Understanding the mental health system

Doctors look after the health of people in their local community and deal with a whole range of health problems. They also give health education and advice on things like smoking and diet, run clinics, give vaccinations and carry out simple surgical operations.
Doctors usually work with a team including nurses, health visitors and midwives, as well as a range of other health professionals such as physiotherapists and occupational therapists. If a Doctor cannot deal with your problem themselves, they’ll usually refer you to a hospital for tests, treatment or to see a consultant with specialised knowledge.

If a health problem cannot be sorted out through primary care, or there is an emergency, the next stop is hospital. If you need hospital treatment, a GP will normally arrange it for you. NHS hospitals provide acute and specialist services, treating conditions which normally cannot be dealt with by primary care specialists.

Primary Care Trusts are responsible for planning secondary care. They look at the health needs of the local community and develop plans to improve health and set priorities locally. They then decide which secondary care services to commission to meet people’s needs. Therefore they work closely with the providers of the secondary care services that they commission to agree about delivering those services.

Mental Health services can be provided through your GP, other primary care services, or through more specialist care. This might include counselling and other psychological therapies, community and family support, or general health screening. For example, people suffering bereavement, depression, stress or anxiety can get help from primary care or informal community support. If they need more involved support they can be referred for specialist care.
More specialist care is normally provided by Mental Health Trusts or local council social services departments. Services range from psychological therapy, through to very specialist medical and training services for people with severe mental health problems. About two in every thousand people need specialist care for conditions such as severe anxiety problems or psychotic illness.

The Community Mental Health Team (CMHT) is a multidisciplinary team (i.e. involves workers with a wide range of skills and professionalisms e.g. Community Psychiatric Nurses, Social Workers, Occupational Therapists etc.) CMHT’s work alongside GP’s providing mental health assessment, care co-ordination and on-going support to individuals who have a wide range of mental health needs. Community Mental Health Teams have a key role in the ongoing monitoring of medication, providing support and help with daily living skills as well as preventing relapse and giving support and information to families and carers.

Assertive OutreaMental illness who find it difficult to engage with traditional mental health services. Assertive outreach teams work with individuals in their own environment, anywhere where their service users feel the most comfortable. The proactive approach of assertive outreach work helps to keep people in touch with services so they can be adequately supported and helps to link them into other mental health services. AOT teams have smaller caseloads and try to see their clients as frequently as possible aiming to: -

Help individuals to increase their daily living skills

Try to reduce the number of times individuals are admitted to hospital especially compulsory admissions.

Help to maintain existing or gain new social networks and relationships with families and friends.

Assist with money management and budgeting.

Ensure that individuals keep taking their medication and stick to their treatment plan.

Help people find and maintain accommodation

Assertive Outreach is an active form of working with individuals who have severe and lasting Psychiatrists, Community psychiatric Nurses (CPN’s), Social Workers, Occupational Therapists, Community Support Workers and often substance misuse workers and counsellors

In Warwickshire teams include Social Workers, Psychologists, Community Psychiatric Nurses (CPN’s) and Community Support Workers.

Early intervention services exist in the North and South of the county and offer assessment, treatment and support to young people aged 14 years to 35 years who are in the first three years of an episode of Psychosis, and careful planning for the subsequent care of clients following their discharge from the EIS is a service priority. A key role of the EIS is to reduce stigma and raise awareness of psychotic illness via active involvement in community based programmes drawing upon information provided within the Mental Health Promotion Framework and other evidence supported approaches, including family therapy. The EIS offers a team approach with intensive case management support. Early Intervention workers develop strong links with youth and young peoples services including Social Services Children’s Teams, Special Educational Needs Services, Connexions as well as local schools, colleges acknowledging that the onset of symptoms typically occurs in adolescence and early adulthood. ELS teams in Warwickshire are multidisciplinary consisting of Approved Social Workers, CPN’s, STR Workers (South) and, Clinical psychology.

Psychiatric services focus on diagnosing and treating mental disorders of adults and children, including mood disorders, anxiety disorders, schizophrenia, and attention deficit hyperactivity disorders. Psychiatrists evaluate the need for psychiatric medications and meet with clients on a regular basis for medication management. Psychiatric nurses are available to answer questions about the purpose, side effects, and regime of prescribed medications.

Outpatient therapy is offered to deal with a range of problems; stress, anxiety, depression, anger, social fears, and family conflict are explored in individual, marital, and family therapy sessions. Psychological testing is also available to assess personality traits and dynamics, memory and attention processes, and general intellectual functioning.

Long-term psychiatric inpatient units service judicially committed and voluntary. Programmes include: reality orientation, goals/community group, social skills training, medication/health group, recreation and individual therapy. Professionals involved on the unit area are: nurses, mental health workers, activity personnel, therapists, and physicians. The goal is to provide comprehensive inpatient services as close as possible to the patients' local community, to shorten the length of stays for committed patients, and to facilitate the connection between inpatient and outpatient services to make the continuum of care the patients as seamless as possible.

Adult Day Services provides adult day care. The goal is to help the adult stay as independent as possible as long as possible. Professional health services are offered in a protective environment for those who don't require 24 hour care due to a physical or mental disability, have difficulty with independent living. Services include: medical monitoring, medication monitoring, activities, day respite, nutrition, health education, exercise program, information and referral.

The acute care unit is often the first intervention a person in crisis receives. The staff and facility provide a safe haven for the person in crisis. The qualified staff of nurses, social workers, therapists, recreation therapists, mental health workers, and physicians work as a team to bring about the best possible outcome for the patient and family. Licensed nursing staff are available 24 hours a day to provide services ranging from crisis intervention to personal care. Services are provided to individuals from early teens to the elderly who have a wide variety of mental disorders. Family members are provided with educational information about mental illness and treatment. At the time of discharge patients are assisted in obtaining appropriate living arrangements and follow-up care.

Services provided to people experiencing difficulties through the misuse of drugs, alcohol and other substances
Substance Misuse Services can offer support to people who are experiencing difficulties through the misuse of illegal drugs, alcohol, volatile substances (e.g. aerosols, glue etc), prescribed and over the counter medication.

Substance Misuse Team

A substance misuse team aims to provide services that enable people who misuse substances to improve their quality of life, to reduce the risk of harm and offer opportunities for lifestyle changes.

The misuse of substances not only impacts on the lives of those directly involved but also on their families and the wider communities in which they live. Therefore they can also provide a service for people caring for those who misuse substances.

How they can help

People are encouraged to refer themselves to the team. Also, with the individual's permission, family members, friends and professionals (such as doctors) can make referrals. When the team receives a referral, a specialist worker will arrange to meet you to talk about the problems you are experiencing. This gives you the opportunity to share your views about the changes that you would like to make in your life. This will be an assessment of your needs.

When the assessment is completed, a plan will be drawn up which details the support you require. If we do not feel that your circumstances require our support, they may be able to suggest alternative sources of help or advice.

How they meet your needs

In order to meet the needs of individuals and their carers, the Substance Misuse Team works in partnership with healthcare providers, a range of voluntary sector and independent agencies and community groups. The team themselves could well be a voluntary organisation.

Support provided may include :

• Counselling and advice.
• Residential and community rehabilitation.
• Medical help e.g. prescriptions, GP support

Your rights

In accordance with the Data Protection Act, everything you tell them will be treated confidentially. As with any other organisation they will keep written records of meetings with you, which you have a right to see.

Have your say

You will have a right to comment on or complain about the decisions they make, or the response you receive.  If you want to tell them how you feel about the service you can speak to any member of the team.  Your comments are useful, as they can help them improve services in the future.

Relationship Counselling - face-to-face

Relate is all about relationships. If you want to talk about your relationships past, present or future, how your family is affected by your relationship, how you can improve your relationship, how you can manage a separation constructively, how you can get over a break up, Relate is here to help you.

Relate counsellors see over 100,000 people a year. Their role is to listen, to encourage you to talk openly about your concerns, and help you reach your own decisions about the best way forward.

Who is it for?

Relate counselling is open to everyone aged over 16. Whether you are married, living together, in a same-sex relationship, separated, divorced or single, our confidential service can help you to deal with your relationship difficulties. You can come on your own or with a partner.

How does it work?

With your counsellor you’ll explore your feelings, values and expectations, and gain assistance with communication and problem solving and look at options and new possibilities.

At the end of counselling 90% of the people we see feel they understand their problem better and feel more able to deal with it.