UNDERSTANDING REPEAT PRESENTATION TO HOME TREATMENT TEAMS

Abstract

Background: Increased number of individuals re-attending mental health services over short period of time observed across emergency departments, hospital and more recently home treatment teams. Due to gap identified in research on repeat presentations to home treatment teams we aimed to shed more light on factors impacting repeat presentations.
Subjects & methods: The cross-sectional study design was implemented to examine common characteristics of high frequency users of Home Treatment Teams across South London and Maudsley NHS Foundation Trust. The quantitative data was extracted using Clinical Records Interactive Search (CRIS) system. The data on the total of thousand five hundred twenty-five service users was analysed conducted using Microsoft Excel looking at 3 groups of characteristics: socio-demographic, clinical & service use.
Results: From thousand five hundred twenty-five service users, eighty-five identified as high frequency users indicated by three of more attendances. Two socio-demographic characteristics differed between groups, with a higher prevalence of females and identified carers in high frequency group. In terms of clinical characteristics, both groups found to have highest number of psychotic and affective diagnosis, with no F99 or Z codes in high frequency group. Lastly, with regards to service use, high frequent users show greater number of attendances to A&E, psychiatric hospitals as well as longer length of stay & contacts while under the service. High frequency attenders also more likely to undergo mental health act assessment.
Conclusions: Clinical implications of our study include the need for training around working with female service users as well as implementing transdiagnostic way of working. Additionally, integrating identified carers into the care and the carer-focused support to be provided as part of the treatment. Lastly, the needs of high frequent attenders might be met by understanding of their use across crisis pathways and more specifically tailored to individual needs by examining separate geographic areas.