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Mental Health - Adult Crisis and Acute Care

Mental health problems are the largest single cause of disability in the UK, with one in four adults experiencing at least one diagnosable mental health problem in any given year.

Adult crisis and acute mental health services encompass the care, treatment and rehabilitation of adults with severe mental illness as part of wider health and social system responses. The services cover both urgent and emergency care and planned care.

The GIRFT national report presents 17 recommendations to improve services and reduce variation. A key focus is on developing well-managed patient flows through the crisis pathway and between services, to ensuring people receive the right treatment at the right time. These measures can help to significantly reduce the risk of people reaching severe or crisis state, as well as reducing the number of people needing inpatient admission.  

From November 2025, NHS England brought together its improvement teams under the GIRFT brand, delivering a more unified, clinically led and data-driven approach to service improvement. The team formerly known as the Mental Health Improvement Support Team (MHIST) is now part of the expanded GIRFT programme – together, we are working to build on existing strengths and ensure improvement recommendations are embedded within regional performance oversight to maximise impact.

Click the link in the Resources box, right, to visit the community of practice of the former MHIST team on FutureNHS, where you will find resources for improving quality, experience and productivity in mental health service.

  • Mental Health - Adult Crisis and Acute Care Joint Clinical Lead
Dr Neeraj Berry

Mental health – adult crisis and acute care joint clinical lead

Dr Neeraj Berry is a consultant psychiatrist and group medical director at Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust in Newcastle upon Tyne. 

Having been appointed consultant in 2003, he has extensive clinical experience of adult inpatient, crisis and community mental health pathways, specialising in psychiatric intensive care. 

He has held several senior medical leadership positions in the trust, as well as regionally and nationally, successfully establishing urgent care mental health pathways with seven-day consultant led care, a community mental health hub with system partners, new models for mental health bed management services, and a pioneering scheme for the development of overseas psychiatrists. 

As a NICE expert committee member (2017), he helped to develop discharge standards for transition between inpatient and community care. 

He is currently an associate dean at the Royal College of Psychiatrists, where he has led on new General Medical Council portfolio pathway guidance all psychiatric sub-specialities.  

  • Mental Health - Adult Crisis and Acute Care Joint Clinical Lead
Dr David Somerfield

Mental health – adult crisis and acute care joint clinical lead

Dr David Somerfield trained in Manchester and Bristol and became a consultant in old age psychiatry in 1999. He was medical director for 12 years and chief operating officer for four years at Devon Partnership NHS Trust. He is currently a consultant psychiatrist in old age psychiatry at South West London and St George’s Mental Health NHS Trust, and for the Greater London Authority Rough Sleepers and Mental Health Programme for South West London 

He has previously been an associate registrar in leadership and management at the Royal College of Psychiatrists and introduced the college’s leadership and management fellow scheme. 

He has led several large-scale service design and development programmes and taken a particular interest in the use of technology to improve quality of care and productivity, with a Healthcare Information and Management Systems Society (HIMSS) European award for clinical software design. 

As a clinician, he was part of the winning team for the BMJ Dementia Team of the Year and, more recently, the RCPsych London Division Team of the Year for the development of services to improve the quality of life for those living in care homes. 

  • Former Mental Health - Adult Crisis and Acute Care Clinical Lead
Dr Ian Davidson

Former mental health – adult crisis and acute care clinical lead and national report author

Dr Ian Davidson stepped down from his role as GIRFT clinical lead in 2025.

He is a consultant general adult psychiatrist at Cheshire and Wirral Partnership NHS Foundation Trust with extensive experience of community and inpatient general psychiatry. He has been a medical director, deputy chief executive and interim chief executive, among other leadership and management roles.

He has held a variety of regional and national roles and has a background in research, education and national quality and improvement services. He has also contributed to national policies, always alongside continuing clinical roles.

Dr Davidson has presented nationally and internationally on a range of topics, including care pathway development and evaluation. He has contributed as an external expert to a wide range of serious untoward incident reviews and service reviews.

Dr Davidson’s service development work has included helping design and commission a new hospital and procuring and implementing clinical IT systems, as well as care pathways. He has been, and remains,  a long term advocate for ensuring that people who access services, deliver services or are affected by services are able to help shape and review services through their development.

Mental health review in Urgent and Emergency Care (October 2025)  

Effective management of mental health patients in the UEC pathway is not a new issue. However, rising demand, increasing complexity of cases and delays in care have resulted in greater national prioritisation, as outlined in the strategic objectives in the NHS 10-Year Health Plan and NHS England’s UEC plan 2025/26.  

GIRFT is working to review mental health care in UEC services, helping to support shorter term and winter pressure planning, as well as the long-term transformation of mental health services in the UEC pathway.  

This work aims to assess the reality of the current landscape of mental health provision for patients in the UEC pathway, to identify best practice and significant gaps in pathways, and to provide recommendations for improved access, flow and delivery of mental health services in the UEC pathway at local, regional and national levels, with an initial focus on 12- and 24-hour ED breaches.  

Mental health review is also a core part of GIRFT’s Further Faster programme for UEC, which is working closely with 20 acute providers to build on their existing efforts and strengthen UEC pathways ahead of the winter period. The focus of FF UEC is on improving Category 2 ambulance response times; enhancing 4-hour emergency department performance; reducing long ED waits; shortening length of stay to improve patient flow; and understanding the interaction of mental health services within the UEC pathway.  

  • Ten high impact changes in mental health – view
  • Adult crisis and acute mental health care pathway overview – view
  • Clinical decision making and risk management – view
  • Agreeing purpose of admission and expected date of discharge (example) – view

 

  • Summary of National Report Findings
GIRFT national report for mental health crisis and acute care focuses on reducing barriers to access

Providing the right treatment at the right time reduces the risk of people reaching severe or crisis state, says a new national report into adult mental health. 

The Getting It Right First Time (GIRFT) programme’s latest national report has reviewed adult crisis and acute mental health care, looking at how services are delivered and who is delivering them with the aim of ensuring that patients receive the appropriate level of treatment in a timely way to avoid mental health conditions becoming more chronic and difficult to treat.   

Mental health care is overwhelmingly community based, playing a crucial role in delivering mental health care for adults as close to home as possible. Further recommendations call for improvements to data collection methods to support trusts in being able to identify the most vulnerable in their population – and target resources and interventions to improve equality of access.

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Find out more about GIRFT’s data-led approach and best practice resources:

GIRFT resources on FutureNHS here
  • Mental Health – Adult Crisis and Acute Care National Report

In April 2021, GIRFT published its national speciality report for Mental Health – Adult Crisis and Acute Care:

Click above to view the pdf report (via Future NHS)

Watch the video about the Mental Health – Adult Crisis and Acute Care report…

Click above to play the Mental Health Adult Crisis and Acute Care national report video

  • Mental Health – Adult Crisis and Acute Care News
Additional focus on mental health services in urgent and emergency care as two new clinical leads are appointed
Webinar series focuses on the integration of housing within mental health pathways
GIRFT appoints third mental health clinician to lead national review

Mental Health - Adult Crisis and Acute Care Academy Resources

  • Guidance

Clinical Operational Standards: Adult Acute Mental Health Urgent & Emergency Care >