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INFORMATION ABOUT CLIENTS FIRST EPISODE

 

1.   What made you first decide to seek care?

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2.   Who did you first go to for help?

1 =GP 10 = Primary Care Team
2 = Private Doctor 11 = Home Treatment Team
3=CPN 12 = Child & Adolescence Services
4 = Psychiatrist 13 = CMHT (unspecified)
5 = Psychiatrist (Drugs Service) 14 = Social Services
6 = Neurologist 15 = Asian Support Worker
7 = Counsellor 16 = Religious leader
8 = Casualty Department 17 = Police
9 = Psychiatric Hospital 18 = other - details -------------------

 

         

3.   How long was it between you deciding to seek care and seeing someone?

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4.   What did they do?

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5.   How helpful do you feel they were?

Not at all  
A little
 
Fairly
 
Extremely
 

6.   Were you referred to anyone else?

YES   NO  




If yes please specify----------------------------------------------------------------------------------------------------------------------

 

7.     Were you admitted to hospital?

YES   NO  

 

 

If NO please go to Question 13

 

8.     If YES was it by a section or informally?

SECTION INFORMALLY  

 



9.     Was the admission procedure explained?

YES   NO  





10.    Were your patient rights explained to you?

YES   NO  





11.    Were you given the opportunity to ask any questions?

YES   NO  



 

12.    Were you able to talk to the doctor easily?

YES   NO  

 

 

 

13.    Did you ask for a diagnosis?

YES   NO  

 



14.    Were you given a diagnosis at this time?

NO   YES  

 

If yes please specify Diagnosis ----------------------------------------------------------------------------------------------------------                         

15.    Were you given any treatment at this time?

NO   YES  





16.    Were you included in the planning of your care?

ALWAYS

NEVER

SOMETIMES  





17.    Did you understand any treatment/care plan?

YES

A LITTLE

NO  



 

18.    Did anyone talk to you about follow up care?

YES   NO  




If YES please specify who -------------------------------------------------------------------------------------------------------------------------------------------------------------


19.    Which professionals were involved at that time?

     

1=GP  10= Home Treatment Team
2= Private Doctor 11= Child & Adolescence Services
3=CPN  12= CMHT (unspecified)
4 = Psychiatrist 13= Social Worker
5 = Psychiatrist (Drugs Service)   14= Asian Support Worker
6 = Neurologist 15= Religious leader
7= Counsellor   16= Other - details----------------------------------
8 = Key Worker  
= Primary Care Team  


      

20.    Did you know how to contact them?

YES   NO  


 

21.    Did you have a named key worker?

YES   NO  





22.    If yes, is this key worker still involved?

YES   NO  





23.    Which professionals are currently involved in supporting you?

      

1=GP  10= Home Treatment Team
2= Private Doctor 11= Child & Adolescence Services
3=CPN  12= CMHT (unspecified)
4 = Psychiatrist 13= Social Worker
5 = Psychiatrist (Drugs Service)   14= Asian Support Worker
6 = Neurologist 15= Religious leader
7= Counsellor   16= Other - details------------------------------------
8 = Key Worker  
9 = Primary Care Team  

24.    If you became worried or concerned who would you contact first?

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25.    Do you know what the Care Programme Approach Is?

YES   NO  





26.    How much advice have you been given on how to cope with the illness?

A LOT

A LITTLE

NONE
 





27.    Have you been told about any local support groups?

YES   NO  






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