What is Community Mental Health Transformation?
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.
What is a CMHT and what Is their purpose?
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?
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 the CMHT for?
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).