Why focus on home treatment teams?

It is estimated that 1 in 4 of us will suffer from a mental illness in our lifetimes. 

In the past, people experiencing an acute episode of mental illness were admitted to acute inpatient wards to receive treatment. 

This is necessary in some cases, but in others the person with the illness, their families or carers may feel that they would rather be supported at home. 

If treated in the community, any social stressors which might have contributed to the episode of acute mental illness are more apparent than they would be if the person is removed from their social environment to a hospital. 

Without addressing social stressors, the person may return from hospital to the same situation and relapse. 

Treatment at home enables a more holistic approach to the person's health and their social support systems, and avoids some of the stigma which may come from admission to an acute inpatient ward.

The introduction of Home Treatment services was one of the key elements in the 1999 National Service Framework for mental health; the NHS Plan (2000) made the provision of home treatment services a national priority; and the Department of Health’s 2002 Public Service Agreement included targets both for the number of teams and the number of people treated.

The primary functions of these teams are to:

• provide an alternative to acute inpatient care
• provide a service that responds rapidly, and is intensive and time-limited
• gatekeep acute inpatient beds to prevent admission of people who could be treated in the community
• support early discharge of people who are admitted to acute inpatient services

The Royal College of Psychiatrists Centre for Quality Improvement already hosts numerous other successful accreditation programmes for mental health services, and was approached by the Royal College of Psychiatrists General and Community Psychiatry Faculty to set up an accreditation scheme for home treatment teams. 

It is designed to complement the Accreditation for Inpatient Mental Health Services (AIMS).

Why accreditation is important

• Home treatment teams formed an integral part of a comprehensive mental health service as defined by the National Service Framework for Mental Health (DH 1999), and of the acute care pathway. (Acute Care Declaration, DH, 2009)  Our accreditation scheme can support services to improve and demonstrate the quality of care they provide to service users and carers, their wider organisation and commissioners.
  
• The standards provide a guide to the functions of a home treatment team, as well as supporting teams to achieve accreditation, which can help to protect services from dilution or amalgamation.  Accreditation has been shown to help services gain the resources they need.
  

• Implementation of teams was overseen by the National Institute for Mental Health England (NIMHE) and, latterly, the National Mental Health Development Unit (NMHDU). Since NMHDU ceased to exist, monitoring and ongoing development has been seen as the remit of local services. HTAS aims to provide quality monitoring and improvement as a nationwide scheme, allowing sharing of knowledge between home treatment teams across the UK.
  

• Information gathered through the accreditation process can be used in Trust quality accounts, as recommended by the National Quality Board.

Benefits of the accreditation process

• A wide range of stakeholders are involved, including staff from all professional backgrounds, service users and their carers and our partner organisations.
  
• Development support: Services are supported to identify and address areas for improvement.
  
• Active on-going network support:  Members are supported to share best practice, seek advice and pool learning through a regular newsletter, email discussion group, annual conference and publication of resources on a member-only website.
  
• Sharing good practice:  Services are engaged with a network of peers, enabling sharing of good practice and providing a forum for advice and information sharing.
  
• Personal development:  Individuals can receive training in peer reviewing and are able to visit another home treatment team(s) as part of the review process.
  
• Spread of learning within the organisation:  Learning and innovations arising from the process are often spread beyond the participating service to other services within the organisation.
  
• Benchmarking and trend analysis:  We produce an annual national report enabling services to benchmark their own performance against other services, and to identify trends in service provision.