IT is unusual for people not to face at least one crisis in their lives. The word can be used to describe many different situations.

However, in mental health, the term 'crisis' usually suggests that someone’s mental or emotional state has reached breaking point and they may need urgent help and support.

People experiencing a crisis often feel unsafe, distressed or worried. They may suffer mood changes they are unaccustomed to, withdraw from people, feel out of control, worry excessively or hear voices. Other signs may include changes in the way they think, having unusual ideas and thinking about harming themselves or others.

For those experiencing such difficulties a special service has been launched for people of all ages living in Bradford, Airedale, Wharfedale and Craven.

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Set up by Bradford District Care Trust (BDCT), First Response provides quick access to the right care for those in crisis.

With specialist staff including psychologists, mental health nurses and social workers, it provides one phone number, available 24 hours a day, seven days a week, which can also be used by friends or family if they have concerns.

The service comes in response to feedback from people using mental health services, carers and the trust’s partners. Previously, out-of-hours support only operated during certain times and was only available to people already accessing services. Local hospitals were reporting a high number of people arriving at Accident & Emergency who were experiencing a crisis, and West Yorkshire Police also received calls.

Now these are answered by a ‘telecoach' experienced to talk to people in distress, who assesses their needs and can provide guidance to help manage the situation. Telecoaches have information on health, social and voluntary services that are available to support the person and can make an appointment if needed. For urgent support, another member of the team - a First Responder - will be asked to visit as soon as possible.

First Responders are mental health nurses and Bradford Council social workers. They visit the individual wherever they are and at whatever time of day and can also prescribe medication. Sometimes they might attend with a member of the emergency services.

The care trust has involved service users and carers in its development. One of them, John Thompson*, has been caring for his wife and two daughters - who all have long-term mental health issues - for 30 years.

“A crisis can be very frightening,” he says, “Not only for the person but their carer too, especially when you see they might put themselves in a dangerous situation. A crisis can happen any day, any time. I’ve been known to make phone calls in the middle of the night to everyone from out-of-hours GPs to the emergency services, until I have got through to someone who can help. If a member of my family is going through a crisis they need help straight away.”

First Response was commissioned by the three local NHS groups, Airedale, Wharfedale and Craven, Bradford City and Bradford Districts, and supported by the organisations who signed the Mental Health Crisis Care Concordat in December last year. West Yorkshire Police, Bradford Council, Bradford District Care Trust, MIND, Sharing Voices, Bradford Teaching Hospitals NHS Foundation Trust and Airedale NHS Foundation Trust all signed, joining forces on an action plan for improving the care for people in a mental health crisis.

Nicola Lees, director of nursing at BDCT says: “First Response is unique to the district. It is a local service, for all local people regardless of their current involvement with services.”

Sarah Deacon, clinical lead with First Response, says: “Most conditions are managed well through medication and/or therapy, but if your first experience of mental health is a crisis, or if you have an existing problem, we want to reassure people that trained professionals are just a phone call away.”

Dr Janangir Akhtar, of Frizinghall Medical Centre has used the service. “I found them very helpful, quick in response and easy to contact,” he says.

Superintendent Vince Firth, partnerships lead at Bradford Police, says: "The service has revolutionised how we respond to people in crisis in Bradford district. It gives officers immediate, round-the-clock access to health professionals, allowing for informed decisions to be made about how best to support the patient, without the need for them to be brought into custody."

He adds: "If a person with mental health issues is brought into custody, partners are able to work together to carry out a swift but detailed assessment of that person's needs."

*First Response Team 01274 221181; *name has been changed.