Accepting referrals from all sources
The CRT accepts referrals from:
a) All secondary mental health services.
c) Other health services.
d) Agencies other than health services which support people with mental health problems.
e) Known service users and their families.
f) New service users and their families.
Why this is important
Allowing anyone to refer directly to the CRT is likely to minimise delays in accessing treatment and avoid difficult situations for service users and families where a distressed, acutely ill person has to be persuaded or helped to get to a GP or A&E. Our survey of CRT managers found that most teams accepted referrals from Primary Care and service users already known to the CRT, and over 20% of teams accepted referrals from people not previously known to services.
For both new and known service users and their families it can be invaluable to be able to make a self-referral. If someone is very unwell, having to make contact with a GP or secondary MHS, and ensuring they know who to phone both in hours and out of hours, can add to the stressful and often frightening nature of a crisis.
Below is a video clip of service users and professionals talking about how import it is for crisis teams to be open to referrals from a number of sources:
Ways of doing this well
Well publicised and clear criteria for accepted referrals
As in Item 1, ensuring that there is a clear acute care pathway is key to improving access for referrers. Stating this in the CRT Operational Policy can be helpful.
Open referral system
Opening access so that anyone can refer (other health professionals, voluntary sector, known and unknown service users and carers) can be daunting for services, who may feel as though they will be inundated with inappropriate referrals. However, in practice teams that have open referral policies have not experienced this, and have very positive stories to tell about the way that this works:
Single point of access
Some teams operate in contexts where there is a single point of access or similar service, and this can also help service users and carers to access services quickly and easily. As in Item 1, here is Sunderland CRHTT's case study describing the development of their Initial Response Team.
Examples of good practice
In our fidelity review survey of 75 crisis teams in 2014, the following teams achieved excellent model fidelity, and can be contacted for advice about how they achieved this:
- Bristol Intensive Team, Avon & Wiltshire Mental Health Partnership NHS Trust
- Sunderland, Northumberland, Tyne and Wear NHS Foundation Trust
- Maidstone CRT, Kent and Medway NHS and Social Care Partnership Trust
- Gateshead CRT, Northumberland, Tyne and Wear NHS Foundation Trust
- North East Kent CRHTT, Kent and Medway NHS and Social Care Partnership Trust
- South Tyneside Initial Response Team, Northumberland, Tyne and Wear NHS Foundation Trust
- Redbridge HTT, North East London NHS Foundation Trust
- Walsall CRT, Dudley and Walsall Mental Health Partnership NHS Trust
- West Berkshire CRHTT, Berkshire Healthcare NHS Foundation Trust
- Manchester North, Manchester Mental Health and Social Care Trust
- East Berkshire CRHTT, Berkshire Healthcare NHS Foundation Trust
- Sandwell CRHTT, Black Country Partnership NHS Foundation Trust
- Yeovil CRT, Somerset Partnership NHS Foundation Trust
- Bath Intensive Team, Avon & Wiltshire Mental Health Partnership NHS Trust
- Mendip CRHTT, Somerset Partnership NHS Foundation Trust
- South Hams and West Devon CRHTT, Devon Partnership NHS Trust
- North Devon CRHTT, Devon Partnership NHS Trust
- Taunton and Bridgewater CRHTT, Somerset Partnership NHS Foundation Trust
- Norwich HTT, Norfolk & Suffolk NHS Foundation Trust
- Barnet HTT, Barnet Enfield and Harringay Mental Health NHS Trust
The CRT accepts referrals from all sources
In the UK, most referrals will come from GPs, community mental health teams (CMHTs) / social services and from hospital A&E departments. A smaller number of referrals will come from other sources such as hospital inpatient units, police, voluntary organisations, emergency duty teams and private psychiatrists. An obvious advantage in direct self-referral by clients previously known to the service is that it is reassuring and quick. The disadvantage would be in inappropriate self-referrals being made by clients and or carers. (p.16)
The CRT accepts referrals from all sources
Referral to the service should be easy and pathways of care clear to all involved. The service should have a system in place that allows direct referrals from primary care, community mental health teams, ASWs, staff on inpatient wards, the criminal justice system, non-statutory agencies, former service users and their family/carers, A+E departments and other parts of the acute medical service. (p.22)