Care Plans in Community Mental Health: an Audit Focusing on People with Recent Hospital Admissions

Abstract

Care planning is a key requirement for recovery-focused mental health care. Audit tools are available so that services can assess their alignment with accepted care planning standards but few benchmarks are available, especially for health services outside the United Kingdom.To assess implementation of recommended care planning in an Australian mental health setting for people recently hospitalised, a sample of service user records was audited against care plan requirements. Of 164 eligible records, 113 (69%) showed a care plan. Of the 113 care plans, 40 (35%) contained a risk assessment and 1 (1%) a crisis management plan.Thirty five (31%) contained some social needs assessment, 1 (1%) contained a physical health assessment, and 53 (47%) identified a primary healthcare physician. This audit indicated a large gap between recommendations and actual practice. Similar audits in other health services are required. Action is needed to integrate care planning into behavioural health practice.

Why Do People with Severe Mental Illness Have Poor Cardiovascular Health?—The Need for Implementing a Recovery-Based Self-Management Approach

“…To date, psychiatry has heavily relied on an illness model where the service user is treated for their illness with medications mostly, and this has been argued to generate iatrogenic trauma for many patients [ 34 ]. According to health professionals, high workload, frequent staff turnover and resultant discontinued care, role ambiguities between mental and physical health staff and a lack of resources are some of the other commonly identified barriers that hinder the providing of quality service and recovery-oriented care to service users [ 18 , 19 ]. Recovery-oriented care demands time and is a risk-preferred model, which often becomes difficult to adopt within a community mental health system that is resource-scarce [ 34 ].…”

“…Furthermore, where there are clear guidelines on how to identify and manage physical health risk factors among people with SMI, health policies and procedures are poorly implemented; here, Australia is no exception [18]. As a consequence, people with SMI have limited access to preventative care, motivational interventions and evidence-based guideline-concordant treatments that address both lifestyle risk-factors and physical illnesses such as CVD [19]. [20].…”