Mental Health Services

The main strategic direction for the development of mental health services in the Foyle area is now governed by ‘Moving Forward’ the Trust’s recent review of mental health services.

The review process focused on a number of key areas including, responding to crisis; links with primary care; psychological therapies; services for those with long term and serious mental health problems; early intervention; and addiction services. The replacement of the admission clinics at Gransha Hospital with a new modern facility is one of over 40 recommendations.

Although “Moving Forward” predates Bamford by 18 months, all of its recommendations are in line with the Bamford Review.

One of the review’s key recommendations was the development of a Crisis Resolution Service to replace the admission clinics. In March 2005 despite having a total of 68 admission beds available, including 12 emergency beds, in-patient services still struggled to meet demand. Moving Forward recommended that all potential hospital admissions should be initially assessed by a mental health professional and proposed a more comprehensive response to psychiatric crisis.

The new Crisis Resolution Service will include:

30 admission beds with integrated ICU facilities
a Home Treatment Team
an Acute Day Care facility

This new service will be located in a purpose built facility by 2010. The £10.4 million Business Case for the replacement of the admission clinics at Gransha has now been accepted by the Department. It will also provide accommodation for the Programme’s management team, and a Multi-disciplinary Education suite.

Since the review was completed the admission clinics have been refurbished and now include 2 x 20 bed segregated male and female wards each with their own 3 bed integrated ICU facility. An acute day care facility has been developed and a Home Treatment team established.

Admission beds have been reduced from 68 to 40. A further reduction to 30 is planned by October 2007.
A Home Treatment team currently treating over 30 people in the community has been established.
A new Acute Day Care service providing for up to 25 in-patients and out-patients has been developed.
Two years ago there would have been up to 68 service-users in hospital - today there are 40 in hospital and a further 40 supported at home through Home Treatment and Acute Day Care.

In addition to the development of the new crisis service, the Programme’s six community mental health teams will be reorganised and modernised to provide a new set of mental health teams specifically focussed on:

Primary Care Liaison Services
Rehabilitation & Recovery Services
Psychological Therapies Services
Addiction Services

The Moving Forward process fully embraces the Modernisation Agenda. To date all of the changes have been managed within existing resources i.e. no specific additional funding was available for Moving Forward. In particular, the restructuring of the in-patient service will facilitate the movement of 26 nursing staff - £630,000 - to a range of new community based services. However, the Trust estimates that, at least, an additional £1 million would be required to fully implement all of the Moving Forward recommendations.

Mental Health services in Foyle now have one of the highest community to hospital resource ratios in the U.K. with 80% of the Mental Health budget now allocated to community based services. In 1990 95% of the Mental Health budget was spent in the hospital.

MENTAL HEALTH SERVICES