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Pathway to care- Client Form
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'Carer' refers to each point of call the client has made before his/her referral to Mental Health Services. The last carer always refers to the early Intervention service.
NAME:
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INTERVIEWER:
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Past history of care by any mental health service?
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YES / NO
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If yes please give details:
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For each contact point in the pathway:
a) Who was seen?
| 1=GP |
7 = Police |
13 = Psychiatrist (Drugs Service) |
| 2=CPN |
8 = Psychiatric Hospital |
14 = Neurologist |
| 3 = Social Services |
9 = Home Treatment Team |
15 = Counsellor |
| 4 = Religious Leader |
10 = Primary Core Team |
16 = Asian Support Worker |
| 5 = Casualty Dept. |
11 = CMHT (unspecified) |
17 = Child & Adolescence Services |
| 6 = Private Doctor |
12 = Psychiatrist |
18 = Other (give details) |
b) When did you see this person/team?
(Help the person estimate the time, if he/she is unclear of the date, to the beginning/middle/end of a month if possible
c) Who suggested that care was sought?
| 1 = Client |
7 = Client and family only |
| 2 = Family member |
8 = Referred by casualty/hospital deportment |
| 3 = Friend |
9 = GP (info, about who contacted GP unknown) |
| 4 = Referred from previous carer |
10 = Detained by police (owing to offending behaviour) |
| 5 = Referred by professional at client/ Relatives request |
999 = information unavailable |
| 6 = Client and family only |
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d) What was the main problem presented (record details)?
| 1 = Psychotic |
2 = Non-psychotic |
3 = Symptomology unclear |
e) What was the main treatment/advice offered?
| O = None |
| 1 = Neuroleptic |
| 2 = Other form of meds. |
| 3 = Counselling |
| 4 = Support / monitoring through regular visits (no neuroleptic meds.) |
| 5 = Referral to another agency / professional |
| 6 = Referral to EIS (but not accepted) |
| 7 = Accepted by EIS |
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8 = Physical health checks
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| 9 = Religious intervention |
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