title: Who is a heavy service user? Preliminary development of a screening instrument for prospective consumers of a mobile intensive treatment team.
abstract: OBJECTIVE
  The mobile intensive treatment team (MITT) of the Valley Integrated Adult Mental Health Service in Brisbane, Australia, aims to provide services in the community to people with severe and persistent mental illness who have traditionally been heavily reliant on inpatient services (i.e. heavy service users). The MITT screening instrument (MITTSI) was developed to provide an objective measure to appropriately identify patients for referral to the service.
  
  
  METHODS
  A literature review and a panel of multidisciplinary clinicians were consulted to identify a list of specific attributes that would assist in the detection of heavy service users. These attributes were then formulated into an easy-to-administer screening instrument entitled the MITTSI. The MITTSI was administered in an interview format to MITT case managers (intensive case management) and to case managers in standard case management with prospective MITT patients (prospective heavy service users).
  
  
  RESULTS
  Analyses of the responses indicated support for the MITTSI as a valid screening instrument in identifying heavy service users and for determining appropriate patients for referral to the MITT.
  
  
  CONCLUSIONS
  The MITTSI is an easy-to-administer screening instrument which provides clear guidelines for inclusion and exclusion, and is an objective measure regarding the patients' urgency for referral to the MITT. Follow-up of the MITTSI within a broader, longer-term project will attempt to further refine the MITTSI and to further determine its validity. Outcomes will be published at a later stage.
authors.affiliation: Valley Integrated Adult Mental Health Service, Royal Brisbane Hospital, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Abbott
authors.forename: S
authors.initials: S
authors.lastname: Smith
authors.forename: R
authors.initials: R
authors.lastname: Clarke
authors.forename: C
authors.initials: C
authors.lastname: Curson
authors.forename: J
authors.initials: J
authors.lastname: De Souza Gomes
authors.forename: K
authors.initials: K
authors.lastname: Heslop
authors.forename: E
authors.initials: E
authors.lastname: Trainer
authors.forename: P
authors.initials: P
authors.lastname: Yellowlees
mesh_terms: D000328:Adult; D019090:Case Management / Q000706:statistics & numerical data; D003419:Crisis Intervention; D003422:Critical Care / Q000706:statistics & numerical data*; D005260:Female; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008501:Medical Records, Problem-Oriented; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D008952:Mobile Health Units / Q000706:statistics & numerical data*; D010348:Patient Care Team / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales; D011793:Queensland / Q000453:epidemiology; D012017:Referral and Consultation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires