G76 Working together to improve the care of young people with mental health problems in hospital

Abstract

Aims To reduce variability in the management of young people with mental health problems in hospital by improving communication and joint working between Paediatrics, Child and Adolescent Mental Health Services (CAMHS) and Emergency Medicine (EM) teams within our region. Method In order to identify the problems affecting the management of young people with mental health problems in hospital, a series of meetings was held with doctors, nursing staff and allied health professionals from the Paediatrics, CAMHS and EM teams in two hospitals in our region. 17 different issues were raised at these meetings. Using a structured questionnaire, teams identified the three most important of these to be: 1. Management of young people with acute behavioural disturbance; 2. Poor communication between teams; and 3. Insufficient training of hospital staff. Three interventions were then developed to address these problems. First, multidisciplinary team debriefs were introduced at each hospital, providing all three teams with an opportunity to discuss challenging cases. Second, an interprofessional study day on the management of acute behavioural disturbance was developed and delivered by members of the CAMHS, Paediatrics and EM teams. Third, a group of Paediatric nurses visited the local CAMHS inpatient unit to discuss nursing issues with the specialist CAMHS nursing team. Results Feedback from debriefs was universally positive, and they will now run six-monthly at each hospital. The study day has run twice, with a total of 75 attendees. Pre- and post-course feedback forms showed a marked improvement in confidence managing acute behavioural disturbance across all staff groups attending. This course will now run three times per year. Additionally, all those who visited the inpatient unit reported that it would lead to a positive change in their practice. Conclusion These efforts to bring teams together have been highly valued by all involved, and we are receiving ongoing support from our deanery to continue this work. Several further joint-working initiatives are now being developed within our region as a result of this project, showing the positive and far-reaching repercussions of these relatively simple interventions.