Independent investigation: Stephen Rees, Cardiff (2011)

The Health Board should review the referral process for individuals attempting to access mental health services ensuring that: a. Clarity is gained regarding the urgency level attached to each referral with clear guidance issued to both primary care and the … Read more The Health Board should review the referral process for individuals attempting to access mental health services ensuring that: a. Clarity is gained regarding the urgency level attached to each referral with clear guidance issued to both primary care and the community teams. b. The process of MDT referral meetings at each of its CMHT’s is reviewed and audited, ensuring that the level of urgency attached to GP referrals correlates to the content of any referral. c. In line with Welsh Government guidance23, individuals who are referred to CMHT’s are offered an appointment within the allotted timeframe. d. Assertive attempts are made with those individuals who are difficult to engage with, who are homeless, or reside in temporary or hostel accommodation. Show less

The Health Board, in conjunction with Welsh Government, should review the ability of its mental health professionals to access information about previous mental health referrals or engagement with services. Each assessment of a service user should have full access of … Read more The Health Board, in conjunction with Welsh Government, should review the ability of its mental health professionals to access information about previous mental health referrals or engagement with services. Each assessment of a service user should have full access of any previous periods of engagement to ensure that any decision regarding any care and treatment is fully informed. Show less

The Health Board should review what arrangements it has in place in order to reduce the Duration of Untreated Psychosis (DUP)24. DUP can be reduced by the effective use of early intervention teams and by mental health promotion campaigns25.

The Health Board and Local Authority should review the adequacy of the arrangements currently in place to provide psychiatric services for homeless, vulnerable people. This review should consider arrangements that are in place in other areas of the UK. Read more The Health Board and Local Authority should review the adequacy of the arrangements currently in place to provide psychiatric services for homeless, vulnerable people. This review should consider arrangements that are in place in other areas of the UK. Show less

In respect of service responses to homeless people, arrangements for the consistent sharing of information between mental health services and voluntary organisations, or local authority run accommodation, should be significantly strengthened. These arrangements should give consideration to: a. Improve liaison … Read more In respect of service responses to homeless people, arrangements for the consistent sharing of information between mental health services and voluntary organisations, or local authority run accommodation, should be significantly strengthened. These arrangements should give consideration to: a. Improve liaison and the flows of information between respective organisations, in particular including keyworkers from voluntary organisations at any case review, or CPA meetings being held to discuss care and treatment of service users. b. Improvement of the links between the CMHTs and the homeless/temporary accommodation residences within Cardiff, including where possible regular input from mental health professionals. c. For individuals who are difficult to engage with, making appointments to see them at their home, minimising the possibility of appointments being missed, cancelled, or not attended. This should be done with appropriate risk assessments having been considered. Show less

Cardiff Mind should fully review its assessment and allocation processes, ensuring that key information relating to risk and to previous involvement with mental health services is fully taken into consideration when assessing where they may seek to reside clients. This … Read more Cardiff Mind should fully review its assessment and allocation processes, ensuring that key information relating to risk and to previous involvement with mental health services is fully taken into consideration when assessing where they may seek to reside clients. This review should include consideration of: a. The information required to make a fully informed assessment and being proactive in attempting to access that information. b. Ensuring that clients are always appropriately homed, taking full consideration of the risks of housing individuals together who have very different support needs. Show less