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 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 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 Do recovery outcome measures improve clinical practice? A linguistic analysis of the impact of the Hope, Agency and Opportunity measure in community mental health teams

2019 ◽  
Vol 140 (2) ◽  
pp. 102-107
Author(s):  
A Bowen ◽  
T Maguire ◽  
K Newman-Taylor
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Single Case ◽  
Linguistic Analysis ◽  
Community Mental Health Team ◽  
Long Term Conditions ◽  
Mental Health Team ◽  
Health Team ◽  
The Impact

Aims: Recovery approaches are identified as the overarching framework for improving mental health services for people with severe and enduring conditions. These approaches prioritise living well with long-term conditions, as evidenced by personal recovery outcomes. There is little research demonstrating how to support busy mental health teams, work in this way. This study assessed the impact of introducing a brief measure of recovery, the Hope, Agency and Opportunity (HAO), on the attitudes and behaviours of staff working in community mental health teams, to test whether routine use of such measures facilitates recovery-based practice. Methods: Linguistic analysis assumes that language is indicative of wider attitudes and behaviours. Anonymised clinical notes recorded by community mental health team clinicians were analysed for recovery and non-recovery language, over 30 months. This covered periods before, during and after the introduction of the recovery measure. We used a single-case design ( N = 1 community mental health team) and hypothesised that clinicians would use recovery-focused language more frequently, and non-recovery-focused language less frequently, following the introduction of the measure, and that these changes would be maintained at 18-month follow-up. Results: Visual inspection of the data indicated that recovery-focused language increased following the introduction of the HAO, though this was not maintained at follow-up. This pattern was not supported by statistical analyses. No clear pattern of change was found for non-recovery-focused language. Conclusions: The introduction of a brief measure of recovery may have influenced staff attitudes and behaviours temporarily. Any longer term impact is likely to depend on ongoing commitment to the use of the measure, without which staff language, attitudes and behaviours return to previous levels.

Audit of Pattern of Benzodiazepine Prescribing in a Community Mental Health Team in England

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Ghosh Nodiyal ◽  
N. Ahuja
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Sleep Hygiene ◽  
Medical Conditions ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team ◽  
Psychological Therapies ◽  
Pro Forma

Aims:To audit benzodiazepine prescribing in a Community Mental Health team, with a view to identifying areas for improvement.Methods:All the 245 patient's case notes were audited, from October 2004 to October 2005, of those in the Outpatients Clinic's case load, in North Shields. A semi structured pro-forma was designed. On the basis of the guidelines from Committee on Safety of Medicines (CSM) (1988), DOH Document (1999), DOH Ireland report of benzodiazepine commission (2002), www.benzo.org.uk, Newcastle, North Tyneside and Northumbria NHS Trust Guidelines for hypnotic/anxiolytic use and Lanarkshire PCT guidelines, the standards were finalised. The audit tool looked at demographics, indications of benzodiazepine prescription, co-morbid medical conditions, substance misuse, psychotherapeutic intervention and follow up of patients prescribed benzodiazepines.Results:245 notes were audited. 24% of all patients were on benzodiazepines. Out of those, 56% were women. A third of these patients were between 41-50 year olds, while another third were older than 50years. Co-morbid substance and alcohol dependence was uncommon. The most common diagnoses in these patients were mood disorder (31%), schizophrenia (20%), and personality disorders (12%). Nearly two-third of patients suffered from co-morbid medical conditions. 25% patients had had psychological therapies. None of them were given advice about sleep hygiene and driving.Conclusions:Older women with mood disorders are more likely to be prescribed benzodiazepines longer than recommended. Advice about driving, sleep hygiene, information about side effects and risks was not offered to most patients. Recommendations have been made, with a view to re-auditing and improving services.

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.

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