scholarly journals Liaison-consultation meetings in general practice

1999 ◽  
Vol 23 (3) ◽  
pp. 161-164 ◽  
Author(s):  
Rebecca J. Tipper ◽  
Ian M. Pullen
Keyword(s):  
Mental Health ◽  
General Practice ◽  
Community Mental Health ◽  
Information Exchange ◽  
Clinical Implications ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team ◽  
Audio Recordings ◽  
Shared Information

Aims and methodAudio-recordings were made over a period of six months of liaison–consultation meetings between general practitioners and a community mental health team in the Scottish Borders to show general trends in length of discussion and information exchange.ResultsMeetings were predominantly supportive, with high levels of shared information, but little educational content. Some trends in discussion time are shown.Clinical implicationsAudio-recording could form the basis for reviewing the function of liaison-consultation meetings.

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 Medicines reconciliation at the community mental health team–general practice interface: quality improvement study

2019 ◽  
Vol 44 (1) ◽  
pp. 12-18
Author(s):  
Chris F. Johnson ◽  
Karen Liddell ◽  
Claudio Guerri ◽  
Paul Findlay ◽  
Alex Thom
Keyword(s):  
Mental Health ◽  
General Practice ◽  
Quality Improvement ◽  
Community Mental Health ◽  
Electronic Prescribing ◽  
Team Approach ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team ◽  
Medicines Reconciliation

Aims and methodTo increase the proportion of patients with no psychotropic drug discrepancies at the community mental health team (CMHT)–general practice interface. Three CMHTs participated. Over a 14 month period, quality improvement methodologies were used: individual patient-level feedback to patient's prescribers, run charts and meetings with CMHTs.ResultsOne CMHT improved medicines reconciliation accuracy and demonstrated significant reductions in prescribing discrepancies. One in three (119/356) patients had ≥1 discrepancy involving 20% (166/847) of all prescribed psychotropics. Discrepancies were graded as: ‘fatal’ (0%), ‘serious’ (17%) and ‘negligible/minor harm’ (83%) but were associated with extra avoidable prescribing costs. For medicines routinely supplied by secondary care, 68% were not recorded in general practice electronic prescribing systems.Clinical implicationsImprovements in medicines reconciliation accuracy were achieved for one CMHT. This may have been partly owing to a multidisciplinary team approach to sharing and addressing prescribing discrepancies. Improving prescribing accuracy may help to reduce avoidable drug-related harms to patients.

scholarly journals Use of psychotropic medication among psychiatric out-patients with personality disorder

2010 ◽  
Vol 34 (3) ◽  
pp. 83-86 ◽  
Author(s):  
Elena Baker-Glenn ◽  
Mark Steels ◽  
Chris Evans
Keyword(s):  
Mental Health ◽  
Personality Disorder ◽  
Community Mental Health ◽  
Psychotropic Medication ◽  
Primary Diagnosis ◽  
Total Annual Cost ◽  
Clinical Implications ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team

Aims and methodThis survey was conducted to ascertain the use of psychotropic medication in the treatment of patients with a primary diagnosis of personality disorder within a community mental health team. A sample of 113 patients were identified, their notes were reviewed, and details of current medications and diagnoses recorded.ResultsFour-fifths of patients were prescribed at least one psychotropic medication. The most commonly prescribed medication class was antidepressant, comprising almost half of prescriptions. The total annual cost across 107 patients was £37 000.Clinical implicationsMedication is commonly prescribed to people with personality disorder but more needs to be known about why prescriptions are started and stopped, what the benefits are, and how these are judged by patients and care teams.

scholarly journals Polypharmacy and high-dose antipsychotic regimes in the community

2010 ◽  
Vol 34 (2) ◽  
pp. 44-46 ◽  
Author(s):  
Tongeji E. Tungaraza ◽  
Seema Gupta ◽  
Jane Jones ◽  
Rob Poole ◽  
Gary Slegg
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Atypical Antipsychotics ◽  
Case Note ◽  
Clinical Implications ◽  
High Dose ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team ◽  
Standing Problem

Aims and methodTo determine the pattern of psychotropic prescribing in a group of people with psychosis who were living in the community under community mental health team (CMHT) care. Case-note entries over the previous 12 months were examined.ResultsOnly a third of individuals were on one psychotropic medication. Atypical antipsychotics were prescribed to 80.6%. Polypharmacy was common. A third of people were taking three or more psychotropic drugs and 13.7% were on high-dose regimes, mostly involving two atypical antipsychotics.Clinical implicationsThe use of atypicals has not eliminated polypharmacy or high-dose antipsychotic regimes. Clinicians need to be aware of this long-standing problem.

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.

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