Only 10 integrated care boards have set up a mental health crisis text service, leaving a “gap” in service provision that could risk future deaths, a coroner has warned.
Joanne Kearsley, senior coroner for Manchester North, raised this concern in a Prevention of Future Deaths report relating to 27-year-old Jessica Smithson, who died by suicide last August.
During the inquest, the coroner discovered that before her death Ms Smithson, who was under the care of Pennine Care Foundation Trust, contacted Shout, a mental health crisis text message service, after making an allegation of sexual assault to Greater Manchester Police.
Ms Kearsley noted that Shout receives 1,500 to 2,000 crisis texts per day and is contacting police forces with, on average, 28 cases per day where there is an immediate risk to life.
The coroner found that the text crisis service did not know Ms Smithson’s name or location but had an arrangement with the Metropolitan Police, who have the power to try to locate anyone who is at “real immediate risk”.
It was found the service did not contact the police but should have done, although Ms Smithson’s death would not have been averted even if contact was made, Ms Kearsley said.
However, Greater Manchester ICB is one of about 30 ICBs which have not commissioned a local crisis text service, and the coroner warned that this created a “gap” across much of the country, which is being filled by more informal services run by charities. These are not connected to local healthcare providers, and have different policies if someone’s life is at risk, resulting in a “lack of consistency”.
The coroner warned: “As they are not linked into local NHS trusts, [these [providers] have limited ability to understand local mental health NHS pathways or to offer a more co-ordinated response where someone is already under local mental health services.”
Source: HSJ, 5 September 2025
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