Caithness Geography

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Caithness Geography

• Caithness is the most northerly county in
  mainland Britain
• It covers an area of about 700 square miles
  stretching from Dunnet Head in the north to the
  Ord of Caithness in the south
• It has a population of around 27,500 and its only
  land boundary is with the County of Sutherland to
  the south and west, both are part of the Highland
  Region, administered from Inverness

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Caithness Geography

• The two main towns in Caithness are Wick, with a
  population of around 8,000, once famous as the
  herring capital of the world and Thurso,
  population around 12,000, with close ties to the
  U.K.A.E.A. site at Dounreay

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Caithness Community Mental Health
TeamOperational policy (under amendment)

• The Community Mental Health Team (CMHT) is based
  at Community Mental Health Services, Bankhead
  Road, Wick.
• The team currently works from 9am -5pm Monday -
  Friday.
• There is currently no out of hours service within
  the CMHT. Mental health officers are accessed
  through Area Social Work team, or social work
  standby
• Currently looking at expanding hours

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Core Statement

• The CMHT is funded with mental health resource
  transfer monies and Primary Care Trust funding to
  enable comprehensive mental health services to be
  provided in the Caithness community and will work
  collaboratively with the Local Health Care
  Co-operative (LHCC)

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Core Statement continued

• Service to those who experience severe and/or
  enduring mental illness are prioritised.
• Time limited intervention to those who experience
  mild to moderate problems are provided but may
  have a delay in response time

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Service Elements

• The community team has 3 service
  elements(a) Substance misuse service
  (CMHN)(b) Older Adult service (CMHNs)(c) Multidi
  sciplinary Generic Team (MDT)All interact with
  each other although each service has a different
  focus

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Team Members

• Community Mental Health Nurses
• Social Workers
• Technical Instructor
• Accommodation Support Officer
• Group Worker
• Consultant Psychiatrist
• Support Workers
• Team Leader
• Clerical Staff

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Team Members (continued)

• A clinical psychologist holds clinics in both
  Wick and Thurso, on a monthly basis, and provides
  consultation to CMHT members.
• Various interventions are offered by the team
  depending on the individuals clinical need.
  These are offered on a 1-1, 2-1 or group basis.

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Referrals

• All adults aged from 16-65 years who experience
  mental ill health can be referred to the
  Community Team
• Referrals are received by letter through the team
  manager. Urgent referrals may be telephoned to
  either the team manager or, in her/his absence,
  the professional on duty with the letter to
  follow.

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Referrals

• Referrals are considered at the weekly team
  meeting where allocation for initial assessment
  is completed
• Primary addiction problems would be referred
  directly to substance misuse nurse.
• Persons aged over 65 years with either functional
  or organic illness will be assessed by one of the
  older adult CMHNs and referrals made direct to
  them.

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Do We Use Outcome Measures?
NO
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AVON Mental Health MeasurePositive Aspects

• 3 Statements surrounding
• ease of use of AVON measure
• usefulness of AVON measure in identifying areas
  of need
• participants motivation in changing identified
  areas of need

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AVON Mental Health MeasurePositive Aspects
continued

• Provides information to better plan services
• Allows client to build up a profile about
  themselves
• Service users are central to individual needs
  assessment, enhancing their role will improve
  both process and outcome

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AVON Mental Health MeasurePositive Aspects

• Identifies unmet needs, thus a method for
  recording gaps in services etc.
• From Staff perspective - forum for discussion -
  increase understanding of clients difficulties

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AVON - User Mental Health Assessment Measure

• Undertook small presentation to CMHT - HONOS
  AVON
• Team Decided to look more closely at AVON measure
• Rating scale devised and sent out to participants
  
• Statements devised using the Likert rating scale

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RESULTS of Questionnaire

• AVON TOOL identified as easy to use
• AVON tool useful in identifying areas of need
• However, clients identified difficulty with
  motivating themselves to make changes

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AVON Results
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AVON Results
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AVON Results
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Evaluation of questionnaire (AVON)

• Overall the AVON measure identified wider issue
  gaps
• Central theme of unmet needs consistently
  appeared to surround stigma and discrimination
• Users found the tool easy to use
• Identifying area of need was useful, I.e.
  increasing understanding, insight into
  difficulties
• Motivating clients to make change in areas
  slightly more difficult
• Identified by Whitehead-Black report

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CONCLUSION

• This project has highlighted issues for the
  Caithness Community Mental Health Team,
  surrounding the ethos of what we are attempting
  to strive towards with clients.
• There remains a great deal of work and innovation
  to changing community/public perceptions of
  mental illness.
• Interesting and challenging times lie ahead, as
  we attempt to tackle identified areas of weakness
  and need, if we are to empower this client group.

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CONCLUSION Continued

• Need to develop method/database for recording
  unmet needs, to build up picture of gaps in
  service
• The AVON will provide a starting point for
  addressing quality issues and a spur to the
  development of more adequate data
• Highlight possible examples of good practice
• Looking at database

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CONCLUSION Continued

• To empower clients to receive responsive or
  relevant services
• To develop services that more fully reflect the
  needs and expectations of mental health service
  users
• To be effective clinical governance will require
  data about the quality of care. This is a
  starting point (although no direct conclusions)

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. And Finally
Historically, services for disabled people have
been constructed upon the erroneous belief that
they are unable to assume responsibility for
their own individual needs. Therefore, logic
dictated that if individuals cannot assume
responsibility they cannot participate, if they
cannot participate they are excluded from main
stream society and discriminated against
(Woods, 1990)