Community Mental Health Teams

 

Community mental health teams (CMHT) are multidisciplinary teams that consist of the key healthcare professions involved in mental health. This includes occupational therapy, nursing, psychology, psychiatry, pharmacy and social work. CMHT’s have formed the mainstay of community based mental healthcare. CMHT offers assessment, treatment and social care to patients with mental health illnesses such as schizophrenia in the community. People are usually referred to a CMHT for an initial assessment and are then placed within a more specialised service such as early interventions and assertive outreach.



Early Interventions Service

 

Early intervention services is a community based multidisciplinary team which focuses on the care and treatment for:

 

(a) People aged between 14 and 35 years who first present with psychotic symptoms including the prodromal phase of the disorder
(b) People aged 14 to 35 years during the first 3 years of psychotic illness.

The NICE guidelines recommend that the service may be provided by a team or a specialised element of a team, which has designated responsibility for at least two of the following functions:

 

• Early identification and therapeutic engagement of people in the prodromal phase
• Provision of specialised pharmacological and psychosocial interventions during or immediately following a first episode of psychosis
• Education of the wider community to reduce obstacles to early engagement in treatment.



Assertive outreach team

 

An assertive outreach team or also known as assertive community treatment is a proactive community based service. The service provides treatment and rehabilitation, which is adapted to meet the particular needs and requirements of patients with a severe and enduring mental health illness. These patients usually find it difficult to maintain contact with health services and consequently have a history of relapse and frequent hospital admissions.

The service aims to keep these individuals in contact with services more independently, to enhance the individual’s strengths and recognise any limitations experienced due to the condition. Furthermore, an assertive outreach team provides home visits and rapid help during a crisis which can thereby reduce the number and frequency of admissions to hospital. In addition, this service allows for an improvement in the outcome of the patient, particularly with social functioning and the quality of life i.e., finding a house, employment and managing basic daily living (cooking, shopping and washing).



Crisis resolution and home treatment teams

 

The Crisis Resolution and Home Treatment Team (CRHTT) is a service that provides intensive home-based treatment and a high level of support for acutely ill people with a severe mental illness, thereby avoiding admission to hospital.

The service:

 

• Operates 24 hours per day, 7 days per week.
• Offers assessment, treatment and support in a community setting which focuses on the safety, well being and empowerment of the patient/client and their carers during the time of crisis.
• Focuses on beginning treatment as soon as possible and aims to relieve immediate distress and assist recovery.
• Provides intensive monitoring and supervision in response to the presenting needs.
• Gives support to carers and family members.north
• Encourages involvement from the patient/client, their family and carers in the assessment and in agreeing to a care plan.



Inpatient Care

 

This service is available for individuals who are experiencing an acute episode that need urgent assessment and stabilisation. Additionally, this service is available for those patients under the Mental Health Act who refuse necessary treatment and care.

Acute Day Hospital

 

Acute psychiatric day hospitals provide diagnosis and treatment for acutely ill patients who would otherwise be treated in an inpatient care setting. This service also facilitates an early discharge from inpatient care. NICE recommends acute day hospitals to be considered alongside crisis resolution and home treatment teams as an alternative to acute admission to inpatient care and to help early discharge from inpatient care.