Setting

This audit was carried out in the alcohol and drug service, but it would be equally relevant to any general adult psychiatry or older persons’ out-patient or in-patient service.

Background

The various guidelines on psychological therapies produced by the National Institute for Health and Clinical Excellence (NICE) (listed below) make clear recommendations regarding the provision for a number of common psychiatric conditions.

Standards

The standards were obtained from NICE guidelines:

ᐅ At a minimum, all patients with mild depression, generalised anxiety disorder, panic disorder or anorexia nervosa should be offered psychological therapy as the first-line treatment.

ᐅ Patients with moderate or severe depression or schizophrenia should be offered psychological therapy as an adjunct to medication.

The target is that all patients will be offered psychological therapies, as appropriate for their diagnosis, as suggested by the NICE guidelines.

Method

Data collection

For the purposes of this audit a computerised records system was used to identify a sample of 50 consecutive patients receiving an initial assessment. The assessment forms on the system were examined to acquire the information listed below. It is also possible to collect information prospectively, with the relevant information recorded each time an assessment is done. Information required from the initial assessment was as follows:

ᐅ Were any psychiatric and/or psychological problems identified?

ᐅ If so, were these problems past or current?

ᐅ What treatment, if any, was the patient offered and by whom?

ᐅ What treatment, if any, did the patient receive and from whom?

Data analysis

The percentages of patients with current psychiatric and/or psychological problems and with past problems were calculated (one patient could be present in both subsets). For each of these subsets, the percentages of those receiving or who had received psychological therapies in line with NICE guidelines were calculated.

Resources required

People

This audit can be undertaken by one person for a sample of around 50 patients, although this will depend on the records system in use (it will be more timeconsuming if paper notes have to be located and searched through). Where a team undertakes initial assessments, each member could be involved and could collect information as they go along.