a new model for the delivery of forensic community mental health services bigspd, manchester, 23 rd...
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A New Model for the Delivery of Forensic Community Mental Health
ServicesBIGSPD, Manchester, 23rd March 2012
Presented by:Memtaz Begum Forensic Social Worker Jon Carey Senior Forensic Practitioner/ PhD student, Durham University
Service Developments by all members of the Forensic CMHSRidgeway Roseberry ParkMiddlesbrough
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Forensic Community Mental Health Team
Secondary CMHT Prisons Forensic Inpatients
MDT AssessmentsReportsAdvice
11 Clinical SessionsForensic CPN's
Social Work SupportTransition & follow up
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Referral
Clinic(Under 2 weeks from referral)
Further Specialist
Assessment
Formulation/CPA Meeting(4 weeks from clinic)
Intervention
Discharge
InterventionNFAAdvice/Supervision
Roseberry ParkSandwell Park
West ParkLanchester Road
Pathway through the new Forensic Community Mental Health Service
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ReferralReferral Criteria
New Referral Form
10 Historical Items(HCR20 informed)
Current PresentationInclude behaviour/ risks that
have triggered referral
Assign to Clinic(Max 2 weeks)
Reject More information
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The Forensic CMHT considers a new referral.
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Clinics
Two FCMHS membersF-CAM
Care co-ordinator + Patient
Roseberry Park West Park Sandwell Park Lanchester Road
Other activities:
Clinical SupervisionTrainingAdvice
1. Introduction/ Information Leaflet2. Confidentiality3. Clinical/ Risk Interview (HCR20)4. Protective Factors (SAPROF)5. Psychometrics, (BPRS,SAPAS, DUDIT/ AUDIT, Quality of Life Scale *1)6. Professional Discussion/ decision
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Clinic Outcomes
No further action(Letter within a
week)
Clinical Supervision
Contract:Time limited
Straight to Intervention
Further Specialist
Assessment
Advice
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Further Specialist AssessmentSupplementary Psychometrics
Personality Disorder: MCMI-III; IPDE; PCL-sv
Substance Misuse: C-BIT
Mental Illness: PSYRATS; BDI
Stalking: SAM
Trauma/ PTSD: CAPS
Fire Setting: FAFS Sexual Risk: SVR20Intelligence: WASI
Violence: ERM/ FESAI; RM2000
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Formulation/ CPA Review
Discuss triggers, protective factors
Treatment options Develop a care plan
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Summary Report
Summary of the assessment + outline of the agreed Care Plan
Advice/Clinical supervision
CareCo-ordination
by FCMHS
Intervention/Co-working
No further action
Very High RiskMAPPA 2-3Ex-Secure Care
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Interventions:Various timescales
Offence Related
Work
DBT/ CBT:6-24
months
Alexithymia Group:1 day
JIGSAWongoing
ERM/ FESAI:6-10
sessions
ASRO:20
sessionsPSST
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Discharge
Quality of Life Scale *2 PARIS Entry Discharge Letter
After 6 + 12 monthsQuality of Life Scale *3 + 4
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Forensic Community Mental Health Team
Secondary CMHT
Durham Cluster of Prisons
Frankland/ Durham/ Low Newton
Forensic Inpatients
MDT AssessmentsReportsAdvice
11 Clinical SessionsForensic CPN's
Social Work SupportTransition & follow up
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Referral
Accept Reject
Assessmentwith Prison Team
within 7 days
No further actionAdvice and
supportInterventions
Critical Case Panels
Complex Case Review
Co-facilitated withPrison MH Team
Discharge
Training/ supervision
Discharge
Further SpecialistAssessment
As needed
Discharge
Request more information
The new Forensic Community Mental Health Service for the Durham Prisons
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Reaction in the team was mixed
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Pre-release and Aftercare service
Referral (if no previous involvement)6 months prior to release
Review (if assessed previously)6 months prior to release
Accept Reject
6 months prior to release
6 months post release
Referral to Secondary services
Collaboration of needs assessment
Pre-release plan
Community support and interventions
Liaison with external agencies- MAPPA, Probation, Housing, Police
Possible FCMHS Care Co-ordination
Discharge Plan
Release Pathway through the new Forensic Community Mental Health Service for the Durham Prisons
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Forensic Inpatient ServiceRidgeway
Roseberry Park
Memtaz BegumForensic Social Worker23rd March 2012
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Current Social Work provision
• 10 wards • Medium and Low Secure -135 patients• 1 Senior Social Worker• 6 Social Workers• S117 Responsibility for out of area
patients
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New model includes…
•Admission packs•Weekly clinics•Discharge packs•Shared care post discharge
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New model includes
• Community focused interventions• PSST, ASRO, DBT and others • Care co-ordination
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On-going work of the team
• AMHP role• Social Supervision • BIA • Child Visiting• Appropriate Adult• MHT & Managers Reviews
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Thanks…any questions?
Dr Brian Docherty, OBE, kindly provided some of the picture slides
Roseberry Topping, Great Ayton, Middlesbrough
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Glossary:
AUDIT Alcohol Use Disorders Identification TestBDI Becks Depression Inventory BPRS Brief Psychiatric Rating Scale CAPS, Clinician Administered PTSD Scale CBIT Cognitive-Behavioural Integrated Treatment DUDIT Drug Use Disorders Identification Test ERM Early Recognition MethodFESAI Forensic Early warning Signs of Aggression InventoryFAFS Functional Assessment of Fire SettingF-CAM Forensic Collaborative Assessment ModelHCR20 Historical/ Clinical/ Risk 20 IPDE, International Personality Disorder Examination PCL-sv Psychopathy Check List, shortened versionQoLS Quality of Life ScaleRM2000 Risk Matrix 2000SAM Stalking Assessment & Management GuideSVR20 Sexual Violence Risk 20SAPAS Structured Assessment of Personality – Abbreviated ScaleSAPROF Structured Assessment of Protective FactorsWAIS III Wechsler Adult Intelligence Scale, 3rd Edition