B
FMH9 Develop and review an integrated care programme for an individual in forensic mental health care
Overview
This standard draws on the Care Programme Approach (CPA), which underpins effective and consistent management and treatment of individual’s problems through multidisciplinary partnership working. It covers development of the care programme, which brings together the individual’s need for treatment through psychosocial and other approaches to progress towards recovery with the security conditions necessary for ensuring that treatment can be delivered safely. Such a programme may cover many years of an individual’s treatment, and even relatively short programmes are subject to review as the evidence of the individual’s response emerges. Regardless of which member is formally responsible for drawing it up, a plan requires the input of a range of members of the multidisciplinary team.
Users of this standard will need to ensure that practice reflects up to date information and policies.
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Knowledge and Understanding
You will need to know and understand:
- Mental health disorders
- Psychopathy and personality disorder
- Drug, alcohol or substance misuse
- Self-harming behaviours, including ligation
- Offending behaviours, especially violent behaviour not related to mental illness
- Formulation of mental health problems
- Recovery focused interventions
- The range of medical, psychological, nursing and psychosocial interventions available at your own establishment
- Evidence of the effectiveness of different treatments, singly and in combination
- Enquiry reports on forensic mental health settings, including recommendations and analysis of practice in the treatment of individuals
- MDT roles and integrated care planning
- Risk assessment
- Identifying benefits to individuals from different settings and treatments
- The need to build and maintain positive relationships with all members of the individual’s clinical team and significant others
- The need to present clear and concise information in either written or verbal form
- How to develop the individual’s participation in the assessment process
- How to adapt communication styles in ways which are appropriate to different people (e.g. culture, language or special needs)
- The importance of establishing rapport and how to do so
- Methods of communicating sensitive information to individuals
- Current mental health legislation and regulations and the working of Mental Health Tribunals
- The legal rights of individuals
- How to support individuals in a Mental Health Tribunal
- The religious beliefs of different cultures
- The effects of culture and religious beliefs on individual communication styles
- The different features services must have to meet people’s gender, culture, language or other needs
- The effects of different cultures and religions on care management
- The principle of confidentiality and what information may be given to whom
- How information obtained from individuals should be recorded and stored
- Audits of clinical effectiveness
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The relevant research and evidence base for medical and psychosocial treatments
Performance Criteria
You must be able to do the following:
- review the formulation of the individual’s problem using a recognised evidence base
- identify and review realistic goals of treatment for different stages of recovery (e.g. reduced security, re-engagement with family, improved interpersonal behaviour, discharge to the community)
- identify how to make best use of roles and expertise in the multidisciplinary team
- engage the individual and family or carer in identifying goals, treatments and the pattern of day-to-day life to which they aspire
- consult and share the care planning among the multidisciplinary team, including the keyworker
- draw on comprehensive assessments of the individual (e.g. risk assessment, assessment of complex condition)
- determine the availability and applicability to the specific individual of treatments broadly suitable for their history and mental and general health problems
- choose treatments for which there is evidence that they are likely to work for the individual
- identify the lowest level of security that reasonably protects the individual and others while allowing the benefits of identified treatments and day-to-day life
- set out the risks to be taken and the benefits of doing so
- develop a contingency plan to deal with a change in risk (e.g. the event of a relapse occurring)
- set out an integrated care plan with a clear pathway to recovery
- establish a review process involving the multidisciplinary team according to local policy and guidelines
Additional Information
This National Occupational Standard was developed by Skills for Health.
This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004):
Dimension: HWB2 Assessment and care planning to meet health and wellbeing needs