scholarly journals Increasing staff confidence about domestic abuse identification, disclosure and safeguarding in a community mental health team

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S146-S147
Author(s):  
Beth McCausland ◽  
Nicola Minicozzi ◽  
Siobhan O'Halloran ◽  
Avril Ward ◽  
Kerry Elliott
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Trust Management ◽  
Domestic Abuse ◽  
Pilot Project ◽  
Baseline Survey ◽  
Service Users ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team

AimsTo increase staff confidence about identifying Domestic Abuse (DA), particularly regarding ‘how to ask’ to encourage disclosure and the pathways available for appropriately safeguarding survivors; in a Community Mental Health Team (CMHT) setting.BackgroundDA is bi-directionally associated with mental health (MH) disorders; 1:4 women in contact with MH services are currently experiencing DA. MH professionals (MHPs) are in a privileged position to identify DA and support survivors. However, this is dependent on MHPs receiving adequate training about DA. For this, we collaborated with Pathfinder, a national pilot project run by a consortium of five expert partners that aims to establish comprehensive health practice in relation to DA and Violence Against Women & Girls in Acute Hospital Trusts, MH Trusts and Primary Care. In Southampton, Pathfinder has funded two domestic and sexual abuse (DSA) advocates to both train MH staff and take a small caseload of MH service users who are experiencing abuse.MethodWe conducted a baseline survey of staff confidence across the following domains:Knowing the legal definition of DA,The process used to escalate a DA concern,How to make a referral,How to complete DASH forms,How and when to refer to Pathfinder,What the following acronyms mean: PIPPA, MAPPA, MARAC, IDVA, DASH,What HRDA and MASH mean,How to ask about DA,Who to signpost service users to if they make a disclosure, and when to involve the police.We presented the survey results at the regional Pathfinder strategic group, with Trust management representatives present. This project fits within the strategic group's sustainability aims to increase DA awareness and safeguarding processes across the Trust.The Pathfinder funded DSA Advisors delivered a four-hour training package targeting the surveyed questions and wider information on DA. We then re-surveyed to see if staff confidence had increased. We are currently analyzing the number of referrals to the Pathfinder service pre- and post-training.ResultStaff confidence increased across all domains following the training (% mean increase): Qs1 (35%), Qs2 (9%), Qs3 (45%), Qs4 (81%), Qs5 (25%), Qs6 (49%), Qs7 (89%), Qs8 (62%) and Qs9 (48%).We have now arranged a bi-monthly drop-in at the CMHT by the DSA advisor who provided the training, to embed the link between the services and maintain staff confidence. We will circulate these results to advocate that this training is provided across the Trust.

scholarly journals To improve the communication between a community mental health team and its service users, their families and carers

2020 ◽  
Vol 9 (4) ◽  
pp. e000914
Author(s):  
Priyalakshmi Chowdhury ◽  
Amir Tari ◽  
Ola Hill ◽  
Amar Shah
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
User Satisfaction ◽  
Service User ◽  
Service Users ◽  
Not Given ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Specialist Registrar ◽  
Health Team

This article describes the application of quality improvement (QI) to solve a long-standing, ongoing problem where service users or their carers felt they were not given enough information regarding diagnosis and medication during clinic assessments in a community mental health setting. Service users and carers had shared feedback that some of the information documented on clinic letters was not accurate and the service users were not given the opportunity to discuss these letters with the clinician. The aim of this QI project was to improve the communication between the community mental health team (CMHT) and service users and their carers. Wardown CMHT volunteered to take on this project. The stakeholders involved were the team manager and deputy manager, the team consultant, the team specialist registrar, team administrative manager, two carers and one service user. The project had access to QI learning and support through East London NHS Foundation Trust’s QI programme. The team organised weekly meetings to brainstorm ideas, plan tests of change to review progress and to agree on the next course of action. The outcome was an increase in service user satisfaction from 59.9% to 78% over a period of 6 months, and a reduction in complaints to zero.

scholarly journals A follow-up study of the use of a patient-held record in mental health

2002 ◽  
Vol 26 (3) ◽  
pp. 91-92 ◽  
Author(s):  
A. Stafford ◽  
R. Laugharne ◽  
K. Gannon
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Pilot Project ◽  
Clinical Implications ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team ◽  
Follow Up Study ◽  
The Past

Aims and MethodPatient-held records have been introduced in mental health over the past 2 decades. This follow-up study aimed to evaluate one pilot project 5 years after the records were introduced. All patients initially interviewed 4 years previously were approached and asked about their use and opinion of the record.ResultsOf the 19 people interviewed, 12 were still using the record and had a positive opinion of its usefulness. Of all community mental health team contacts, 72% were recorded in the patient-held notes.Clinical ImplicationsPatient-held records are sustainable in a naturalistic clinical setting over the period of 5 years.

scholarly journals Perceptions of the social worker role in adult community mental health teams in England

2020 ◽  
pp. 147332502092408
Author(s):  
Michele Abendstern ◽  
Jane Hughes ◽  
Mark Wilberforce ◽  
Karen Davies ◽  
Rosa Pitts ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Work ◽  
Community Mental Health ◽  
Social Workers ◽  
Social Model ◽  
Service Users ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team ◽  
The Social

There is a growing recognition of the importance of the social work contribution within community mental health services. However, although many texts describe what the mental health social work contribution should be, little empirical evidence exists about their role in practice and the difference it might make to service users. This qualitative study sought to articulate this contribution through the voices of social workers and their multidisciplinary colleagues via focus group discussions across four English Mental Health Trusts. These considered the impact of the social worker on the service user. Thematic analysis resulted in the identification of three over-arching themes: social workers own perceptions of their contribution situated within the social model; the high value their colleagues placed on social work support and leadership in a range of situations and the concerns for service users if social workers were withdrawn from teams. Key findings were that social workers are the only professional group to lead on the social model; that this model enhances the whole teams’ practice and is required if service users are to be offered support that promotes long-term recovery and that without social workers, the community mental health team offer would be more transactional, less timely, with the potential for the loss of the service users’ voice. If social work is to make a full contribution to community mental health team practice, it must be clearly understood and provided with the support to enable social workers to operate to their full potential.

‘Recovery’ - towards integration into an Irish community mental health team

2009 ◽  
Vol 26 (4) ◽  
pp. 197-201 ◽  
Author(s):  
John McFarland ◽  
Paula Street ◽  
Esther Crowe Mullins ◽  
Anne Jeffers
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Service Users ◽  
Community Mental Health Team ◽  
Group Discussions ◽  
Mental Health Team ◽  
Health Team ◽  
Made In

AbstractObjectives: We aimed to further our understanding of the concept of recovery by analysing comments made in small group discussions that occurred on a planning Away Day held by a community mental health team along-side service users and carers, which had recovery as its theme. The purpose of this was to reshape the structure and workings of the team.Method: Five small groups, of approximately 10 individuals each, comprised of service-users, carers, representatives from voluntary organisations and mental health professionals were asked to discuss three questions related to Recovery.Results: The commentary reflected previous qualitative research on the philosophy of recovery. Issues that were raised included defining wellness as independent to illness, constructive risk taking, the importance of social factors, medication issues and the importance of self-management and optimism. The comments subsequently went on to shape community mental health team service delivery.Conclusion: Discussion and reflection between mental health professionals, service users and carers can lead to a change in attitude and practice in a well-resourced, fully multi-disciplinary community mental health team, within which both the biological and non-biological aspects of mental illness are accepted. The result has been an introduction of service changes which have helped develop a team that is more accessible and increasingly collaborative.

scholarly journals How long does it take community mental health team staff to suspect autistic spectrum disorder?

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S35-S36
Author(s):  
Kirsty Knight ◽  
Ian Ellison-Wright
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Screening Test ◽  
Autistic Spectrum Disorder ◽  
Spectrum Disorder ◽  
Service Users ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Screening Questionnaire ◽  
Health Team

AimsWe wanted to discover the time delay between the initial assessment of service users referred to a Community Mental Health Team (CMHT) and suspicion that they had an Autistic Spectrum Disorder (ASD). We wanted to know whether early use of a screening questionnaire could significantly reduce this delay.BackgroundAbout 1% of the UK population have ASD and the rate is higher among service users within CMHTs. Although CMHT staff are trained to recognize service users with ASD, often the diagnosis is only suspected when service users do not make progress with standard treatment. Early recognition of ASD informs a treatment pathway individualised for people with ASD. Brief screening instruments for ASD can help clinicians decide whether to refer someone for a full diagnostic assessment. The fifty question Autism Questionnaire (AQ50) and ten question Autism Questionnaire (AQ10) both perform well as a screen for ASD.MethodAll referrals from two adult CMHTs to a specialist Wiltshire Autism Diagnostic service (WADS) over a 2.5 year period were ascertained from a referral database. 24 service users referred from the CMHTs were identified. We determined from their records: (A) overall time between initial CMHT appointment and referral to WADS, (B) time between initial CMHT appointment and screening test (when used), (C) time between screening test and referral to WADS.ResultFor all 24 cases, the average time between initial CMHT appointment and referral to WADS was 186 days. 18 of the 24 service users completed a screening questionnaire prior to WADS referral (AQ10 or AQ50 or both); 16 of these had positive screening tests. The average time between initial CMHT appointment and use of screening test was 164 days. The average time between screening test use and referral to WADS was 32 days.ConclusionOur results demonstrated the average time taken from CMHT staff first seeing a patient to suspecting ASD and referring to a specialist diagnostic team was about 6 months. However, after a screening questionnaire had taken place, the time to referral was only around one month. We propose that screening is considered at an earlier opportunity; ideally during (or prior to) the first appointment with the CMHT in order to reduce the time before a referral to a specialist diagnostic team is made. This would enable treatment in a care pathway which incorporates the diagnosis of ASD at an earlier stage.

scholarly journals Birmingham community mental health team for the homeless

1997 ◽  
Vol 21 (2) ◽  
pp. 74-76 ◽  
Author(s):  
Martin Commander ◽  
Sue Odell ◽  
Sashi Sashidharan
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Mentally Ill ◽  
First Year ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team ◽  
Severely Mentally Ill ◽  
Homeless Mentally Ill ◽  
History Of

Mental health services have been criticised for failing to respond to the needs of the rising number of homeless mentally ill. We report on the first year of referrals to a community mental health team established to meet the needs of the severely mentally ill homeless in Birmingham. Most users had a psychotic disorder and a lengthy history of unstable housing, and experienced a range of other disadvantages. Although the team is successfully reaching its priority group, examination of other characteristics of users has highlighted a number of issues which should inform the future planning and development of the service.

scholarly journals Patient factors associated with the use of psychotropic polypharmacy in patients under the care of a community mental health team in the West of Ireland

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S106-S106
Author(s):  
Karthika Srikumar ◽  
Richard Walsh ◽  
Donnchadh Walsh ◽  
Sonn Patel ◽  
Sheila O'Sullivan
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Psychotic Disorders ◽  
Drug Regimen ◽  
Psychotropic Medications ◽  
Community Mental Health Team ◽  
Patient Factors ◽  
Mental Health Team ◽  
Health Team ◽  
Factors Associated

AimsPsychiatric polypharmacy refers to the prescription of two or more psychotropic medications to any one patient. This definition is purely quantitative and does not take into account whether such a prescription is detrimental, or unnecessary. In many cases, polypharmacy has been implemented in challenging illnesses, and some studies have shown that it can improve overall outcomes for certain patients. Evidence suggests that the prevalence of psychotropic polypharmacy is increasing, despite advances in psychosocial interventions. The aim of this study was to assess the current prevalence of polypharmacy among patients being treated by a community mental health team (CMHT), and the patient factors associated with its use.MethodWe performed a cross-sectional study of all patients registered with a CMHT in a mixed urban/rural area on a single date. Case records were examined to determine the most recently prescribed drug regimen for each patient. Clinical chart diagnoses were recorded and each one independently verified by the team consultant using ICD-10. A number other sociodemographic variables were recorded. Using Microsoft Excel, we analysed the medications prescribed as well as rates and levels of polypharmacy based on multiple different patient characteristics.ResultOf the 245 patients, the mean age was 56.3 and 51.2% (n = 126) were female. Psychotropic polypharmacy was seen in 62% (n = 152) of patients. 33% (n = 82) of patients were on two psychotropic medications, and of this subset, a combination of one antipsychotic and one antidepressant was the most common drug regimen, seen in 16.7% (n = 41) of all patients. Polypharmacy was more prevalent in females, with 68% (n = 85) being on two or more psychotropics, in comparison to 58% of male patients. In relation to age, patients aged between 51 to 65 years had the highest prevalence of polypharmacy, at a rate of 71% (n = 49). Among all primary diagnoses, polypharmacy was most common in patients with affective disorders, with 80% (n = 40) of this patient cohort on two or more medications. Second to this was psychotic disorders, with polypharmacy seen in 65% (n = 62) of this group.ConclusionWe found that psychotropic polypharmacy is highly prevalent in psychiatric patients being treated in a community setting. Certain demographics and patient factors, such as age, gender and psychiatric diagnosis influenced the rate of polypharmacy and certain drug combinations were more commonly prescribed than others.

scholarly journals Psychiatric admission for homeless people: the impact of a specialist community mental health team

1997 ◽  
Vol 21 (5) ◽  
pp. 260-263 ◽  
Author(s):  
Martin Commander ◽  
Sue Odell ◽  
Sashi Sashidharan
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Homeless People ◽  
Discharge Process ◽  
Community Mental Health Team ◽  
Psychiatric Admission ◽  
Mental Health Team ◽  
Health Team ◽  
Before And After ◽  
The Impact

The difficulty in achieving good quality community mental health care for homeless people has received increasing attention during the last few years. Less consideration has been given to the provision of inpatient care. By comparing data collected before and after its inception, we examined the impact of a specialist community mental health team for homeless people on ‘no fixed abode’ admissions in Birmingham. Although the team was successfully involved in the admission and discharge process in a substantial proportion of cases, many admissions still took place out of hours and involved the police, while discharge was often against medical advice and occurred without follow-up. These findings and their implications for the provision of homeless services are discussed.

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