East Lothian out-of-hours emergencies
Out-with the normal working hours of the CMHT, emergency/urgent support is available via the Intensive Home Treatment Team (IHTT). This operates from 08:00-midnight, 7 days per week, 365 days per year.
East Lothian Intensive Home Treatment Team (IHTT)
Please phone: 0131 536 8300. The receptionist will take some basic details and the shift coordinator will call back. IHTT acts as gatekeepers for acute inpatient admissions and must be contacted if it is felt someone requires admission.
The team triages all urgent/emergency referrals who may require intensive support and are at risk of being admitted to hospital. The service is for adults aged over 18 (no upper age limit) residing in East Lothian, who are experiencing an acute mental health crisis or functional illness (not dementia).
IHTT in East Lothian works from 8am to 12 midnight. From 12 midnight to 8am all urgent/emergency cases will be seen in the MHAS suite at the Royal Edinburgh Hospital.
When to contact IHTT
If you have seen the person on the same day and you consider:
- the person is experiencing a severe level of mental distress
- the person and/or others are at risk due to this mental distress
- admission is being considered.
You should contact IHTT via the pager number above and the shift coordinator will call you back immediately to discuss your referral.
What we will do
The team will discuss with you the most appropriate course of action. If appropriate IHTT will assess the person – for the first appointment this is usually in a clinical setting, but ongoing appointments may be at home if suitable.
The person will have a skilled mental health assessment to explore the best treatment options and agree a plan. Hospital admission will be facilitated if necessary. The referrer will be informed of the outcome of this assessment promptly (preferably that day but certainly by the next working day).
Suggested information to be gathered by the referrer prior to contacting IHTT
- Demographic information – IHTT is targeted at people aged over 18 living in East Lothian
- Involvement with Mental Health Services – current or past including history, current plan, Key Workers, next appointment or current medication
- Previous presentations e.g. presenting with mental health problem, self-harm, suicidal to A&E, GP
- Drug/alcohol use – substance use can mimic symptoms of mental illness and make assessment problematic, or they may be used to cope with mental health problems
- Presentation – appearance, communications, behaviour (overactive, aggressive, pacing, fearful, upset, etc)
- Clinical signs of mental health problems e.g. poor sleep, appetite changes, voices, paranoia
- Social circumstances – who does person live with, employment, marital status, vulnerable adult, children
- Physical health
- Willingness to engage with IHTT, expectations, referrers impression
- Risks
- Deliberate self-harm
- Suicidal thoughts – plan, attempts, preparations
- Risk/history of self-neglect or vulnerability due to mental illness
- Risk/history of violence or aggression
- Forensic/criminal history
- Protective factors e.g. what stops person from self-harming.
