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APPENDIX 1

SCHEDULE 3 THE SERVICE: SERVICE USERS, MANNER, LOCATION AND ACCESS

1. The Services will be provided for residents of Lambeth who are:- • Adults (aged 18 – 65 years) who meet the eligibility criteria for any of the services described in Section 2.1 o For the Early Intervention in Psychosis Service, the age eligibility criteria is 16 – 35 yrs (from 14 yrs for OASIS service only) o Existing service users over 65 years of age will receive services that are most appropriate for their health and social care needs irrespective of their age. • Patients and service users may be referred if they live within the boundaries of the Borough. From time to time, there may be prospective clients who seek referral or are referred by other professionals who are not within the responsibility of the Council. In those cases, such clients will be dealt with on a case by case basis through negotiation on behalf of the Partners by the Council with the neighbouring Local Authority and where necessary also with other NHS Commissioners of care and according to any existing national guidelines on district of residency or commissioner responsibility.

2. The Services to be provided comprise of: 2.1 For Adult Mental Health • Primary care, housing, police, internal council departments, screening assessment & short term interventions (provision of information, advice and signposting) delivered in a primary care setting • Secondary care assessment • Management of those service users with complex needs, or high risk levels, via the Care Programme Approach • Medication clinics and symptom & side effect monitoring • Outpatient Clinics • 24 hour Crisis Resolution, home treatment and the Approved Mental Health Professional service. • Housing related support: assisting with accommodation • Assessment, on going support and joint case holding with other secondary care services of Mentally Disordered Offenders i.e. anyone arrested for an offence and believed to be suffering from any

DRAFT 12 as at 20 March 2012 1 DRAFT 12 as at 20 March 2012 : form of mental disorder including mental illness and learning disability, acquired brain injury and personality disorder • Early Intervention in psychosis team including Bipolar affective disorder • Engaged with Commissioning partners to assist Community development focussing on improving mental health commissioning, access and outcomes for all ethnic communities • Vocational service • Mental Health Act Administration • Psychological therapies in both individual and group settings • Occupational therapy as part of integrated multidisciplinary teams • Professional leadership in each key discipline (including Social Care Leadership) • Section 136 Place of Safety • The management of adult safeguarding cases when referred by other agencies. • All staff aware of child safeguarding procedures and referral pathways. • Joint management of dual diagnosis (with substance misuse) clients • Assessment for clients using Fair Access to Care eligibility.

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1. Recovery and Opening Hours: 9am-5pm, Monday – Friday (excluding Support Service Bank Holidays) [Psychosis CAG] Location North Locality – 332 Brixton Road London SW9 7AA South Locality – 380 Streatham High Road London SW16 6HP Summary The Recovery and Support service provides care co-ordination for service users, who suffer severe and enduring mental disorder and who meet the criteria for inclusion for the Care Programme Approach. The Recovery and Support Team make sure that people are supported in their recovery, encouraging them to find opportunities to become more involved in their local communities. The team consists of multi-professional staff (nursing, social work, OT, admin and Consultant Psychiatrist/ Medical input). The team also carries out an Assertive Outreach function. This part of the service will support people who are at risk of repeatedly becoming ill and being admitted to hospital. This may be because they have a range of problems such as drug or alcohol use and mental health problems, finding it hard to take their medication and / or lack of support from friends or family. Access Criteria The service is for people aged over 18 with a serious mental illness (i.e. schizophrenia). Some of this cohort will have: § A severe and persistent mental illness, associated with a high level of social disability. § A history of high use of inpatient or intensive home based care (e.g. more than 2 admissions in the previous six months) § Difficulty in maintaining lasting and consenting contact with services § Multiple, complex needs including a number of the following: 1. history of violence or persistent offending 2. significant risk of persistent self-harm or neglect 3. poor response to previous treatment 4. dual diagnosis of substance misuse and serious mental illness Accepted referrals will meet the criteria for inclusion in the Care Programme Approach and meet the Fair Access to Care thresholds for “critical” or “substantial” need. Referrals Referrals to this service can be made from Early Intervention services, GPs, MAP CAG teams and self referrals of previously known clients. All referrals must be made in line with agreed protocols.

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2. MAP Community Opening Hours: 9am-5pm, Monday – Friday (excluding Bank Holidays) [CAG – Mood, Anxiety & Personality Disorder] Location North Locality – 332 Brixton Road London SW9 7AA South Locality – 380 Streatham High Road London SW16 6HP Summary The MAP Community team provides the main gateway to adult mental health services to residents of the Borough of Lambeth who are experiencing mental health problems that are not responding to Primary Care intervention or require more specialist interventions where there is no clear diagnosis of a psychotic illness. The service is GP aligned and provides a multi- disciplinary approach to initial mental health assessments and offer short term focused interventions to those with severe mental illness on an individual or group basis. These include CBT and CAT approaches, brief solution-focused therapy, group treatments and art therapy, and long term care co-ordination for people with treatment resistant depression. The teams are able to refer to other agencies, both statutory and non-statutory where required. It also provides a consultation service to other health professionals. Access Criteria The service offers community based assessment, advice and treatment service to adults, usually aged between 18-65, and with mental health problems and complex needs Referrals The team assesses everyone who is referred to a community mental health team without a clear diagnosis of psychosis. Referrals to this service can be from multiple sources including GPs and other members of the Primary Care Mental Health Team within, Lambeth PCT borough secondary mental health services, other Lambeth borough specialist mental health teams, direct access mental health services including Accident and Emergency, Lambeth Borough Housing Department and other local housing providers, the courts, local police probation service and solicitors. Referrals are also accepted from other agencies acting on behalf of patients who are the responsibility of the Lambeth PCT catchment area. Self referral would only be accepted if it is part of a previously agreed plan of care for people who have been discharged from the service or where there are duties to assess that relate to the Lambeth Local Authority functions undertaken by the CMHTs under Fair Access to Care and the Mental Health Act.

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3. Forensic Assessment Opening Hours: Admin support 9am-5pm, Monday – Friday & Treatment Service (excluding Bank Holidays) [CAG – Behavioural & Clinicians work 37.5 hrs. per week with flexible hours Developmental adapted to needs of service Psychiatry] Location Landor House, Lambeth Hospital 108 Landor Road London SW9 9NU Summary The team provides assessment and treatment services for mentally disordered offenders from Lambeth. It provides for: § Lambeth Forensic Pathways and Referrals group § Camberwell Green Magistrates Court Psychiatric Liaison § High Secure, High Support and Prisons liaison § Forensic Assessments § Forensic Treatments and Interventions (Psychotherapy, Link- working, etc) § Risk Assessment & Management Training / Consultancy for HCR 20 § Forensic Clinic Reviews – Specialist advice and support to Secondary Services Access Criteria The service is for patients with a severe mental illness or mental disorder who have shown or who are showing a risk of serious harm to others and who require care in institutional or community setting. This will include those who have committed or have demonstrated a potential to commit, the following offences: § Homicide § Attempted Homicide § Grievous Bodily Harm § Wounding with Intent § Fire setting, either reckless or with intent to endanger life § Rape / attempted rape / indecent assault (adult or child) § Other offences as deemed appropriate for detention in medium secure mental health services as a result of judicial proceedings Patients may also be subject to Ministry of Justice restrictions, Probation Orders or may have judicial proceedings outstanding. Referrals The decision to admit a Lambeth patient is the sole responsibility of the Clinical Director and the Forensic Referral group. Referrals to these services will be accepted from: § HM Prisons § Lambeth Community Forensic Team § Psychiatric Intensive Care Units

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4. Forensic Case Opening Hours: 9am-5pm, Monday – Friday (excluding Management Service Bank Holidays) [CAG – Behavioural & Developmental Psychiatry] Location Landor House, Lambeth Hospital 108 Landor Road London SW9 9NU Summary The service provides case management for mentally disordered offenders from Lambeth for: § Lambeth Forensic Referrals § Camberwell Green Magistrates Court Liaison § Lambeth Out of Area Placements § Forensic Assessments § Forensic Treatments and Interventions § Carers group Access Criteria The service is for patients aged over 18 years who are residents of Lambeth, on the basis of GP registration or in line with the conditions of responsibility set out in the Responsible Commissioner Guidance. The service is for patients with a severe mental illness or mental disorder who have shown or who are showing a risk of serious harm to others and who require care in a community setting. This will include those who have committed or have demonstrated a potential to commit, the following offences: § Homicide § Attempted Homicide § Grievous Bodily Harm § Wounding with Intent § Fire setting, either reckless or with intent to endanger life § Rape / attempted rape / indecent assault (adult or child) § Other offences as deemed appropriate for detention in medium or low secure mental health services as a result of judicial proceedings Patients may also be subject to Ministry of Justice restrictions, Probation Orders or may have judicial proceedings outstanding.

Referrals The decision to Case Manage a Lambeth patient is the sole responsibility of the forensic community team. Referrals to these services will be accepted from: § HM Prisons § Psychiatric Care Units § Medium secure wards § Low secure wards

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5. LAMBETH Opening Hours: 9am-5pm, Monday – Friday (excluding Bank CENTRALISED AMHP Holidays) SERVICE Location Orchard House, Lambeth Hospital 108 Landor Road London SW9 9NU Summary This service organises and carries out all Mental Health Act assessments during normal office hours, thus fulfilling London Borough of Lambeth’s statutory responsibilities under the Act. There is a full-time team manager and practitioner manager, and some five approved mental health practitioners are rostered on at all times to cover the requirements of the service. Duty AMHPS liaise with doctors, police, ambulance services, carers, bed managers and other involved professionals in order to set up assessments, which are then carried out, and liaise with in-patient wards and community teams with regard to ongoing care. Access Criteria Direct access to an AMHP referral Referrals Referrals are taken from community mental health teams and in- patient wards, as well as from A&E departments, general hospitals, Section 136 Place of Safety, police stations and courts. GP referrals are made to the community teams who make preliminary enquiries and pass on if appropriate.

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6. Placements Opening Hours: 9am-5pm, Monday – Friday (excluding Bank Assessment and Holidays) Monitoring Service [CAG – Psychosis] Location 308 Brixton Road London, SW9 6AA Summary The Placement, Assessment and Monitoring Service (PAMS) provide care co-ordination, assessment and rehabilitation for people, aged over 18, with mental illness who are in nursing or residential care accommodation. The team provides care for people who live in the London Borough of Lambeth. The team consists of mental health and social care professionals, including psychologists, nurses, occupational therapists and social workers. PAMS helps people to maintain their health and to live more independently. They also make sure that the users are in the most appropriate residential or nursing care accommodation for their specific needs. They also enable people to have more choice and control in their care through the self directed support framework. Access Criteria This service is for adults of working age and above if they have been under the care of the Lambeth Adult Mental Health Service who are in London Borough of Lambeth funded adult Mental Health NHS and social care placements either within the borough or in an out of area placement who require continuing help to live as well as possible Referrals People are referred in to the service when a decision is made by the Lambeth Adult Mental Health placements panel to agree to a placement. Referrals to the placement panel can only be received from Lambeth Adult Mental Health Services

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7. Amardeep Opening Hours: 9am-5pm, Monday – Friday (excluding Bank Holidays) [CAG – Psychosis] Location 308 Brixton Road London SW9 6AA Summary AMARDEEP provides a comprehensive and culturally acceptable assessment and treatment service to the South Asian Community with a range of mental health and social care problems in Lambeth. Its Adult Community Mental Health Team offers a range of interventions to address both health and Social care needs. The team is able to communicate in Bengali, Gujarati, Hindi, Punjabi, Urdu as well as English. Our aim is to provide care for people in the South Asian community who, for cultural or language reasons are unable, or who refuse, to use sector-based mental health services Access Criteria The service offers community based assessment, advice and treatment service to adults, usually aged between 18-65, and with mental health problems and complex needs Referrals Referrals can be made to the service by an authorised assessor from Health and Social Services, GP surgeries, local community groups. Self and family referrals will be advised/supported in obtaining a referral from their GP.

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8. Home Treatment Opening hours: 7 days a week; 08.00-22.00 Team [CAG – Psychological Medicine] Location Orchard House, Lambeth Hospital 108 Landor Road, London SW9 9NU Summary The Home Treatment Team provides a service for people, aged 18-65, with severe mental illness who would benefit from assessment and treatment at home as an alternative to Hospital. The team also gate keeps admissions into the inpatient services by incorporating the bed management function, continuing to liaise with the patient on the ward and endeavouring to get them back into their own home as quickly as possible. The team provide short-term treatment for people who are having a mental health crisis. Wherever possible, we avoid the need for hospital admission. Access Criteria The service is for people aged over 18 with a severe mental illness (i.e. schizophrenia, manic depressive disorders, severe depressive disorder) with an acute psychiatric crisis of such severity that, without the involvement of the Home Treatment Team, hospital treatment would be necessary. Referrals All referrals to this service must be made by secondary care mental health professionals. All referrals must be made in line with agreed protocols

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9. Early Intervention Opening Hours: 9am-5pm, Monday – Friday (excluding Bank CMHT Holidays) [CAG – Psychosis] Location 190 - 192 Kennington Lane, London SE11 5DL London Summary The LEO (Lambeth Early Onset) service works for young people living in Lambeth aged between 16 and 35 with their first episode of psychosis. The service aims to engage clients at the earliest possible opportunity and provides: • Specialist help for young people and their carers for the first two years of contact with mental health services • Education to increase public awareness, detection and referral of people with early signs of psychosis Support and education to General Practitioners, Community Primary Care Services and agencies to help recognise early signs and encourage young people to get help early Access Criteria The service is for people aged 16-35 who are experiencing or have experienced their first episode of psychosis, who are resident in Lambeth. This may include: • Someone who has a history of untreated psychosis going back a number of years • Someone who has experienced an episode of psychosis of shorter duration • Someone who has started a course of treatment for psychosis within the last 12 months. This includes anyone who has been treated by another early intervention team before moving into the Lambeth area. For young people aged 16 and 17, acceptance by the Early Intervention service would only follow discussion with the Child and Adolescent Mental Health Services (CAMHS). Referrals First episode psychosis: This includes anyone presenting with what appears to be any type of psychosis. Referrals are accepted from Lambeth residents between the age of 18 – 35 (the day before the 36 th birthday). Referrals are accepted for persons presenting for the first time within the last 12 months to mental health services with psychosis and not previously given a diagnosis of a psychotic disorder or antipsychotic medication for psychosis. This includes contact with any mental health services outside Lambeth e.g. rest of UK or overseas. All psychoses are included. Psychosis is defined as more than one week of unremitting frank psychotic symptoms

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10. Hospital based Opening Hours: 9am-5pm, Monday – Friday (excluding Bank Social Care Team Holidays) [CAG – Psychosis] Location Reay House – Lambeth Hospital Summary The service provides assessment and care for people, aged 18- 65, who have been admitted to a Lambeth inpatient bed The service will assess individuals who have been admitted for inpatient care. • The team will assess clients and, where eligible will complete a FACS and SSAQ. • The team will undertake MHRT and Managers reports for those clients not known to a community team. • The team will facilitate the discharge of clients from inpatient beds. • The team will work with other agencies as required, i.e. no recourse team, other teams in ACS to ensure client’s needs are met. • To investigate any adult safeguarding cases referred from the Lambeth hospital acute and rehab beds. • To liaise with carers and advocates. • To participate in MDT meetings and offer advice about social care needs. • To comply with MH act and MC Act.

Access Criteria The service is for people aged over 18 with an acute mental illness (or who are suspected to have an acute mental illness), and for those with relapses of long term mental illnesses who, due to the level of identified risks to self or others, cannot be safely assessed and treated anywhere but in an acute or Rehabilitation ward on Lambeth Hospital.

Referrals All admissions to the inpatient service can only be agreed by secondary care mental health professionals and many are referred by the community mental health teams. Although referrals may also be made by or accepted from the Police (e.g. Sect. 136 MHA), prisons, through A&E, Acute Hospital wards, secondary care professionals will assess all such referrals and decide whether admission is necessary or not.

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11. OASIS Opening Hours: 9am-5pm, Monday – Friday (excluding Bank Holidays) [CAG – Psychosis] Location 190- 192 Kennington Lane, London SE11 5DL London Summary OASIS (Outreach and Support in South London) is a service offering advice and support for people who may be having psychological and emotional problems. The OASIS service addresses co-morbid mental health difficulties as well as psychosis, and the treatments offered are tailored to the individual, including low dose antipsychotic medication and cognitive behavioural therapy. If it is felt after assessment that the individual's needs may be better met elsewhere, then the service facilitate referral. The service is provided by a multidisciplinary team who will see patients at their local GP surgery, in CMHT base or at home. It offers rapid individually tailored assessment and treatment of people between 14 and 35 years who are thought to be at risk of developing psychosis. Specific symptoms suggestive of the prodromal phase of psychosis may be relatively subtle and include attenuated or brief psychotic symptoms; disturbance of social function; decline in occupational function, depression and anxiety. The team provide care for people who live in the London boroughs of Lambeth and Southwark.

Access Criteria The service is for people aged 14-35 who are experiencing or have experienced their first episode of psychosis. This may include: • Someone who has a history of untreated psychosis going back a number of years • Someone who has already started a course of treatment for psychosis within the last 6 months and or has had contact with mental health services within the last year • Someone who has already had contact and treatment for other mental health problems prior to the periods above. This includes contact and treatment by the CAMHS services • Someone who is moving into the Borough and is a patient of another borough’s EI service for less than 1 year.

Referrals Clients can be referred from GPs, schools and colleges, social and faith groups, adolescent and adult mental health services and by themselves or their relatives.

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12. Vocational Services Opening Hours: 9am-5pm, Monday – Friday (excluding Bank Holidays) [CAG – Psychosis] Location 3-6 Beale House Lingham Street London SW9 9HG Summary Lambeth Rehabilitation Services in the Community works in partnership with Vocations Matters, Volunteer for well-being, and Carpet Cleaning Care. They support people, aged 18-65, who receive mental health services, to become more included in their community. They provide paid and voluntary work for people who live in the London Borough of Lambeth. Vocation Matters provides an information service about employment, training, volunteering and education opportunities. It also provides information about benefit entitlements for people with mental health problems who are unable to work, in work or returning to work. Volunteering for well-being provides people using mental health services with support and advice about local volunteer opportunities. Carpet Cleaning Care provides employment opportunities for people who have severe and on going mental health problems.

The service pay staff wages with the income generated by the scheme. Through this experience of paid employment and training the team offers clients support, guidance and assistance in how to cope with the demands of working life.

Access Criteria Vocation matters & Volunteering for well-being There are no eligibility criteria as such. Individuals would typically have mental health problems of a nature or degree that indicates the need for support in finding and supporting rewarding, sustainable and socially inclusive day time activity, usually but not exclusively in the form of work, paid or voluntary.

Carpet cleaning Historically Carpet Cleaning has recruited its employees from the population of service users attending the Resource Centre at 65 Effra Road. Eligibility for the service includes: • Motivation and energy to work • Ability to sustain routine hours • A severe and enduring mental illness rendering the individual unlikely to cope with mainstream employment- but with mainstream employment as a desired outcome • Ability to learn the work role of a carpet cleaning operative

Referrals No formal access is required but appointments have to be made. Self referrals are welcome.

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13. SHARP Opening Hours: 9am-5pm, Monday – Friday (excluding Bank Holidays) [CAG – Psychosis] Location 308-312 Brixton Road London SW9 6AA Summary The SHARP (Social, Hope and Recovery Project) service provides specific, evidence-based, psychosocial interventions to decrease distress and increase social inclusion for people aged 18-65 with severe mental illness including psychosis. The main role of the multi-disciplinary team is to provide psycho- social interventions to: • Promote social inclusion • Help reduce distressing symptoms • Help reduce relapse • Promote healthy living and wellbeing The team comprises of mental health and social care professionals, including psychologists, nurses and occupational therapists. The service help people to maintain their health; teach them the skills they need to live more independently and help them lead a more active life in the community. It also provides advice on educational and employment opportunities.

Access Criteria Accepted referrals will meet the following criteria: • Be a service user of The Trust Lambeth Mental Health • Have some willingness to engage with the service, possibly after persuasion and/or encouragement

Have needs in at least one of the following areas: • distressing symptoms • social inclusion • physical health • daily living skills • vocational needs

Referrals SHARP is an interventions only service and receives referrals from care co-coordinators from other parts of the Secondary care service. This ensures that referrals are appropriate in terms of eligibility criteria and need.

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Structure Chart for Lambeth Section 75 Partnership Agreement

Chief Executive

Service Director Service Director MAP CAG Service Director Psychosis CAG And B&D CAG Psych Med CAG

Head of Deputy Dir Deputy Dir Deputy Dir Deputy Dir Deputy Dir Lambeth Head of Care Pathway In Patient & Business & Community & Operations Clinical Service Performance & Social Care Emergency Complex Care Performance Early Onset MAP Delivery Access

Clinical Service Head of Head of Head of Lead – Clinical Service Care Pathway Care Pathway Care Pathway MAP Assessment Lead – Lambeth Complex In Patient Complex Care Lambeth & Southwark & Early Onset

Clinical Service Clinical Service HT Teams Clinical Service Clinical Service Clinical Service Lead – Lead – Early Triage Wards Lead - Lambeth Lead - Placements Lead - Lambeth MAP Treatment Onset Lambeth

River House Recovery & PAMS Team LEO Services Support Team Hopton

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