h o m e t r e a t m e n t e x p e r i e n c e c h o i c e & a l t e r n a t i v e
TRANSCRIPT
H o m e T r e a t m e n t E x p e r i e n c e
C h o i c e & A l t e r n a t i v e
Kevin Heffernan
Nurse11 years leading HT developments in BirminghamConsultant for the World Health OrganisationNational Institute Mental Health England (RegionalImplementation…5.5 M pop….39 HTT, 27 AOT)Research fellow Birmingham City UniversityWest Midlands Strategic Health Authority (Service Development)
Characters represent
CRISISDanger/risk and Adversity
Opportunity forPersonal Growth
Fidelity principles
• Gatekeeper to all potential admissions • Operating a corporate caseload (utilising MDT skill mix) • Rapid Response (1-4 hour variable)• 24 hour/7 day availability • Flexible visiting (duration/frequency/Intensity)• Clearly targeted Caseloads (acute)• Time limited (average length of stay)• Fully Integrated (not operating in isolation, whole system responsibility)
• Comprehensive Assessment• Address social issues (in vivo)• Medical staff involved/available• Mobile• Practical problem solving approach• Supervision and administration of medication• Advice, support for Carers• Early Discharge (not becoming discharge team)• Effective communication and planning
Fidelity principles
Advantages
• Intensive monitoring of complex cases• Can be more flexible/sensitive ethnic minority groups• Extended Support for Carers• Explanation and advice and post crisis planning• Confront social problems directly• Work closely with Dual Diagnosis issues• Reduce stigma of hospitalisation• Higher satisfaction users and carers• Development of an acute team
Advantages
Avoidance of admission (1st presentations….Zacch)Interrupt cycle of admission (change expectations…David)Facilitate early dischargeReduced bed use - admissions and length of stayDifferent framework for sustaining recovery focused engagementSupport can be perceived as;
• More Personal/Individualised• Increased Negotiation leading to a sense of increased autonomy• Potential to develop more true Partnership working (Trialogue can emerge)• Narrative scrutiny (exploration of the why now and true context becomes more possible)
I hope this conference is inspiring and gives you hope for the future development of local community based mental health services
This is your opportunity! And not a danger or risk
Home Treatment
HopeOptimismMotivationExploration
TemperanceRecoveryEmpowermentAutonomyTruthMeaningEmpathyNegotiationTrust
Values of Home Treatment working
Support Client’s to acknowledge and value theuniqueness of their experience, personal narrative exploration allows intervention to beless stigmatising and medicalised
Become a catalyst for inspiration
Encourage personal responsibility
Clients can begin the journey of recovery andnot become passive victims of illness
Community teams in BirminghamCaseload size and distribution in a
locality of 150,000 population
Distribution of Cases
CMHT’s20 staff
Rehab & recovery15 staff
Assertive Outreach12 staff
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600 Cases
Days Years
Intensity of support & Length of stay in the service
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370 Cases
123 cases
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Seri
ou
s M
en
tal Il
lness
Distribution of Cases
CMHT’s20 staff
Rehab & recovery15 staff
Assertive Outreach12 staff
*************************************************************************************************
600 Cases
Days Years
Intensity of support & Length of stay in the service
**********************************************************************
370 Cases
123 cases
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***********************
Seri
ou
s M
en
tal Il
lness
Home Treatment
14 staff20 cases
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