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Improving triage of referrals to adult MHS

Improving triage of referrals to adult MHS

Who are adult mental health services?

Our adult mental health services are comprised of multiple teams who work alongside our service users and their family/whānau to provide treatment that will help them recover from mental illness. The teams are made up of:

  • three community mental health services
  • two satellite services
  • two inpatient units on the North Shore and Waitakere Hospital sites
  • a Liaison Psychiatry service on the North Shore

Our adult mental health services support service users from North Shore, Waitakere and Rodney districts, and also help to process referrals for Pacific, Māori and maternal mental health services.

What are we trying to achieve?

As an outcome of a recent review we identified that there was an inconsistent approach to managing new referrals to our acute adult community mental health services.

Our service users told us:

  • not everyone gets the same service
  • there is limited access to psychological therapies
  • they often have to wait for a phone call
  • they often have to tell their story to yet another person

To ensure a consistent approach to the management of new referrals and to improve our service user experience we decided to introduce a Referrals Management function which includes a triage scale.

What have we done?

Service-wide triage and referrals management

We have developed and introduced a new process for triage and referrals management:

  1. Clinician receives a phone enquiry from someone in the community or an electronic referral from a GP
  2. Clinician will assess the case and assign an appropriate triage category using the UK Mental Health Triage Scale[1], and this is recorded in our mental health services electronic clinical records system (HCC)
  3. The assigned team within adult mental health services can then view the type and urgency of response required for the case

UK Mental Health Triage Scale

We have chosen the UK Mental Health Triage Scale to prioritise referrals to our adult mental health services[1]. The triage scale sets out very clear guidelines for the maximum time that should be taken to respond to a case based on the triage code. It also ensures that people who need to be seen urgently will be prioritised in the same way, and that referrers across the district can expect the same response and support.

This scale also has an associated training package which we have used to trained a small number of clinicians who have been identified to carry out the Referrals Management role to ensure that the triage scale is applied consistently across the district.

UK Mental Health Triage Scale

  1. Sands, N., Elsom, S. & Colgate, R. (2015). UK Mental Health Triage Scale Guidelines. UK Mental Health Triage Scale Project. Wales

Did we make a difference?

Since the introduction of the triage scale and referrals management function, our service users, GPs and clinicians tell us that:

  • they now have a clearer idea of what to expect following a referral
  • service users are seen within appropriate time frames
  • for service users not requiring face-to-face support, they are able to access appropriate advice and information more easily

We can also now track the number of people we see in each urgency group.

Where to from here?

  • We will continue to monitor our referrals to ensure that triage categories are applied consistently
  • Training will be rolled out to all acute clinicians who may be called upon to take referrals outside of normal business hours
  • A reorganisation of our acute community assessment and treatment functions is underway
  • Another Auckland based DHB is intending on using this triage scale which will mean that service users can expect to receive a similar response from mental health services across Auckland