AT A GLANCE
THE CHALLENGE
Almost three quarters of all referrals to the trust’s adult community mental health teams (CMHTs) each year did not meet the criteria for care – equating to 10,303 (74%). These patients were left without support because of a gap in appropriate services with some being re-referred to the CMHTs.
Many patients had unmet emotional and social needs, low mood and past trauma. People with neurodevelopmental disorders made up a disproportionate number. Staff reported that referral rejection increased hopelessness and dissatisfaction with services. According to primary care practitioners, people who were unable to access services had a higher number of GP appointments and ED attendances.
WHAT THEY DID
The CLEAR project team spoke to 50 healthcare professionals through interviews and focus groups. Participants included staff from CMHTs, psychiatric liaison and single point of access teams, psychiatrists, representatives from PCNs, the homeless mental health team and voluntary organisations. This information was analysed alongside five years of data from the Mental Health Services Data Set from April 2017.
CLEAR RECOMMENDATIONS
Each primary care network (PCN) in Cornwall could develop an integrated mental health team to provide low level mental health support and interventions. It would take direct referrals from GPs and offer a 30 minute follow up appointment after assessment, social prescribing review, wellbeing calls and, where appropriate, six one-hour sessions of psychological intervention.
Easy access drop-in support centres could be set up and staffed by mental health workers providing immediate support for people in distress who are not under mental health services and in need of emotional support, This would offer an alternative to other crisis options like A&E.
Trained staff within the CMHTs could provide support for people after a diagnosis of a neurodevelopmental condition. The new service would allow each patient to have six one-hour coping skills sessions from an advanced mental health practitioner.
FORECAST IMPACT
There would be improved access to mental health care for patients falling though the gap in services with a projected reduction in detentions under section 136 of the Mental Health Act and fewer people needing long term health support.
The new PCN mental health teams would reduce CMHT referrals and pressure on GPs and A&E. It’s estimated the annual cost to implement across Cornwall would be £896,718 with projected cost savings per annum across the system of between £640,109 and £1.1m, resulting in an overall productivity saving of up to £275,000.
It’s anticipated the support centres would provide a safe environment for patients in emotional crisis and reduce re-referrals into services for those who need brief interventions during times of stress or increased anxiety.
There would be improved staff wellbeing by ensuring better quality services for patients and more career development opportunities.
