Service inspections: independent mental health services

Acute wards provide care and treatment for people who are acutely unwell and whose mental health problems cannot be treated and supported safely or effectively at home. This service does not include wards where people stay for longer periods (for example, long stay or rehabilitation wards).

Psychiatric intensive care units (PICUs) provide high intensity care and treatment for people whose illness means they cannot be safely or easily managed on an acute ward. People normally stay in a PICU for a short period before they can transfer to an acute ward once their risk has reduced.

These wards provide care and treatment for people whose needs are more complex, which require them to stay in hospital for longer. People may be referred here after a period on an acute ward when they have not recovered enough to be discharged home. Rehabilitation wards may also provide step-down for people who are moving on from secure mental health services.

These wards provide care and treatment in hospital for people with mental health problems who pose, or who have posed, risks to other people. People in secure services have often been in contact with the criminal justice system. These services may be low or medium secure, reflecting the different levels of risk that people may present.

Child and adolescent mental health services (CAMHS) may assess and treat children and young people as an inpatient in hospital. This may be when community-based services cannot meet their needs safely and effectively because of their level of risk and/or complexity and where they need 24-hour nursing and medical care.

These services provide assessment, care and treatment for people whose mental health problems are often related to ageing. This may include a combination of psychological, cognitive, functional, behavioural, physical and social problems.

These are specialist inpatient services for adults with a learning disability and/or autism who need assessment and treatment for mental health conditions. There are different models of services, but all patients in these wards should have their mental and physical healthcare needs assessed and receive care and treatment in line with their care plan. In all cases, the clear goal is to support people to return to the community and a good quality of life. This involves locally provided treatment in the least restrictive setting.

Please also refer to our guidance on registering these services.

These services provide care and treatment for people who need a greater level of mental health care than primary care services can provide. There is a wide range of service models and different types of interventions. People using these services may receive support over a long period or for short-term interventions.

Community-based mental health crisis services provide care and treatment for people who are acutely unwell to avoid having to admit them to hospital. These services include crisis resolution and home treatment teams that see people in their homes and crisis houses for people who cannot be treated at home but who do not need to be admitted to hospital.

A health-based place of safety is a room, or suite of rooms, where people are assessed when they have been detained by the police under section 135 or 136 of the Mental Health Act 1983. People will usually stay in a place of safety for a very short period, normally no longer than 24 hours.

Specialist community child and adolescent mental health services (CAMHS) provide assessment, advice and treatment for children and young people with severe and complex mental health problems. They also provide support and advice to their families or carers. Services are usually multi-disciplinary teams of mental health professionals providing a range of interventions in the community, working with schools, social care, charities, voluntary and community groups.

These services provide assessment, care and treatment to older people with mental health problems that are often related to ageing. People may receive services in their own home or in a care home.

These specialist services are usually provided by local community learning disabilities teams. There are different types of service models, but the teams normally include staff from a range of health professions, such as psychiatrists, clinical psychologists, speech and language therapists and nurses (learning disabilities and sometimes mental health). Many teams include social care professionals, such as social workers. These multi-disciplinary teams are providing more out-of-hours crisis services to support people with behaviour that challenges.

We also inspect the following independent mental health services:

• specialist mental health eating disorder services
• personality disorder services
• perinatal mental health services
• specialised mental health services for people who are deaf
• specialist mental health services for people with acquired brain injury
• gender identity services