Depression Treatment by Bedford East Community Mental Health Team an Audit to assess how many patients in a Bedfordshire Community Mental Health Team might safely be transferred to Primary Care

Psychiatr Danub. 2010 Jun;22(2):317-22.

Abstract

Introduction: Recently there has been pressure on Secondary Psychiatric services to discharge patients back into Primary care. This project is to show what depression treatments are used by Bedford East Community Mental Health Team (BECMHT) and therefore identify whether some of these patients could be appropriately managed in Primary care.

Subjects and method: We identified, using an anonymised database, patients being treated with different anti-depressant regimens in BECMHT. We compared these treatments with the steps described in NICE Guidelines, and other evidence based treatment modalities which we found on literature search. Based on this data, we attempted to predict which patients it might be safe to discharge to primary care for ongoing treatment.

Results: Many different combinations of medications were found. Many patients had other intercurrent mental health diagnoses.

Discussion: There are many possible evidence based treatments for depression which can be employed once those listed by NICE are exhausted. We review all of these. Some patients are, accordingly, on combinations of medication as augmentation strategies.It is responsible to only discharge patients into Primary care when their symptoms are controlled.

Conclusion: We identified groups of patients who might be transferred back to primary care for maintenance treatment, provided that shared care protocols are in Place, and there is easy access to secondary care services should the need arise.

MeSH terms

  • Antidepressive Agents / adverse effects
  • Antidepressive Agents / therapeutic use*
  • Community Mental Health Services*
  • Cooperative Behavior*
  • Depressive Disorder / drug therapy*
  • Drug Therapy, Combination
  • England
  • Evidence-Based Medicine
  • Humans
  • Interdisciplinary Communication*
  • Long-Term Care
  • Medical Audit*
  • Patient Care Team*
  • Patient Discharge
  • Practice Guidelines as Topic
  • Primary Health Care*
  • State Medicine

Substances

  • Antidepressive Agents