{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T08:03:50Z","timestamp":1789545830705,"version":"build-2803163510"},"reference-count":40,"publisher":"Royal College of Psychiatrists","issue":"5","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"unspecified","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec id=\"S2056472426120948_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Improving access to community-based crisis care and reducing in-patient admissions are key policy objectives in England, yet evidence on who uses crisis-related services remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426120948_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine sociodemographic patterns in the use of six crisis-related services in England: crisis phonelines; crisis caf\u00e9s; Crisis Resolution and Home Treatment teams (CRHTs); voluntary in-patient admissions; compulsory in-patient admissions under the Mental Health Act 1983 (MHA); and conveyance to a Place of Safety (PoS) by police under section 136 of the MHA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426120948_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This retrospective observational study used the Mental Health Services Data Set (2021\/2022\u22122023\/2024). Adults (18+ years) using any of the six services were included. A multinomial logit regression model estimated average marginal effects for age, gender, ethnicity and area-level deprivation, with robust patient-level standard errors and year fixed effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426120948_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among crisis-related patients, adjusted analysis showed that several ethnic minority groups were more likely than White individuals to be compulsorily detained or brought to a PoS, and less likely to use CRHTs, with the largest disparities in compulsory admissions for Black (+15.0 percentage points) and Asian (+7.3 percentage points) groups. Compulsory admissions were more common among older adults and men (+1.5 percentage points). Crisis phonelines were used less by older adults, men (\u22124.8 percentage points), Black (\u221215.6 percentage points) and Asian (\u22124.7 percentage points) groups. Although adjusted differences by deprivation were small (&lt;1.0 percentage points), over half of users lived in the 2 most deprived quintiles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426120948_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Groups at greater risk of coercive care were less likely to access community crisis services. Addressing these disparities could reduce inequalities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjo.2026.12094","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T07:20:56Z","timestamp":1789543256000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Patterns of use of mental health crisis-related services in the English NHS: retrospective observational study"],"prefix":"10.1192","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8782-3311","authenticated-orcid":false,"given":"Maria Ana","family":"Matias","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04m01e293","id-type":"ROR","asserted-by":"publisher"}],"name":"University of York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica L.","family":"Griffiths","sequence":"additional","affiliation":[{"name":"King\u2019s College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Simpson","sequence":"additional","affiliation":[{"name":"King\u2019s College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anam","family":"Bhutta","sequence":"additional","affiliation":[{"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Grundy","sequence":"additional","affiliation":[{"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beverley","family":"Chipp","sequence":"additional","affiliation":[{"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo","family":"Lomani","sequence":"additional","affiliation":[{"name":"NHS England"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jude","family":"Beng","sequence":"additional","affiliation":[{"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Edbrooke-Childs","sequence":"additional","affiliation":[{"name":"University College London"},{"name":"University College London and the Anna Freud Centre"},{"name":"Anna Freud Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5865-4726","authenticated-orcid":false,"given":"Kylee","family":"Trevillion","sequence":"additional","affiliation":[{"name":"King\u2019s College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Holden","sequence":"additional","affiliation":[{"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Webber","sequence":"additional","affiliation":[{"name":"University of York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Nyikavaranda","sequence":"additional","affiliation":[{"name":"University College London"},{"name":"University of Sussex"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Rowan Olive","sequence":"additional","affiliation":[{"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2519-1539","authenticated-orcid":false,"given":"David","family":"Osborn","sequence":"additional","affiliation":[{"name":"University College London"},{"name":"North London NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rowena","family":"Jacobs","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04m01e293","id-type":"ROR","asserted-by":"publisher"}],"name":"University of York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Johnson","sequence":"additional","affiliation":[{"name":"University College London"},{"name":"North London NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9866-788X","authenticated-orcid":false,"given":"Brynmor","family":"Lloyd-Evans","sequence":"additional","affiliation":[{"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"S2056472426120948_ref27","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2004.03331.x"},{"key":"S2056472426120948_ref3","doi-asserted-by":"publisher","DOI":"10.1080\/14999013.2021.1887978"},{"key":"S2056472426120948_ref31","doi-asserted-by":"publisher","DOI":"10.1177\/00368504221135469"},{"key":"S2056472426120948_ref15","unstructured":"15 National Institute for Health and Care Excellence. Dementia: Assessment, Management and Support for People Living with Dementia and Their Carers (NG97). NICE, 2018 (https:\/\/www.nice.org.uk\/guidance\/ng97\/resources\/dementia-assessment-management-and-support-for-people-living-with-dementia-and-their-carers-pdf-1837760199109)."},{"key":"S2056472426120948_ref38","volume-title":"The State of Health Care and Adult Social Care in England 2023\/24","year":"2024"},{"key":"S2056472426120948_ref39","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2023.1053502"},{"key":"S2056472426120948_ref19","unstructured":"19 Department of Health and Social Care. Modernising the Mental Health Act. 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NHS England, (https:\/\/assets.publishing.service.gov.uk\/media\/5a80099ded915d74e33f812d\/Annex_B4_Mental_health_clustering_booklet.pdf)."},{"key":"S2056472426120948_ref23","unstructured":"23 Kapadia, D , Zhang, J , Salway, S , Nazroo, J , Booth, A , Villarroel-Williams, N , et\u00a0al. Ethnic Inequalities in Healthcare: A Rapid Evidence Review. NHS Race & Health Observatory, 2022 (https:\/\/nhsrho.org\/wp-content\/uploads\/2023\/05\/RHO-Rapid-Review-Final-Report_.pdf)."},{"key":"S2056472426120948_ref18","unstructured":"18 Office for National Statistics. Ethnic Group, England and Wales: Census 2021. ONS, 2022 (https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/culturalidentity\/ethnicity\/bulletins\/ethnicgroupenglandandwales\/census2021)."},{"key":"S2056472426120948_ref6","unstructured":"6 NHS. Fit for the Future: 10 Year Health Plan for England. NHS, 2025 (https:\/\/assets.publishing.service.gov.uk\/media\/6888a0b1a11f859994409147\/fit-for-the-future-10-year-health-plan-for-england.pdf)."},{"key":"S2056472426120948_ref20","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.114.153882"},{"key":"S2056472426120948_ref24","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-62728-1"},{"key":"S2056472426120948_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(19)30406-7"},{"key":"S2056472426120948_ref4","unstructured":"4 Davidson, I. Mental Health \u2013 Adult Crisis and Acute Care. 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Mental Health Act Statistics, Annual Figures, 2023\u201324. NHS Digital, 2024 (https:\/\/digital.nhs.uk\/data-and-information\/publications\/statistical\/mental-health-act-statistics-annual-figures\/2023-24-annual-figures)."},{"key":"S2056472426120948_ref40","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-024-11662-0"},{"key":"S2056472426120948_ref5","doi-asserted-by":"publisher","DOI":"10.1192\/pb.bp.112.039933"},{"key":"S2056472426120948_ref11","unstructured":"11 Bignall, T , Jeraj, S , Helsby, E , Butt, J. Racial Disparities in Mental Health: Literature and Evidence Review. Race Equality Foundation, 2019 (https:\/\/raceequalityfoundation.org.uk\/wp-content\/uploads\/2022\/10\/mental-health-report-v5-2.pdf)."},{"key":"S2056472426120948_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2016.09.002"},{"key":"S2056472426120948_ref16","unstructured":"16 Ministry of Housing, Communities & Local Government (2018 to 2021). English Indices of Deprivation 2019. Ministry of Housing, Communities & Local Government, 2019 (https:\/\/www.gov.uk\/government\/statistics\/english-indices-of-deprivation-2019)."},{"key":"S2056472426120948_ref32","doi-asserted-by":"publisher","DOI":"10.1177\/1557988316630953"},{"key":"S2056472426120948_ref8","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-07181-x"},{"key":"S2056472426120948_ref36","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-015-1092-4"},{"key":"S2056472426120948_ref28","unstructured":"28 NHS Digital. NHS Talking Therapies, for Anxiety and Depression, Annual Reports, 2023\u201324. NHS Digital, 2024 (https:\/\/digital.nhs.uk\/data-and-information\/publications\/statistical\/nhs-talking-therapies-for-anxiety-and-depression-annual-reports\/2023-24)."},{"key":"S2056472426120948_ref30","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0049779"}],"container-title":["BJPsych Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056472426120948","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T07:21:13Z","timestamp":1789543273000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056472426120948\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":40,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["S2056472426120948"],"URL":"https:\/\/doi.org\/10.1192\/bjo.2026.12094","relation":{},"ISSN":["2056-4724"],"issn-type":[{"value":"2056-4724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e239"}}