scholarly journals Evaluation of a client held record introduced by a community mental health team

1997 ◽  
Vol 21 (12) ◽  
pp. 757-759 ◽  
Author(s):  
Anna Stafford ◽  
Richard Laugharne
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Community Mental Health ◽  
Patient Involvement ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team

A client held record for patients with long-term mental illness was introduced by a community mental health team in east London. The record was evaluated by asking the opinions of 45 patients and examining how their client record had been used. Over 80% of the patients found the record and the information it contained useful, 74% of contacts were recorded in the booklet and the client held record had begun to be used by many professionals for purposes other than appointments and medication. A client held record can increase patient involvement in care and help communication between professionals.

The importance of service level measures for mental health policy

1997 ◽  
Vol 6 (S1) ◽  
pp. 229-237 ◽  
Author(s):  
Rachel Jenkins ◽  
Gyles Glover
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health Policy ◽  
Community Mental Health ◽  
Health Services ◽  
Mission Statement ◽  
Mental Health Policy ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team

The policy of any organisation is a setting out of the purposes for which it exists - its mission statement. Governments spend money on mental health services and therefore need a coherent mission statement for the use and goals to which that money is put. Moreover, the consequences of mental illness pervade all aspects of a nation's existence. Therefore a mission statement is needed to tackle mental illness and its consequences, not only by developing and using specialist mental health services to best effect, but also by using other relevant organisations as appropriate.Mental health policy is formulated at all levels from the community mental health team to the national government and thence to the World Health Organisation and the United Nations. Indeed national and international mental health policies have generally been led by local innovative best clinical practice. At local level, the policy of a community mental health team will identify the types of patients to which it seeks to provide a service, the channels through which referrals will be accepted, the type and nature of assessment and decision making about consequent interventions which will be used and a range of quality standards within which it will seek to operate. It may set out a set of desired goals in terms of the improvement in the health status of clients and the degree of consumer satisfaction it seeks to achieve. Some adverse consequences may be set out. For example, it may seek to minimise readmissions to hospital within a specified period of time or the frequency of violent or self-destructive behaviour on behalf of its clients.

scholarly journals Community mental health team management in severe mental illness: A systematic review

2001 ◽  
Vol 178 (6) ◽  
pp. 497-502 ◽  
Author(s):  
Shaeda Simmonds ◽  
Jeremy Coid ◽  
Philip Joseph ◽  
Sarah Marriott ◽  
Petertyrer
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Illness ◽  
Community Mental Health ◽  
Severe Mental Illness ◽  
Odds Ratio ◽  
Team Management ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team

BackgroundCommunity mental health teams are now generally recommended for the management of severe mental illness but a comparative evaluation of their effectiveness is lacking.AimsTo assess the benefits of community mental health team management in severe mental illness.MethodA systematic review was conducted of community mental health team management compared with other standard approaches.ResultsCommunity mental health team management is associated with fewer deaths by suicide and in suspicious circumstances (odds ratio=0.32, 95% CI 0.09–1.12), less dissatisfaction with care (odds ratio=0.34, 95% CI 0.2–0.59) and fewer drop-outs (odds ratio=0.61, 95% CI 0.45–0.83). Duration of in-patient psychiatric treatment is shorter with community team management and costs of care are less, but there are no gains in clinical symptomatology or social functioning.ConclusionsCommunity mental health team management is superior to standard care in promoting greater acceptance of treatment, and may also reduce hospital admission and avoid deaths by suicide. This model of care is effective and deserves encouragement.

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 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 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 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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