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Enhancing Mental Health Care: Liverpool Assertive Outreach Team's Innovative Approaches

The Liverpool Assertive Outreach Team, established in 2000, focuses on providing specialized support for individuals with mental health challenges, particularly in the inner city. With a team comprising managers, care coordinators, and specialists, they manage a caseload of 135 patients, emphasizing person-centered care and strong relationships. They prioritize collaborative approaches to treatment, risk management, and consistent contact, while also addressing the challenges of information sharing and team flexibility. Through initiatives like the Well Person Clinic, they enhance health monitoring and engagement, paving the way for better health outcomes.

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Enhancing Mental Health Care: Liverpool Assertive Outreach Team's Innovative Approaches

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  1. LIVERPOOLASSERTIVE OUTREACH TEAM VINNIE FARRELL TEAM MANAGER ROBERT HIGGO CONSULTANT PSYCHIATRIST

  2. POPULATION Inner City Liverpool Drifting Population Unstable Accommodation BEM Mix Dual Diagnosis Offending/Risk Behaviours Sounds familiar !

  3. ESTABLISHMENT Formed 2000 135 Caseload 1 Manager 1 Deputy Manager 12.5 Care Co-Coordinators 1 Assistant Nurse Practitioner 5 STR Workers .4 Psychologist 1 Consultant Psychiatrist 1 SpR / 1ST3

  4. CASE MANAGEMENT Engagement is……. Trust Relationships (Carers/Service Users) Face to face contact Consistency in contact Monitoring of treatment plans Assessing risks Negotiation/Collaborative approach

  5. DOWNSIDE Information shared ineffectively Less flexibility/team response Protecting caseloads Over Dependence Prevents Recovery Reduces Throughput

  6. PREVENT AGAINST THIS BY : Team Ownership Team Responsibility Communication is key : Share knowledge Team Meetings Case Reviews / Presentations Use CPA effectively

  7. PLAN – What are we doing ? Challenge – What / Why – Test out – Encourage innovative approaches – Supervision Don’t do more of the same!

  8. CARE OF IN-PATIENTS Some figures : Admissions/year – 53 – 44 – 36 – 30 – 29 >50%come in informal and stay informal Maximum number >20 For last 2 years <10 Vast majority admitted directly by AOT

  9. WE MANAGE OUR OWN IN-PATIENTS : Continuity Engagement Risk Management Discharge Planning Active in-reach

  10. SOME NEGATIVE CONSEQUENCES : Not the fashion (in-patient consultants) Some longer admissions Activity figures Consultant case load numbers

  11. HOW : Nothing radical ! Care Co-Ordinator in-reach Escorted leave Home visits Team discussion (Tuesday) Ward MDT (Thursday)

  12. WELL PERSON CLINIC Why: Worse physical health Die early Co morbidity Little preventative health care Poor help seeking Medication effects

  13. WELL PERSON CLINIC What: Started with monitoring – Clozapine, Lithium etc. Now, offered full screen Trainee Psychiatrist Assistant Practitioner (champion)

  14. WELL PERSON CLINIC Benefits : A very thorough check Generally preferred by SU Engagement

  15. WELL PERSON CLINIC Downside : Social inclusion Skills/limits Time costs Using Trainee

  16. WELL PERSON CLINIC Future : GP session ? Audit

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