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Should all community mental health teams be sectorised?

Published online by Cambridge University Press:  23 January 2020

R. Vaughan Open the ORCID record for R. Vaughan [Opens in a new window] ,
K. Antczak ,
L. Kowalewski  and
L. Feeney
R. Vaughan*
Affiliation:
Cluain Mhuire Community Mental Health Service, Blackrock, Dublin, Ireland
K. Antczak
Affiliation:
Cluain Mhuire Community Mental Health Service, Blackrock, Dublin, Ireland
L. Kowalewski
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
L. Feeney
Affiliation:
Royal College of Surgeons in Ireland, Dublin, Ireland
*
*Address for correspondence: R. Vaughan, Cluain Mhuire Community Mental Health Service, Newtownpark Avenue, Blackrock, Dublin, Ireland. (Email: roisin.vaughan@sjog.ie)
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Abstract

Objectives

Sectorised 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.

Method

We 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.

Results

Referral 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.

Conclusions

We 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.

Keywords

Community mental healthpsychiatryrecoverysectorisationservice delivery
Type
Short Report
Information
Irish Journal of Psychological Medicine , Volume 37 , Issue 1 , March 2020 , pp. 48 - 54
Copyright
© College of Psychiatrists of Ireland 2020

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References

Borgeat, F (1994). Some consequences of catchment area psychiatry: a stand against sectorization. Revue Canadienne de Psychiatrie 39, 85–90. (article in French).Google ScholarPubMed
Commission of Inquiry on Mental Illness (1967). Report of the Commission of Inquiry on Mental Illness. The Stationery Office: Dublin.Google Scholar
Health Research Board (2019, Quarter 2). Community Health Organisation (CHO) 6 Performance Indicator Report, Dublin 2 (https://www.hrb.ie/data-collections-evidence/psychiatric-admissions-and-discharges/latest-data/).Google Scholar
Expert Group on Mental Health Policy (2006). A Vision for Change: Report of the Expert Group on Mental Health Policy. The Stationary Office: Dublin.Google Scholar
Health Atlas Ireland (2018). Health Intelligence Unit, Health Service Executive, Dr. Steevens Hospital, Dublin 8 (https://www.healthatlasireland.ie/). Accessed 21 June 2019.Google Scholar
HSE Community Healthcare East Operational Plan (2018). Health Service Executive (https://www.hse.ie/eng/services/publications/serviceplans/service-plan-2018/operational-plans-2018/cho6-community-healthcare-east-operational-plan-2018.pdf). Accessed 24 June 2019.Google Scholar
IBM Corp. (2013). IBM SPSS Statistics for Windows, Version 21.0. IBM Corp: Armonk, NY.Google Scholar
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.Google Scholar
Kelly, BD (2016). Hearing Voices: The History of Psychiatry in Ireland. Newbridge: Irish Academic Press.Google Scholar
Khan, S, Kashif, M, Wilson, L, McCauley, M, Roche, E (2018). Patients prefer a continuity model of inpatient psychiatric consultant care: a patient survey in the Louth Mental Health Service. Irish Journal of Psychological Medicine 1, 1–4.CrossRefGoogle Scholar
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.Google Scholar
Omer, S, Priebe, S, Giacco, D (2015). Continuity across inpatient and outpatient mental health care or specialisation of teams? A systematic review. European Psychiatry 30, 258–270.CrossRefGoogle ScholarPubMed
Sharpe, M, Naylor, C (2016). Integration of mental and physical health care: from aspiration to practice. The Lancet Psychiatry 3, 312–313.CrossRefGoogle Scholar
St John of God Hospitaller Ministries (2014). Mental Health Information System (http://www.mhis.ie/profilesummary.htm). Accessed 13 September 2017.Google Scholar
Study Group on the Development of the Psychiatric Services (1984). The Psychiatric Services – Planning for the Future. The Stationary Office: Dublin.Google Scholar
Thornicroft, G, Strathdee, G, Johnson, S (1995). The case for catchment areas for mental health services. Psychiatric Bulletin 19, 343–345.CrossRefGoogle Scholar
Walsh, D, Daly, A (2004). Mental Illness in Ireland 1750–2002: Reflections on the Rise and Fall of Institutional Care. Health Research Board: Dublin.Google Scholar