Case Study: A Home Counties CAMHS and Autism Service

Claimont supports a Home Counties CAMHS to prevent Tier 4 hospital admission

After being discharged from an adolescent ward, a 14 year old child left the family home after assaulting their parents, who had found a note in their bedroom describing ways to kill themselves. They were later found, arrested and kept in police custody overnight. The Police brought them to A&E under Section 136.

The child was highly agitated and required four police officers to handcuff and restrain them. They were prescribed and administered 2mg lorazepam which helped calm them. Following assessment, they were detained under Section 2 for further treatment and a full assessment on a psychiatric ward.

AMHP report findings

“Taking into consideration all the information gathered, and all the relevant circumstances of the case, the assessing Team is satisfied that [the patient] meets the criteria for detention under Section 2 of the Mental Health Act as follows:

• [They] appear to be suffering from a mental disorder of a degree which warrants her detention in hospital for assessment (followed by medical treatment) for at least a limited period of time
• [They] ought to be detained in the interest of their own health, and safety with a view to the protection of others
• Joint medical recommendation for Section 2 of the Mental Health Act have been obtained

It is my opinion that on the balance of probabilities, she lacks capacity to make a decision about the treatment options and hospital admission.”

Outcome: detained under Section 2 of the Mental Health Act.

Claimont deliver inpatient support with a view to discharge

Considering the current degree and nature of presentation (it was noted that they tended to remain mute when emotionally distressed and suicidal), they would require a period of assessment in a psychiatric inpatient unit with an aim to treat their underlying mental health illness and to contain the risk.

The child did not seem to have any insight into their underlying emotional state and appeared to lack competence to consent to a care plan. Their current presentation could not be managed safely in the community due to the risks involved (risk of further deterioration in their mental state).

Claimont were commissioned to mobilise an initial support package, supporting the hospital team by providing direct support for the patient – freeing up the ward team to treat their other patients, whilst delivering person centred support to our patient. Claimont provided 1:1 support, Monday to Friday between 5pm-9pm and Saturday and Sunday 4pm -10pm.

Claimont facilitate a safe discharge with a comprehensive support package

With support from Claimont, the patient stabilised and was deemed medically fit for discharge. Claimont developed a care plan that allowed for a safe discharge from hospital with a comprehensive support package. Claimont delivered 1:1 support in the patient’s home environment. These were delivered in five-hour blocks, on a daily basis, afternoon to early evening; providing support in the home, trips to the park, and interactions with family, focusing on relationship building.

Outcomes

Claimont supported a Home Counties CAMHS and Autism service to facilitate a safe & high-quality discharge with a comprehensive home support plan. With input from Claimont, the patient was supported to live at home safely – helping to avoid a Tier 4 admission.

How Claimont can help you

Claimont understands the challenges that NHS and Local Authorities are facing, from a commissioning, operational and service delivery perspective. The service works in partnership with mental health commissioners and providers to support the continued delivery of high-quality mental health services across the UK. Contact us today to find out how Claimont can support your NHS mental health services.