Predicting suicide attempts with electronic medical records

Approximately half of people who take their own life have previously made a suicide attempt. People who survive are therefore at high risk of ending their own life later.

A new project, led by Dr Rina Dutta at the Institute of Psychiatry (IoP), King’s College London, will aim to predict who is most at risk, and when, by analysing data from electronic medical records. Identifying warning signs may then allow healthcare professionals to intervene before a serious suicide attempt is made.

The project, called e-HOST-IT (Electronic health records to predict HOspitalised Suicide attempts: Targeting Information Technology), is being led by Dr Dutta, from the Department of Psychological Medicine at the IoP at King’s. The funding was awarded by the Academy of Medical Sciences, as a Clinician Scientist Fellowship.

Dr Dutta will use data from South London and Maudsley NHS Foundation Trust’s anonymised electronic mental health records system, CRIS, developed by the National Institute for Health Research Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and King’s College London.

Dr Rina Dutta says: “What we know about why people make suicide attempts lags behind our understanding of other life-threatening problems.  One reason is stigma.  Studying risk factors in detail has also been difficult, because health records have been handwritten and kept in paper files.  Predicting who is most at risk and when is the riskiest time is a huge challenge.”

She adds: “The NHS aims to be paperless by 2018. Now is the ideal time to see whether warning signs of a serious suicide attempt could be picked up early using anonymised electronic medical records. These warning markers could be changes in symptoms, behaviours or healthcare service use, which happen before a suicide attempt.”

With help from Mind, Dr Dutta has actively involved patients in the design and planning of the research to ensure it is patient-centred. The aim of the project is that the information be used to help health professionals personalise care for people most at risk.  The long-term goal is that as professionals use the electronic records system in their day-to-day work, they will be directly alerted to high risk times for their patients.  Finally, Dr Dutta also aims to develop prevention strategies and self-management tools by feedback of patterns indicating risk to individual patients.

Via Bridget via http://www.kcl.ac.uk/iop/news/records/2014/March/Predicting-suicide-attempts-with-electronic-medical-records.aspx

 

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keeping people updated about the proposed changes to Lewisham Adult Mental Health Services

Hello everyone,

In November, we held the Mental Health and Wellbeing Stakeholders Day.  Around 200 people attended.   At the event this year, we held focussed discussions about some changes to community adult mental health services.  We also invited people to give their views during November & December – see attached information sheet.

Information about proposed changes to Lewisham adult mental health services

I would like to let you know about a meeting we are holding in January (see attached flyer) to keep people informed and involved in the process.   Please do circulate to those who you feel may be interested.

A4 flyer – stakeholder feedback Jan 2014

With best wishes

Alice

Alice Glover

Patient & Public Involvement Lead – Mood Anxiety & Personality CAG and Psychological Medicine CAG
email:  alice.glover@slam.nhs.uk tel: 020 3228 0959

113 Denmark Hill |The Maudsley Hospital | Denmark Hill | London | SE5 8AZ



Summary of discussions – SLaM service user and carer advisory group for mood, anxiety & personality disorder services

Hello all,

The departments that manage the services at South London & Maudsely NHS Foundation Trust have ‘advisory groups’ where service users and carers come together to advise on and discuss developments.   The Mood, Anxiety & Personality department advisory group produces a brief summary of their discussions.  The purpose  is to let interested people know what is being discussed.  Please circulate as appropriate.

With best wishes,

Alice

Alice Glover

Patient & Public Involvement LeadMood Anxiety & Personality CAG and Psychological Medicine CAG
email:  alice.glover@slam.nhs.uk tel: 020 3228 0959
113 Denmark Hill |The Maudsley Hospital | Denmark Hill | London | SE5 8AZ

The Service User and Carer Advisory Group is part of the Mood, Anxiety & Personality (MAP) Clinical Academic Group – an organisational structure which manages services for mood, anxiety & personality disorder across the South London & Maudsley NHS Foundation Trust (SLaM). Most advisory Group members have experience of using mental health services or of being a family member/carer of someone who does. Other members include senior managers.  We meet every month and our aim is to keep the views of service users at the heart of all service developments and improvements. To make sure that people know what we are discussing in our meetings we have developed this short briefing sheet:

1)    Six service user/carer consultants were present at the November meeting, plus two Clinical Governance Project Officers, and the Patient & Public Involvement (PPI) Lead . Apologies were received from 7 service user/carer consultants and 4 staff members.

2)    Following our interest in the process of discharge, we have arranged to continue our discussions with the Lambeth head of pathway in December.  In January, we will also meet to discuss progress on the Southwark Discharge audit and recommendations to improve the implementation of the process.

3)    We heard that the workshop with staff and advisory group members to improve reception areas was productive.  Reception staff from all boroughs except Lewisham attended and action plans were developed.   We will be monitoring progress in this area, and identifying any actions that can be developed across the clinical academic group.  Group members found it interesting to hear the perspective of receptionists.

4)    We agreed that group members would visit teams to talk to them about the importance of getting and using feedback from service users.  Members that are interested in this work will first need to understand more about the current feedback system Patient Experience Data Intelligence Centre (PEDIC).  We highlighted the fact that questionnaires are just one way of getting feedback and more qualitative information can be gained through focus groups or user forums.

5)    4 members of our group and other service user consultants will join staff to visit services to check on quality.  3 members of the group have contributed to the development of the checklist which will be used.  The reviews will be reported back both to the advisory group and to management.

6)    We heard how the work to develop the personality disorder pathway has been on hold while the appointment of the new clinical director has been finalised.  The advisory group has asked to meet the new clinical director – Dr. Hugh Jones as soon as possible.

7)    A group member has been involved in the engagement work to understand more about people’s experience of services if they have a diagnosis of bi-polar disorder or recurrent depression. A series of focus groups are being held, but it has been agreed that the engagement will be ongoing as the work is developed.

8)    Advisory group members have been asked to try out the self assessment section of the new integrated health & social care assessment.

PDF here: Briefing Sheet November 2013


Summary of discussions – SLaM service user and carer advisory group for emergency access and complex care services

Hello all,

The departments that manage the services at South London & Maudsely NHS Foundation Trust have ‘advisory groups’ where service users and carers come together to advise on and discuss developments.   The Psychological Medicine department advisory group produces a brief summary of their discussions.  The purpose  is to let interested people know what is being discussed.  Please circulate as appropriate.  

PDF here: briefing – Nov 2013 – doc

With best wishes,

Alice

Alice Glover

Patient & Public Involvement LeadMood Anxiety & Personality CAG and Psychological Medicine CAG
email:  alice.glover@slam.nhs.uk tel: 020 3228 0959
113 Denmark Hill |The Maudsley Hospital | Denmark Hill | London | SE5 8AZ

The Psychological Medicine Clinical Academic Group (CAG) runs services across the South London and Maudsley NHS Foundation Trust (SLaM). The services include emergency access services (such as home treatment services, A&E psychiatric liaison), complex care services (such as eating disorders, chronic fatigue, mother & baby services) and neurosciences services (such as brain injury). Advisory group members have experience of services either as service users or family members/carers.  We work with the senior managers to keep the views of service users & carers at the heart of all service developments and improvements.  To make sure that people know what we are discussing in our meetings, we have developed this short briefing sheet:

  1. Six people with experience of using services or being a family member/carer were present at the November meeting.  Also present were the managers of the 3 Triage Wards, the Patient & Public Involvement Lead and the Croydon Clinical Service lead.  Apologies were received from 3 service user/ carer consultants and 1 staff member.
  2. As agreed at the last meeting, the focus of this meeting was patient experience on Triage wards. We focussed on the improvement work happening on triage wards following the recent visits by group members. Initial visits were held in the Spring and follow up visits in October. Discussions focussed on the following areas:

Care planning

Members of our group will continue to advise the wards on developing a user friendly template for a care plan for people on a triage wards.  We will make sure that black/black british people are involved in developing this because they are currently significantly less likely to say they are satisfied with care planning.  One ward manager has designed a poster about care planning and she will share this with the other managers.

Food/Refreshments

The quality and quantity of food available has been raised as an issue.  There is a time-limited trustwide working group working with the food providers to make improvements.  Ward managers will ensure that complaints continue to be logged and forwarded.  They will also ensure that there is easy access to water 24 hours a day.

Community meetings

Group members advised that community meetings should be run by service users, but that staff should be present.  Patients should be able to read the notes from the meetings which should be presented in a clear, but accessible style.    Advisory group members will assist ward staff to develop the community meetings when the work on care planning has been completed.

Information

The group acknowledged that a lot of discussions focussed on patient information.  It was agreed that a time limited working group should be set up to develop a consistent approach to: developing ward induction packs, care planning folders, notice boards and ensuring adequate availability of appropriate leaflets

Satisfaction Questionnaires

The ward managers agreed to display ‘Thank You and Feedback’ posters, showing how the service will use patient feedback for improvements.

This work will continue to be monitored through the Triage pathway meetings, the governance management meeting and the service user & carer advisory group.

The advisory group thanked the ward managers for attending and offered continued support to their work to improve patient experience.

Views and comments from SLaM service users and carers on any of the above issues, as well as feedback on how you would like the Psychological Medicine Service User & Carer Advisory Group to develop its strategic work with SLaM, are welcome.  Please contact Alice Glover, Patient & Public Involvement Lead on 0203 228 0959  or email alice.glover@slam.nhs.uk


Public Consultation with SLaM 2013 in Lewisham

South London and Maudsley NHS Foundation Trust would like to meet with their service users, carers, staff and public and discuss their plans for next year.

We will be holding meetings in each of the boroughs where anybody is welcome to attend. You will get together in small groups and suggest things that might be changed or improved in our mental health provision in the coming year.

We will be holding meetings in each of the boroughs where anybody is welcome to attend. You will get together in small groups and suggest things that might be changed or improved in our mental health provision in the coming year.

Our Lewisham meeting is on

19th November

2.00 to 4.00pm

Lewisham Carers Centre

Waldram Place

Forest Hill

SE23 2LB

After the meetings we will incorporate your ideas into our Annual Plan.

No booking needed – just turn up!

Enquiries:

Please ring Carol on 0203 228 2441 or e-mail membership@slam.nhs.uk

See flyer here: Public Consultation with SLaM 2013a lewisham


Mood, Anxiety & Personality Services – SLaM mental health service user and carer advisory group – summary of discussions – October 2013

Hello all,

The departments that manage the services at South London & Maudsely NHS Foundation Trust have ‘advisory groups’ where service users and carers come together to advise on and discuss developments.   The Mood, Anxiety & Personality (MAP) department advisory group produces a brief summary of their discussions.  The purpose  is to let interested people know what is being discussed.  Please circulate as appropriate.

PDF here: Briefing Sheet October 2013

With best wishes,

Alice

Alice Glover

Patient & Public Involvement LeadMood Anxiety & Personality CAG and Psychological Medicine CAG
email:  alice.glover@slam.nhs.uk tel: 020 3228 0959
113 Denmark Hill |The Maudsley Hospital | Denmark Hill | London | SE5 8AZ

Service User and Carer Advisory Group : 

Supporting people who use Services for Mood, Anxiety & Personality Disorders, through collaborative work with Service Managers

The Service User and Carer Advisory Group is part of the Mood, Anxiety & Personality (MAP) Clinical Academic Group – an organisational structure which manages services for mood, anxiety & personality disorder across the South London & Maudsley NHS Foundation Trust (SLaM). Most advisory Group members have experience of using mental health services or of being a family member/carer of someone who does. Other members include senior managers.  We meet every month and our aim is to keep the views of service users at the heart of all service developments and improvements. To make sure that people know what we are discussing in our meetings we have developed this short briefing sheet:

1)    Seven service user/carer consultants were present at the October meeting, plus the Clinical Governance Project Officer, the Manager for Lambeth Services, the Deputy Director, the Patient & Public Involvement (PPI) Lead and the Trust-wide Strategic Lead for PPI.  Apologies were received from 8 service user/carer consultants and 1 staff member.

2)    We are interested in the process of discharge to primary care. We discussed the need for vigilance when people discharge themselves from services and that some people will disengage from services when their relationships with care co-ordinators are problematic.  We will have a more detailed discussion about this.

3)    In response to our advice, the PEDIC feedback posters have been amended to clarify that PEDIC relates to patient satisfaction.  We hope that this will encourage more people to fill in the questionnaires.

4)    In terms of the Trust-wide involvement structure we generally agreed that it would be good to have clearer lines of accountability, but highlighted the need to maintain the structures and good relationships that have developed in the CAGS.

5)    As agreed at our last meeting, a small group met to devise some objectives to improve reception areas. This follows on from the recent visits that we have made to reception areas for the MAP community teams.  Our next step will be to hold a workshop in November for staff, service users and carers to develop some action plans for improvements.

6)    Group members will be accompanying staff to check on the quality of services.  Our first step is to contribute to the set of questions that will be used.  A small group of us will get together to review the proposed set of questions and make suggestions for amendments or additions.

7)    We heard that improvements to the pathway for people with personality disorder will be integrated into the programme for changes to adult mental health services in general. This will include increasing the capacity for community mental health teams to offer treatment.  We highlighted the need to identify and support people with this diagnosis at the earliest possible stage.

8)    Group members have been involved in the development of the recurrent depression and bi-polar disorder pathway.  Service user consultants will facilitate some focus groups to find out how people are experiencing services now.  The plan is to provide psycho education and develop a network of expertise and interest.


Emergency Access, Complex Care & Clinical neurosciences – SLaM mental health service user and carer advisory group – summary of discussions – October 2013

Hello all,

The departments that manage the services at South London & Maudsely NHS Foundation Trust have ‘advisory groups’ where service users and carers come together to advise on and discuss developments.   ThePsychological Medicine department advisory group produces a brief summary of their discussions.  The purpose  is to let interested people know what is being discussed.  Please circulate as appropriate.

PDF here: briefing – Oct 2013 – doc

With best wishes,

Alice

Alice Glover

Patient & Public Involvement LeadMood Anxiety & Personality CAG and Psychological Medicine CAG
email:  alice.glover@slam.nhs.uk tel: 020 3228 0959
113 Denmark Hill |The Maudsley Hospital | Denmark Hill | London | SE5 8AZ

The Psychological Medicine Clinical Academic Group (CAG) runs services across the South London and Maudsley NHS Foundation Trust (SLaM). The services include emergency access services (such as home treatment services, A&E psychiatric liaison), complex care services (such as eating disorders, chronic fatigue, mother & baby services) and neurosciences services (such as brain injury). Advisory group members have experience of services either as service users or family members/carers.  We work with the senior managers to keep the views of service users & carers at the heart of all service developments and improvements.  To make sure that people know what we are discussing in our meetings, we have developed this short briefing sheet:

Six people with experience of using services or being a family member/carer were present at the October meeting.  Also present were the Patient & Public Involvement Lead, the Clinical Governance Project officer, and the Service Manager for the CASCAID (HIV and mental health) team.  Apologies were received from 2 carer consultants and one staff member.

We heard that following our suggestion at the last meeting, Home Treatment Teams were now offering people the choice of completing satisfaction questionnaires on paper or on an electronic hand held device.

We discussed the proposals to change the structure of how patient experience is linked into the work about improving quality across the Trust.  We broadly agreed with the idea to develop one group at Trust level which is co-chaired by the Medical Director and a Service User Consultant.  We acknowledged that the detail needs to be agreed and that it was vital to have open and transparent discussions as new structures were developed.

We heard that the CASCAID team which provides services for people who are affected by HIV has undergone a 30% cut in funding. They are having to signpost more people to Improving Access to Psychological Therapy (IAPT) services in primary care. We discussed the stigma that remains around HIV as well as mental health highlighting the need to see the whole person.  We heard how the service had extended its opening hours in response to changing needs of service users. We are keen to see CASCAID resume the routine use of patient satisfaction questionnaires. We offered to help the service if they would like a service user/carer perspective in reviewing and/or improving services based on patient feedback.

We were pleased to hear that the innovative patient satisfaction questionnaire that group members had helped develop for A&E psychiatric liaison services was now aligned to the system and would soon be ready to pilot in Lewisham A&E.

A group member has re-visited the Triage wards with another service user consultant. Before the visits they reviewed patient satisfaction data and complaints data.  They will also review minutes of community meetings to identify themes that patients raise.   We were disappointed to hear that, overall, progress against the action plans has been slow. The quality of food has also now been raised as an issue.  The group member will be discussing the issues with the Pathway Lead, and feeding back to the Governance Executive Management Group. In light of their concerns, the advisory group agreed to focus on Triage Wards at their next meeting and request that ward managers attended, so that progress can be agreed.

We heard brief feedback from members about the work to develop an integrated health & social care assessment, the Southwark Peer Support project and the work being developed on mental health & policing.