Five mental health services, five different risks

Children’s services on three scales and an eighteen-week clock, eating disorders on a physical monitoring register, perinatal on a score with a date, dual diagnosis holding both sides, and forensic on a MAPPA review that cannot slip.

1 Five services that can’t share a caseload screen

Children’s mental health, eating disorders, perinatal mental health, dual diagnosis and forensic mental health all sit under one heading and none of them measures the same thing. Each has its own instruments, its own risk, and its own legal or safeguarding frame. Putting them on a generic caseload loses the only column that matters in each.

2 CAMHS: three scores and an eighteen-week clock

Every case carries an age, a tier from one to four, and three scores: the Children’s Global Assessment Scale, HoNOS for children and adolescents, and the Strengths and Difficulties Questionnaire. The eighteen-week standard is counted at the top with a breach count next to it.

The table explains its own scales underneath — CGAS runs 0 to 100 and higher is better functioning. A tier 4 child with a CGAS of 31 is in a different world from a tier 1 child at 74, and nobody reading the screen has to remember which way the scale runs.

Four rows read “unknown person, not linked”. The demonstration instance holds the case without the person joined to it, and says so instead of filling in a name.

3 Eating disorders: the physical risk is the risk

This is the one where a psychological service has to run a physical monitoring register. The caseload holds a tier, a BMI, a MARSIPAN risk band, the EDE-Q and CIA questionnaire scores, and two columns that are about staying alive: ECG and electrolytes.

A tier 4 inpatient with a BMI of 13.2 and a very high MARSIPAN band has both done. Three of the outpatients have neither, and the blank is visible instead of absent. In this service that blank is the finding.

4 Perinatal: two questions and a unit that keeps mother and baby together

The Edinburgh Postnatal Depression Scale with the date it was taken, the Whooley questions as positive or negative, and whether the woman has been admitted to a mother and baby unit. Gestation for the antenatal women, postnatal weeks for the rest.

The EPDS date is doing real work here. A score of 15 taken three months ago tells you about a different woman from the one in front of you, and a caseload that shows the score without the date invites exactly that mistake.

The page carries a plain warning that it’s a seeded demonstration surface, not a live feed.

5 Dual diagnosis: two services, one person

Co-occurring mental health and substance use is the group that falls between two services, so the caseload holds both sides: DAST-10 and AUDIT-C with their risk bands, the opioid substitution therapy and dose, whether a drug and alcohol team referral has been made, and the national dataset identifier.

One row shows moderate drug risk, harmful drinking, no substitution therapy and no referral. That is the person this service exists for, and the row makes it obvious without anyone running a query.

6 Forensic: the register that has to be right

MAPPA level one, two or three, the criminal justice pathway — probation liaison, prison in-reach, court diversion — the review date and the count of court reports. A MAPPA review date that slips is a multi-agency failure, so it sits on the caseload, not in somebody’s calendar.

Where it lives in commvita