"Unhappy with telephone call - lack of informed..."

About: West London Mental Health NHS Trust

I was called by a mental health professional who wanted to ask me some questions because I was new to the service. I found some of the questions intrusive and deeply personal for a telephone conversation without a clear rationale for asking them. I was also asked a question about a traumatic event that I did not want to go into detail about, and was asked three times for an answer when I had already made it clear that I did not want to disclose that particular information about my past traumatic experience, which made me very upset on the phone, only to have the caller rush onto the next question when I was clearly upset. I tolerated the questions in order to ask if I now was able to get an appointment for my psychiatric assessment and then they told me "this is the psychiatric assessment". I explained that I was unhappy that I was not informed at the start of the conversation that this was an assessment and the caller apologised. However, I am still disturbed by the fact that I never consented to this psychiatric assessment over the phone, because I was never informed that that's what it was in the first place! So no informed consent, and I had to ask the mental health nurse what their role was, because they hadn't introduced them-self fully.

I understand that mental health services are stretched to the limit and that this is an ongoing problem, however the rationale for the conversation should have been clearly stated and my informed consent obtained at the beginning (and therefore made the conversation much more straightforward and less time consuming for both of us!) I think that when some individuals are vulnerable this sort of conversation could really push them over the edge, so they should be informed so that this is an assessment, and that personal questions may be asked to gain a clearer picture of their current condition. This would greatly improve the current service with no cost or extra time involved.

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Responses

Response from West London Mental Health NHS Trust We are preparing to make a change

Dear Anonymous

We are sorry to hear of your less than positive experience of the telephone assessment and thank you for bringing this to our attention. We would like to reassure you that the Trust seeks to ensure a positive patient and carer experience for all our service users and takes all complaints and comments very seriously.

Your comments were received via Patient Opinion on 20th July 2016. I was asked to respond whilst covering the service manager post for the Single Point of Access (SPA).

Your concerns in summary are that: -

The nurse you spoke to did not explain their role or the purpose of the call. You found some of the questions too intrusive for a telephone assessment. The nurse you spoke to appeared insensitive to the fact that you were distressed by the questions.

The WLMHT Single Point of Access (SPA) provides 24/7/365 access to secondary care mental health. It is the primary referral route for people requiring secondary care. It provides a clinical advice service for GP’s and other professionals. In addition it undertakes an initial telephone assessment (triage) for those referred which may result in identifying that a face to face assessment is required or if sign-posting to another service or support framework is more appropriate. The service also delivers a 24/7 telephone support line for service users and carers if experiencing a mental health crisis.

The Single Point of Access (SPA) is a relatively new service provided by the trust. The purpose of the SPA is to triage all referrals into the service and determine what level of response maybe required. Referrals may come from any number of sources so the staff will gather as much information from as many sources as possible before determining if, when and who will see a patient. You are absolutely right that you should have received a full explanation of the purpose of the call and an introduction by the member of staff explaining their role and profession. The triage used by the staff is a semi structured assessment similar in content to the assessment used for face to face contact. The challenging nature of mental health assessments are that the questions can appear intrusive, however the need for direct questioning is to ensure that appropriate care is provided for the risks identified.

In regards to the insensitivity of the nurse, I again apologise that this was your experience, if you were to contact the SPA (03001234244) and speak to the Manager or PALS (0800 064 3330) and give your name and date of the original call, we would be able to identify the nurse and address your concerns directly.

I hope you feel that this has addressed your concerns.

Best wishes

Diana Wiggins

Crisis Resolution Team Manager