Abstract
Aims and Method We describe activity and outcome concerning a consecutive series of older community patients referred to an outreach support team while waiting for acute psychiatric admission. Results Forty patients on an admissions waiting list who were referred to the outreach support team were followed up. Each patient was reassessed for admission by the responsible medical officer when an in-patient bed became available. Thirty patients who would have been admitted (if a bed had been available at the time of the first assessment) remained at home and did not need hospitalisation. Clinical Implications This study suggests that intensive domiciliary support might offer an acceptable form of crisis intervention for older people with mental illness. Further research is needed before generalisation of these findings can be recommended.
Highlights
This study suggests that intensive domiciliary support might offer an acceptable form of crisis intervention for older people with mental illness
The sample excluded patients detained under the Mental Health Act 1983 and those patients considered at high risk of self-harm or harm to others because of their mental illness
No studies have examined these issues in older patients with mental illnesses
Summary
Forty patients on an admissions waiting list who were referred to the outreach support team were followed up. The outreach support team was established in November 1999 because of winter bed pressures within the acute geriatric wards at the local District General Hospital These pressures led to the closure of 20 acute psychiatric beds for older patients. The team has three aims: to provide additional support to community mental health teams (CMHTs) for older, community patients experiencing crisis - irrespective of the nature of their mental illness; to reduce acute admissions and to facilitate early discharge from psychiatric in-patient care. The day hospital provides additional respite (daytime) support for functional patients and the in-patient units provide occasional day respite services for organic cases. A prospective descriptive study was undertaken in order to quantify the activity of the team and establish the outcome of a subsequent, consecutive series of patients referred to the waiting list for acute psychiatric in-patient care, to inform future audit and service development. During the period of the study, the team continued to provide support for patients in crisis who were not on the waiting list and those being discharged from in-patient care
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