A New Model for the Delivery of
Forensic Community Mental Health Services
BIGSPD, Manchester, 23rd March 2012
Presented by:
Memtaz Begum Forensic Social Worker
Jon Carey Senior Forensic Practitioner/ PhD student, Durham University
Service Developments by all members of the Forensic CMHS
Ridgeway
Roseberry Park
Middlesbrough
Forensic Community
Mental Health Team
Secondary CMHT
Prisons
Forensic Inpatients
MDT Assessments
Reports
Advice
11 Clinical Sessions
Forensic CPN's
Social Work Support
Transition & follow up
Pathway through
the new Forensic
Community Mental
Health Service
Referral
Clinic
(Under 2 weeks from referral)
Roseberry Park
Sandwell Park
Further
Specialist
Assessment
Advice/Supervision
West Park
Lanchester Road
NFA
Formulation/CPA Meeting
(4 weeks from clinic)
Intervention
Discharge
Intervention
Referral
Referral Criteria
New Referral Form
10 Historical Items
(HCR20 informed)
Current Presentation
Include behaviour/ risks that
have triggered referral
Assign to Clinic
(Max 2 weeks)
Reject
More information
The Forensic CMHT considers a new referral.
Clinics
Two FCMHS members
F-CAM
Care co-ordinator + Patient
Other activities:
Clinical Supervision
Training
Advice
Roseberry Park
West Park
1.
2.
3.
4.
5.
Introduction/ Information Leaflet
Confidentiality
Clinical/ Risk Interview (HCR20)
Protective Factors (SAPROF)
Psychometrics, (BPRS,SAPAS,
DUDIT/ AUDIT, Quality of Life Scale *1)
6. Professional Discussion/ decision
Sandwell Park
Lanchester Road
Clinic Outcomes
No further action
(Letter within a
week)
Clinical
Supervision
Contract:
Time limited
Straight to
Intervention
Further
Specialist
Assessment
Advice
Further Specialist Assessment
Supplementary Psychometrics
Violence: ERM/ FESAI; RM2000
Personality Disorder: MCMI-III; IPDE; PCL-sv
Substance Misuse: C-BIT
Mental Illness: PSYRATS; BDI
Stalking: SAM
Trauma/ PTSD: CAPS
Fire Setting: FAFS
Sexual Risk: SVR20
Intelligence: WASI
Formulation/ CPA Review
Discuss triggers,
protective factors
Treatment options
Develop a care plan
Summary Report
Summary of the assessment +
outline of the agreed Care Plan
Advice/
Clinical supervision
Care
Co-ordination
by FCMHS
Very High Risk
MAPPA 2-3
Ex-Secure Care
Intervention/
Co-working
No further action
Interventions:
Various timescales
Offence
Related
Work
DBT/ CBT:
6-24
months
Alexithymia
Group:
1 day
JIGSAW
ongoing
ERM/
FESAI:
6-10
sessions
ASRO:
20
sessions
PSST
Discharge
Quality of Life Scale *2
After 6 + 12 months
Quality of Life Scale *3 + 4
PARIS Entry
Discharge Letter
Forensic Community
Mental Health Team
Secondary CMHT
Durham Cluster of
Prisons
Frankland/ Durham/
Low Newton
Forensic Inpatients
MDT Assessments
Reports
Advice
11 Clinical Sessions
Forensic CPN's
Social Work Support
Transition & follow up
Referral
The new Forensic
Community Mental
Health Service for
the Durham Prisons
Critical Case
Panels
Accept
Complex Case
Review
Reject
Request more
information
Assessment
with Prison Team
within 7 days
No further action
Advice and
support
Interventions
Further Specialist
Assessment
Training/
supervision
Co-facilitated with
Prison MH Team
As needed
Discharge
Discharge
Discharge
Reaction in the team was mixed
Pre-release and Aftercare service
Referral (if no previous involvement)
6 months prior to release
Review (if assessed previously)
6 months prior to release
Accept
Reject
6 months prior to release
Referral to
Secondary services
Collaboration of needs assessment
Pre-release plan
6 months post release
Community support and interventions
Release Pathway through the
new Forensic Community
Mental Health Service for
the Durham Prisons
Liaison with external agenciesMAPPA, Probation, Housing, Police
Possible FCMHS Care Co-ordination
Discharge Plan
Forensic Inpatient Service
Ridgeway
Roseberry Park
Memtaz Begum
Forensic Social Worker
23rd March 2012
Current Social Work provision
•
•
•
•
•
10 wards
Medium and Low Secure -135 patients
1 Senior Social Worker
6 Social Workers
S117 Responsibility for out of area
patients
New model includes…
• Admission packs
• Weekly clinics
• Discharge packs
• Shared care post discharge
New model includes
• Community focused interventions
• PSST, ASRO, DBT and others
• Care co-ordination
On-going work of the team
•
•
•
•
•
•
AMHP role
Social Supervision
BIA
Child Visiting
Appropriate Adult
MHT & Managers Reviews
Thanks…any
questions?
Dr Brian Docherty, OBE, kindly
provided some of the picture slides
Roseberry Topping, Great Ayton,
Middlesbrough
Glossary:
AUDIT
BDI
BPRS
CAPS,
CBIT
DUDIT
ERM
FESAI
FAFS
F-CAM
HCR20
IPDE,
PCL-sv
QoLS
RM2000
SAM
SVR20
SAPAS
SAPROF
WAIS III
Alcohol Use Disorders Identification Test
Becks Depression Inventory
Brief Psychiatric Rating Scale
Clinician Administered PTSD Scale
Cognitive-Behavioural Integrated Treatment
Drug Use Disorders Identification Test
Early Recognition Method
Forensic Early warning Signs of Aggression Inventory
Functional Assessment of Fire Setting
Forensic Collaborative Assessment Model
Historical/ Clinical/ Risk 20
International Personality Disorder Examination
Psychopathy Check List, shortened version
Quality of Life Scale
Risk Matrix 2000
Stalking Assessment & Management Guide
Sexual Violence Risk 20
Structured Assessment of Personality – Abbreviated Scale
Structured Assessment of Protective Factors
Wechsler Adult Intelligence Scale, 3rd Edition