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Mental Health Crisis Plans. Steve Lennox. Mental Health Care. Broadly split into two areas of provision Provision 1 = Conveyance Patients in Crisis Section 136 & 135 Community Sections Provision 2 = Interventional Patients in Crisis Uncomplicated diagnosed patients receiving care
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Mental Health Crisis Plans Steve Lennox
Mental Health Care • Broadly split into two areas of provision • Provision 1 = Conveyance • Patients in Crisis • Section 136 & 135 • Community Sections • Provision 2 = Interventional • Patients in Crisis • Uncomplicated diagnosed patients receiving care • Complicated diagnosed patients receiving care • Uncomplicated undiagnosed patients • Complicated undiagnosed patients • Worried Well
Mental Health Care • Broadly split into two areas of provision • Provision 1 = Conveyance • Patients in Crisis • Section 136 & 135 • Community Sections • Provision 2 = Interventional • Patients in Crisis • Uncomplicated diagnosed patients receiving care • Complicated diagnosed patients receiving care • Uncomplicated undiagnosed patients • Complicated undiagnosed patients • Worried Well
Mental Health Care • Broadly split into two areas of provision • Provision 1 = Conveyance • Patients in Crisis • Section 136 & 135 • Community Sections • Provision 2 =Interventional • Patients in Crisis • Uncomplicated diagnosed patients receiving care • Complicated diagnosed patients receiving care • Uncomplicated undiagnosed patients • Complicated undiagnosed patients • Worried Well
Mental Health Care • Broadly split into two areas of provision • Provision 1 = Conveyance • Patients in Crisis • Section 136 & 135 • Community Sections • Provision 2 =Interventional • Patients in Crisis • Uncomplicated diagnosed patients receiving care • Complicated diagnosed patients receiving care • Uncomplicated undiagnosed patients • Complicated undiagnosed patients • Worried Well
Mental Health Care Case Study
Mental Health Care • Issues for 136 and Emergency Assessment • Accessibility • Full • Short of staff • Regarded as “out of area” • Not seen as an emergency
Mental Health Care • Section 136 • Emergency mental health care to be equivalent to emergency acute commissioning by all • Treat the patient first and ask the questions afterwards
Mental Health Care • Broadly split into two areas of provision • Provision 1 = Conveyance • Patients in Crisis • Section 136 & 135 • Community Sections • Provision 2 = Interventional • Patients in Crisis • Uncomplicated diagnosed patients receiving care • Complicated diagnosed patients receiving care • Uncomplicated undiagnosed patients • Complicated undiagnosed patients • Worried Well
Mental Health Care Case Study
Mental Health Care • Issues for those in crisis • Expertise • Accessibility • Difficult to know who the provider is • Can not always access • Professional issues • Opening hours • Don’t respond to crisis • Few alternatives to conveyance
Kent & Medway Mental Health / Ambulance referral Pathway • SECAmb Ambulance Paramedic Practitioner/paramedic/technician on scene • Mental Health (MH) problem identified does not require attendance for medical/physical intervention at the emergency department (ED). • Consider contacting MH team for advice / referral (see guidance notes), if unsure discuss with paramedic practitioner. Contact relevant MH Team (Duty or Crisis Team) ** for advice or to make a referral When referring the term ‘Ambulance on scene’ will identify that an urgent response is required from the mental health service • MH team respond • Duty worker will co-ordinate response and ensure Ambulance crew are informed of outcome within 10 minutes of end of initial contact • Exchange phone numbers with Ambulance crew • Ask for ambulance incident number; patient details; presenting problem/concerns; observations; contact information; and patient consent • Speak with patient and carer • MH team will: • determine Urgency • Identify most appropriate MH service to assess • Agree a timescale for contact from MH services with patient/carer and ambulance crew • Agree time and place for assessment. • Give the patient/carer the relevant mental health team contact number • Ambulance crew can leave unless otherwise indicated* * If timescale cannot be achieved then patient will be taken to the nearest ED Community mental health services Respond / assess within agreed timescale with AMHP if MHA required CRHTT Respond / assess as per agreed timescale with AMHP if MHA required Acute Care (as per Acute care pathway) Community Mental Health Team
Mental Health Care • Broadly split into two areas of provision • Provision 1 = Conveyance • Patients in Crisis • Section 136 & 135 • Community Sections • Provision 2 = Interventional • Patients in Crisis • Uncomplicated diagnosed patients receiving care • Complicated diagnosed patients receiving care • Uncomplicated undiagnosed patients • Complicated undiagnosed patients • Worried Well
Mental Health Care • Looking for commissioner support for: • Section 136 • London Ambulance to have access to crisis teams for advice • Crisis teams to accept referrals • Think about next year • Alcohol • Frequent callers