Home based crisis team initial steps towards recovery in the community
Download
1 / 49

Home Based Crisis Team: initial steps towards recovery in the community - PowerPoint PPT Presentation


  • 178 Views
  • Uploaded on

Home Based Crisis Team: initial steps towards recovery in the community. Dr. Sinead O’Brien. Consultant Psychiatrist, Home Based Crisis Team. North Lee Mental Health Services. Today. Vision for Change City North Sector Development of HBCT-City North. Audit of case-load

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Home Based Crisis Team: initial steps towards recovery in the community' - celina


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Home based crisis team initial steps towards recovery in the community l.jpg

Home Based Crisis Team: initial steps towards recovery in the community

Dr. Sinead O’Brien.

Consultant Psychiatrist,

Home Based Crisis Team.

North Lee Mental Health Services.


Today l.jpg
Today..... the community

  • Vision for Change

  • City North Sector

  • Development of HBCT-City North.

  • Audit of case-load

  • Future Directions


A vision for change l.jpg
A Vision for Change the community

  • Person centred

  • Recovery orientated

  • Holistic – all aspects of mental health: biological (e.g. medication), psychological (e.g. “talking therapies”) and social (e.g. housing, employment, education/training).


A vision for change4 l.jpg
A Vision for Change the community

  • Community-based – provide services in communities where people live, reduce hospital admissions, more home-based treatments and outreach services.

  • Multi-disciplinary

  • Population Based


Mission statement l.jpg
Mission Statement the community

To provide a home-based crisis assessment and multi-disciplinary treatment and intervention service for individuals presenting with acute psychiatric illness in City North sector. We endeavour to respect each individual’s rights and values.


Cork city north sector l.jpg
Cork City North Sector the community

  • Population: 53,000

  • 2 Sector Multidisciplinary Teams.

  • CNW: Dr Ruth Collins

  • CNE: Dr Nataraj Gojanur


Cork city north sector7 l.jpg
Cork City North Sector. the community

  • Sector includes:

    Knocknaheeny

    Gurranabraher

    Fairhill

    Blackpool

    Mayfield

    The Glen.


Rapid l.jpg
RAPID the community

  • “Revitalising Areas through Planning, Investment and Development”.


Rapid aims to l.jpg
RAPID aims to...... the community

  • Increase the investment made by Government departments and state agencies in the 46 communities;

  • Improve the delivery of public services through integration and coordination

  • Enhance the opportunities for communities to participate in the strategic improvement of their areas.


Rapid areas in cork l.jpg
Rapid Areas in Cork the community

  • Knocknaheeny/Hollyhill/Churchfield

  • Blackpool /The Glen/Mayfield

  • Fairhill/Gurranabraher/Farranree

  • Togher/Mahon


Priorities of rapid l.jpg
Priorities of RAPID.... the community

  • family support,

  • physical environment,

  • health,

  • community safety,

  • education,

  • employment

  • training and youth support.  


The haase and pratschke index l.jpg
The Haase and Pratschke Index the community

  • uses 3 dimensions of affluence/disadvantage to comprise their index. 

  • ‘Demographic Profile’,

  • ‘Social Class Composition’

  • ‘Labour Market Situation’


Extremely disadvantaged l.jpg
“Extremely disadvantaged” the community

  • Farranferris,

  • Knocknaheeny,

  • Fair Hill B

  • 9% of National ED rating


Slide14 l.jpg
HBCT the community

  • Set up in 2007

  • Funding for 1 additional Consultant

  • CD and Heads of Discipline examined need within North Lee MHS


North lee mhs l.jpg
North Lee MHS the community

  • Majority (>50%) of ALL admissions to Acute Unit were from City North Sectors


Slide16 l.jpg
HBCT the community

  • 1 Consultant Psychiatrist

  • 1 Registrar

  • 2 CMHN

  • 1 social worker

  • 0.6 Occupational Therapist

  • 1 Psychologist

  • Clerical Support


Evolution of hbct april 2009 l.jpg
Evolution of HBCT...April 2009 the community

  • 1 Consultant Psychiatrist

  • 1 Registrar

  • 2 CMHN

  • 0.6 social worker

  • 0.6 Occupational Therapist

  • Clerical Support


My vision l.jpg
My Vision... the community

Optimising Physical &Psychological Health

Intensive Case Management

Evidence Based Practice

Health Economics

SB

Audit

Ethics

Autonomy

Beneficence

Non-Maleficence

Justice

Research


Inclusion criteria l.jpg
Inclusion Criteria the community

The crisis team (HBCT) aim to treat individuals in the community, where appropriate, for approximately 4 weeks. We are targeting adults with severe mental illness, who require urgent assessment.

This includes:

Those in acute psychosocial crisis

Those with acute psychiatric conditions in need of urgent psychiatric attention

And those with long term, severe psychiatric problems who experience either of the first two problems.


Exclusion criteria l.jpg
Exclusion Criteria the community

risk of violence in home &/ or to staff

primary diagnosis of organic brain damage and dementia

medical illness which may require medical assessment

primary diagnosis of active substance misuse.

severe personality disorder


Hbct working hours l.jpg
HBCT Working Hours the community

Mon-Fri.

Mon-Thurs 9am-5pm.

Fri 9am-4pm.


Referrals l.jpg
Referrals the community

Referrals must be made by healthcare professionals using the referral form.

An urgent referral must be followed up by a phone call to the team in order to discuss the case.

The client must be aware of the referral and agreeable to assessment in their home.


Assessments l.jpg
Assessments the community

  • Initial assessment by 2 team members.

  • HBCT Proforma

  • HONOS

  • MADRAS

  • Risk Assessement.


Acceptance non acceptance procedure l.jpg
Acceptance/Non Acceptance Procedure the community

  • Referrer notified immediately via fax.

  • Full detailed assessment to referrer within 2 working days.


Clients working with hbct l.jpg
Clients working with HBCT the community

  • Keyworker

  • Initial daily reviews

  • Weekly review of Collaborative Care Plan.


Slide26 l.jpg

Audit of Home Based Crisis Team (HBCT)-Cork City North, the community

Activity over a 6 month period


Aims of audit l.jpg
Aims of Audit... the community

  • To review Practices within HBCT

  • Accountibility

  • Service Development


Methods l.jpg
Methods the community

  • conducted over a six month period

  • from 1/10/2009 to 31/03/2010.

  • Data was analyse using SPSS version 14 and graphs compiled using Minitab Graphics.


Slide29 l.jpg

Results....... the community


Referrals30 l.jpg
Referrals the community

  • 158 referrals.


Slide42 l.jpg

GP Perspectives on the Home Based Crisis Team. the communityCity North Sectors, Cork.


Gp satisfaction with hbct l.jpg
GP Satisfaction with HBCT the community

  • 92% of GPs were satisfied with the team re

  • management of patients

  • as suitable alternative to admission,

  • time from referral to assessment,

  • satisfaction with feedback and correspondence from the team


Slide44 l.jpg
GP’s..... the community

  • 100% of GPs identified they would refer again


Future plans l.jpg

Future Plans the community


Future plans46 l.jpg
Future Plans the community

  • Further strategy Meeting with CNE

  • Further Meeting Primary Care Teams

  • Meeting with Liaison Psychiatry


Future plans47 l.jpg
Future Plans the community

  • Study ongoing re MDT input to HBCT case-load.

  • Continued CSQ-8 Collection

  • Assessment of family/carer views

  • Collection of emergency presentations/admissions to acute unit.


Slide48 l.jpg

  • the communitySuccessful implementation of the

    CRHT teams as alternatives to hospital admission requires resources for home treatment out of hours, effective systems working among local services, stronger local understanding and advocacy of the

    teams’ role”

    Onyett 2008


The team l.jpg
The Team! the community

  • Mairead Murphy (CMHN)

  • Martina Cullinane (CMHN)

  • Aisling Hassett (CMHN)

  • Damien Fleming (SW)

  • Valerie Morrison (OT)

  • Freda Wynne (Psychologist in Clinical Training)

  • Geraldine Kenny, Martina Carroll (Clerical support)

  • Dr. Deirdre Muller-Neff (Registrar)

  • Dr. Sinead O’Brien


ad