scholarly journals A Clinical Audit Of Service User And Carer Involvement In An NHS Community Mental Health Team Risk Assessment Tool

2019 ◽  
Vol Volume 11 ◽  
pp. 29-36
Author(s):  
Brendan J Dunlop
2020 ◽  
Vol 9 (4) ◽  
pp. e000914
Author(s):  
Priyalakshmi Chowdhury ◽  
Amir Tari ◽  
Ola Hill ◽  
Amar Shah

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.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S333-S334
Author(s):  
Sophie Mellor ◽  
Shay-Anne Pantall ◽  
Lisa Brownell

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.


2001 ◽  
Vol 25 (7) ◽  
pp. 250-252 ◽  
Author(s):  
Michael Campbell ◽  
Robert Chaplin

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.


1997 ◽  
Vol 21 (2) ◽  
pp. 74-76 ◽  
Author(s):  
Martin Commander ◽  
Sue Odell ◽  
Sashi Sashidharan

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.


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