Case study: improving the mental health of care home residents in London


In Tower Hamlets, North East London, a large number of care home residents were living with mental health issues e, such as dementia and depression. The multi-disciplinary team was bolstered with support from mental health practitioners to provide extra care to residents.

How was this pilot set up?

 In a 2020-2021 pilot, a Consultant Psychiatrist and 3 Occupational Therapists (OT’s) were funded to provide support to the Tower Hamlets integrated multi-disciplinary team (MDT). The role of these mental health practitioners was instrumental in proactively supporting the mental health needs of people living in care homes, as well as upskilling the mental health knowledge and skills of the wider MDT, including care home staff.  

What impact did this pilot have?

The pilot reduced ambulance call-outs from care homes when a resident’s  mental health illness exacerbated. It also reduced the use of psychotropic medications by residents. The pilot received positive feedback from residents, carers, care home staff and the wider MDT, as it was clear that this approach improved the lives of residents. 

How have you found working as part of this pilot?

“Regular mental health input from a consultant psychiatrist and an OT is invaluable to the patient care. Issues can be addressed quickly and solutions sought rather than dragging on and getting by. Especially with now-mandated regular antipsychotic review this is easier to achieve. I learn a lot from these sessions both in pathology as well as in behaviour management to hopefully be able to transfer the skills to my day-to-day patient care. It is invaluable to help the carers to learn about management/distraction strategies. Ongoing input from the Mental health team will help to upskill and empower the carers and the whole MDT.”

Community Geriatrician in Tower Hamlets

What impact has the mental health team had on residents?

A 68-year-old female with alcohol related dementia and emotionally unstable personality disorder has been in the care home for a year. She had lost weight and had threatened to self-harm multiple times. She was reviewed by her GP and started on Aripiprazole. The Enhanced Health in Care Homes MDT discussed her needs together. Following the MDT meeting, urgent bloods were done which confirmed low sodium. The resident’s hyponatremia was treated and she was reviewed by the psychiatry team. Her antipsychotic medications were stopped and care home staff were given suggestions on ways of managing her behaviour including developing life history and identifying groups that she could be part of. Also, the complex needs psychologist worked with the staff to identify the resident’s triggers. These non-pharmacological management strategies were very helpful to both address the resident’s mental health needs, responding to the needs of the patient in short period of time, improving her quality of life and build the care homes staff confidence in managing mental health illness within the care home. 

For more information, please contact:

  • Dr Kapila Sachdev, Consultant Old Age Psychiatrist, Tower Hamlets Mental Health Care of Older People,
  • Georgina Birch, Operational Lead for the Integrated Care Liaison Team;