Community Mental Health Teams. A rapid review of service models

The Mental Health Strategy 2021-2031 for Northern Ireland (Department of Health, 2021) provides guidance to improve and promote the mental health of those living in Northern Ireland, and it covers a wide range of policy areas. Actions 15 and 31 focus on reshaping mental health services to provide a person-centred approach and to ensure a regionally consistent mental health service across Northern Ireland.

Community Mental Health Teams (CMHTs) offer services to individuals with moderate to severe persistent mental health difficulties, to improve wellbeing and functioning and reduce inpatient stays. There is a need to further develop CMHT provision in Northern Ireland to ensure services are consistent across all Trust areas and enable equity of access and support for all.
This rapid review aimed to examine the literature on the provision of CMHTs in Northern Ireland, as well as international examples of CMHTs and service models, and, based on the findings of the rapid review, provide recommendations for CMHT provision in Northern Ireland.

We identified some relevant evidence from the international literature and guidance for CMHTs from across the UK and Ireland, as well as standards that all CMHTs can work towards. The literature highlighted the importance of team working within CMHTs and the role of management in ensuring services are delivered to a high standard.
Recommendations to ensure regionally consistent CMHTs in Northern Ireland include:

There needs to be a systemic approach to service development so the model for CMHTs needs to be considered along with the roles and resourcing of all components to ensure the most effective balance within mental health services, and across sectors and society.

There is a clear need for a consistent approach to the provision of CMHTs across Trusts. The very positive introduction of Primary Care Multi-Disciplinary Teams enables CMHTs, across Trusts, to refocus on those who require support beyond Primary Care.

There should be agreed guidance and standards for CMHTs which include referral and discharge processes, the interventions that should be available, the language used to describe services, and staffing levels, mix and roles.

The role of peer support workers should be further developed as a routine part of CMHTs.

There is a need to ensure that ongoing CMHT training, quality improvement and research are appropriately supported.

Leadership has been identified as an important part of the effectiveness of CMHTs and Team Leaders should be provided with the necessary support and opportunities for development.

CMHTs will also be crucial for the implementation of the Regional Mental Health Outcomes Framework and will be a key source of data to inform the further development of services to promote positive outcomes for service users and carers.