Name of the Procedure:

Community Psychiatric Supportive Treatment (CPST)
Common names: CPST, Community mental health support
Technical term: Community Psychiatric Supportive Treatment, face-to-face, per 15 minutes (H0036)

Summary

CPST is a direct, face-to-face mental health service provided to individuals who need assistance with psychiatric crises, improving functioning in various life domains, and support to prevent relapses or hospitalizations. Sessions are typically billed in 15-minute intervals.

Purpose

CPST aims to address a variety of mental health conditions, including but not limited to depression, anxiety, bipolar disorder, and schizophrenia. The primary goals include stabilizing the patient during psychiatric crises, teaching skills to handle daily life, and reducing the need for hospitalization by providing consistent support.

Indications

• Acute or chronic mental health disorders
• Recent psychiatric hospitalization
• Poor functioning in daily life activities
• High risk of psychiatric relapse
• Difficulty adhering to treatment plans or medications

Preparation

• No specific fasting or medication adjustments are usually required.
• Initial assessments might include psychiatric evaluations, medical history reviews, and discussions about current medications and existing treatments.

Procedure Description

1. Initial Contact: The mental health professional meets the patient in a pre-determined setting, such as their home, clinic, or community space.
2. Assessment and Planning: During the face-to-face meeting, a psychiatric assessment is conducted. The practitioner collaborates with the patient to create a personalized treatment plan.
3. Implementation: The acts of supporting the patient can include teaching coping skills, helping with medication management, and providing crisis intervention if necessary.
4. Review and Follow-Up: Regular sessions are scheduled based on patient needs, and progress is reviewed continuously to adjust the treatment plan as required.

Tools/Equipment: Typically, there is minimal use of equipment beyond possibly electronic devices for record-keeping and tools for clinical assessments.

Anesthesia or Sedation: Not applicable.

Duration

CPST sessions are typically 15 minutes each but can extend based on the patient's individual needs.

Setting

CPST is commonly performed in various settings, including outpatient clinics, community centers, and sometimes the patient's home, depending on what's most beneficial for the individual's treatment.

Personnel

• Licensed Psychiatric Nurses
• Licensed Clinical Social Workers
• Licensed Professional Counselors
• Psychiatrists or Psychologist for oversight

Risks and Complications

• Common: Mild anxiety or resistance to intervention.
• Rare: Severe emotional distress, which requires immediate crisis intervention or hospitalization.

Benefits

• Improved coping skills and daily functioning
• Decreased need for hospitalization
• Better medication adherence
• Stabilization of psychiatric symptoms
• Enhanced overall quality of life

The benefits can be realized progressively, with significant improvements expected within a few weeks to months of consistent treatment.

Recovery

• Post-Procedure Care: Generally involves following the treatment plan, attending regular follow-up appointments, and possibly making lifestyle adjustments based on the practitioner’s recommendations.
• Expected Recovery Time: Ongoing, as mental health care is generally a continual process.
• Restrictions/Follow-Up: No significant restrictions; regular follow-up sessions necessary.

Alternatives

• Individual therapy or counseling sessions
• Group therapy
• Intensive Outpatient Programs (IOPs)
• Medications alone without supportive treatments

Pros and Cons of Alternatives:
Individual Therapy: More focused interventions but less holistic.
Group Therapy: Peer support but less individual attention.
Intensive Outpatient Programs: More structured but may be less accessible.
Medications alone: Effective for symptom management but lack comprehensive support.

Patient Experience

During the Procedure: Patients typically feel supported and listened to, though some may experience discomfort discussing personal issues.
After the Procedure: Patients often feel relief, increased motivation, and empowerment, though some may feel emotionally drained after intense sessions.

Pain Management and Comfort Measures: Emotional support and the development of coping strategies are critical components. Comfort measures may include a safe and familiar environment for sessions or having family members involved in the treatment when appropriate.