Summary

Mental Health refers to our psychological wellbeing, but serious mental illness is when someone’s symptoms cause significant distress or impairment of personal functioning.

QOF targets relate to people with schizophrenia, bipolar affective disorder, other psychoses, and those on lithium therapy.

Psychosis is when people lose some contact with reality. This might involve seeing or hearing things others can’t (hallucinations) and believing things that are not actually true (delusions) (see 🧠Psychosis).

Schizophrenia is a long-term mental health condition, and is often described as a type of psychosis (see 🧠Psychosis).

Bipolar affective disorder is a condition that affects someone’s mood, which can swing from one extreme to another. They have episodes of depression, feeling very low & lethargic, and episodes of mania, feeling very high and overactive (see 🌗Bipolar Disorders).

Lithium is a mood stabiliser, and is used in the treatment of mania & bipolar, and can also help to reduce aggressive or self-harming behaviour.

Care pathway

1️⃣ Book the appointment

1. We are using a combination of platforms / tools / teams to book patients in correctly with minimal manual effort. If @Louis Williams hasn’t already been in touch, check out the page to find our Monthly Summary plans or reach out to him to find out what you should be doing:
• If we’re using Hippo Labs, log into app.hippolabs.co.uk to find patient lists (see for more information)
• If we’re using Hero Health or AccuRX, @Louis Williams will send your team manual excel recall lists

2. Call the patient to book appointments with Mental Health Nurse (If there are no MHN appointments, book with a GP).

Ask the patient if they would like a friend, relative or carer to also be reminded about their appointments.

Explain what the appointment is for, and advise them that they might have a blood test on the day.

2️⃣ Patient arrives for appointment

1. Record that the patient has arrived in the appointment book
2. Allow the patient a moment to relax before asking to capture data on height, weight, blood pressure (if possible) and add to patient’s EMIS record
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How-to guides

5️⃣ MHN review

Open the clinical template: ‘Penrose Health - SMI’ and complete

1. Ask the patient if they are happy for us to speak to a relative about their care, and if so, record consent.
2. Complete first page of template, ‘MH Review’.
3. Review medications as per template page ‘Med Review’.
4. Perform annual physical checks using template page: ‘Annual Physical Checks’. (See 🪗Blood Pressure Readings if needed).
5. Consult template to determine appropriate blood tests, then organise by raising TQuest (for details, see ☕TQuest).
6. Ask patient to arrange phlebotomy appointment by talking to reception, who can:
• make an appointment with the in-house phlebotomist/HCA, or
• show patient how to get blood tests done in the community
7. Record status for smoking, alcohol and illegal substance use.
8. Discuss diet and physical activity.
9. Complete care plan with the patient using the SMI clinical template page: ‘Care Plan’.
10. Refer, if necessary:
• For BMI, refer to 🍎The Lambeth Healthy Weight Hub, 🍎Up! Up! Lewisham (Tier 2 Weight Management), 🍎NHS Tier 2 Weight Management Service or 🍎NHS Tier 3 Healthy Weight Programme as appropriate
• For smoking cessation, refer to 🚭Southwark Stop Smoking Service, 🚭Lewisham Stop Smoking Service or 🚭Lambeth Stop Smoking Service
11. Discuss any concerns with a GP.