Mental health in A & E

• To improve ongoing support in the community for individuals who have recently been discharged from hospital.
• To prevent, hospital admission whenever possible, by providing support and treatment in the community.
• To provide a thorough assessment of mental and physical health needs for individuals referred to the service.
• To maintain people in their own homes through flexible use of resources for as long as is appropriate.
• To provide, support for carers' participation, in all aspects of care. assessment, planning, implementation and evaluation.
• To promote joint partnership between Health, Social Services, Local Authorities and Voluntary Agencies.
• To provide a rapid response for clients'/carers' at times of crisis.
• To promote mental well-being by use of health promotion and education.

Nurse co-ordinated, multidisciplinary team approach to care, using a holistic model to assess client's problems and care needs.

Each person should be treated as part of a unit or family group and that family/carers, as well as the client, should be involved in the planning of care. The emphasis will be on recognising clients as individuals, supporting and encouraging them and their carers' to retain optimum levels of independence within the local community.

Uphold the person's rights under the Patient's Charter and recognise their value as a human being.

24-hour, throughput of mental health problems to Accident and Emergency; identifying gaps in the service provision.

Use of staff questionnaires to evaluate service and education.

• Changing traditional ways of providing services.
• Works as a member of the Accident and Emergency team, ensuring patients psycho-social needs are addressed; therefore, the patient is treated holistically.
• Raises standards of patient care.
• The role offers medical and nursing staff more time to deal with the physical illness.
• Provides rapid response.
• Cost effective; Reduces junior doctors hours.
• Cost effective reduces patient admission.
• Provides a close link between Accident and Emergency, general wards, mental health services and GPs.
• Offers the patient an alternative to seeing a psychiatrist.
• Speedy access to mental health services and immediate assessment.
• Direct short-term interventions and health education.
• Close liaison between social services, police and other statutory services.
• Education - Mental Health Issues.
• To all medical and nursing staff in Accident and Mental Health patients.
• Police, social services and voluntary agencies.
• Advice and Guidance, to all non-mental health medical and nursing staff on the management of mental health patient.

Day Hospital Assessment
Each person referred to a day hospital has a pre-admission visit, either at home or in hospital, by a qualified member of staff, to assess the needs of the individual/carer. Based on this assessment, the appropriate day(s) of attendance can be identified, and a named nurse will be appointed. Upon admission to the day hospital, the named nurse will carry out a more in-depth assessment of the client/carers' needs. During this period referrals will be made to other agencies such as physiotherapy and occupational therapy. Assessment will be carried out with regards to suitability for the Care Programme Approach (C.P.A) register, and a care co-ordinator will be appointed. When assessment is completed, usually after six to eight weeks, a multidisciplinary team review will be arranged by the named nurse, following which a package will be formulated with the agreement of all concerned.

One Day Assessments
Some clients' and carers' are admitted for a 'One Day Assessment'. This is usually following a domiciliary visit by the Consultant Psychiatrist. Clients' are given a full physical, mental and behavioural screening at the Day Hospital. Clients' and Carers' are offered information and advice, about the many support services available, and urgent referrals to other agencies are made immediately. Clients' and Carers' are given a contact telephone number in case of further problems arising in the future.


The daily activities within the day hospital are varied and organised to suit the need of the client attending.

• Individual counselling sessions: Grief/Loss, Anxiety Management, Alcohol Dependency, Tranquilliser withdrawal/drug dependency, Abuse.
• Group Counselling: Anxiety management programmes, Drug/alcohol withdrawal, Commitment group, Carer support group, Self help group.
• Group Activities: Health Promotion (lifestyles), Home Management group, Reminiscence, Reality Orientation, Conversation skills, Men's group, Sensory story telling, Art and craft, Music appreciation /activity, Music as a medium for reminiscence.
• Individual or group sessions: Relaxation techniques, Facial and massage, Sensory stimulation, Life story work.