Should all community mental health teams be sectorised?

Author:

Vaughan R.ORCID,Antczak K.,Kowalewski L.,Feeney L.

Abstract

ObjectivesSectorised catchment areas have characterised Irish mental health service delivery since the devolution of institutional care. Unlike other catchment areas, the Cluain Mhuire Community Mental Health Service (CMCMHS) never sectorised. With the development of Community Health Networks (CHNs) and Primary Care Centres, the CMCMHS has come under renewed pressure for structural change. We aimed to consider the implications of these proposed changes on staff and service users.MethodWe obtained demographic information comparing the CHNs with respect to attendee numbers, new referrals and admissions over a 1- year period. Secondly, we conducted an anonymous survey seeking opinions on the proposals to switch to a sector-based model and/or specialist inpatient care.ResultsReferral and admission rates differed across CHNs, broadly consistent with populations. About 36% of staff and 33% of service users supported changing to a sector-based system. In the event of a sector-based system of care being implemented, 66% of service users felt that existing service users should remain under the care of their current team. There was little support among any group for the development of specialist inpatient teams.ConclusionsWe discuss the benefits and drawbacks of sectorisation of mental health service provision. Most patients did not want to change teams either as current service users or as re-referrals (indicating it will take a significant time to transition to a sector-based system). Without clear pathways towards integration with primary care teams, the advantages of sectorisation may not outweigh the challenges associated with its implementation.

Publisher

Cambridge University Press (CUP)

Subject

History and Philosophy of Science,Psychiatry and Mental health,Applied Psychology

Reference17 articles.

1. Continuity Across Inpatient and Outpatient Mental Health Care or Specialisation of Teams? A Systematic Review

2. National Service Plan (2016) Mental Health Key Performance Indicator Metadata (2016). Health Service Executive (https://www.hse.ie/eng/services/publications/kpis/mental%20health%20kpi%20metadata%202016.pdf). Accessed 24 June 2019.

3. Integrated Service Area Review Group (2014). Community Healthcare Organisations Report & Recommendations of the Integrated Service Area Review Group (https://www.hse.ie/eng/services/publications/corporate/choreport.html). Accessed 24 June 2019.

4. Health Atlas Ireland (2018). Health Intelligence Unit, Health Service Executive, Dr. Steevens Hospital, Dublin 8 (https://www.healthatlasireland.ie/). Accessed 21 June 2019.

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