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WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES BY DEPUTY M.R. HIGGINS OF ST. HELIER
ANSWER TO BE TABLED ON TUESDAY 9th SEPTEMBER 2014
Question
Will the Minister -
- set out how members of the public seeking the urgent assistance of mental health professionals for friends and family members who are suffering psychotic episodes or other conditions that require admission, voluntarily or by compulsion of law, to Orchard House, St. Saviour or to some other institution can get the help they require and the procedures that must be followed in such cases;
- inform Members whether a person who calls for assistance in these cases is compelled first to contact their GP to arrange for a psychiatrist to consult the person being referred and whether this person will be billed for both the GPs consultation and also that of the psychiatrist who is called out to assess the person who needs urgent medical assessment and treatment at a cost of £100s and, if so, whether she considers this is reasonable;
- explain what she considers to be an acceptable or reasonable timescale for a person to be seen by a doctor, psychiatrist or to be taken to Orchard House or a similar institution from time of first request for assistance or from examination by a psychiatrist?
Answer
- Any member of the public requiring urgent assistance' in regard to their mental health has immediate access to the Adult Mental Health Liaison Service located at the Emergency Department in the General Hospital.
This service is available on a 24/7 basis and provides immediate access to a triage assessment, including relevant access to a specialist community psychiatric nurse, staff grade psychiatrist and Consultant Psychiatrist, as required.
The outcome of an immediate assessment of a person in urgent need of assistance, may lead to further inpatient assessment and/or treatment which can be accommodated in one of two ways:
- firstly, and preferably, on a voluntary basis, which can be facilitated by the psychiatrist
- secondly, via detention under an Article of the Mental Health Law
- As with access to all secondary care services, the most advisable route is referral by the individual's GP, who will have a holistic view of the patient, and both medical and psychological history. This knowledge is fundamental in being able to provide good mental health care.
Referrals from GPs are prioritised, depending on the risks identified. Any GP can request an urgent appointment through the route outlined in (a).
Wherever possible, urgent assessment is undertaken within the Emergency Department at the General Hospital, which allows for any physical symptoms or conditions to be addressed, enabling a comprehensive mental health assessment to be completed.
GPs are not part of the Health and Social Services Department. They are run as private business and set their charges accordingly. The Minister for Health and Social Services has no control on that issue, although work is ongoing with GPs to develop a Primary Care Strategy for improving access to primary care services to all patients.
In terms of provision that is made within the Health and Social Services Department, any person in need of immediate compulsory psychiatric treatment under the Mental Health (Jersey) Law 1969 is exempt from charges, under the conditions of the Health and Social Services Residents and Non- Residents Charging Policy.
In the context of charges that are made for services provided by the Health and Social Services Department, the Minister believes this is an appropriate position.
- The national average for an immediate response where urgent assistance is required is for a patient to be seen within 30 minutes in the UK, and the Minisiter is proud to say that in Jersey, the average response time is just 20 minutes.
This is a consistently high standard which has contributed to the Community and Social Services Department's National Accreditation by the Royal College of Psychiatry, and to the Mental Health Liaison Service successfully achieving excellence' status for its services, one of only three authorities across the UK to currently hold this accolade.
GP referrals made to the Adult Mental Health Service are screened on the day of receipt.
Where a referral indicates a significant risk, the referred patient is seen on the same day, or at least within 24 hours of the referral being received.
Where a referral is made on a routine' basis, the patient pathway involves a letter from the Adult Mental Health Service being sent to the individual seeking their consent to become involved in the service.
Once confirmation of consent has been received, an appointment is provided within a maximum three- week period.
This standard also exceeds expectations in the national standard set in the UK through NICE guidelines.