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A psychiatrist is a doctor who specialises in the diagnosis and treatment of people who have a mental disorder. Psychiatrists have undergone specialist training. In Hillingdon the consultant psychiatrists are based within the Community Mental Health Teams. They are responsible for the treatment of patients under their care, both in-patients and out-patients. Each consultant supervises and is assisted by a junior doctor, who will often have more day-to-day contact with patients. The junior doctors usually work on rotation at the hospital for up to 6 or 9 months. Psychiatrists work closely with GPs and other professionals when arranging treatment, and for follow-up care that may be needed. The first point of contact for anyone wishing to consult a psychiatrist is a GP, who can make a referral for an out-patient appointment. Everyone has the right to the services of a GP, who are often the first point of contact for a person who becomes concerned about their own mental health, or that of a family member. GPs often know patients and their families well, before mental health problems become apparent. GPs also keep medical records and can therefore see how current problems relate to past history. GPs are sometimes the only professionals involved in the care of a person with a mental health problem, and they can play a central role in mental health care, depending on the skills of the individual GP. Minor mental health problems, including depression and anxiety related to stress in relationships or from life events, would be seen by most GPs as part of their normal work. They may, however, refer on to other professionals for counselling or other help, e.g. psychologists, community nurses or mental health social workers. (See following pages.) With more serious mental illnesses, GPs will usually refer patients for specialist assessment to a psychiatrist who may in turn arrange for hospital treatment. GPs may either share out-patient care with the hospital psychiatrist or provide out-patient care themselves. Their main responsibility is to ensure that their patient receives the treatment needed, although GPs may also provide valuable support to the patient and to other family members also on their practice list. Other professionals such as community mental health nurses and social workers may also be involved in which case the GP would be one of a team of people providing the care and treatment that may be needed Mental health nurses have had special training in psychiatry, and have the skills needed to communicate with and support people who are mentally ill. In-patient nurses will have day to day contact with patients and each in-patient will have a named nurse who will have special responsibility for the patient’s care. Community mental health nurses - also known as community psychiatric nurses (CPNs) - are experienced nurses who work with people in the community. They will visit people in their own homes to assess their needs and provide a care package which will involve emotional support as well as monitoring issues to do with medication. Mental health social workers have had training and experience in mental health, and are familiar with the problems experienced by users of mental health services and their families. As with Community Mental Health Nurses, they work in close co-operation with users and carers in assessing needs, formulating a care plan with the client, carers and other mental health professionals where appropriate. Most social workers in mental health are also ‘Approved Social Workers’ under the provisions of the Mental Health Act and have a particular role in assessing people where compulsory hospital admission is indicated. Over the past ten years or so it has been recognised that whilst Community Mental Health Nurses and Mental Health Social Workers have different training routes, in fact, the skills and abilities required to undertake each role have many similarities. Generally speaking, it will be a Community Nurse or a Social Worker who will be allocated to be a person’s Care Co-ordinator. Residential and day programme workers Residential and Day Programme workers in Social Services hostels and day centres, offer close support to users of mental health services, both individually and in groups. Each user is assigned a ‘key worker’ who is responsible for co-ordinating the care that is being provided within the day programme or hostel setting, and reviewing this regularly with the user and with any other professionals involved, and carers if appropriate. Clinical psychologists have special training in psychology (the study of human behaviour and the mind) and in mental health. Psychologists have skills in the assessment and treatment of mental illness and psychological problems. Unlike psychiatrists, they are not medical doctors. Their skills are mainly in the assessment of mental health problems and in providing talking treatments: psychotherapy and counselling. In Hillingdon, the psychologists are based in Community Mental Health Teams. The type of help they offer depends on the needs of the individual. The starting point is a thorough assessment and patients may then be offered individual, marital or family psychotherapy, or counselling. The psychologists also run a number of groups, such as anxiety management training and supportive group therapy. Referrals to a psychologist normally come from a GP or a psychiatrist. Occupational therapists use purposeful activities to treat people with physical or mental health problems. The object is to enable people to obtain their optimum independence at home, at work and in their social life. OTs help people identify and solve their problems. These can range from a lack of confidence, anxiety, depression, irrational thoughts, and relationship difficulties to the more practical like coping with the stresses of a family or a job. People are helped and encouraged to take part in activities which reflect aspects of daily life. Therapy may include cooking, shopping, work skills, sport and exercises, relaxation and leisure pursuits, as well as specific groups such as anxiety management, self help, communication and art to develop and enhance their coping skills and self esteem. Mental health OTs are based in Riverside Mental Health Unit, the Woodland Centre, and the Community Mental Health Teams. Most people are referred via the appropriate service or team and allocated an OT as needed. |
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