The Adult Mental Health Team

Since 2001 there has been opportunity to improve the mental health service to the local community by re-invigorating and re-structuring the main corp of clinical staff in the Bowral service.Initially, this was first seen in the response of the service to the needs of the Bowral Hospital, and a significant collaboration with primary carers of the mentally ill community members.The Mental Health Hospital Consultation Liaison (HCLN) role became a dedicated position with, not only a commitment to maintain the role, but also to back it up with a second clinical position on the team. The primary HCLN position became a Clinical Nurse Consultant (CNC) position, the second became a Clinical Nurse Specialist (CNS) position. Additionally, both clinicians underwent the NSW College of Psychiatry training to become Accredited Persons (AP).The outcome for the Bowral Hospital (and the Mental Health Service) was that their response to the hospital was more certain, timely, and provided clinically sound consultation advice. More importantly, the outcomes for the patient and the hospital staff were better and based on good clinical practice and sound judgment.Additionally, following the transfer of the receiving inpatient unit from the Chisholm Ross Centre (CRC) in Goulburn to Campbelltown Hospital there has been access to the consultation support of the Campbelltown on-call psychiatry services to the Bowral MH Services and hospital.The second initiative with the Bowral Adult Mental Health team has been the strong commitment to care coordination of current patients of the service. This means that the responsibility for care of the patient is linked to the partnerships of the patient, the clinician, the family or carer, the treating psychiatrist and general practitioner, and other service providers. This means, of course, that the patient must be accepting, and be an active participant in, their own care.The clinical documentation, in both the electronic and paper form, used universally by all NSW Mental Health services is designed to both acknowledge the joint participation of all in the care of the patient, but also allows the service to ensure that regular contacts with the patients are made and recorded.Care coordination of patients of the Bowral Mental Health Service has been made easier due to some of the innovative practices that the team has initiated. This has included improved medication compliance with the use of the use of imprest items of medications, especially injections; the use of a single community pharmacy for the dispensing of scripts of (usually) non-compliant patients, and the use of WebsterPacks for the self-dosing of medications by patients who are sometimes confused about the time of dose, and type of medications they are prescribed. These arrangements have significantly improved medication compliance and stability in the lives of patients whose care is coordinated by the Adult Mental Health team.In the next post shall be described some of the additional tasks undertaken by the Adult Mental Health team.