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Community mental health team case-loads and diagnostic case-mix

Department of Community Psychiatry, St George's Hospital Medical School, Cranmer Terrace, Tooting, London SW17 ORE

AIMS AND METHOD

Information concerning team staffing, keyworker case-loads, and keyworker diagnostic case-mix was collected from six community mental health teams caring for 1651 patients to establish the clinical burden across teams and professions.

RESULTS

Team case-loads varied from 427 to 121, an average of 275 patients. Over half the patients were female, and psychotic disorders constituted 44% of the sample. The most common diagnoses were schizophrenia (28.6%) and depression (23.6%). Keyworker case-loads varied across both teams and professions, averaging 30 patients per full-time equivalent. Psychiatrists' case-loads were the largest. Diagnostic case-mix varied with profession. Community psychiatric nurses had the largest proportion of patients with psychosis (73.8%).

CLINICAL IMPLICATIONS

Multi-disciplinary community mental health teams have a shared view of appropriate work distribution. Consultant psychiatrists may under-estimate the resources required by patients with non-psychotic disorders even in inner city areas.

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