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

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

Abstract

Copyright © 2017 John Wiley & Sons, Ltd. Objective: Integrated 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. Methods: A bespoke national postal survey of CMHT managers collected data on teams' structure, composition, organisation, working practices, case management, and liaison activities. Results: A 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. Conclusions: Compared 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.

Citation

Verbeek, H., Worden, A., Wilberforce, M., Brand, C., Tucker, S., Abendstern, M., & Challis, D. (2018). Community mental health teams for older people in England: Variations in ways of working. International Journal of Geriatric Psychiatry, 33(3), 475-481. https://doi.org/10.1002/gps.4775

• Journal Article Type: Article
• Acceptance Date: Jul 14, 2017
• Online Publication Date: Aug 23, 2017
• Publication Date: Mar 1, 2018
• Deposit Date: Feb 8, 2020
• Journal: International Journal of Geriatric Psychiatry
• Print ISSN: 0885-6230
• Electronic ISSN: 1099-1166
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 33
• Issue: 3
• Pages: 475-481
• DOI: https://doi.org/10.1002/gps.4775
• Public URL: https://nottingham-repository.worktribe.com/output/3706350
• Publisher URL: https://onlinelibrary.wiley.com/doi/full/10.1002/gps.4775