Building the Evidence Base for Mental Health Staff Working With Mental Health Consumers with High

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Building the Evidence Base for Mental Health
Staff Working With Mental Health Consumers with
High Complex Needs Clinical Trial

• Jeff Symonds Nurse Practitioner/Scott Elliott
  Technical Support
• Waikato Adult Mental Health Services
• and
• Te Pou -The NATIONAL CENTRE of MENTAL HEALTH
• RESEARCH and WORKFORCE DEVELOPMENT

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Background

• The study aims to assess the use of risk
  assessment models with outcome rating scales to
  support
• the therapeutic discourse
• provide evidence based risk monitoring and review
• inform a safe recovery plan

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Methodology

• A broadly based audit, analysing routinely
  collected data, to inform quality improvement
  activities.

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Building Safety into Care Planning

• Risk assessment/management plans are completed
  but not effectively linked to an ongoing
  evidenced based care process.
• Or more particularly, not integrated into the
  (single), overall comprehensive patient recovery
  plans (Mellsop Banzato, 2006).

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Outcome rating scales support clinical practice

• The HoNOS (Wing et al, 1998) and PSP (Morosini
  2000) can give specific information on
• patterns/trends and issues related to clinical
  progress
• social support and other external circumstances

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What else?

• outcome scales support the application of theory
  to practice

aid communication

• help clinicians and service users to identify
  goals

monitor progress
target intervention
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Staff challenges

• how to best provide recovery based principles
  within an evidence base to support safe practice?
• Individually tailored approches for people who
  experience enduring mental health problems often
  with substance and alcohol problems?

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Support the evidence base!

• To assist staff there are a number of different
  outcome rating scales and risk assessment tools
  available, each with different criteria.

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• A mini-project between the Waikato DHB and Te
  Pou/examining the effectiveness of combining
  

a risk assessment model
clinical risk opinion
selected outcomes rating scales
Recovery Plan
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• Tools

Clinical risk opinion
WDHB risk assessment model
Health of the Nations Outcomes Scale (HoNOS)
Personal and Social Performance Scale (PSP)
Global Assessment Functioning Scale (GAF).
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Electronic Clinical Record

• Present the ECR demonstrating how the risk tools
  link a treatment plan and clinical opinion and
  are then supported by the use of outcome rating
  scales HoNOS, PSP and GAF
• Present the ECR

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Do the use of the
Risk tools
Outcome rating scales
Combining risk tools and outcome rating scales
together
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• add to the provision of high-quality
• evidence-based information

b. aid skill development for clinicians
delivering mental health care
c. assist with clinical planning and support
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Questions to answer
What are the specific workforce issues, which if
addressed will support staff to become confident
and proficient in using risk tools and outcomes
ratings scales?
in discussions with colleagues and services
users
in safe recovery planning
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Participants Criteria

• Selection will be clinical staff from the WDHB
  Community Mental Health Assertive Community Team
  (ACT).
• To complete a short demographic questionnaire on
  entry to the project
• To meet monthly with project team members with
  the view to update individual risk plans and the
  HoNOS, PSP and GAF rating scales

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Project success criteria

• This will take account of the staff subjective
  opinions on the usefulness of this approach, and
  examination of the quantitative outcomes and
  relationships between the various measures.

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Project timelines and deliverables

• clinical assessment
• project report
• research paper
• monthly reports
• presentations to AMHS teams, SM/CDs.