Mental health assessment unit audit.

INTRODUCTION

the mental Health Assessment Unit (MHAU) is a unit set up in 2009 as a gateway between community services and in-patient services. The aim of the MHAU is to provide an acute setting in which to assess patients within 72 hours, with the view to reducing in-patient hospital admissions.

AIM

to ascertain the number of referrals made to the MHAU and admissions during a one month period. The presentation and length of stay was investigated and the diagnosis and follow up plans made were explored.

METHOD

data was collated from a one month period, from the 1st June to 2nd July 2010 inclusive. Crisis and home treatment team (CRHT) notes, medical notes and nursing notes were reviewed.

RESULTS

100 referrals were made to the MHAU; 48 patients were admitted. 25 patients had care coordinators. Despite this, in the majority of cases the source of referral was through the Emergency Department. There was a range of presenting complaints ranged and diagnoses included a wide variety of nature and severity. Average length of stay was 2 nights. Patients deemed to require in-patient management had shorter length of stay with swift transfer to treatment units. Shorter stays were also associated with milder degrees of illness. Longer length of stay was associated with more complex illness. 37 patients were discharged home from the MHAU, 8 were transferred to in-patient treatment units and 3 were transferred to in-patient units elsewhere. The majority of patients discharged home were followed up by the CRHT. 5 patients were admitted to the MHAU more than once. 4 were admitted twice, and one was admitted three times. 4 of these patients were discharged home but one was admitted to in-patient unit on his second admission. This may represent a subgroup of more complex patients.

CONCLUSION

we recommend further study into patients' experiences with care coordinators particularly at times of need. We also plan to re-audit for a longer time frame with the view to compare data to in-patient admissions and bed occupancy.