COMMUNITY ASSESSMENT AND TREATMENT TEAM CATT TOWNSVILLE

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COMMUNITY ASSESSMENT AND TREATMENT TEAM
(CATT)TOWNSVILLE
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History of CATT in Townsville

• The CAT Team was formed in Oct 2005
• The team was an amalgamation of the existing
  Intake and Assessment Team and the Acute Care
  Team
• At commencement the CAT Team had 5 core
• Duties
• Intake
• Triage
• Initial Ax (Home or Health Facility)
• Acute Care
• Crisis response (Home or Health Facility)

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Additional Core Functions

• Alternatives to Admission (December 2007)
• Early Psychosis Intervention (July 08)
• Mental Health Intervention Co-ord ( January 2008)
• Emergency Department Mental Health Team (January
  2007)

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CATT Staffing ED Staffing

• 5 STAFF morning shift 0800-1630 2 morning shift
  0800-1630
• 3 STAFF evening shift 1300-2100 2 evening shift
  1300-2130
• 3 STAFF Weekends 1000-1800 1 night duty Fri,
  Sat, Sun
• Townsvilles Demographics
• 150,000 within Townsville/
• Thuringowa
• 250,000 in the wider catchment area
• Projected Growth
• According to 2001 census data by 2011
• Townsville/Thuringowa will have a population of
  188,322

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WHAT IS THE MIX OF THE CAT TEAM WORKERS?

• Multi disciplinary team comprising of
• Team leader
• CATT EDMH
• CNC NO4 CNC NO4
• 5x NO2 Nursing 2X NO2
• 1x HP3 Psychologist 3.6x Generic
• 1x HP3 Occupational Therapist
• 1x HP3 Social Worker
• 1x HP3 Occupational Therapist
• 1x Generic
• 1X Consultant Psychiatrist
• 1x Registrar
• 2x Administration Officers

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CATT Referrals

• Anyone can contact CATT including GPs, self
  presentation or families etc.
• This can be done by letter, fax or phone (there
  is a referral format for CATT on the TGPN
  website)
• The purpose of CATT is to provide community based
  assessment and short term follow up treatment

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CATT Referrals cont.

• CATT can provide services to
• -Adults who are not currently receiving
  treatment by the CMHS and who do not require
  assessment at ED for other clinical/medical
  needs
• -Adults requiring short term community follow
  up and or crisis support
• -Current consumer of the service who is
  requiring extra support of a weekend or in the
  evening
• -Consumers requiring additional support to
  transition from AMHU to the community

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Who should you refer to CATT?

• Patients who are presenting with moderate to
  severe psychotic symptoms
• Patients who are presenting with moderate to
  severe mood disturbance
• Patients who are expressing imminent risk to
  themselves or others (suicidal / homicidal
  ideation)
• Patients who have a plan and access to a means of
  hurting themselves or others

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How to refer to CATT

• Referral forms can be found on the TGPN
  website www.tgpn.com.au
• Referral forms can be faxed to CATT on 47 999 506
• OR
• If you believe the patient is at imminent risk
  to themselves or others and require urgent
  assessment phone CATT 47 999 480 and discuss your
  concerns

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The Importance of Information in a Referral

• Presenting problem
• Clinical observations - how long has the patient
  been experiencing symptoms, what are the specific
  symptoms i.e. Poor sleep, weight loss, poor
  appetite, hearing voices, paranoia etc. Severity
  of problem
• Is there a risk of self harm/suicide? Is there a
  plan or intent?
• Have they attempted before? How?
• How often has the patient been thinking of
  hurting themselves?
• Does the patient have access to means such as a
  gun or medication?
• Is there a risk of harm to others?

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Other Options

• ATAPS (Access to Allied Psychological Services)
• Better Access (Medicare)
• Non Government Organisations
• Private Counsellors/Psychologists via Private
  Health Insurance
• Mental Health Nurse Incentive Program
• Contact Mental Health Liaison Officer for support
  and ideas!!!!!

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Consumer Pathway
GP Referral
Triaged
MDT meeting
AMHU
GP
Full Ax
NGO
Psychiatrist
CMHS
ACT F/U
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MHA for GPs

• PRINCIPLES
• Least restrictive alternative
• Patients have the same human rights as others
• Support and information to be provided to assist
  person to exercise their rights
• Help the person to achieve maximum potential and
  self reliance
• Acknowledge any specific needs
• Promote the maintenance of supportive
  relationships and community participation
• A persons environment and values to be
  maintained
• Only appropriate treatment to be given
• Confidentiality to be recognised

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Exclusions from definition

• intellectual disability alone
• drug or alcohol use alone

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Assessment Documents

• Two documents required
• Request for assessment
• Recommendation for assessment

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Request for Assessment

• Can be made by any person
• Must reasonably believe the person has a mental
  illness of a nature or to an extent that
  involuntary assessment is necessary
• Must be made
• within 3 days of seeing the person
• within 7 days before or after the recommendation
  for assessment

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Recommendation for Assessment

• Can be made by
• any doctor or
• an authorised mental health practitioner
• Cannot be the same person who made request for
  assessment
• Must be made within 3 days of examining the
  person
• Valid for 7 days

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Emergency examination order

• Police or ambulance must reasonably believe that
• person has a mental illness
• there is an imminent risk of significant physical
  harm being sustained by the person or someone
  else
• applying for a JEO would cause dangerous delay
  and significantly increase the risk of harm
• NB Psychiatrist must be satisfied of these
  matters

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Justices Examination Orders

• An application can be made to a magistrate or
  justice of the peace for a justices examination
  order.
• The magistrate of JP must reasonably believe
• the person has a mental illness
• the person should be examined by a doctor or AMHP
  to decide whether a recommendation for assessment
  should be made
• the examination cannot be properly carried out
  unless the order is made

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Justices Examination OrderProcess

• Once the JEO is made, a copy of the order is sent
  directly to the authorised mental health service
  (usually the one closest to the person who is the
  subject of the order)
• The JEO authorises a doctor or AMHP to examine
  the person involuntarily and, if necessary, enter
  a place to conduct the examination to decide
  whether a recommendation for assessment should be
  made
• If the recommendation for assessment is made, the
  person may only be transported to the authorised
  mental health service for assessment if a request
  for assessment has also been made

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Questions?