Secondary care

Community Mental Health Team (CMHT)

Service eligibility

The selection criteria for the above Service are applicable to:

  • All adults irrespective of gender, age (18 years or over), ethnicity, sexuality, culture or physical abilities
  • People who have substantial and complex mental health needs which cannot be met by primary care, the IAPT Service or other community services.

Selection criteria:

The CMHT will accept referrals for service users with substantial and complex mental health needs which include:

  • Significant cognitive, emotional and behavioural problems associated with a mental health diagnosis.

The individual is likely to present predominantly with/as:

  • Psychosis, such as schizophrenia or bi-polar disorder.
  • Severe depressive disorder where the levels of risk/complexity/engagement require treatment by a specialist mental health service.
  • Severe disorders of personality where there is a clear role identified for the community mental health team, and the service user is agreeable to engage with the service.
  • Longer term severe disorders which are characterised by poor treatment adherence and increased levels of risk/vulnerability which cannot be managed solely by primary care.
  • Dual diagnosis of mental illness and substance misuse where the mental illness is the primary need, severe and complex in nature.
  • Co-morbid mental illness in service users with a neurodevelopmental disorder for treatment of the mental disorder where this is the primary issue.
  • Complex presentations associated with severe mental illness, which impacts a significant risk of self-harm, harm to others, risk of harm from others or serious self-neglect.
  • An expectant mother with a history of mental ill health or perinatal/post-natal mental health issues, even where there may be lower or more moderate risks identified.

Decision support

Referrals for mild to moderate disorders may initially be diverted to primary care and voluntary sector services. However, the above list of criteria is not exhaustive.. There may be situations which fall outside the scope of this specification which will require clinical judgement. Decision support and brief assessment is provided locally where the Liaison Mental Health Practitioner roles are operational, or alternatively the appropriate locality CMHT duty desk can be contacted for referral discussion and advice (contact details below)

WNW CMHT Central, CTM, Gary Poxton and Clinical Lead, Rob Edwards, based at Malham House - 0113 85 59300

WNW CMHT Millfield, CTM, Kay Tschanschek and Clinical Lead, Sean Devanny, based at Millfield House - 0113 85 59350

WNW CMHT West, CTM, Kate Baker and Clinical Lead, Karen Ridealgh, based at Linden House - 0113 85 50930.

Time limited interventions

Interventions are provided if the multidisciplinary assessment and formulation concludes there is a treatable mental disorder requiring specialist mental health interventions in the CMHT. Interventions require the full agreement of the person using our service. They will be expected to work towards specific positive goals outcomes, which will be collaboratively agreed as a care plan on commencing treatment. Interventions will be reviewed at an agreed time, and may not necessarily be extended if outcomes have not been met.

Safety

CMHT can provide safe, specialist, multidisciplinary assessment and interventions, but are unable to manage or impact on risk as a separate issue from interventions to treat mental illness/disorder. We aim to work within a recovery focus collaboratively with service users, to enable them to manage their own safety, rather than 'holding' in services indefinitely, or assuming responsibility for their actions, even if those actions are thought to be unwise. When service users are finding it difficult to manage themselves safely as a direct impact of their mental health, we may recommend more intensive treatment options in the community or hospital.

Psychology referral info

Helpful information to include in Psychological Therapies referral:

  • Does the individual have a psychological difficulty which is of at least moderate severity and/or complexity, is impacting significantly upon their lives, and is persisting over time?
  • Are there sufficient grounds for considering a direct referral at this point rather than accessing the earlier steps first?
  • If the referral is sought after low-intensity intervention, what are the reasons for not accessing a high-intensity intervention?
  • After either low or high-intensity interventions, is there sufficient evidence that the individual is likely to be able to engage and potentially make use of a level four intervention?
  • Does the individual present an immediate or imminent risk of harm to themselves or others? If so, then the service is not equipped to offer an urgent response to such risks. (We may become involved in working alongside another agency in a partnership model when the acute situation has settled).
  • If the individual is misusing alcohol and/or other substances, do you think this should be the current priority for specialist treatment elsewhere before referring?
  • Would the individual consider the benefits of a group therapy?

Memory Services referral: SPA

Memory Services Assessment, diagnosis and appropriate treatment and interventions for older people experiencing early dementia.

Referral criteria:

  • Older people with memory problems for at least six months.
  • Memory problems interfering with everyday functioning.
  • Family/carer/significant others aware of these problems.
  • Memory problems not linked to a recent traumatic head injury.
  • Investigations have been undertaken in primary care prior to referral – see basic dementia screen.
  • Should also include physical examination, recent and past medical history, current prescribed medications.

Younger people with dementia

Dementia - Younger people with dementia assessment, diagnosis and appropriate treatment and interventions for younger people under age of 65 with dementia or suspected dementia and their families.

One of the following should be present: memory problems, language difficulties, attention/concentration difficulties, behavioural or personality changes. Investigations should have been undertaken in primary care prior to referral - see basic dementia screen. Should also include physical examination, recent and past medical history, current prescribed medications.

Tel: 0113 279 0121

Address: St Marys Hospital, Leeds

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