Inside England's first 'safe haven' 24/7 NHS neighbourhood mental health centre

There are two words that James, 28, uses repeatedly to describe England's first 24/7 neighbourhood mental health centre: "Safe haven." After treatment in hospital following a suicide attempt and struggles with alcoholism, he was initially given two options: go home or be admitted to a psychiatric ward. Both terrified him. Instead, staff at Barnsley Street Neighbourhood Mental Health Centre in east London offered him a bed at their pioneering project where support is available around the clock.

The Daily Express was invited to spend a morning at the centre - the first of six NHS pilot sites to open across the country. It brings together psychiatrists, mental health professionals, peer support workers and voluntary sector staff under one roof, ready to provide immediate help for locals. Dr Sheraz Ahmad, consultant psychiatrist and clinical lead for the centre, says this walk-in hub model is radically different to often fragmented local services, where people can be passed between different teams with long waiting times for appointments.

He explains: "Our patients often tell us they feel like they're being pushed around and nobody really knows them. This place is where we're saying, 'No, the person stays with us'. We're providing that continuity.

"We're trying to do away with all the fragmentation so we're not referring people who then wait eight weeks for a reply, then need another appointment and have to repeat their whole story. We want to try and build a relationship. You get to know them, and they can start to trust you a little bit."

James had arrived the day before from The Royal London Hospital. The thought of returning to normal life was overwhelming and he did not want to move to a psychiatric unit.

He says: "My biological mother committed suicide and I remember going to see her on a psych ward. That terrified me. My diagnosis has been PTSD. A lot of people I've spoken to have said that being on a psych ward is in itself quite traumatic."

Barnsley Street serves a population of around 60,000 and has four simple rooms where guests can stay for anything from one night to several weeks. The rooms feel more like a hotel than a ward, with users invited for a "stay" rather than an "admission" and free to come and go as they please.

James describes the centre as a "happy medium" where he has independence but staff are always on hand. He was nervous about returning to the place where he tried to end his life, so someone went with him to collect clothes from his flat. And he shared a cup of tea with a mental health nurse in the evening.

James was previously in touch with different teams for mental health, cognitive behavioural therapy, anxiety services and alcohol. At Barnsley Street, he can access services under one roof and sit down with multiple experts at once to deal with overlapping issues, such as his use of alcohol to cope with trauma.

He explains: "What I found very difficult was navigating the system when I'm not at my best. Having to bring up the traumas again and again is not a nice experience. Whereas here you say it once and everyone knows you, your history."

The media manager adds: "I view it as a little bit of a halfway house, assisted living. I can't function in society by myself at the moment but I don't think going to a psych ward would be the right option.

"If I had known this existed before, I don't think I would have got to the stage I did. It's a safe haven. I can talk to people about some awful traumas, and then I'm still here in a safe environment."

When James returns home, he will be able to visit the centre during the day without an appointment. It is open 10am-6pm seven days a week, with plans to extend to 8am-8pm soon.

Visitors are greeted by colourful bunting, balloons and paper chains, and the reception is open - unlike the receptions of many GP surgeries that are still shielded by perspex screens post-Covid.

The main area holds a pool table and cushioned seating. There are sofas, soft chairs, beanbags, a large table next to a kitchenette for making tea and coffee, and private consultation rooms.

The centre is staffed by a dozen nurses and six psychiatrists plus social workers, occupational therapists, psychologists, peer support workers and staff from Look Ahead, the housing organisation that owns the site.

Some mingle with users, working on laptops but always easily accessible for a chat. The overall atmosphere is less clinical and more informal than a typical NHS facility.

Moyna Miah is sitting at a coffee table playing chess. The 49-year-old comes almost every day to play games or pool or take part in daily activities such as film club. "It's a very relaxing, nice place," he says. "Time goes quickly."

Former electrical engineer Adrian, 64, also visits on most days. He suffered a breakdown two months ago and was admitted to hospital after drinking heavily for three weeks.

Adrian was diagnosed with bipolar disorder 20 years ago and says his entire adult life has been "a bit of a mess really, a rollercoaster". He adds: "I've been coming here every single day. That's not a permanent thing, I'm just grounding myself here and then there's other stuff I want to do.

"There are amazing benefits. I would honestly say without this place, it would be less than 50/50 I'd be back in hospital again, because you just come home and there's nothing to do."

Barnsley Street is in Tower Hamlets, which has one of the highest deprivation and poverty rates in the country, driving higher rates of mental ill health.

Leah White, the borough's clinical director for adult mental health, says the centre was developed with input from local residents who want "compassionate, empathetic care and defragmentation of the system".

She adds: "That feeling of fragmentation that service users feel - when they're retelling their story one, two, three, four, five times, before they end up where they need to be - is reduced by a project like this."

The centre's success will be measured by metrics including whether it reduces pressure on local hospitals. Ms White says: "The numbers are not high enough at this stage to produce a research paper, but the figures are certainly showing us lower numbers of admissions on the ward from this patch that the pilot covers, and the length of stay is shorter and going down. The hope is certainly that it will be rolled out."

Demonstrating that the centre improves continuity of care will be key, Dr Ahmad adds. "I think our system is very stuck in its fragmented way...this will be a big culture shift."

A vast network of neighbourhood health centres that move care away from hospitals and into the community was at the heart of Labour's 10 Year Health Plan, published earlier this year.

Minister of State for Care Stephen Kinnock told the Express this "innovative approach" will "tear down potentially devastating barriers to vital and timely support, and forms part of our seismic shift in care from hospitals to the community, as we deliver an NHS fit for the future".

He added: "For too long, mental health patients have been left let down and bounced around a broken system. Through our Plan for Change we are fixing this, getting people in crisis the care they need and when they need it, in a welcoming and comfortable environment."

Living with mental illness can make people feel and become isolated from the people they love and the communities they live in. It can be a lonely and frightening experience.

But it doesn't need to be this way. How we respond as communities to people struggling with mental ill health and how we organise the care, support and treatment available can make a difference.

As a psychiatrist, I know what a difference it can make when people feel there is somewhere familiar, safe and welcoming for them to turn. That is why the NHS is piloting new 24/7 neighbour mental health centres.

The objective is to create welcoming spaces in the heart of the community where people with severe mental illness are able drop into at any time of the day.

These spaces will be designed to bring more aspects of existing mental health care together so people can spend less time trying to navigate a complex health and care system and more on getting well or back to things that matter most to them.

The Centres will aim to provide a safe place, evidence-based care and treatment and a range of different supports. Whether it's for just a quiet cup of tea with some friendly faces, talking to a psychiatrist or social worker, or getting support and advice on practical challenges like housing or employment - they will be more able to respond to the range of needs that people may have.

Evidence shows that being supported by the same health or care professional person makes a difference to people's recovery from illness. We all know what a difference it makes when you see a clinician who knows you, your family, your story and what helps and what doesn't when you are unwell. By bringing services together under one roof, these centres will aim to give people more consistency and connection with the person overseeing their care and a wider team.

Last month, the NHS opened the first of six pilot Centres, with the others due to fully open soon. An evaluation of their impact will inform their further roll out and development.

They are a central part of the NHS 10-Year Plan, which is committed to making mental health care more joined-up and also rooted in people's local communities. Alongside psychiatric teams in every A&E, dedicated mental health emergency departments and 24/7 crisis helplines these combined approaches will be designed to improve how easy it is to get the right help when it is needed.

- Dr Mary Docherty is the NHS's national clinical director for adult mental health