Epsom and St Helier University NHS Trust

Project aim: To develop a standardise screening tool to identify the mental health status of our patients.

Group Photo - Epsom & St Helier NHS University Trust

Project aim

To develop a standardise screening tool to identify the mental health status of our patients.

Background

At ESTH we wish to improve the way Mental health care, including learning and educational issues in young patients with epilepsy are detected and care delivered.

As a  group of clinicians delivering a service, we would like to optimise the currently available resources with a view to improving the service for the patients and families and demonstrate the need for additional or even a different form of service or resources

We would like to have a screening tool in place to assess children and young people in our caseload’s mental health and recognise any children who are at increased risk and be able to refer to appropriate services. 

Tests, changes and what was learned in the process

Research screening tools already in place and ascertain which would be most suitable for our group – have identified the strengths and difficulties questionnaire and HEADS-ED as potential screening tools. We have found two potential screening tools which could be used in our setting, although they are challenges with both. The HEADS-ED tool allows for open conversation but will be time-consuming and relies on a safe space for children to talk. The SDQ can be completed outside of clinic and the results sent automatically to the team, but there is a cost implication and it would be difficult to complete for children with neuro-disability.  

We have been researching mental health services available in our local area, including those within schools and CAMHS. We feel it is really important that we are able to find suitable support for the children who need it based on their screening tool result.  

Patient and Parent engagement:

Plan to get patient and parents’ thoughts on the need for such a screening tool and how they would best prefer it is completed i.e. a conversation with a member of the team outside of clinic, an online form they can fill out in their own time, a paper form etc.  

Using data to drive change

  • What data are you capturing or planning to capture ie retrospective, currently, in the future and beyond this project?
    • we’re planning to keep track of how many patients are now being captured using the screening tool – this will also have the information on what their ‘score’ was.
  • What challenges have you experienced with capturing data?
    • we’re doing the project based at 2 different sites so we’re trying to figure out what will work best at each site, but also keep it consistent so that our measures are the same.
  • What solutions have you found?
    • we’re using the screening tool (ie single piece of paper) and our clinic lists (which were already being used for other things) to keep track of which patients are scored. We’re trying not to add much admin to already busy clinic slots.
  • What help do you need or do you have any questions?
    • we’re currently only screening new patients to try out the screening tool but have noted that we don’t actually have large numbers to track. We also are starting from nothing and so aren’t sure how to demonstrate our progress – ie the before is zero patients being screened. The after is (hopefully) all patients over 5 being screened. I’m used to using ‘run charts’ or other graphs to show progress but our project doesn’t really fit into that mould.

Results

  • Have not yet got patient and parent feedback. 
  • It has been challenging for everyone to get together as a team, partly due to annual leave but also due to work patterns/demands. Everyone still feels it’s a really important project to be working on and want to get it up and running. 
  • We plan to have a team meeting to discuss the progress we have made. We plan to get patient and parent feedback on introducing a mental health screening tool and how they would prefer to complete it. More research to be done around what mental health resources are available in our community.  

Challenges and successes

It has been challenging for everyone to get together as a team, partly due to annual leave but also due to work patterns/demands. Everyone still feels it’s a really important project to be working on and want to get it up and running.

Next steps

We plan to have a team meeting to discuss the progress we have made. We plan to get patient and parent feedback on introducing a mental health screening tool and how they would prefer to complete it. More research to be done around what mental health resources are available in our community.


Team presentation

 


Would you like to know more about these projects? If you would like to contact any of these teams about their QI work then please get in touch with the EQIP faculty at eqip@rcpch.ac.uk

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