Transcript No Slide Title

GP Perspectives on the Home Based Crisis Team.
City North Sectors, Cork.
Muller Neff, D., O’Brien S.M.
ABSTRACT:
OBJECTIVES: The introduction of crisis resolution and home treatment teams has been
associated with a reduction in hospital admissions. The home based crisis team
attached to the Mercy University Hospital is an example of such a team, and provides a
service to both city North sectors.
METHOD: We sent a brief questionnaire to all GPs within our catchment area
(n=50).This focused on 3 main areas including knowledge of the team, general
satisfaction with the team and finally general feedback from GPs.
RESULTS: The response rate was 50% within the specified time period
CONCLUSION: The overall satisfaction with the HBCT was 88%. A limitation to this
study was the response rate.
Figure1. Catchment Area of Home Based Crisis Team
.
Background.
The aim of the Home Based Crisis Team (HBCT) is to provide a home-based
crisis assessment and multi-disciplinary treatment and intervention service for
individuals presenting with acute psychiatric illness in Cork City North sector.
The HBCT provide 5-day week, Mon-Thurs 9-5 Fri 9-4pm service.
The Team consists of : 1 consultant, 1 registrar, 3 community mental health
nurses, 1 social worker, 1 part time occupational therapist, 1 psychologist-in-
Very Satisfied
Satisified
training.
The HBCT aim to treat individuals in the community, for approximately 3 weeks.
We are targeting adults with severe mental illness, who require urgent
assessment.
Figure 2. GP satisfaction with HBCT
Inclusion Criteria
1. Those in acute psychosocial crisis
2. Those with acute psychiatric conditions in need of urgent psychiatric attention
3. And those with long term, severe psychiatric problems who experience either
of the first two problems.
Exclusion Criteria
1. risk of violence in home &/ or to staff
2. primary diagnosis of organic brain damage and dementia
3. medical illness which may require medical assessment
4. primary diagnosis of active substance misuse
5. Severe personality disorder
Method.
Questionnaires were sent to all GPs within our sector(n=50).
This questionnaire addressed three general areas including
1. General knowledge of the working of the HBCT.
2. Satisfaction with the team.
3. General feedback from GPs including feedback they may have received
from their patients previously involved with the HBCT
RESULTS:
The response rate was 50% within the specified time period. Of the returned
questionnaires, 88% of GPs correctly identified catchment area covered and
working hours of the team. Ninety two% of participating GPs were satisfied
with the team in the management of patients. Measures included provision
of suitable alternative to admission,prompt time from referral to assessment,
and satisfaction with feedback and correspondence from the team. Two
questionnaires were returned with this section incomplete. 100% of GPs
identified they would refer again to the HBCT. Forty eight% of GPs had
received feedback from patients all of whom identified that the HBCT
provided a realistic alternative to admission and reduced stigma of
admission to an acute psychiatric unit.
Feedback received from
GPs
No Feedback
Figure 3: Feedback from GP’s re HBCT Care
Discussion.
The perspectives from returned questionnaires were largely positive
and indeed GPs generally identified the HBCT as an accessible team
which provided a suitable alternative to admission in acutely unwell
patients and thus greatly improved overall management of these
individuals. A major limitation to our survey was the low response
rate.
Home treatment teams provide intensive support for people in mental
health crises in their own home and stays involved until the crisis is
resolved. It is designed to provide prompt and effective home
treatment in order to prevent hospital admission and provide support
to informal carers.
The HBCT accepts referrals from GPs and the sector teams. We
endeavoured in this study to survey GPs perspectives and knowledge
of the team, in particular GP satisfaction with the team in providing
an alternative to admission for patients in acute crises. We would hope
that increasing knowledge and utilisation of the team would decrease
acute referrals to the inpatient unit for the two Cork City North
sectors. These sectors have high rates of acute referrals to the inpatient
unit within and outside working hours.