mental health

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Bringing together physical and mental health

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Psychiatrists in the multidisciplinary team work alongside medical consultants,

junior doctors, ward nurses and others to offer rapid, senior psychiatric opinions.

They can assess suspected mental health, confusion or memory problems, or general

risk. They can give advice about managing behavioural disturbance or on medicolegal

issues regarding capacity and use of the Mental Health Act. They assist with

discharge planning and can facilitate dialogue with mental health services outside

of the acute trust for onward management. In palliative medicine, the service’s

consultant psychiatrists provide assessment and treatment for patients, as well as

training and supervision for palliative care team members.

Psychologists in the team work as members of medical teams, adding a psychological

dimension to patient management. In respiratory medicine, for example, a clinical

health psychologist works with the respiratory team to assess and provide evidencebased

treatment to patients with psychological issues that have a negative impact on

their physical and mental health.

One of the benefits of the service is that it provides an opportunity for team

members to teach and train their physical health care counterparts as they work

closely together. At the time of writing, this mental health training was a trust-wide

requirement for staff in cancer and women’s services.

In addition to the Psychological Medicine Service, a separate Emergency

Department Psychiatric Service assesses patients presenting with psychiatric issues

to the emergency departments at the John Radcliffe and Horton General hospitals.

This service is provided by Oxford Health NHS Foundation Trust.

Outcomes

The Oxford Psychological Medicine Service has been in place for two years and

in that time has received highly positive feedback from physicians, surgeons and

nursing staff. Acute care staff greatly appreciate a quick response and diagnosis of

patients’ mental health issues. The value that acute care staff place in the service is

evidenced in the growing number of clinical departments that have commissioned

its input over the past two years. One of its most important perceived impacts is

that it has challenged pervasive stereotypes about mental illness within the acute

care setting, and has helped to change how patients with challenging behaviours

Appendices: case study site profiles 84

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