Understanding Repeat Presentation to Home Treatment Teams

Background: Increased number of individuals re-attending mental health services over short period of time observed across emergency departments, hospital and more recently home treatment teams.Duetogapidentifiedinresearchonrepeatpresentationstohometreatmentteamsweaimedtoshedmorelightonfactors impacting repeat presentations.Subjects & methods: The cross-sectional study design was implemented to examine common characteristics of high frequencyusersofHomeTreatmentTeamsacrossSouthLondonandMaudsleyNHSFoundationTrust.Thequantitative data was extracted using Clinical Records Interactive Search (CRIS) system. The data on the total of thousand five hundred twenty-five service users was analysed conducted using Microsoft Excel looking at 3 groups of characteristics: socio-demographic, clinical & service use.Results:Fromthousandfivehundredtwenty-fiveserviceusers,eighty-fiveidentifiedashighfrequencyusersindicated bythreeofmoreattendances.Twosocio-demographiccharacteristicsdifferedbetweengroups,withahigherprevalence of females and identified carers in high frequency group. In terms of clinical characteristics, both groups found to have highestnumberofpsychoticandaffectivediagnosis,withnoF99orZcodesinhighfrequencygroup.Lastly,withregards to service use, high frequent users show greater number of attendances to A&E, psychiatric hospitals as well as longer lengthofstay&contactswhileundertheservice.Highfrequencyattendersalsomorelikelytoundergomentalhealthact assessment.Conclusions:Clinicalimplicationsofourstudyincludetheneedfortrainingaroundworkingwithfemaleserviceusers aswellasimplementingtransdiagnosticwayofworking.Additionally,integratingidentifiedcarersintothecareandthe carer-focused support to be provided as part of the treatment. Lastly, the needs of high frequent attenders might be met by understanding of their use across crisis pathways and more specifically tailored to individual needs by examining separate geographic areas.