FMH18 Respond to potential crisis and relapse for an individual in the community

Overview

This standard covers dealing with the contingencies that occur when an individual has returned to the community, such as using a relapse prevention plan that includes positive risk taking and how a crisis is to be dealt with as part of the Care Programme Approach. Involvement of and conditions laid down by the Home Office may need to be included. The individual takes responsibility for informing the team of their possible difficulties; the team then takes a professional decision about what action will occur, which includes readmission as well as respite. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 1

Knowledge and Understanding

You will need to know and understand:

1. mental health disorders
2. self-harming behaviours, including ligation
3. offending behaviours, especially violent behaviour not related to mental illness
4. substance misuse
5. psychopathy and personality disorder
6. the potential of relapse prior to moving on from one setting into another
7. re-entry to the community
8. the implications when an individual with high media profile is moving on from one setting to another
9. triggers and stressors that act on individuals
10. the need for co-operation and sharing of information between different members of the individual’s care team and the potential risk when this is not achieved
11. the range of treatments available at your own or other establishments and how to access them in an emergency
12. evidence of the effectiveness of different treatments, singly and in combination
13. inquiry reports on forensic mental health settings, including recommendations and analysis of practice in the community based treatment of individuals
14. the need to identify relapse signatures, behavioural indicators and trigger factors in the setting up of support structures in the community
15. local admission criteria
16. criteria for admission to establishments of all levels of security
17. risk assessment
18. identifying benefits to individuals from different settings and treatments
19. current mental health legislation and regulations
20. issues of individual confidentiality in the community
21. the legal rights of individuals and families
22. the religious beliefs of different cultures
23. the effects of culture and religious beliefs on individual communication styles
24. the different features services must have to meet people’s gender, culture, language or other needs
25. the effects of different cultures and religions on care management
26. the principle of confidentiality and what information may be given to whom
27. how information obtained from individuals should be recorded and stored

Performance Criteria

You must be able to do the following:

1. engage with the individual without threatening their developing sense of independence
2. support and reinforce the individual’s coping strategies, skills and abilities
3. identify signs of relapse (eg face-to-face observation, information from a carer or the individual) and communicate these to the multidisciplinary team
4. refer to the relapse prevention plan and complete an up-to-date assessment and risk assessment as soon as possible, involving the individual and carers (eg early indicators of relapse, engagement in risky behaviour and evidence of a individual’s relapse signature)
5. make a risk management plan available for immediate or emergency reference
6. communicate with and act according to legal and governmental requirements where relevant
7. work in partnership with the individual, their carers and the team to make an informed decision on how and where to treat the individual (eg in the community or to readmit the individual)
8. make arrangements for the individual to receive treatment and support, appropriate to the level of risk and need (eg respite, closer engagement with a care worker, support for carer, anxiety management, coping strategies)
9. make accurate, legible and complete records and adjust the care plan and relapse prevention plan to reflect changes
10. communicate the updated care plan within the multidisciplinary team, inform the individual, carer and family and regularly review

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: HWB4 Enablement to address health and wellbeing needs