Falling through the net: Discrepancies between community mental health services and primary care services in care plans for patients recently discharged from a community mental health team

Abstract

Deficiencies in communication are often identified by enquiries into the care of patients where there have been tragic outcomes. This study aims to identify which parts of community care plans are more difficult to communicate between community mental health teams and GPs and which patients are associated with communication failures. Community health team workers' care plans were compared with GPs care plans after discharge from the team for 61 consecutively discharged patients. The agreements were calculated using the kappa statistic. Items of need (e.g. need for a community psychiatric nurse) tended to have lower agreement than items of fact. Items requiring named individuals had lower kappa values than items of binary choice (e.g. involvement of a community psychiatric nurse). No group of patients was identified which was associated with poor agreement. Adequate communication between primary care and community mental health teams is a crucial task and new strategies to ensure its success are needed.