Crisis Management

Aim – to develop understanding of

the process of managing crisis in community mental

health care

1Community Mental Health NursesJunior PsychiatristCarer

4CMHT AdministratorGeneral PractitionerSupport Worker

2Approved Social WorkerCMHT ManagerCrisis Team Leader

3Consultant PsychiatristCMHT Support WorkersPolice Officer

For each occupation, consider –What are the general roles & responsibilities of this occupational group?Do they have specific roles in relation to crisis management?

TASK 1 ROLES

TASK 2

THE BACKGROUND

Read the Case Study

Michael

TeensTwenties

Thirties

ThirtiesNow, 34

TASK 3

CRISIS MANAGEMENT

Play your role according to your knowledge of it.

The task for the group, as the scenario evolves, is to –

a. identify and analyse the issuesb. make decisions on actions

c. make decisions on communication & liaison

The CMHT Administrator takes a phone call from Michael’s Housing Support Worker. The Support Worker says that they are worried about Michael – they have noticed that during the past week he has become more isolated, he is not coming out of his flat, he’s drinking, associating with shady characters. She says she can hear Michael talking to himself inside the flat, and he is short with other residents.

MONDAY

Michael’s CMHN manages to see Michael. The report from the Support Worker is confirmed by his CMHN. The CMHN further assesses Michael’s mental state. Michael says that he believes people in the other flats are stealing money from him. He’s drinking 3 cans of strong lager a day and is not taking his olanzapine regularly. Michael is having problems getting off to sleep, and feels anxious and irritable at times. However, he is cooperative and willing to work on staying out of hospital.He agreed to the following care plan

to see the CMHN twice that week (Wed & Thu)to stop drinkingthe Support Worker will see Michael every day, take him shopping and check he is taking olanzapine 10mg daily

The CMHN makes an out-patient appointment with the consultant for the following Monday.The care plan goes to the MDT for discussion

Are the other CMHT members happy with the care plan?

TUESDAY

Michael’s CMHN calls on Wednesday, but Michael is not in. What should s/he do?

WEDNESDAY

MorningOn Thursday, another resident phones, saying that Michael has been seen in the street, gesticulating, and in a right state. What should be done?

THURSDAY

AfternoonThe CMHN calls and sees Michael in a dishevelled state. There is a smell of urine in the flat. Michael’s speech is disjointed. He is talking about other residents ganging up on him, stealing money. One resident says he has been threatened with a knife. The Support Worker no longer feels able to visit alone. The CMHN suggests admission to hospital to Michael, who refuses. What should be done?

What have you learned?

Aim – to develop understanding of

the process of managing crisis in community mental

health care