SBAR Mental Health With Examples

As mental health professionals, we all know how crucial it is to communicate our client's condition effectively. But let's face it; it can be challenging to share all the necessary information without sounding like a broken record or missing out on essential details. Thankfully, a fantastic communication tool called SBAR can help us out. The SBAR provides a systematic way to communicate client details during handoffs, referrals, or consultations. Using this invaluable framework, we can ensure that all the critical client information is conveyed smoothly.

Trust me, once you start using SBAR, you'll never go back to your old ways of communication. Keep reading to dive in and explore how SBAR can revolutionize how you interact with your colleagues and care teams.

What is SBAR and Why Does It Matter in Mental Health?

Mental health professionals have adopted the SBAR framework, initially created for physicians, to enhance communication between themselves. The SBAR (Situation, Background, Assessment, and Recommendation) is a simple and practical communication framework that enables mental health professionals to communicate critical client information and treatment plans to their colleagues. It provides a concise yet comprehensive summary of a client's condition and needs, allowing for quick and accurate communication between clinicians during handoffs, discharges, referrals, or emergencies.

Using the SBAR framework, clinicians can reduce the likelihood of misunderstandings or lost information, promoting client safety and enhancing efficiency during client handoffs and consultations. The SBAR framework is a clear example of how simple yet effective tools can significantly impact client outcomes in mental healthcare.

The four components of SBAR are:

Situation: What seems to be the issue?

Briefly summarize the client's current condition and reason for contacting the other clinician. For example, "I'm calling about my client, a 45-year-old male with schizophrenia and depression who was admitted yesterday."

Background: What is the relevant background information?

Include relevant medical and psychiatric history, current medications, living situation, and available support. For example, "My client has a 20-year history of schizophrenia and depression. He takes Olanzapine and Sertraline but stopped taking them two weeks ago. He lives alone and has limited social interaction."

Assessment: What do you think is going on with the client?

Carefully analyze the situation and background information to formulate a diagnosis or hypothesis. Identifying issues that require consultation and paying close attention to the client's condition are crucial steps in this process. For example, "My client presented with disorganized thoughts, paranoia, and suicidal ideation. His depression and hallucinations seem uncontrolled off medications."

Recommendation: What do you suggest should be done to address the issue?

Suggest the next course of action or treatment for the client and explain your recommendation. For example, "I recommend restarting my client's medications, increased monitoring, and group therapy."

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How to Use the SBAR Tool for Effective Communication

When creating an SBAR report, you must be confident and specific in your language while providing actionable recommendations. Collect all the necessary details and present the situation and background objectively and chronologically. Analyze the information collected to determine the underlying issues. Additionally, provide well-supported recommendations that confidently address the problems identified. Finally, communicate your SBAR report to the necessary individuals, colleagues, doctors, or family members using plain and simple language. Use short sentences and everyday speech that is easy to understand. Avoid using acronyms, jargon, and legal terminology. Preparing to provide examples and evidence to support your assessment and recommendations is essential.

To use SBAR to enhance your communication skills, follow these steps:

Gather the Situation and Background

First, gather the relevant details about the client and their current situation. Ask yourself:

• What is the client's diagnosis or presenting problem?
• What is their mental health history? Treatment history?
• What life events lead up to their current state? Family, health, or work stressors?

Assess the Client's Needs

Next, assess the client's acute needs and risks. Consider things like:

• Their symptoms and severity. Are they in crisis?
• Safety risks like suicidal thoughts or self-harm.
• Ability to care for themselves (hygiene, eating, sleeping).
• Medication compliance and side effects.

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Recommend an Action Plan

Finally, determine recommendations to address the client's needs. This may include:

• Scheduling more frequent sessions.
• Adjusting medications or dosages.
• Safety precautions like hospitalization or removing access to means of self-harm.
• Referrals to other practitioners like a psychiatrist.
• Community resources for extra support.

Additional Tips to Further Improve Your SBAR Communication Skills

• Practice using SBAR regularly with teammates and providers to build confidence with the format.
• Collect all necessary information before communicating. Gather data from charts, tests, and observations.
• Use templates and checklists as reminders of the SBAR components.
• Review client cases and role-play SBAR with coworkers for practice and feedback.
• After communicating, confirm the receiver's understanding by asking them to repeat the salient points.
• Periodically self-assess your SBAR skills and identify areas for improvement.
• Seek feedback from others on how effectively you follow the SBAR format and provide helpful information.

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The Benefits and Limitations of Using SBAR for Mental Health Practitioners

The SBAR communication tool is valuable for mental health professionals but has some limitations. While it can be used to optimize client care outcomes, it may only sometimes be effective in complex cases. To achieve the best results, mental health practitioners should balance the structured benefits of SBAR with flexibility and discretion. This approach can improve communication and client care, improving client outcomes.

Benefits

• SBAR is an effective tool that enhances communication and teamwork among all care team members. This reduces the risk of missing important information, which can negatively impact treatment and lead to confusion and delays in client care.

• SBAR helps minimize miscommunication due to differences in professional jargon between different disciplines.

• SBAR communication is concise yet thorough so clinicians can quickly grasp the situation.

• For new practitioners, SBAR provides a helpful framework for learning practical communication skills.

• The SBAR format provides a structured and concise way to communicate client information to other healthcare team members.

• SBAR streamlines communication and reduces the time needed to relay critical client information. This is helpful in time-sensitive situations where quick action is required.

Limitations

• Some clinicians may find the SBAR format too rigid or time-consuming, requiring a change in communication patterns.

• SBAR also does not replace sound clinical judgment. Relying too heavily on the SBAR tool without applying critical thinking can lead to crucial oversights.

• SBAR does not cover non-verbal aspects of communication that can impact message clarity, such as tone of voice and body language. These social cues are still essential to convey urgency or emphasize key points.

• It may oversimplify complex clients or miss secondary issues.

• Clinicians must review all relevant client data, not just recent information, and verify recipients understand the SBAR content.

• Proper training on SBAR is needed to understand its purpose and limitations fully.

SBAR in Action: Case Examples of Depression and Schizophrenia (Mental Health SBAR Examples)

When discussing mental health concerns, the SBAR tool is an invaluable resource. Let's see SBAR in use for two typical conditions: depression and schizophrenia.

SBAR example for Depression #1

Situation: A 37-year-old female is experiencing a severe depressive episode. The client reports sadness, worthlessness, and hopelessness over the past six weeks.

Background: No previous history of depression. Recently, she lost her job and ended a long-term relationship. She feels isolated and unable to cope.

Assessment: Meets DSM-5 criteria for Major Depressive Disorder, single episode, severe. The client is at high risk of self-harm.

Recommendation: Hospitalize the client for inpatient treatment, including medication and therapy. Provide 24-hour observation and support.

Depression Example #2

Situation: A 65-year-old male with a history of treatment-resistant depression. Currently experiencing worsening depressive symptoms.

Background: The client has a 20-year history of depression. He has been on multiple antidepressants and has received ECT in the past with minimal response. Current symptoms include decreased appetite, sleep disturbances, lack of interest in activities, and feelings of hopelessness.

Assessment: The client's depression appears to have entered an acute phase with worsening chronic depressive symptoms and a lack of response to previous interventions.

Recommendation: Recommend a genetic test to identify gene variants that may predict response to specific antidepressants. Adjusting medication based on genetic information may improve treatment outcomes for this client with treatment-resistant depression.

SBAR example for Schizophrenia #1

Situation: A 41-year-old male exhibiting disorganized and delusional thinking. He believes he is receiving special messages through the TV and radio. Has become increasingly withdrawn and agitated.

Background: The client was diagnosed with schizophrenia two years ago and has been inconsistent with prescribed medication. The family reports that the client has not left the house in over a week and is not bathing or eating regularly.

Assessment: Acute psychotic episode due to noncompliance with antipsychotic medication. The client lacks insight into illness and is unable to care for self.

Recommendation: Hospitalize the client for inpatient treatment to stabilize the condition. Restart and adjust medications under supervision. Provide structured support and therapy to improve insight and self-care skills before transitioning to outpatient treatment.

Schizophrenia Example #2

Situation: A 23-year-old female with schizophrenia was brought to the emergency room by police after being found wandering the streets and talking to herself.

Background: The client was diagnosed with schizophrenia three years ago and has a history of medication noncompliance. She has been living on the streets for the past six months and has not followed up with her treatment team.

Assessment: The client is experiencing an acute exacerbation of schizophrenia symptoms due to a lack of medication and a stable living situation. She is disorganized, delusional, and paranoid.

Recommendation: Admit the client to the inpatient psychiatric unit for stabilization. Restart antipsychotic medication under supervision. After symptoms improve, arrange for supportive housing and connect the client with community mental health services to improve medication adherence and promote recovery. Regular check-ins and case management will be essential to prevent future hospitalizations.

Conclusion

Empowering mental health professionals with practical communication tools is essential for improving client outcomes and promoting interprofessional collaboration. The SBAR communication tool can help clinicians streamline conversations, ensure thoroughness, and provide optimal client care. While SBAR is imperfect, it has revolutionized mental healthcare communication for decades and has become increasingly valuable with the rise of integrated care. Incorporating SBAR in your workflow is crucial when speaking with colleagues about a client or presenting a case in a team meeting. With consistent practice using SBAR templates and client cases, you can confidently master concise yet comprehensive communication.

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FAQs

Here are some frequently asked questions and answers regarding the SBAR:

How do I complete an SBAR?

To complete an SBAR, follow these steps:

• Situation : Briefly state the client's condition, symptoms, and recent status changes. For example, "Mr. Lindon is a 45-year-old male with schizophrenia experiencing worsening auditory hallucinations over the past week."
• Background: Provide relevant information, including medical and psychiatric history, recent life events, and current medications or treatments. For example, "Mr. Lindon has a 15-year history of schizophrenia. Mr. Lindon was stable on oral medications for several years but recently lost his job and health insurance. He has not taken his medications in over a month."
• Assessment: Analyze the situation and background to determine the severity and implications. For example, "Mr. Lindon's lack of medication and worsening symptoms put him at high risk of hospitalization, self-harm, or harming others. His condition seems to be deteriorating rapidly."
• Recommendation: Propose appropriate recommendations to address the issues identified in the assessment. For example, "I recommend Mr. Lindon to be assessed immediately for inpatient psychiatric hospitalization and treatment."

When would I use an SBAR?

SBAR is ideal for efficiently communicating critical client information in time-sensitive situations or during provider handoffs. It is commonly used when:

• Consulting with physicians or nurse practitioners about a client's condition or treatment.
• Transferring a client from one provider or care setting to another.
• Discussing a client's status during shift changes or between providers.
• Requesting orders, medications, or resources for a client.

How should I complete an SBAR when communicating over the phone?

When using SBAR over the phone, concisely and only provide the most relevant information. Start with the situation, then background, assessment, and recommendation. Speak slowly and clearly. Ask the listener to repeat back key details to confirm accuracy.

What are some examples of situations in mental health that require SBAR communication?

• Psychiatric emergencies like suicidal or homicidal thoughts
• Severe medication side effects
• Rapid changes in mood, behavior, or cognition
• Changes in living situation, support system, or life stressors

How can I practice and improve my SBAR skills?

Practice using SBAR with colleagues to discuss real or mock client cases. Request feedback to identify areas for improvement. Over time, aim to reduce the time it takes you to deliver an effective SBAR. Keep a record of the SBARs you provide to track your progress.

What should I include in the 'Recommendation' section of an SBAR for a client with suicidal thoughts?

You should recommend immediate actions to ensure the client's safety and potentially life-saving interventions like a psychiatric evaluation, hospitalization, and suicide prevention strategies.

When would I use SBAR to communicate with a client's family members?

SBAR can effectively communicate important information to family members during transitions of care, changes in the client's condition, or when seeking information from family to aid in the client's treatment.

Resources:

Brenner, B. (2021, April 25). What is SBAR, and Why is It Important? MEDPRO Disposal, LLC. https://www.medprodisposal.com/what-is-sbar-and-why-is-it-important/

Shahid, S., & Thomas, S. (2018). Situation, Background, Assessment, Recommendation (SBAR) Communication Tool for Handoff in Health Care – A Narrative Review. Safety in Health, 4(1). https://doi.org/10.1186/s40886-018-0073-1

SBAR | ASQ. (n.d.). Asq.org. https://asq.org/quality-resources/sbar

SBAR Handover in Patient Safety: advantages and disadvantages - CAREFUL. (2022, September 13). Careful. https://careful.online/sbar-handover/

SBAR | Turas | Learn. (n.d.). Learn.nes.nhs.scot. https://learn.nes.nhs.scot/3408

Tool: SBAR | Agency for Healthcare Research and Quality. (n.d.). https://www.ahrq.gov/teamstepps-program/curriculum/communication/tools/sbar.html