The Mental Health Liaison Team (MHLT) provide assessment and brief interventions to our adult patients who present with a mental health concern. They also offer advice and guidance to ward colleagues when a full assessment may not be required. They are available 24 hours a day, seven days a week.

The team includes Team Leader, Sophie Heminway and Specialist Practitioner in Trauma Informed Pathways for Personality Disorder, Abi Smith. Our Consultant Nurse for Mental Health, Ian Noonan, recently had a chat with the pair to get to know their roles.

What is it that attracted you to working in liaison?

Abi: “You’ve got that opportunity of early intervention in the liaison team. It might be the person’s first contact with a mental health professional and usually we are assessing people who are not open to secondary mental health services.”

When is the right time to refer?

Sophie: “Each case is different, if someone is confused, in pain, intoxicated or delirious, our assessment would not be valid. If the person’s physical health would hinder the assessment, we would have to repeat it again. But if TOXBASE have advised the person needs a period of observation because of tablets they have taken, but they are not going to need treatment, we could take the referral straight away.

“If in doubt, call and discuss the person with one of the MHLT practitioners. If someone is medically fit enough to engage in the assessment then we can do an interim assessment, or advise about risk management, for example if they were transferring to Bradford for plastics review following self-harm – we would then hand over to mental health colleagues in Bradford to complete the assessment.”

How do you manage the emotional labour of being a mental health liaison practitioner?

Sophie: “We have a really supportive team and after every assessment, the practitioner comes back to the office and talks through the assessment and plan, and it becomes an informal supervision. Wherever possible, we make decisions together.”

Abi: “There are things that are upsetting as in all areas of healthcare, so there is a lot of informal debriefing and support within the team.”

What do you think we could do differently at CHFT to support our patients who are experiencing mental distress?

Sophie: “I see sometimes that people fear mental illness or fear that the person might go off and harm themselves or end their life.”

Abi added: “That fear can be a barrier to compassion. If something about someone frightens us, we risk unknowingly blaming them for their distress. When we are not sure what to do or are worried by someone’s behaviour, just think how can I show them compassion? How can I be kind to them in that moment even if I feel uncertain? They are likely to have experienced trauma and are also going to be feeling frightened or disoriented.

“If I had to tell someone they had a cancer diagnosis, or that an operation has had to be postponed, I’d be scared. It is about using the communication skills we have in one context and thinking about how we can confidently use them in another.”

More information about the Mental Health Liaison Team and other mental health services at CHFT can be found on the new Mental Health Care - CHFT Intranet (cht.nhs.uk) intranet pages and you can contact the Mental Health Liaison Team on x4624 (CRH) or x5521 (HRI)

Making a referral

Before making a referral, please make sure you can provide the following:

• The patient’s name and NHS number
• The reason for admission to hospital
• Reasons for referral to MHLT and current concerns
• Any previous mental health diagnosis if known
• Brief overview of mood, suicidal thoughts, self-harm, psychotic symptoms if present (hallucinations, delusions, paranoia)

The team also need to know…

• Is there any evidence of substance misuse?
• Any aggressive, bizarre, or challenging behaviours on the ward?
• Is the patient confused?
• Does the patient have capacity, and have they consented to the referral? If the patient doesn’t have capacity, please contact us to discuss further.
• Current risks identified (risk to self/others/self-neglect/further deterioration).
• Any other information that we would need to be aware of such as safeguarding issues or social issues