Community mental health teams for older people in England: Variations in ways of working

Hilde Verbeek, Angela Worden, Mark Wilberforce, Christian Brand, Sue Tucker, Michele Abendstern, David Challis*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

ObjectiveIntegrated community mental health teams (CMHTs) are a key component of specialist old age psychiatry services internationally. However, in England, significant shifts in policy, including a focus on dementia and age inclusive services, have influenced provision. This study portrays teams in 2009 against which subsequent service provision may be compared. MethodsA bespoke national postal survey of CMHT managers collected data on teams' structure, composition, organisation, working practices, case management, and liaison activities. ResultsA total of 376 CMHTs (88%) responded. Teams comprised a widespread of disciplines. However, just 28% contained the full complement of professionals recommended by government policy. Over 93% of teams had a single point of access, but some GPs bypassed this, and 40% of teams did not accept direct referrals from care homes. Initial assessments were undertaken by multiple disciplines, and 71% of teams used common assessment documentation. Nevertheless, many social workers maintained both NHS and local authority records. In 92% of teams, nominated care coordinators oversaw the support provided by other team members. However, inter-agency care coordination was less prevalent. Few teams offered the range of outreach/liaison activities anticipated in the national dementia strategy. ConclusionsCompared with previous studies, teams had grown and changed, with a clear increase in non-medical practitioners, particularly support workers. Measures to facilitate integrated care within CMHTs (eg, common access and documentation) were widespread, but integration across health and social care/primary and secondary services was less developed. Consideration of barriers to further integration, and the impact of current reforms is potentially fruitful.
Original languageEnglish
Pages (from-to)475-481
Number of pages7
JournalInternational Journal of Geriatric Psychiatry
Volume33
Issue number3
DOIs
Publication statusPublished - 1 Mar 2018

Keywords

  • community mental health teams
  • consultant psychiatrists
  • integration
  • older people
  • AGE PSYCHIATRY
  • ELDERLY-PEOPLE
  • OPEN ACCESS
  • SERVICE
  • PSYCHOGERIATRICS
  • IMPACT

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