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Should all community mental health teams be sectorised?

Published online by Cambridge University Press:  23 January 2020

R. Vaughan Open the ORCID record for R. Vaughan [Opens in a new window] ,
K. Antczak ,
L. Kowalewski  and
L. Feeney
R. Vaughan*
Affiliation:
Cluain Mhuire Community Mental Health Service, Blackrock, Dublin, Ireland
K. Antczak
Affiliation:
Cluain Mhuire Community Mental Health Service, Blackrock, Dublin, Ireland
L. Kowalewski
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
L. Feeney
Affiliation:
Royal College of Surgeons in Ireland, Dublin, Ireland
*
*Address for correspondence: R. Vaughan, Cluain Mhuire Community Mental Health Service, Newtownpark Avenue, Blackrock, Dublin, Ireland. (Email: roisin.vaughan@sjog.ie)
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Abstract

Objectives

Sectorised catchment areas have characterised Irish mental health service delivery since the devolution of institutional care. Unlike other catchment areas, the Cluain Mhuire Community Mental Health Service (CMCMHS) never sectorised. With the development of Community Health Networks (CHNs) and Primary Care Centres, the CMCMHS has come under renewed pressure for structural change. We aimed to consider the implications of these proposed changes on staff and service users.

Method

We obtained demographic information comparing the CHNs with respect to attendee numbers, new referrals and admissions over a 1- year period. Secondly, we conducted an anonymous survey seeking opinions on the proposals to switch to a sector-based model and/or specialist inpatient care.

Results

Referral and admission rates differed across CHNs, broadly consistent with populations. About 36% of staff and 33% of service users supported changing to a sector-based system. In the event of a sector-based system of care being implemented, 66% of service users felt that existing service users should remain under the care of their current team. There was little support among any group for the development of specialist inpatient teams.

Conclusions

We discuss the benefits and drawbacks of sectorisation of mental health service provision. Most patients did not want to change teams either as current service users or as re-referrals (indicating it will take a significant time to transition to a sector-based system). Without clear pathways towards integration with primary care teams, the advantages of sectorisation may not outweigh the challenges associated with its implementation.

Keywords

Community mental healthpsychiatryrecoverysectorisationservice delivery
Type
Short Report
Information
Irish Journal of Psychological Medicine , Volume 37 , Issue 1 , March 2020 , pp. 48 - 54
Copyright
© College of Psychiatrists of Ireland 2020

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