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Tuesday 26 March 2019
Derbyshire Healthcare NHS Foundation Trust
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For Professionals

Guidelines for referral to TMHD

Talking Mental Health Derbyshire is part of the National Improving Access to Psychological Therapy (IAPT) service. We offer short term, NICE approved therapies at step 2 (guided self-help) and step 3 (Cognitive Behavioural Therapy, Counselling for Depression, Interpersonal Therapy, Dynamic Interpersonal Therapy, Eye Movement Desensitization and Reprocessing, Couples Therapy, Psychosexual Therapy, Mindfulness for Depression).  We provide high quality, compassionate and confidential care to as broad a range as people seeking help as possible. In order to do so safely within the limitations of a primary care service we provide assessments and offer pre-referral case discussions to identify those people who need a higher level or different type of support that we can offer.

We offer treatment for specific common mental health problems of mild to moderate severity and relatively low risk. We can only expedite cases where the client is a veteran or pregnant or the mother of a child under 1. We do not conduct urgent assessments. Clients may self-refer or be referred by health professionals using the form at the end of this page. If you call to refer someone by phone, please include your name and contact number with your message. We encourage case review before referral (please see further details at the end of this page)

 Conditions Treated by TMHD           

Conditions NOT Treated by TMHD           

Adjustment Disorder

Depression

Generalized Anxiety Disorder

Health Anxiety

Obsessive Compulsive Disorder

Panic Disorder

Phobias

Post Traumatic Stress Disorder

Relationships Problems

Social Anxiety

Anger (low risk and secondary to anxiety/depression presentations)

Eating Disorders (low risk and secondary to an anxiety/depression presentations)


Bipolar Disorder

Body Dysmorphic Disorder

Dissociative Disorders

Personality Disorders

Psychotic Disorders

Eating Disorders

Substance Misuse (physically dependent; high risk and/or not able/willing reduce use)

Any condition where suicide risk is high or has been high in recent months and there is poor emotional regulation.

Severe functional impairment

Chronic, lifelong problems

Anger (unless secondary to anxiety or depression and low risk to self or others)

Eating Disorders  (unless secondary to anxiety or depression and low risk)


Examples of cases where TMHD may be able to help:

•           Able to work psychologically and engage in self-help/self-management

•           Able to commit to appointments over an agreed time

•           Able to work within a limited number of sessions

•           Able and willing to tolerate high levels of emotion

People with a condition not treated by IAPT (eg personality disorder) may benefit from our help if they also have a presenting problem which we do treat (eg depression or anxiety) in the following circumstances:

  • ·Risk is low
  • ·The underlying problem is relatively stable
  • ·The underlying problem is unlikely to be activated by providing short term treatment for the presenting problem.

Examples of cases where TMHD may not be able to help:

Risk to staff as indicated by history of violence to others

Recent (within the last 3 months) suicide attempt/suicidal behaviour; moderate/high risk self- harming behaviour– in the majority of cases, once the immediate high risk has passed, the person’s risk remains changeable and may be activated by focusing on traumatic events. Hence we recommend a period of stability, medication management, help with emotional regulation or referral to secondary care mental health services. In a minority of cases, people are safe to be seen in primary care sooner as their circumstances have significantly changed. We encourage case discussion to avoid poor patient experience of people being referred to us when we can not help, so please contact us on 0300 1230542 to discuss cases before you refer if there has been a recent suicidality/serious self harm and we can advise on suitability for TMHD/next steps which in some instances may include referral to TMHD in future, once risk has stabilised.

 Problem drinking or drug use within the last 3 months.   Lower risk alcohol and substance misuse may not present a barrier to treatment, however higher use may be therapy interfering. The type of substance and circumstances of use will be assessed to establish if a short term talking therapy may help or conversely may risk an escalation of risk relating to alcohol or substance misuse. If you work in a substance misuse service please see further guidelines here (insert link to IAPT substance misuse protocol).

Click here for the Drug and Alcohol services referral information.

People already receiving care in secondary mental health services are unlikely to benefit from short term therapy as their problems may need longer term talking therapy or support from a number of professionals. However if people are receiving medication management in outpatients and are relatively stable then we may be able to help. We ask that staff call us for case review prior to referral as outlined in the IAPT secondary care referral criteria that forms part of the DHCFT and IAPT services contracts (please contact us if you would like a copy of this document).

People with Dementia or severe learning difficulties

People who have had repeated short term treatment episodes for the same problem who may need longer term help.

We request that professionals make referrals to us directly using the form at the bottom of this page, rather than giving out our leaflets. We will liaise with you to discuss the case before booking an assessment. If we can’t make contact with you, we will write to you and close the referral.

We encourage you to call us to discuss any questions you may have about the suitability of a referral you are thinking of making. Please call our main office number at 0300 123 0542 during business hours, option 3 and ask for a service manager or duty worker.

Talking Therapies Referral Form has been revised. Please replace your version with this new version by clicking here.