Read how this service has enhanced accessibility from Shane Kirwan, Nurse Practice Development Coordinator, and Gráinne Donohue, Programme Manager of the Academic Institute, at SPMHS.
Primary features of the Homecare service
The Homecare service at SPMHS provides high quality mental healthcare to service users in the comfort of their own homes. The service involves one-to-one mental health support delivered daily, or more frequently, through video call, email, or phone.
This innovative approach accommodates most mental health presentations. It’s important to note, however, the suitability of virtual treatment depends on the person’s specific needs and the severity of their symptoms. All people referred to the service are assessed using the organisation’s risk assessment tool. A mental health professional evaluates each person to ensure the most appropriate treatment plan is implemented.
The Homecare service is designed to meet the needs of service users comprehensively. Key features of the service include the below.
- Multidisciplinary team (MDT) care: Service users are supported by a specific and dedicated MDT.
- Individualized care plan: Each service user has an individual care plan. Elements specific to the Homecare service are identified in the plan, including provision of information on the Homecare service and commitments from the service user and service.
- Regular check ins: Clinicians conduct regular calls with the service user. These calls monitor the service user’s progress, assess outstanding issues or risks and update treatment plans if needed.
- Remote therapy sessions: Ongoing individual sessions with members of the MDT are arranged and conducted through video call.
- Medication management: Medication and prescriptions are issued to the service user’s nominated pharmacy as frequently as clinically indicated. If medication is altered, new prescriptions are reissued.
- Remote psychotherapy: Ongoing psychotherapeutic interventions including, but not limited to, individual sessions, group sessions and family sessions or meetings take place remotely.
- Access to in-person activities: All social and recreational activities occurring in-person are available remotely for Homecare service users.
- Seven day support: Support is provided seven days a week for all service users accessing Homecare.
Key innovations behind the Homecare service
The implementation of this Homecare service resulted in the development of a tailored mental healthcare service that delivers high quality assessment and treatment to service users remotely, as an alternative to admission to an inpatient facility.
The development of the Homecare service was driven by key innovations.
- Video-enabled Cognitive Behaviour Therapy (CBT) pilot:A pilot programme for video-based CBT was successfully implemented before the pandemic. This allowed the service to experience the transition to providing care and intervention through video or telephone on a smaller scale.
- Electronic health records: Our successful implementation of electronic health records in 2017 streamlined remote care processes.
- Remote technology: All staff who could deliver remote care were provided with laptops enabling the use of Microsoft Teams for the delivery of remote group care, one-to-one treatment, and multidisciplinary meetings.
Doyle et al (2023) reported high levels of service user satisfaction across all domains for the Homecare service, and preliminary assessments have indicated that remote care is an effective way to improve access, enhance quality and provide efficient care for mental health service users.
Lessons from implementation
The Homecare service was designed with a human rights-based approach at its core, aiming to prioritise the rights and dignity of the service user in both the technology and processes, in line with our Charter of Service User and Family Rights. This charter is based on the values of the Mental Health Act 2001, the European Charter of Fundamental Rights and the United Nations’ principles for the protection of persons with mental illness and the improvement of mental health care.
Staff training
Staff training has been a key element of the Homecare service since it was set up in 2020. Healthcare professionals are trained on the safe and secure use of virtual healthcare platforms, as well as the risks associated with virtual care, such as communication barriers, technology failures, safety, and privacy concerns. Staff also undertake mandatory data protection training to ensure that they understand best practices for data protection and privacy to prevent accidental disclosure of service user information.
Risk assessments and safety measures
Regular risk assessments are conducted to identify any potential vulnerabilities with service users. If there are concerns about the safety of a service user, their risk will be assessed using our risk assessment tool. If the service user needs to be transferred to an onsite inpatient ward, a bed is provided for them on the main hospital site.
Empowering service users
A vital element of this approach to healthcare is the education of service users about the risks and safeguards associated with the virtual environment. Service users are encouraged to use secure internet connections, practice good password hygiene and be cautious when sharing personal or medical information online. All service users have data protection protocols explained to them before any interaction to empower them to take an active role in protecting their privacy and to reduce overall risk.
Conclusion
The Homecare service, involving virtual mental health inpatient wards, offers a creative and systematic approach to providing enhanced mental health support for service users, who often have complex needs.
Healthcare staff have become used to working with service users onsite and virtually daily. This dual mode of care not only fosters greater flexibility and accessibility for service users, but also allows clinicians to monitor progress in real-time, ensuring that interventions can be adjusted promptly based on individual requirements.
By integrating technology into the therapy process, the service promotes a more service user-centred approach, empowering people to take an active role in their recovery, while still receiving the necessary expertise and support from qualified professionals.
Ultimately, this innovative model not only reduces the burden on traditional inpatient facilities, but also enhances overall outcomes for service users, paving the way for a more responsive and effective mental healthcare system.
Download Homecare service brochure
Homecare service brochure
