1. What is in a Message? Use of Telephone Answering Services

2. What is in a Message? Use of Telephone Answering Services in Mental Health Services in NI 2

3. Background  Answering machines are routinely used across many patient services within Mental Health in Northern Ireland.  The use of this type of facility allows patients to leave messages for staff when they are not available to take a call.  3 reported deaths where the individual attempted to contact the service, but, for a variety of reasons, were unable to make direct contact and left a message on a telephone answering machine! 3

4. Aims of the Study  To establish practice in relation to the use of answering machines as well as procedures for responding to messages within Mental Health services. 4

5. Information Collation  No academic Literature!  Questionnaire  Pilot  Response from all Trusts  67 Surveys Returned  38 Services with messaging Facilities (6 mobiles) 5

6. Analysis of Information  All types of services use answer messaging facilities on land line and mobile phones.  33 of the 38 phone numbers are made available to patients, with 17 provided specifically for contact in an emergency or crisis.  Out of 17 services above, 4 provide an alternative number which the patient can use in a crisis, that will always be answered, such as the Life Line number.  5 of the 38 messaging services provide Life Line number  All services receive Crisis Calls! 6

7. The average number of crisis calls left on the answer machine per month analysed by service provided ServiceNone1- 56 - 1011 +(blank)Total Community Addictions Services2417 Community Forensic Services213 Community Mental Health84113 Crisis Response Home Treatment33 Crisis Service - other22 Mental Health Day Hospital213 Other (please specify)33 17 Grand Total191611138 7

8. Analysis of Information cont…..  No services had a Protocol or Guidelines in place in relation to the use of answer machines  Twenty-eight of the 38 services (74%) had no specified response time for responding to messages  There was no consistency in approach and no standard means for checking that the message has been received by the appropriate person  The recorded voice instruction differed across every answering machine  18 of the 38 answer messages were rated as ‘Very Poor’ or ‘Poor’ with only two rated as ‘Good’ 8

9. Patient safety!

10. Learning!  Recommrendations All telephones that may be accessed by service users including mobile phones should have an answer message. The message should contain as a minimum the following information:- – Name of service/Hours of operation/How to leave a message/Time frame for getting back to the person/Action to take in a crisis or emergency/Out of hours GP contact/Help line number that is available 24/7 (Life Line) All Trusts should have a policy in place for the management of telephone answering services that includes:- – The above information in points 1 and 2 – Who is responsible for picking up messages – How messages will be communicated to appropriate person – Time frame for responding to messages – Training where appropriate for risk assessing messages 10

11. Actions Recommendations to be implemented across All Mental Health Services within HSC in NI Results of Survey shared with all other Services across the HSC due to general relevance

12. Conclusion What is in a Message! MORE THAN ONE WOULD THINK!

13. Thank You!