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Downs raises concerns about NHS plans to open specialist centres for patients in mental health crisis to use instead of the emergency department.1 As a doctor, I think the initiative is commendable.2 Specialist emergency centres already exist for ophthalmology and paediatrics, for example. These show that emergency mental health centres could be feasible with proper implementation. I do, however, recognise the author’s concern about separate hospitals being perceived negatively by patients. Concerns about mental health emergencies being perceived as “less real” or “less urgent” must not be dismissed.1