NELFT Crisis Alternatives - Redbridge

This specification outlines the development of a Mental Health Crisis Alternative in Redbridge, a service providing non-clinical, community-based mental health support. The service will focus on supporting those experiencing a self-defined mental health crisis who do not require immediate medical attention. It will offer timely interventions aimed at preventing escalation to statutory services like psychiatric liaison or emergency departments. This initiative aligns with local needs, addressing the unique demographic and socio-economic factors of Redbridge.

This service supports the objectives of the North East London Integrated Care Board (ICB) and aligns with the Redbridge Joint Strategic Needs Assessment (JSNA), which emphasises mental health as a key priority. Please see the link below for the London Borough of Redbridge Joint Strategic Needs Assessment (JSNA) 2022: Joint Strategic Needs Assessment.

The NHS Long-Term Plan and the North East London Joint Forward Plan highlight the importance of non-clinical, community-based crisis services that reduce the pressure on statutory services, emergency departments, and inpatient facilities. The Crisis Alternative will serve as a critical component of Redbridge 's mental health crisis.

North East London Foundation Trust (NELFT) have experienced significant increase in referrals and complexity of service user presentations; resulting in increases in waiting times and high caseloads with the number of discharges back into primary care not matching the increase in referrals. The impact on NELFT services means high caseload levels which impacts on the ability to provide high quality care in a timely manner. The expectation is that the crisis alternative reduces the pressure and demand on other services i.e. Emergency Departments, and supports those patients discharged back into primary care as part of the provision for patients not requiring clinical support in a crisis.

The primary aims of the Redbridge Mental Health Crisis Alternative are to:

• Provide immediate, non-clinical support for individuals experiencing a mental health crisis, preventing escalation to statutory services like emergency departments and psychiatric liaison teams

• Reduce pressure on emergency services by offering a safe, non-medical alternative to hospital-based crisis interventions

• Address mental health inequalities by providing targeted support to underserved and underrepresented groups in Redbridge including the homeless, LGBTQI+, older adults, black males and Asian/Asian British communities, utilising current peers support worker and volunteering resources

• Promote early intervention and de-escalation through crisis listening, safety planning, and peer support, empowering individuals to manage their mental health and avoid future crises.

• Enhance community resilience by offering practical support and linking individuals to appropriate local services, thereby reducing social isolation and promoting long-term mental wellbeing.

• Collaborate with local VCSEs and statutory services to ensure an integrated care pathway, allowing smooth transitions between community and clinical services where needed.

• Easy Access to provide a safe space that is easily accessible to all adults and older adults during the operating hours via self-referral, third party referral and walk-ins.

Hours of Operation: The Alternative will operate seven days a week Monday to Friday from 5:30 PM to 10:30 PM, providing out-of-hours support to residents. The provider is expected to offer a weekend service, the provider is to advise of the weekend opening hours. Bank holidays are not mandatory but at the providers discretion.

Venue: The service will be delivered at an accessible community venue, ideally in a central location with good transport links. The Provider will supply a suitable premises in the London borough of Redbridge.

The property shall be secure for all members of staff and users of service within the building with effective security & emergency measures in place; this shall include but is not limited to the following:

• fire alarms & fitted detection systems within the venue

• emergency lighting

• fire extinguishers

• fire doors

• gas and electricity compliance

• appropriate insurance

• appropriate access for staff and service users with disabilities

The Provider will be responsible for carrying out its own risk assessment and develop a risk management plan with regards to the building and any equipment used within the venue, including potential ligature risks for those attending the service. The premises environment should be comfortable, inclusive and accessible. It should be tidy, hygienic, well-maintained and as least restrictive as possible.

Crisis Support: The service will provide a safe, non-stigmatising environment for immediate emotional support. The core interventions include:

• Crisis listening and de-escalation: One-to-one sessions to help individuals manage their distress and reduce the intensity of their crisis.

• Safety Planning: Development of personalised plans to support the person to safely manage the crisis situation, including practical coping strategies and signposting or referral to other relevant services.

• Peer Support: Trained individuals with lived experience will offer non-clinical, empathetic support.

• Outreach and Culturally Sensitive Support: Proactive in ensuring ongoing communication is culturally appropriate, utilising partnerships with local VCSEs, volunteers and peer support workers throughout the contract's lifecycle. It is expected that a communications plan will be put in place to support with this. NELFT will manage their own internal communications and systems communications will be taken up by the ICB. The London Borough of Redbridge will be approached to help support the promotion of the crisis alternative. Any created posters/leaflets and/or other physical advertising information will need to hold a presence in (not limited to) local GPs, libraries, community centres and where possible, places of worship.

The provider will be invited to monthly formal contractual meetings where updates, escalations and KPI's will be discussed/reviewed.

NELFT will also make the commitment going forward in supporting the provider by inviting the provider to forums where they can hold a presence in promoting and feeding back on progress with the crisis alternative to other local VCSE's, Primary and Secondary care

Staffing & Safety

The provider will advise what staffing model they will use but as minimum, there should be 2 staff working at one time, once of which being a senior member of staff:

• Manager / Senior staff member for complex case management and oversight.

• Peer Support Workers with lived experience of mental health difficulties or caring for someone with mental health difficulties, from diverse backgrounds

• Volunteers, particularly from local communities, including those with multilingual capabilities to support non-English speakers.

Overall, the providers staff will offer support and recovery guidance to individuals experiencing a self-defined mental health crisis. This could be achieved by providing a therapeutic space as well as positively including people with lived experience of mental health difficulties or people who have cared for someone with mental health difficulties by utilising the benefits this can provide, where appropriate.

• The Crisis Alternative will work in close partnership with local VCSEs, as well as statutory services, to build community links within Redbridge to support the delivery of the service.

• It is expected the awarded provider will expand their knowledge of the local population and services, to identify further organisations during the contract lifecycle, and utilise their services to support the development and delivery of the crisis alternative.

• Outreach programs will be developed with services which may include local faith groups, community organisations, and language support services to engage populations in a trauma informed approach.

Conclusion

The Redbridge Crisis Alternative offers an essential alternative to statutory mental health services, providing culturally sensitive, community-based interventions to prevent the escalation of mental health crises. By delivering timely, accessible support in a non-clinical setting, the service will improve outcomes for individuals, reduce pressure on emergency services, and strengthen the overall mental health provision in the borough.