Older Peoples Mental Health-Edinburgh

Referrals are categorised at triage using the following priorities based around imminent or serious risk to the patient or others (e.g. self harm, violence / aggression, challenging behaviour, neglect):

• Emergency – 24hr response from receipt of referral. This is facilitated by the RRT – please see separate RRT guidance (telephone discussion required with RRT)
• Urgent –   response within 5 working days (CMHTOP is a Monday – Friday service) – telephone discussion needed with the relevant Single Point of Referral
• Routine – at least / minimum 4 weeks (2 weeks for EBSS)

The aim of the triage process is to obtain sufficient information from the person making the referral to:

• Determine whether the person requires a mental health service intervention;
• Direct each referred person to the team likely to meet the identified need for further assessment or treatment;
• Determine the level of risk or distress;
• Initiate emergency response where the need is identified;
• When a mental health service intervention is not required, identify the service most likely to meet the needs of the person;
• Identify local community services and other relevant services;
• Give the referrer clear and concise information about the services available and options for further assessment or treatment;

Referrers should note that patients are triaged to a range of appropriate professionals depending on their needs. Referrers can request that the patient be seen by a particular discipline, but this request may not be fulfilled. Patients should be aware of this when being referred.

Who can refer:

Referrals are accepted from:

• General Practitioners
• Care Homes within Edinburgh for residents with dementia and/or other mental health problems
• Rapid Response Team (RRT).

And specialist services too:

• Hospital clinicians
• REAS Older People Mental Health Inpatient Wards
• Adult Mental Health Consultants
• Mental Health Assessment Service (MHAS)
• Anne Rowling Centre (to facilitate CMHTOP follow up for early onset dementia)

Who to refer:

All patients referred to the CMHT must be registered (or due to register) with a GP within the Edinburgh boundary and appropriate to the over-65 service (except in the case of early onset dementia). They should have an organic or functional mental health condition with at least one of the following:

• History of frequent relapses or hospital admissions
• Acute disruptive, disturbing or threatening behaviours to self or others (related to mental state)
• At serious risk of neglect, or in a position of vulnerability (due to acute mental health problems), which social care are unable to support
• Require advice and management of pharmacological treatment
• Require assessment of mental state
• Requiring assessment for diagnosis of dementia – please ensure that recent blood screening results & relevant brief cognitive testing scores are included in the referral
• Require ongoing support due to severity of mental health condition
• Require other specialist treatments such as non-pharmacological treatment including psychological therapies
• Capacity assessments when the presentation is complex, and the GP requires a psychiatric opinion
• Require follow-up after discharge from hospital regarding above

Please note that referrals as an alternative to hospital admission would require input from the RRT – please see RapidResponseTeamEdinburgh.aspx.

Who not to refer:

If a patient does not meet the criteria for CMHT Older People involvement, then please consider the options under the Resources and Links tab.

How to refer:

SINGLE POINT OF REFERRAL
There is a Single Point of Referral for the North & the South for referrals to the CMHTOP, MATS & EBSS (see below regarding referrals to DOAT & RRT).

GPs should refer using SCI Gateway:

• Edinburgh – Psychiatry of Old Age – North
• Edinburgh – Psychiatry of Old Age – South.

Please see HSCP boundaries.

For those without SCI Gateway, please use the referral form here:  (https://apps.nhslothian.scot/refhelp/guidelines/ResourcesLinks/NonSCIGatewayReferralFormforOlderPeoplesMentalHealthServices.doc) or by letter (containing the headings from the Non-SCI Gateway referral form).

• North Edinburgh Team: 0131 553 8411 (NorthTeamReferrals@nhslothian.scot.nhs.uk)
• South Edinburgh Team: 0131 537 6616 (SouthTeamReferrals@nhslothian.scot.nhs.uk)

DOAT Edinburgh referrals: RIE, WGH & Liberton wards to send email referral to btopmh.referrals@nhslothian.scot.nhs.uk 

Rapid Response Team – please see separate RefHelp page RapidResponseTeamEdinburgh.aspx. 

If a patient does not meet the criteria for CMHT Older People involvement, then please can the referrer consider the following options:

Social Care Direct    0131 200-2324

Referrals for:

• Personal care including bathing or showering
• Meal preparation
• Prompting with medication
• Aids and adaptations such as hand rails and bath chairs
• Respite care
• Long term care
• Day care
• Telecare

Crisis/Counselling

Mental Health Assessment Team, REH   0131 537 6000- ask for MHAS

Edinburgh Crisis Centre – 0808 801 0414 (open 24hrs) 

Samaritans – 0131 221 9999 / 08457 909090

Cruse Bereavement Care – 0845 600 2227

Crossreach Counselling – 0131 552 8901


Dementia

24 Hour Dementia Helpline Freephone 0808 808 3000

Alzheimer Scotland, Action on Dementia – Provide advice and support 24 hours a day, Have wide range of printed booklets free for carers and people with dementia. Same number as above.

Post Diagnostic Support Link Worker- tel 551 9350 – for people with diagnosis of dementia after April 2013 (referral from professional required)