoses and related disorders: Items (quarterly) per 1,000 population
      • Depression and anxiety among social care users: % of social care users

Access to support domain

      • Access to IAPT services: people entering IAPT (in month) as % of those estimated to have anxiety/depression
      • IAPT waiting times < 6 weeks from referral to first treatment: % of referrals (in month)
      • IAPT waiting times < 18 weeks from referral to first treatment: % of referrals (in month)
      • IAPT referrals for BME patients: % of referrals (in quarter)
      • Contact with specialist mental health services: rate per 100,000 population aged 18+ (end of quarter snapshot)
      • People on Care Programme Approach (CPA): rate per 100,000 population aged 18+ (end of quarter snapshot)
      • Mental health service users on Care Programme Approach: % of mental health service users (end of quarter snapshot)

Urgent and emergency care domain

      • People subject to Mental Health Act: rate per 100,000 population aged 18+ (end of quarter snapshot)

Quality of treatment domain

      • IAPT DNAs: % of IAPT appointments (in month)
      • Gate kept admissions: % (quarterly) admissions to acute wards that were gate kept by the CRHT teams
      • Successful completion of drug treatment - opiate users: % who do not re-present within 6 months
      • Successful completion of drug treatment - non-opiate users: % who do not re-present within 6 months
      • Successful completion of alcohol treatment:% who do not re-present to treatment within 6 months
      • Suicide: age-standardised rate per 100,000 population (3 year average)

Recovery and staying well domain

      • IAPT recovery: % of people (in month) who have completed IAPT treatment who are "moving to recovery"
      • IAPT reliable improvement: % of people (in quarter) who have completed IAPT treatment who achieved "reliable improvement" 
      • Follow up after discharge: % (quarterly) of patients on CPA
      • CPA adults in employment: % of people on CPA (aged 18-69) (end of quarter snapshot)
      • Stable and appropriate accommodation: % of people on CPA (aged 18-69) (end of quarter snapshot)
      • Employment of people with mental illness or learning disability: % of those with a mental illness or learning disability

June 2018

Crisis profile 18 indicators updated

Risk factors domain

      • Children under 16 in poverty: % of children aged 0-15
      • Under 18 pregnancy: rate of conceptions per 1,000 females aged 15 - 17
      • Children in the youth justice system: rate per 1,000 aged 10 - 18

Pre-existing MH condition domain

      • Severe mental illness recorded prevalence (QOF): % of practice register (all ages
      • Access to support
      • Access to IAPT services: people entering IAPT (in month) as % of those estimated to have anxiety/depression
      • IAPT waiting times < 6 weeks from referral to first treatment: % of referrals (in month)
      • IAPT waiting times < 18 weeks from referral to first treatment: % of referrals (in month)
      • IAPT referrals for BME patients: % of referrals (in quarter)
      • Contact with specialist mental health services: rate per 100,000 population aged 18+ (end of quarter snapshot)
      • People on Care Programme Approach (CPA): rate per 100,000 population aged 18+ (end of quarter snapshot)
      • Mental health service users on Care Programme Approach: % of mental health service users (end of quarter snapshot)

Urgent and emergency care domain

      • People subject to Mental Health Act: rate per 100,000 population aged 18+ (end of quarter snapshot)

Quality of treatment domain

      • IAPT DNAs: % of IAPT appointments (in month)

Recovery and staying well domain

      • CPA adults in employment: % of people on CPA (aged 18-69) (end of quarter snapshot)
      • Stable and appropriate accommodation: % of people on CPA (aged 18-69) (end of quarter snapshot)
      • IAPT reliable improvement: % of people (in quarter) who have completed IAPT treatment who achieved "reliable improvement"
      • IAPT recovery: % of people (in month) who have completed IAPT treatment who are "moving to recovery"

April 2018

Risk Factors

      • Dementia recorded prevalence (aged 65+): % of practice register - to September 2017 - STP

Access to Support

      • Exception rate for depression: % of patients on depression register - 2016/17 - CCG, STP
      • IAPT referrals for BME patients: % of referrals (in quarter) - 2017/18 Q2 - CCG, STP 

Recovery and Staying Well

      • IAPT reliable improvement: % of people (in quarter) who have completed IAPT treatment who achieved "reliable improvement" - 2017/18 Q2 - CCG, STP

March 2018

Risk Factors

      • Dementia recorded prevalence (aged 65+): % of practice register - to September 2017 - CCG, County & UA, Region
      • Number of adults with dementia known to GPs: % on register - 2016/17 - County & UA

Pre-existing MH Condition

      • GP prescribing for psychoses and related disorders: Items (quarterly) per 1,000 population - to Q2 2017/18 - CCG, STP
      • Depression recorded prevalence (QOF): % of practice register aged 18+ - 2016/17 - County & UA, Region

Urgent and Emergency Care

      • Self-Harm (10-24 year): Hospital admissions - directly standardised rate per 100,000 of the population - 2016/17 - County & UA
      • Child hospital admissions for mental health conditions: rate per 100,000 aged 0 -17 years - 2016/17 - County & UA
      • Young people hospital admissions due to substance misuse: rate per 100,000 aged 15 - 24 - 2014/15 - 2016/17 - County & UA

February 2018

Risk Factors

      • Violent crime (including sexual violence) - violence offences: rate per 1,000 population - District & UA, County & UA, Region to 2016/17
      • Unaccompanied Asylum Seeking Children looked after: count - County & UA to 2017
      • Primary school fixed period exclusions: rate per 100 pupils - County & UA to 2015/16
      • Secondary school fixed period exclusions: % of school pupils - County & UA to 2015/16

Pre-existing MH Condition

      • Estimated prevalence of opiates and/or crack cocaine use: rate per 1,000 population aged 15 - 64 - County & UA to 2014/15

Access to Support

      • Access to IAPT services: people entering IAPT (in month) as % of those estimated to have anxiety/depression - CCG, STP to Sept 2017
      • IAPT waiting times < 6 weeks from referral to first treatment: % of referrals (in month) - CCG, STP to Sept 2017
      • IAPT waiting times < 18 weeks from referral to first treatment: % of referrals (in month) - CCG, STP to Sept 2017
      • Contact with specialist mental health services: rate per 100,000 population aged 18+ (end of quarter snapshot) - CCG to 2017/18 Q2
      • People on Care Programme Approach (CPA): rate per 100,000 population aged 18+ (end of quarter snapshot) - CCG to 2017/18 Q2
      • Mental health service users on Care Programme Approach: % of mental health service users (end of quarter snapshot) - CCG, Mental Health Trust to 2017/18 Q2
      • People subject to Mental Health Act: rate per 100,000 population aged 18+ (end of quarter snapshot) - CCG, STP to 2017/18 Q2

Urgent and Emergency Care

      • Admission for mental and behavioural disorders due to use of alcohol condition: rate per 100,000 population - District & UA, County & UA to 2016/17

Quality of Treatment

      • IAPT DNAs: % of IAPT appointments (in month) - CCG, STP - Sept 2017

Recovery and Staying Well

      • CPA adults in employment: % of people on CPA (aged 18-69) (end of quarter snapshot) - CCG, Mental Health Trust, STP to 2017/18 Q2
      • Stable and appropriate accommodation: % of people on CPA (aged 18-69) (end of quarter snapshot) - CCG, Mental Health Trust, STP to 2017/18 Q2
      • IAPT recovery: % of people (in month) who have completed IAPT treatment who are "moving to recovery" - CCG, STP to Sept 2017
      • Gap in the employment rate for those in contact with secondary mental health services and the overall employment rate: percentage point difference - County & UA, District & UA to 2016/17

January 2018

Access to Support

      • Concurrent contact with mental health services and substance misuse services for alcohol misuse: % people accessing substance misuse services to 2016/17
      • Treatment waiting time: % people waiting more than 3 weeks for alcohol treatment to 2016/17
      • Concurrent contact with mental health services and substance misuse services for drug misuse: % people accessing substance misuse services to 2016/17
      • Treatment waiting time: % people waiting more than 3 weeks for drug treatment to 2016/17

Quality of Treatment

      • Gate kept admissions: % (quarterly) admissions to acute wards that were gate kept by the CRHT teams to 2017/18 Q2

Recovery and Staying Well

      • Follow up after discharge: % (quarterly) of patients on CPA to 2017/18 Q2

December 2017

Risk factors developing MH Crisis

      • Number of people with learning disabilities known to GPs: % on register to 2016/17
      • Number of adults with dementia known to GPs: % on register to 2016/17
      • Children in the youth justice system: rate per 1,000 aged 10 - 18 to 2015/16
      • Number of adults with dementia known to GPs: % on register to 2016/17

Pre-existing MH Condition

      • Depression recorded prevalence (QOF): % of practice register aged 18+ to 2016/17
      • Severe mental illness recorded prevalence (QOF): % of practice register (all ages) to 2016/17

Access to Support

      • Exception rate for severe mental illness (SMI) QOF indicators: % of patients excluded from mental health quality indicators to 2016/17
      • Exception rate for dementia: % of patients on dementia register excluded from quality indicators to 2016/17
      • IAPT referrals for BME patients: % of referrals (in quarter) to Q1 2017/18
      • Contact with specialist mental health services: rate per 100,000 population aged 18+ (end of quarter snapshot) to Q1 2017/18
      • People on Care Programme Approach (CPA): rate per 100,000 population aged 18+ (end of quarter snapshot) to Q1 2017/18
      • Mental health service users on Care Programme Approach: % of mental health service users (end of quarter snapshot) to Q1 2017/18

Urgent and Emergency Care

      • People subject to Mental Health Act: rate per 100,000 population aged 18+ (end of quarter snapshot) to Q1 2017/18

Quality of Treatment

      • Patients with SMI who have comprehensive care plan: % with plan to 2016/17

Recovery and Staying Well

      • IAPT reliable improvement: % of people (in quarter) who have completed IAPT treatment who achieved "reliable improvement" to Q1 2017/18
      • Stable and appropriate accommodation: % of people on CPA (aged 18-69) (end of quarter snapshot) to Q1 2017/18
      • CPA adults in employment: % of people on CPA (aged 18-69) (end of quarter snapshot) to Q1 2017/18

November 2017

Risk factors developing MH Crisis

      • Adult social care users who have as much social contact as they would like: % of adult social care users updated to 2016/17
      • Adult carers who have as much social contact as they would like: % of adult carers updated to 2016/17
      • Mortgage home repossessions: rate per 1,000 dwellings updated to Q2 2017/18
      • Landlord home repossessions: rate per 1,000 dwellings updated to Q2 2017/18

Access to Support

      • IAPT Monthly Indicators updated to June 2017

Quality of Treatment Domain

      • Suicide: age-standardised rate per 100,000 population (3 year average) updated to 2014-16
      • IAPT Monthly Indicators updated to June 2017

Recovery and Staying Well Domain

      • IAPT Monthly Indicators updated to June 2017

September 2017

Risk factors developing MH Crisis

      • Supported asylum seekers updated to Q1 2017
      • Mortgage home repossessions updated to Q1 2016/17
      • Dementia recorded prevalence (aged 65+): % of practice register updated to 2017

Pre-existing MH condition Domain

      • Long-term mental health problems (GP Patient Survey) updated to 2016/17
      • Depression and anxiety prevalence (GP Patient Survey) updated to 2016/17
      • GP prescribing for psychoses and related disorders updated to Q4 2016/17

Access to Support Domain

      • IAPT quarterly indicators have been updated to Q4 2016/17

Urgent and Emergency care Domain

      • IAPT quarterly indicators have been updated to Q4 2016/17

Recovery and Staying Well Domain

      • IAPT quarterly indicators have been updated to Q4 2016/17

Urgent and Emergency care

      • IAPT quarterly indicators have been updated to Q4 2016/17

August 2017

Access to Support domain

      • IAPT monthly indicators have been updated to March 2017
      • IAPT quarterly indicators have been updated to Q3 2016/17
      • MHSDS end of quarter snapshot indicators have been updated to March 2017

One indicator has been updated in the Urgent and emergency care domain

People subject to Mental Health Act: rate per 100,000 population

July 2017

One indicator has been updated in the Pre-existing Mental Health Condition domain

      • GP prescribing for psychoses and related disorders: Items (quarterly) per 1,000 population

One Indicator has been updated in the Quality of Treament domain

      • IAPT DNAs: % of IAPT appointments (in month)

June 2017

Indicators from five new data sets have been introduced.

      • Time To Change (3 indicators) measure feelings of stigma associated with mental health problems
      • Digital Maturity Assessment (3 indicators) indicates how ready trusts are in implementing information technology to improve the service delivered to patients  
      • Data regarding assaults on staff (2 indicators) give an indication on the treatment environment
      • Sexual Orientation/Identity information (5 indicators) highlight groups of people who may be at particular risk of developing a mental health crisis or may have difficulty accessing service
      • Data regarding higher education students (1 indicators) also examine a group who may have particular requirements

Two existing indicators, Estimated prevalence of common mental health disorders: % of population aged 16-74 and Suicide: age-standardised rate per 100,000 population (3 year average) have had data made available at the STP level

One indicator has been updated in the Access to Support domain:

      • Demand for Debt Advice: rate per 10,000 adults

Two indicators have been updated in the Urgent and Emergency Care domain:

      • Admission for mental and behavioural disorders due to use of alcohol condition: rate per 100,000 population
      • People subject to Mental Health Act: rate per 100,000 population aged 18+ (end of quarter snapshot)

Five indicators have been updated in the Recovery and Staying Well domain:

      • IAPT recovery: % of people (in month) who have completed IAPT treatment who are "moving to recovery"
      • Gap in the employment rate for those in contact with secondary mental health services and the overall employment rate: percentage point difference
      • Follow up after discharge: % (quarterly) of patients on CPA
      • CPA adults in employment: % of people on CPA (aged 18-69) (end of quarter snapshot)
      • Stable and appropriate accommodation: % of adults in contact with mental health services aged 18-69 (end of quarter snapshot)

Changes have ben made to the Crisis Care catalogue to reflect these updates

April 2017

To aid ease of use the Understanding Needs domain has been split into Risk Factors Associated With Developing a Mental Health Crisis and Prevalence of Pre-existing Mental Health Condition

Mental Health Trust (26 indicators) and Sustainability and Transformation Plan (21 indicators) geographies have been introduced. The MH Trust indicators alraedy exist in the Severe Mental Illness profile. The STP indicators already exist in the Crisis Care profile at CCG level

Four indicators have been updated in the Risk Factors domain:

      • Looked after children: rate per 10,000 <18 population
      • Unaccompanied Asylum Seeking Children looked after: count
      • Children leaving care: rate per 10,000 <18 population
      • Under 18 pregnancy: rate of conceptions per 1,000 females aged 15 – 17

 One indicator has been updated in the Pre-Existing Mental Health Condition domain:

      • Estimated prevalence of any mental health disorder: % GP registered population aged 5-16

 One indicator has been updated in the Access to Support domain:

      • IAPT referrals for BME patients: % of referrals (in quarter)

 One indicator has been updated in the Recovery and Staying Well domain

      • IAPT reliable improvement: % of people (in quarter) who have completed IAPT treatment who achieved "reliable improvement"

Five indicators have been retired from the profile

      • Emotional well-being of looked after children: average score
      • Repeat child protection cases: % of children who became subject of a child protection plan for a second or subsequent time
      • New child protection cases: Rate of children who became the subject of a child protection plan during the year, per 10,000 aged <18
      • Older people living alone: % of households occupied by a single person aged 65 or over
      • Prison population: Number

The Crisis Care catalogue has been updated to reflect these changes

March 2017

June 2017

Three indicators in the Understanding Need domain have been updated:

      • Child hospital admissions for mental health conditions: rate per 100,000 aged 0 -17 years
      • Self-Harm (10-24 year): Hospital admissions - directly standardised rate per 100,000 of the population
      • Young people hospital admissions due to substance misuse: rate per 100,000 aged 15 - 24

February 2017

Three indicators in the Understanding Need domain have been updated:

      • Children under 16 in poverty: % of children aged 0-15
      • Supported asylum seekers: rate per 10,000 population
      • Emotional well-being of looked after children: average score

Seven indicators in the Access to Support domain have been updated:

      • Access to IAPT services: people entering IAPT (in month) as % of those estimated to have anxiety/depression
      • IAPT waiting times < 6 weeks from referral to first treatment: % of referrals (in month)
      • IAPT waiting times < 18 weeks from referral to first treatment: % of referrals (in month)
      • Concurrent contact with mental health services and substance misuse services for alcohol misuse: % people accessing substance misuse services
      • Treatment waiting time: % people waiting more than 3 weeks for alcohol treatment
      • Concurrent contact with mental health services and substance misuse services for drug misuse: % people accessing substance misuse services
      • Treatment waiting time: % people waiting more than 3 weeks for drug treatment

One indicator in the Quality of Treatment Domain has been updated:

      • IAPT DNAs: % of IAPT appointments (in month)

Two indicators in the Recovery and Staying Well domain has been updated:

      • Excess under 75 mortality rate in adults with serious mental illness
      • IAPT recovery: % of people (in month) who have completed IAPT treatment who are "moving to recovery" 

December 2016

Six indicators in the Understanding Need domain have been updated:

      • Learning disability QOF prevalence
      • Severe mental illness recorded QOF prevalence
      • Depression QOF prevalence
      • Dementia QOF prevalence
      • Long term mental health problems among GP survey respondents
      • Depression and anxiety among GP survey respondents

Two indicators in the Access to Support domain have been updated:

      • Exception rate for severe mental illness
      • IAPT use by BME groups

November 2016

 Four indicators in the Understanding Need domain have been updated:

      • Long term MH problem
      • Long-term unemployment
      • Statutory homelessness rate
      • Supported asylum seekers

 Three indicators in the Access to Support domain have been updated:

      • IAPT access rates
      • IAPT waiting times (6 weeks and 18 weeks)

One indicators in the Quality of treatment  domain has been updated:

      • IAPT DNAs

Two indicators in the Recovery and Staying Well domain have been updated:

      • Employment of people with mental health disorders
      • IAPT recovery rates

 

The NHS 111 Calls per Weekday & per Weekend day indicators have been changed to the average number of calls received per 100,000 people per day. This allows for better comparison between areas as the indicators are now adjusted for   population.

 

October 2016

- the Domestic Abuse indicator in the Understanding need domain has been updated with 2014/15 data.

September 2016

- The indicator quality assessment document has been added.


* Seven IAPT INDICATORS UPDATED

- Four indicators in the Access to Support domain, one in the Quality of Treatment domain and two in the Recovery and Staying Well domain have been updated for January to March 2016.

August 2016

First version released