Advancing community mental health services in Ireland. Guidance papers.

Service users’ needs will vary depending on whether they are in an acute, stabilisation, or recovery phase of their mental health presentation. To respond to these changing needs, and as highlighted in A Vision for Change, all stakeholders need to clearly understand both the function of the stand-alone elements of acute community-based secondary mental health care and how these interface with each other to provide a seamless continuum of care. Chapter one of this resource document highlights the need for the culture of service planning and delivery to be underpinned by a variety of key principles including recovery; meaningful service user and carer involvement at all levels, community partnership and development, social inclusion and inter-disciplinary working. Chapter two describes how Community Mental Health Teams (CMHTs) is the basic unit of service delivery and how this, and other elements of the continuum of care, need to work together to ensure that service users’ needs are met in accordance with their phase of recovery. Chapter three sets out the pivotal role of the service user and carer in the planning and development of services and some of the challenges that must be addressed in seeking to establish this role. The respective chapters on assertive outreach and crisis resolution / homecare teams address two elements of service often confused and interchanged and seeks to clarify the distinction between them, and to indicate the role of both in the provision of comprehensive acute secondary community-based mental health care. This distinction is often further complicated by reference to the term ‘home-based treatment’, that we interpret as pertaining to the intervention of the mental health service that takes place in the home of the service user. Chapter six outlines what a day hospital is and references outpatient clinics as a component of community-based service. Chapter seven delineates the parameters of a crisis house and considers the related matter of respite care. Chapter eight addresses how the purpose and function of the day centre might be reframed on a larger, more socially inclusive and recovery-oriented canvas