Policy and Key Information
Discharge planning policy – workplace, community and members of the public pathways
Background
Discharge planning is key to safe services and addresses
- Risk management and mitigation
- Continuity of the work after the therapy intervention has finished
- Multi agency communication and systemic care.
The closure of a case is important therapeutically too. Endings matter particularly to those who have known abrupt endings or difficult attachments. Endings in terms of the individual’s experience and the collective understanding of the work are a priority in our work.
Assess and be curious to the unplanned discharge
If clients want to end the work suddenly without reasonable explanation where risk features are evident; risk assess because
Sudden absences or increased withdrawal from services and commitments may be representative of suicidal advanced planning.
You can involve the pathway team too in informal connections to gather more information.
Consider other factors in the clients life- underlying neurodiversity, history of mental health illness, history of self harm, isolation or self isolating behaviour that has increased, difficult personal life circumstances and recent or pending changes. Speak to safeguarding lead as a matter of urgency and this might lead to involving the wider professional network if you have concerns and cannot get consent from the client.
Expectations of the practitioner
- Review the work (preferably with the client) and complete the CORE assessment and closure forms including benefits of therapy.
- Ensure that the client has a plan for moving forward that they can articulate or share or if preferred is written out.
- For clients who have a history of being at risk, or who have shown features of risk in our assessments, always ensure there is a safety plan agreed in place and shared with other agencies on discharge (by client consent)
- Risk assess with the client (where appropriate) the impact of the closure, potential added risks by the closure, history of closures and endings and strategies for management of abrupt endings.
- Consider the Atrium Listening Service, Samaritans and community signposting and psyhcometrics as self monitors. Communicate with the client, routes back into our services.
- For all clients who have required safeguarding or are linked with community agency pathways, ensure that other professionals eg.GP, Housing association are aware of discharge and plan agreed with client. You can ask the Pathway team to do this part for you.
- Record your actions for closure in your notes on CORE and invite Pathway team to write their actions as appropriate on CORE front sheet/admin
- GP informed of discharge and has agreed to monitor, safety plan in place, plan for continued work in place.
