scholarly journals Improving the assessment of risk of violence: a clinical audit of case note documentation

2001 ◽  
Vol 25 (7) ◽  
pp. 250-252 ◽  
Author(s):  
Michael Campbell ◽  
Robert Chaplin
Keyword(s):  
Risk Assessment ◽  
Clinical Audit ◽  
Training Session ◽  
Clinical Implications ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team ◽  
Retrospective Audit ◽  
Changes In Risk ◽  
Made In

Aims and MethodsTo improve the rate of documentation of risk in new referrals to a community mental health team. A retrospective audit of 46 case notes was followed by a training session on risk of violence. The following 50 case notes were studied for changes in risk assessment.ResultsPrior to the study there were very low rates of documentation of risk of violence. Significant improvements were made in 45% of the items in the history and mental state although not in the formulation of a risk assessment statement.Clinical ImplicationsIt is possible to improve the risk of violence documentation with no extra time, resources or paperwork and with true multi-disciplinary involvement.

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 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.

‘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 Mental health day centres

2001 ◽  
Vol 25 (2) ◽  
pp. 61-66 ◽  
Author(s):  
Jocelyn Catty ◽  
Tom Burns
Keyword(s):  
Mental Health ◽  
Social Services ◽  
Mental Health Problems ◽  
Clinical Implications ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team ◽  
Team Care ◽  
Physical Health Care ◽  
Day Hospitals

Aims and MethodMental health day centres have been little researched. We carried out a 1-week census at the four day centres run by a London borough.ResultsThe centres catered for a g roup with long-standing mental health problems, mostly under community mental health team care. A surprising number were suffering from physical ill health. They attended the centres primarily for social reasons or to participate in creative groups such as music and art.Very few were concurrently attending day hospitals.Clinical ImplicationsFurther work is essential to understand the distinction between NHS day hospitals and Social Services day centres in terms of utilisation and client group.This client group's needs, particularly for physical health care, require urgent attention.

scholarly journals How many patients self-medicate with St John's wort?

2001 ◽  
Vol 25 (7) ◽  
pp. 254-256 ◽  
Author(s):  
A. Redvers ◽  
R. Laugharne ◽  
G. Kanagaratnam ◽  
G. Srinivasan
Keyword(s):  
Herbal Remedy ◽  
Medical Advice ◽  
Clinical Implications ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team ◽  
St John’S Wort ◽  
Risks And Benefits ◽  
St John's Wort ◽  
Number Of Patients

Aims and MethodSt John's wort is popularly taken as a herbal remedy, but it interacts with prescribed drugs. The aim of this survey was to estimate the prevalence of patients self-medicating with St John's wort. All new referrals to a community mental health team over 5 months were asked about any use of St John's wort.ResultsFifteen patients, of 101, had taken St John's wort at some time and of those seven were currently taking it. Patients who used St John's wort tended to be younger and female. Only nine of the 15 patients took it for depressive symptoms and none had received medical advice. One patient was taking an interacting medication.Clinical ImplicationsA significant number of patients are taking St John's wort. In order to prevent drug interactions, doctors should ask all patients whether they use it, especially young women who may be on the contraceptive pill. Patients need better education about its risks and benefits and it should be taken with medical advice.

scholarly journals Compliance with nice guidelines for management of depression in a community mental health team

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S333-S334
Author(s):  
Sophie Mellor ◽  
Shay-Anne Pantall ◽  
Lisa Brownell
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Community Mental Health ◽  
Psychiatric Comorbidity ◽  
Stepped Care ◽  
List Type ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Nice Guidelines ◽  
Health Team

AimsTo evaluate compliance within a Community Mental Health Team (CMHT) to the NICE guidelines for the management of depression.BackgroundReducing the prevalence of depression continues to be a major public health challenge.Given the complexity and recurrent nature of the condition, the NICE guideline CG90 is an invaluable resource to aid the effective management of depression. Here we present an audit of adherence to this guideline within a CMHT.MethodA retrospective electronic casenote review of all patients diagnosed with depression between January 2016 and October 2019 under the care of a Birmingham CMHT (n = 35), assessing key performance areas including: quality of assessment and coordinated care, risk assessment, choice of pharmacological and psychological treatment using the stepped care model and appropriate crisis resolution planning.ResultKey results include: The majority of patients were Caucasian (63%). Ages ranged from 27 to 69 (mean age 48 years old).Severity of disorder was typically moderate (46%) or severe (48%). Of those with a diagnosis of severe depression, 41% had associated psychotic symptoms.Psychiatric comorbidity was high (49%), of which generalised anxiety disorder was the most common (59%).Referrals were typically from primary care (77%). Approximately half (51%) had reported suicidal thoughts according to the referral.A quarter of patients (26%) were seen by CMHT within 8 weeks of referral; 20% of referrals however waited over 12 months before being assessed.Risk assessments were out of date for 71% of patients.100% of patients had a crisis plan noted within their most recent clinic letter; however, none of these met the required standards.Polypharmacy was common (60%), with 34% prescribed two antidepressants. Use of lithium augmentation was uncommon, with only one patient prescribed this. 43% were prescribed an antipsychotic; of which, 29% had appropriate physical health monitoring completed.Over half of patients (60%) had been referred to psychology services; of these, 38% had either completed or were in ongoing treatment at the time of review.ConclusionCMHTs manage the care of individuals with depression who have high levels of active symptoms and disability, psychiatric comorbidity, care requirements, and complex treatment plans. Pharmacological management was broadly in line with guidelines, and rates of referral to psychology were satisfactory. Risk assessment and crisis planning are clear areas in need of urgent attention in order to comply with guidelines and ensure patient safety.

scholarly journals New community mental health team for acute psychiatric illness

1999 ◽  
Vol 23 (3) ◽  
pp. 143-146
Author(s):  
S. J. Brown ◽  
M. F. Guthrie ◽  
B. M. Shepherd
Keyword(s):  
Psychiatric Illness ◽  
Psychiatric Services ◽  
Clinical Implications ◽  
Community Mental Health Team ◽  
Pharmacological Interventions ◽  
Mental Health Team ◽  
Health Team ◽  
Effective Time ◽  
New Community ◽  
Multi Disciplinary Team

Aims and methodThe aim was to provide effective time-limited management of acute episodes of mental illness in the community, thus reducing dependency on the psychiatric services. A multi-disciplinary team supplied intensive psychological and pharmacological interventions.ResultsFifty-nine per cent were discharged within 12 weeks to the care of their general practitioner. Twelve per cent were admitted to in-patient care.Clinical implicationsA time limited multi-disciplinary approach will have benefits to patients and the service.

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.

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