"lack of transition services and family support"

About: Lincolnshire Partnership NHS Foundation Trust / Adult mental health

(as a parent/guardian),

Following an 18 month in patient stay my daughter was discharged home as she would have to leave the unit because she had just had her 18th Birthday, staff said if it wasn't for her age she would not be discharged at this point; no one expected her to be successful. To her credit she was and has finished a year at college retaking A levels, but at what price for those around her. there is no transition services it has been straight into an adult team for a young adult who lost almost 2 years to her mental health problems so had no resources of a adult to call on.

In our view there has been no family support for reintroducing a member back into a family, apart from a charity which has proved patchy and not around at times of crisis. Every one asks have you had a carers assessment but having had one it seems like it brings nothing at the end but a box tick.

Sadly my daughter have had periods with no CPN often at times of forseeable difficulties which we have been left to cope with, despite service responisbilities post section.

No one is interested if you do manage to screw up courage to feedback how things are going. During the most recent problems it was admitted to me I was monitoring yet no one told me this or asked if I was willing or had the personal strength and I had no faith from previous experience I would be listened to.

Sadly at one point the crisis team said the problem was not one they dealt with and recently failed to act when asked to by the recovery team. No one in the family patient or carer believe they are worth using

Recently my daughter said she had never feltsupported since her discharge

The cost a now broken family and ill health for the primary carer, why no transition services and realistic family support which would have prevented much and enabled the patient to take on more repsonisibilites for herself and her conditon.

on balance her in patient care was difficult at times but lead by professionalism and compassion, at times there are good pockets but not frequently and this seems to be when all is going well.

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Responses

Response from Lincolnshire Partnership NHS Foundation Trust

We are sorry to hear of the difficulties that have been experienced and thank you for sharing your story with us.

Our Head of Community Services has advised that there should always be a transition period when someone is leaving CAMHS to enter adult services. The age for this is between 16 and 18, at the Care Coordinators discretion. We would expect the receiving service to be invited to patient reviews (CPA or other) and a transition plan agreed. As part of this a handover period would be agreed and there may be some joint-working. The appropriate receiving team should in-reach into Ash Villa prior to discharge. Support for reintroducing the patient into the family would be best discussed prior to discharge.

However if IAPT is required (Improved Access to Psychological Therapies), this would not be the case and a referral would be made to them and they arrange an assessment in one of their bases.

Also, if inpatient care was still required we would expect them to be transferred to an adult inpatient unit rather than discharged to the community.

The Carers assessment should be more than a tick-box exercise and there are Carer support groups who are best placed to provide general support for a carer. We can assist in putting them in touch with such a group in their local area. The CPN would have interaction with the carer though and be supportive particularly around education and understanding of the patient’s condition. However, we would need the patients consent to do this and sometimes that isn’t always forthcoming.

Without further details we cannot be any more specific I’m afraid. If you want to get in touch with us our Head of Community Services will gladly look at the individual circumstances.

In respect of the specific issue relating to the Crisis and Home Treatment Team (CRHT), without any details of what the presenting “problem” was or what the Recovery Team was requesting of which Team it is very difficult to provide a meaningful response because we do not know the facts and it would be wrong of us to make assumptions.

If you feel able to provide sufficient information or have a conversation with someone you would be comfortable talking with then our Head of Acute Care would be happy to look at the details of the case. In the absence of any further details he has offered his apologies for the experience you have described. In addition, he would hope the Recovery Team and CPN involved would have raised any concerns they had with the request they made to CRHT as part of their professional code of conduct and if they were not satisfied with the outcome then escalated it through the line management process.

Whilst not a very positive experience for you and your family, we remain committed in working with Service Users, Carers and relatives and stakeholder groups to help us improve people’s experiences and aid their Recovery.