Service delivery for mental health service users with complex needs
Research type
Research Study
Full title
A mixed-method study to inform an evidence-based service delivery model for mental health service users with complex needs
IRAS ID
293237
Contact name
Pooja Saini
Contact email
Sponsor organisation
Cheshire and Wirral Partnership NHS Foundation Trust
Clinicaltrials.gov Identifier
NHS/1582, 1582 CWP Funded Project
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Mental health services for adults, as they are currently configured, have been designed to provide predominantly community-based interventions. These community services are supplemented by additional provision that is accessed on the basis of acuity/risk (i.e. inpatient services) or of diagnostic specificity (e.g. assessment and treatment or psychosis or ADHD). It has long been recognised there are some patients who have such significant clinical and/or risk needs that those needs cannot be adequately met within the generic mental health services. There is a pressing need to consider the best model for delivering a service for this group of service users.
Studies examining the profile of this group indicate that it is not just a matter of the extent of the need, but also the complexity of their clinical profile and history. There is little understanding of why a patient becomes identified as someone in this group.
Although some lessons can be taken from previous evaluations of this group of patients in other areas of the country, there are limitations to the local applicability of this data. Furthermore, other evaluations have focused exclusively on the patient profile and they have ignored a major contributor both to the identification of these patients as in need of ‘specialist’ placements and the wide variability in the way different clinicians and services respond to the patients. Clinical experience and research tell us that decisions about patients are not the reliable product of an objective analysis of patient characteristics. Rather, they are influenced by subjective human factors and oft-ignored systemic dynamics. Understanding these influences allows the development of a holistic model that does not just provide the right approach for this group, but also ensures consistency and predictability of approach by decision-makers.
In this study, as well as examining the relevant patient characteristics, we also intend to examine the use of services by this group, the associated costs, the patient’s experience of current provision and the clinicians approach to in-practice decision-making.
REC name
West Midlands - Coventry & Warwickshire Research Ethics Committee
REC reference
21/WM/0020
Date of REC Opinion
19 Mar 2021
REC opinion
Further Information Favourable Opinion