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Impact of functionalised community mental health teams on in-patient care
- Authors:
- COMMANDER Martin, DISANYAKE Lallana
- Journal article citation:
- Psychiatric Bulletin, 30(6), June 2006, pp.213-215.
- Publisher:
- Royal College of Psychiatrists
A before-and-after design was used to evaluate whether the routine implementation of functionalised community mental health teams (CMHTs) would reduce demand for in-patient care. Residents of west Birmingham, aged 16-64 years, who were in hospital between 23 March 1992 and 22 September 1992 were identified. The same period was studied in 2003 by which time the newly introduced teams were well established. The number of people in hospital fell by one-third between 1992 and 2003. There was no change in the number of admissions by each patient or the length of stay. The percentage identified as Black, single, living with other adults, resident in hostels and unemployed increased, as did the proportion with schizophrenia or manic depression and those detained compulsorily. Functionalised CMHTs can decrease the use of in-patient care in inner-city areas. They may also attenuate, but by no means halt, the rise in compulsory admissions seen across the UK in the past decade.
Promoting healthy choices for mental health clients
- Authors:
- ARNOLD Andrea, et al
- Journal article citation:
- Nursing Times, 22.4.08, 2008, pp.28-29.
- Publisher:
- Nursing Times
This article describes the implementation of an initiative by a multidisciplinary community mental health team to improve the health of clients with mental health problems. The projects developed were: an allotment; a coffee morning; a walking group; a healthy living group; and blood glucose testing. Evidence suggests that people with mental ill health are at greater risk of premature death than the general population. The project resulted in improvements in clients physical and mental well-being.
Service innovations: redesigning a community mental health team
- Authors:
- SHAJAHAN Polash, et al
- Journal article citation:
- Psychiatric Bulletin, 30(7), July 2006, pp.269-271.
- Publisher:
- Royal College of Psychiatrists
The authors describe the redesign of a community mental health team in Lanarkshire (the focused intervention team for Bellshill). Their remit is to provide focused, time-limited therapeutic intervention for patients with mild-to-moderate mental health problems. The redesign involved a closer working relationship with the psychiatrist, establishing a concurrent community psychiatric nurse/psychiatric clinic, recategorisation of ‘soon’ and routine referrals to the team, opt-in letters and the introduction of new assessment formats. These measures combined to provide a shorter waiting list, increased joint working and management plans for patients. Team functioning and morale improved.
Two weeks in the life of a community mental health team: a survey of case-mix and clinical activity in the north-west of Sheffield
- Authors:
- HUNTER Michael D., JADRESIC Danitza
- Journal article citation:
- Psychiatric Bulletin, 26(1), January 2002, pp.9-11.
- Publisher:
- Royal College of Psychiatrists
The aim of the study was to determine whether diagnostic case-mix influenced the distribution of clinical activity within the community mental health team (CMHT). Information concerning every patient involved with the CMHT and every episode of clinical activity was collected over a 2-week period. Results found diagnostic case-mix significantly differed between the professions. The duration of episodes of clinical activity varied significantly according to the type of patients involved and whether or not direct face to face contact occurred. Concludes that patients with psychosis may place an increased time burden upon CMHT members.
Utility of the HoNOS in measuring change in a community mental health care population
- Authors:
- REES Anne, RICHARDS Ann, SHAPIRO David A.
- Journal article citation:
- Journal of Mental Health, 13(3), June 2004, pp.295-304.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Given that, for many community health care teams, the HoNOS is the audit tool of choice, further work is needed to establish the viability of using this instrument to assess health change. Key workers or care co-ordinators of 195 selected patients on the caseloads of a national sample of 10 generic community mental health teams rated patients on the HoNOS four times over a period of 4 - 6 months. Patients had previously received a primary diagnosis of anxiety, depression, psychosis, personality disorder, or substance misuse on the Manchester Audit Tool. In this population, the HoNOS marginally discriminated amongst diagnoses, and was associated with severity and complexity but not chronicity. Scores on the HoNOS changed differentially over time according to diagnosis and severity. A change of 3 to 4 points on the HoNOS is small, but statistically significant, and may be a useful basis for tracking the clinical improvement of neurotic patients, and the clinical stability of those with psychosis.
Mental health matters: a multi-family framework for mental health intervention
- Authors:
- BISHOP Peter, et al
- Journal article citation:
- Journal of Family Therapy, 24(1), February 2002, pp.31-45.
- Publisher:
- Wiley
Reports on a collaborative project, developed jointly by a group of community mental health workers in association with a specialist team commissioned to initiate family work throughout a central London mental health provider. The results of this paper - 'The Mental Health Matters Workshops' - was a series of day workshops for patients who had experienced a major mental illness, and their families, carers and mental health workers. The positive impact of the workshop on attenders is reported, as well as the development of a 'multi-family' and social network culture.
Service innovations: early intervention in psychosis as a core task for general psychiatry
- Author:
- WHITWELL David
- Journal article citation:
- Psychiatric Bulletin, 25(4), April 2001, pp.146-148.
- Publisher:
- Royal College of Psychiatrists
Describes how a generic community mental health team (CMHT) introduced strategies for early intervention with no extra funding. A style of intervention was developed to engage and maintain contact with people with recent onset psychosis. Looks at the model as a possible alternative to setting up specialised teams.
The care programme approach and risk assessment of borderline personality disorder: clinical validation of the CORE risk sub-scale
- Authors:
- WHEWELL P., BONANNO D.
- Journal article citation:
- Psychiatric Bulletin, 24(10), October 2000, pp.381-384.
- Publisher:
- Royal College of Psychiatrists
Article describes the validation of self-report of risk by patients with borderline personality disorder (BPD) as compared with the judgement of experienced psychotherapists in regular contact with them. The aim was to validate the Clinical Outcomes in Routine Evaluation System (CORE) self-report in order to be able to use it monitor risk change for patients with BPD in psychotherapy and general psychiatric settings. There was significant separation correlation between CORE risk sub-scales for self-harm, suicide and risk to others and therapists' estimation of significant risk v. no significant risk.
How predictable is violence and suicide in community psychiatric practice?
- Authors:
- SHERGILL Sukhwinder S., SZMUKLER George
- Journal article citation:
- Journal of Mental Health, 7(4), August 1998, pp.393-401.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Reports on research assessing the level of risk of violence and suicide in patients seen routinely by a community mental health team. Risk assessment questionnaires were completed by community mental health team professionals for all contacts with all patients seen by the team over a one-month period. The variables best identifying those judged at risk of suicide were previous violence to person or property, specific threats towards another, expression of emotions related to violence in the mental state examination and absence of previous depressive illness. Results indicate a large number of patients seen by the community teams are at risk of suicide and violence; yet suicide or incidents of serious violence are rare. This highlights the difficulty in accurate prediction and the limits of risk management strategies recommended by inquiries following such events.
Collaborative community mental health care
- Editors:
- WATKINS Mary, et al
- Publisher:
- Arnold
- Publication year:
- 1996
- Pagination:
- 384p.,bibliogs.
- Place of publication:
- London
Includes papers on: teamwork among professionals involved with disturbed families; integrating hospital and community services; policy and finance for community care; primary health care; day care and rehabilitation services; community care, community compulsion and the law; the role of the voluntary sector; managing the psychiatric emergency in the community; interventions with long-term clients; coping with drug and alcohol misuse; shifting into community focus; dealing with psychosis in families; liaison psychiatry and primary health care settings; long-term medication and the responsibilities of the team; daily living skills for clients in the community; support for community psychiatric nurses in multidisciplinary teams; principles of evaluation; evaluating community services; and multidisciplinary care in the community for users with mental health problems - guidelines for the future.