| View expressed by * | |||
Perceived advantages of delivering screening in secondary care | CMHT | GP | SU | N |
• CMHT staff have a better rapport and understanding of people with SMI |
|
|
| 12 |
• CMHT has better access to and knowledge of people with SMI |
|
| Â | 8 |
• The CMHT setting and workers are less threatening for patients than the GP environment and easier to trust – this might reduce the non-attendance rates |
| Â |
| 6 |
• CMHT staff can access patients in a greater variety of settings, thus enhancing the uptake of screening |
| Â | Â | 6 |
• It promotes a more holistic model of care – 'not just a prescription' |
| Â | Â | 4 |
• It is better to unite clients' physical and mental health care in one place |
| Â |
| 3 |
• CMHT staff are more experienced than GPs in working assertively with people with SMI |
|
| Â | 3 |
• If the CHD risk factors are linked to having SMI, then the CMHT should take responsibility for screening |  |
|
| 3 |
• Psychiatrists prescribe the antipsychotics which require risk factor screening |
|
| Â | 2 |
• CMHT workers have more time and can offer longer appointments |  |  |
| 2 |
• It would allow CMHT staff to develop new skills |
| Â | Â | 1 |
• There are shorter waiting times at CMHT compared to the GP |  |  |
| 1 |
Perceived disadvantages | Â | Â | Â | Â |
• The CMHT workload is already high – they lack the time for extra responsibilities |
|
|
| 19 |
• Lack of skills and knowledge required for screening amongst care coordinators, especially those without nursing or medical training |
|
| Â | 12 |
• Lack of appropriate facilities – e.g. equipment, clinical rooms, access to blood results in community settings |
|
| Â | 9 |
• Unwillingness of CMHT staff to take on extra roles |
|
| Â | 8 |
• Lack of medical expertise in the CMHT regarding appropriate interventions if screening results are positive – care will either be inferior or simply result in re-referral to primary care. |
|
| Â | 5 |
• It blurs the role of the CMHT |
| Â | Â | 5 |
• Some service users mistrust psychiatric services and don't want their involvement |
| Â |
| 4 |
• CMHTs only see the most severely mentally ill people, so some patients will be overlooked |
| Â | Â | 3 |
• It would be stigmatising (not normalising) to have separate services for people with SMI |
| Â | Â | 3 |
• Patients like to keep their mental health and physical health separate |
| Â |
| 3 |
• Mental health meetings such as Care Programme Approach meetings are inappropriate settings for screening |
| Â | Â | 2 |
• It would cause stress for CMHT staff who might feel to blame if CHD morbidity was undetected |
| Â | Â | 2 |
• Lack of continuity with CMHT staff – they tend to come and go more often than GP staff |  |
|
| 2 |
• CMHT bases are less accessible than GPs geographically |  |  |
| 1 |