Improving the assessment and referral of mental health patients

Ambulance clinicians are attempting to avoid inappropriate admissions to accident and emergency (A&E) departments in line with the Bradley Report (Department of Health (DH), 2005), but are hampered by the lack of effective 24-hour mental health (MH) cover and referral pathways to places of safety, although improvements are expected. Increased strategic collaboration between MH care providers and ambulance trusts will liberate opportunities to capitalize on any improvements as joint stakeholders.

The Suicide Risk Assessment score currently listed within ambulance guidelines (JRCALC, 2006) is a fairly blunt tool, with poor staff confidence and use, typically resulting in the patient attending A&E. On review, the research panel proposed the adoption of an evidence-based assessment form for ambulance clinicians to use when assessing and referring MH patients.

Scally and Donaldson (1998) advocate clinical governance to improve care and quality within the NHS. In line with this, this article will use the review, agree, implement and demonstrate (RAID) (Cullen et al, 2000) quality framework for this assignment (Figure 1). It has been specifically designed as a tool for clinical governance and is easy to use and understand. The process is split into four sections and encourages constant re-evaluation in the pursuit of excellence by its cyclic design.