Community Mental Health Team

What is a CMHT and what Is their purpose?

The purpose of a Community Mental Health Team (CMHT)  is to provide local assessment, monitoring, support, and treatment for the full range of mental health conditions. The treatments that are offered by the CMHT are evidence-based and supported by NICE Guidance. The CMHT work with people based on their needs rather than requiring a formal diagnosis. 

CMHTs provide planned and effective supportive interventions alongside the service user, their loved ones and other services in line with the goals and needs of the service user. 

Our guiding principles are:

·       CMHTs are needs-led instead of diagnosis led. This means that the CMHT staff will work with the service user to work out what the presenting difficulties are and what has happened to them, and ways of reducing or eliminating the problem that is affecting the individual's mental health.

·       The CMHTs are accessible to individuals whose needs cannot be met in other services such as NHS Talking Therapies. The CMHTs are working towards a 4 week referral to treatment target (RTT); this means that service users have a meaningful assessment and co-produce a care plan within this period of time.  

·       CMHTs provide evidence-based interventions to support recovery and minimisation of symptoms.

·       CMHTs provide trauma-informed and recovery focused care and treatment. Teams will work on the basis that it is likely that anyone accessing the service may have experienced a level of trauma. 

·       CMHTs are collaborative and centre around a Multi-Disciplinary Team (MDT) model of care. The MDT has core members that work within the CMHT but the MDT can also involve other disciplines and workers from a wide range of other organisations such as Adult Social Care, Drug and alcohol services, Accommodation Concern, and MIND. Some external agencies will actively participate in each team’s MDT meeting.

·       The nature of more complex mental health needs is that there is a level of risk that CMHT workers try to minimise with the service user. It is important to note that not all risk can be eliminated, as risk is dynamic and can change depending on emotional and environmental factors. Individual service user risk, behaviour and presentation will be explored by the key worker and shared with the MDT to ensure a full consideration of all options for minimising risk. 

What care or services do CMHT’s offer to their patients?

CMHTs work with service users to co-produce a recovery plan based on their specific needs. In most cases, service users fully participate in choices about their care and whether they wish to work with the CMHT. If service users do not want to access the evidence-based options available in the CMHT they can choose to explore alternatives within the wider community services in that area.

CMHTs encourage service users to identify and involve any carers, family or friends in their care as they are key in supporting recovery from mental ill health. With the permission of service users, CMHTs can share information about their care and treatment. Confidentiality will not be a barrier to supporting a carer. Sometimes carers don’t realise they have a caring role and might identify instead as a partner, husband, wife, mum or dad. If someone helps when a service user is unwell or to keep them well they could be a identified as a 'carer'. 

All workers should communicate with family and carers to support a person's recovery. They should consider referral for a carers assessment to help them with practical support, or signpost to other services such as accommodation concern to support with housing or financial issues. 

Who is the CMHT for?  

The CMHT is for people with mental health needs which can be met by members of the multi disciplinary team (MDT), which cannot be met by their GP, third sector agencies or other NHFT services e.g. NHS Talking Therapies.

Examples of people using CMHT services include:

• People with severe illnesses such as psychosis or bipolar disorder
• People with personality difficulties and emotional needs which impact on their functioning and day-to-day living
• People with common mental health problems such as depression and anxiety which might be complicated by biopsychosocial factors, who need more care and support than that provided by GP services and NHS Talking Therapies  
• Service users who may present with risks to self and others as a result of their mental health
• People with less complex needs who may require multi-disciplinary involvement.
• People who have co-existing neurodevelopmental conditions such as an ASD or ADHD
• People who have co-existing drug or alcohol-use disorder, and other addiction problems including gambling problems 
• People who require a psychological approach to their care or psychological interventions that cannot be met by NHS Talking Therapies; where there is a psychological need that cannot be met by the CMHT, then consideration will be given to onward referral to more specialist services  
• People with complex needs who are harder to reach and may need an assertive approach to maintain satisfactory health outcomes
• People with mental health needs who are supported under the framework of the Mental Health Act (1983)  
• Service users who are unable to maintain their usual level of function as a result of mental illness, for example, not being able to; work, leave the house, care for dependents, meet daily self-care needs, and where interventions such as those provided by their GP and NHS Talking Therapies and have been used and not been effective 

The CMHT embed a ‘no wrong door approach’ and may support people with the following presentations to access alternative services (such as third sector, social prescribers).

Who you might meet in the CMHT

The CMHT has a variety of different professionals in it including Mental Health Nurses, Medical staff, Psychologists, Assistant Psychologists, Occupational Therapists, Peer and Carer Peer Support Workers, Social Workers and Community Support Workers. Each different member of staff has different skills and come together to help each other and to ensure that the service user’s needs are met which will improve their outcomes.

View a short video of each of the roles to find out what you can expect when referred into our team.

Consultant Psychiatrist

 

Occupational Therapist

Trainee CBT Therapist

Carer Peer Support Worker

Community Support worker

What is Community Mental Health Transformation?

Our Community Mental Health Teams are currently going through a period of transformation, for more information on this and how you may be affected please go to our dedicated transformation page.

Frequently Asked Questions

What does CMHT stand for?

Community Mental Health Team

What does a CMHT do?   

CMHTs work with service users to co-produce a recovery plan that is based on their specific needs. In most cases, service users participate in choices about their care and whether they wish to work with the CMHT. If service users do not want to access the evidence-based options available in the CMHT, they can choose to explore alternatives within the wider community services available in the area.

Who is the CMHT for?

The CMHT is for people with mental health needs which cannot be met by their GP, third sector agencies or other NHFT services e.g. NHS Talking Therapies.

Who works in CMHT?

The CMHT is made up of a Multi-Disciplinary Team (MDT) which has a variety of different professionals in it including Mental Health Nurses, Psychologists, Assistant Psychologists, Occupational Therapists, Peer and Carer Peer Support Workers, Social Workers and Community Support Workers. Each different member of staff has different skills and come together to help each other and to ensure that the service user’s needs are met which will improve their outcomes.

Will I meet everyone who works in the CMHT?

Most individuals referred into the CMHT will not need to see every member of the team, although it is common to see different members of the team at first. They will then decide which members of the team are most approporiate to support depending on the needs of the service user. 

What is a recovery plan?

The different parts of your help or treatment are written down in a recovery plan. This should include:

• the views of the service user
• the problem (or problems) 
• any risks involved
• strengths of the service user
• what needs to be done to aid recovery
• who should be doing what

Each service user should have a copy of their care plan.

Can my friends and family be involved in my care?

Families and carers are usually concerned and want to help in the care of their loved ones. Families often need support and encouragement and at NHFT we have a dedicated page to support families, friends and carers.

The CMHT may want a family to be involved, but are still bound by medical confidentiality so the community mental health team will ask service users about what their are happy for their family to know, and what they do and do not not want discussed with them.

What happens after my last apppointment with the CMHT?

People are only under the care of the CMHT for the period of time that they need the services offered by the CMHT. The length of time people remain under the care of the CMHT is dependent on their needs; some people may require a short period of goal-focused time, whereas other people may require more prolonged support due to the nature of their illness or needs. It is common for service users to feel worried about ending contact with the CMHT. Service users can access most services without being actively under a CMHT referral. 

When a service user comes towards the end of their period of care under the CMHT, the keyworker should, where possible, discuss the discharge process with the service user, their carers and any other agency who is involved in the service user’s care. Keyworkers should also discuss discharge with the wider multi disciplinary team.

All service users should leave the CMHT with a safety plan in place, which might be an up-to-date copy of ‘My Recovery Plan’ which includes clear reminders of how to access services should they need further support.