Community mental health team case-loads and diagnostic case-mix

Abstract

Aims and MethodInformation concerning team staffing, keyworker case-loads, and keyworker diagnostic case-mix was collected from six community mental health teams caring for 1651 patients to establish the clinical burden across teams and professions.ResultsTeam case-loads varied from 427 to 121, an average of 275 patients. Over half the patients were female, and psychotic disorders constituted 44% of the sample. The most common diagnoses were schizophrenia (28.6%) and depression (23.6%). Keyworker case-loads varied across both teams and professions, averaging 30 patients per full-time equivalent. Psychiatrists' case-loads were the largest. Diagnostic case-mix varied with profession. Community psychiatric nurses had the largest proportion of patients with psychosis (73.8%).Clinical ImplicationsMulti-disciplinary community mental health teams have a shared view of appropriate work distribution. Consultant psychiatrists may underestimate the resources required by patients with non-psychotic disorders even in inner city areas.

Is liaison psychiatry a separate specialty? Comparison of referrals to a liaison psychiatry service and a community mental health team

“…Previous descriptions of the work of CMHTs in the UK have reported diagnoses based upon ongoing caseload (Greenwood et al, 2000;Hunter et al, 2002). Their findings of rates of psychotic disorder of around 40% reflect the primary focus of such services being the management of patients with 'severe mental illness', and are not directly comparable with our study, which describes new referrals rather than ongoing case-load.…”

Community mental healthcare for people with severe personality disorder: narrative review

“…3,22 From an English study it was concluded that the case-loads of community psychiatric nurses and occupational therapists in community mental health teams contained far more patients with REVIEW ARTICLE Koekkoek et al Community care for severe personality disorder 23 In a comparable study, it was social workers and again occupational therapists who treated most people with personality disorder. 24 A possible explanation is that patients with severe personality disorders are treated by the professionals with the lowest threshold for inclusion in their case-load (i.e. nonpsychotherapists).…”

Mental health day centres

“…Total figures for frequency of keyworker contact were higher than those ascertained in a recent audit of patient contacts based on CMHT notes (Greenwood et al, 2000): more than double in the case of contact at least every 3 weeks and contact at least quarterly. This implies that either clients were overestimating the frequency of their contact with keyworkers or there is significant under-recording of contacts by professionals.…”