Tackling the mental health crisis head on

The Eating Disorder Intensive Service (EDIS) shows what becomes possible when community‑based mental health support is properly prioritised: fewer hospital admissions and better outcomes for young people and their families.

Delivered by the Royal Free London NHS Foundation Trust, EDIS provides intensive support for children and young people who aren’t progressing in community treatment or are at risk of being admitted to hospital. The service operates seven days a week, offering face‑to‑face care, home visits, and digital support to make treatment more accessible.

This approach enables young people to stay at home, continue to attend school, and receive tailored multi‑disciplinary care that adapts in intensity as their confidence and skills grow. Families and carers are central partners throughout the process.

From April 2022 to March 2024, EDIS treated 78 young people assessed as being at risk of requiring specialist inpatient admission. Remarkably, just 17% ultimately needed admission. Satisfaction with the service was extremely high, with more than four in five patients recommending it.

In just a few years, Open Mental Health has grown from a shared vision of mental health support for everyone, to a joined-up set of accessible services across Somerset. Guided throughout by experts by experience, watchwords like ‘no wrong door’ and ‘warm transfers’ have become a reality.

The Open Mental Health alliance is formed of nineteen voluntary, community, faith, and social enterprises working in close collaboration with the NHS and Somerset Council.

The services offered include specialised mental health services, housing and debt guidance, community activities and physical exercise. This collaborative, partnership-based approach has created real impact:

35% drop in acute hospital stays – creating £6.1 million in savings

• 18% reduction in mental health inpatient admissions
• 4% mental health readmission rate – half the national average
• 15% reduction in A&E attendances

This means that people in Somerset are getting the right response and support, in the community when they need it.

We know that timely access to mental health support close to home can be the difference between recovery and crisis for people living with severe mental illness.

What people tell us, and what evidence shows, is that the most effective support is wraparound: providing access not only to clinical care and treatment but also to support with housing, employment, and building social connections.

These factors can be powerful in preventing relapse and supporting recovery, but when absent, someone’s mental health can significantly worsen. The East London Foundation Trust’s Community Mental Health centre brings together clinical teams, voluntary sector partners and peer support workers to provide mental health input when people need it – to help prevent people becoming very unwell and needing to be admitted to hospital.

Within 6 months of opening, the Barnsley Street Community Mental Health Centre has seen:

• 45% reduction in acute ward admission in areas of Tower Hamlets
• Length of stay reduced
• Improved community engagement with ‘did not attend’ rates dropping from 18 to 13%

For many people who hear voices, auditory hallucinations can be distressing, especially when voices are critical or abusive.

AVATAR therapy has been developed to provide people who hear distressing voices with the tools to confront their main voice along with therapeutic support. A digital avatar is created that looks and sounds like the voice, and a therapist communicates through the avatar, making the sort of negative statements that the person hears.

A randomised control trial of 345 people was conducted in 2024, testing the impact of the brief (six sessions) and extended (12 sessions) versions of AVATAR therapy against a usual antipsychotic medication. The study found: AVATAR therapy is a promising development that may help to alleviate the negative effects of voice hearing and empower people to take back control. The National Institute for Health and Care Excellence (NICE) have recommended that AVATAR is used in the NHS while researchers continue to gather real-world evidence of its effectiveness in clinical practice. The project team hope that the evidence gathered will enable a wider rollout in the NHS within the next five years.

• Participants who received either the brief or extended version of the therapy saw significant improvements in the severity of the voices heard and distress felt;
• Participants who received the extended version saw stronger and more sustained effects over time, with a reduction in the occurrence of voices. 

Cobenfy is the first new medication for schizophrenia in several decades. It works in a different way to other antipsychotics as it combines two different medications (xanomeline and trospium chloride) and targets different receptors in the brain.

It is an exciting development as while existing antipsychotics can be a lifeline for many, they do not alleviate symptoms for everyone. Alternative treatments are desperately needed.

The Phase 3 trial of Cobenfy conducted in the USA in 2024 showed: While Cobenfy has been approved for the treatment of schizophrenia is the USA, it has not yet been licenced for use in England. Bristol Myers Squibb is currently pursuing this with the Medicines and Healthcare products Regulatory Agency (MHRA) and hopes to launch Cobenfy in the UK in 2026.

• Statistically significant improvements in symptoms of psychosis (e.g. delusions and hallucinations), compared to a placebo.
• Fewer negative symptoms of schizophrenia (e.g. lack of motivation, social withdrawal, and cognitive impairment).
• Fewer of the side effects commonly caused by other antipsychotics (e.g. drowsiness, weight gain and abnormal motor movements).

Centre 33 demonstrates what’s possible when early, open-access mental health support is properly integrated with NHS services: faster access, fewer long waits, and more young people getting the help they need, when they need it.

Delivered across Cambridgeshire and Peterborough, Centre 33 provides safe, inclusive and holistic support for young people aged 13–25, without the need for referral. It offers confidential one-to-one support for both emotional and practical needs, alongside routes into additional support such as counselling.

‍

In 2021, Centre 33 became part of YOUnited, a partnership with Cambridgeshire & Peterborough NHS Foundation Trust and Ormiston Families. Together, they co-deliver an integrated referral hub: a single “front door” for children and young people aged 5-25 to access mental health support.

‍

Within this model, Centre 33 applied Single Session Thinking – an approach that aims to make a person’s first contact with services as meaningful as possible, on the basis that it might be the only one. As a result:

• The waiting list for young people waiting for their first contact with services dropped by over 95% (from 750 to approximately 25)

• The percentage of young people requiring an onward referral for additional support dropped from 82% to 44%

‍

This indicates that, when done well, many young people’s mental health needs can be met safely and effectively through one or two timely, tailored sessions. This reduces pressure on specialist services by helping more young people get the support they need before they reach crisis point.

.

Birmingham demonstrates the potential of embedding mental health into local policy and services: stronger prevention, earlier intervention, and coordinated action to improve wellbeing across the population.

Through its Creating a Mentally Healthy City strategy, Birmingham City Council is leading a city-wide, partnership-based approach to mental health and wellbeing. The strategy takes action on the factors that shape mental health: what increases risk and what protects against it.

Delivered through the Health and Wellbeing Board and wider partners, this whole-system approach ensures mental health is considered in local services and decision-making. This includes community-based support, family and school settings, housing, workplaces, and public health.

The strategy is designed to deliver long-term change across the city:

• Improved mental wellbeing, resilience and mental health literacy
• Reduced loneliness and improved social connection
• Better, more equitable access to support and improved recovery
• Reduced hospital admissions for self-harm and lower rates of suicide over time

This highlights what putting mental health at the heart of policy and services can do: boost wellbeing, prevent harm, and tackle the root causes of mental health problems.

‍