Document

Issue 7 - November 2010 Winter edition

The Plymouth MIND Music Group entertained the people who attended the first ever Minds Matter event in the Piazza on 4th September. The event was organised by PIPS members and concentrated on mental health and wellbeing. The day was a great success, bringing together service users and carers with health and social care professionals in an informal setting, with fun and entertainment for everyone.

MINDS MATTER EVENT EVALUATION

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Following the event, organisations who attended were asked for their opinions on how they felt the event was run and organised. In total we received feedback from seventeen organisations, all of whom said they would participate again. Organisations were asked the following questions. Numbers in the answer columns represent how many organisations responded in this way to the question.

In the following section each bullet point represents a different response

Poor Average Good Excellent

How well informed were you leading up to the event?

0 2 4 3

How well did PIPS facilitation of the event help you to participate in the day?

0 1 4 4

How useful did you find the opportunity to interact with the general

public?

0 1 4 4

The Minds Matter Prize draw winners were: Max Miles (pictured) and Linda Barker, both of whom won £50 in Love to Shop gift vouchers.

Is there anything that we could have done to improve the experience?

• Complimentary cup of tea/ coffee for people on the stands

• More variety of entertainment- comedian, maybe army involved or police.

• Our stall was next to the music. Made it difficult to hear some people. Are there any further comments you would like to make?

• Never sure of the effects of the events but usually decide to stand up and be counted along with the other organisations.

• Felt it a shame that stalls packed up before advertised finish time.

• I thought the entertainment outside was great especially the dancers – real crowd pullers. Keep up the good work

• A Really great day, you and your team have helped open up the issues around mental health

• It was a nice day and we all enjoyed taking part. Hopefully we can participate next year too

• Great Day

• Excellent. Thank you.

• Thank you for inviting us.

• Thank you for giving us the chance to perform.

• Great except for noise from music.

Dementia Care Pathway

Plymouth City Council, NHS Plymouth and the University of Plymouth have devised a pathway for dementia sufferers, which is compliant with requests from the Strategic Health Authority. The pathway will go on the Council and NHS Plymouth websites, as well as being available on Google.

This is an open access pathway, so by clicking on individual headings you will see text to describe what the service does, what is available, etc.

This is what it will look like:

GP referral / self referral / 3rd sector referral / Internal NHS referral / social work referral

Multi-disciplinary Team referral meeting

Doctor Psychology/OT Memory Service Complex Care Inappropriate Assessment Dementia Team referral

Diagnostic Clinic

Doctor Medical Cognitive Review Review

Further Cognitive & medical Monitor, review Review care Discharge Investigation review & reassess package

End of life care plan

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On the 11th of October three PIPS members met with Cindy Willcocks, the Clinical

Head of Service of the Child and Adolescent Mental Health Service (CAMHS) to find out a little about it in order to inform PIPS members.

For those of you who don’t know, CAMHS provides a range of treatment services to children and young people aged 0 to 18 who suffer from emotional, psychological and/or psychiatric distress. They also offer advice and support to the families/carers who support these children and to the professionals in contact with them.

Interventions aim to improve emotional well-being and mental health, improve relation-ships and strengthen attachments. The interventions include early interventions, aimed at promoting wellbeing and resilience, systemic family work including multi-family group work, CBT, individual neuro-biological/pharmacological treatments, peer/group/community activity work, psychodynamic (metallisation) techniques and art ther-apy (this list is not exhaustive). CAMHS also make use of experts by experience. These targeted interventions are offered on a short term basis (usually for 6 sessions for children with mild to moderate needs) and on a long term basis for more complex cases. Services for those children and young people with more severe symptoms are offered at Mount Gould hospital, whilst there are community-based services for those children and young people with mild to moderate disabilities.

There are a number of different CAMHS teams. These include; Early Years, Severe Learning Disability, Children in Care, The Devonport Primary Mental Health Worker(PMHW) Team, Targeted Mental Health in Schools (TAMHS) and the Outreach Team, CAMHS is a multi-disciplinary team. It consists of Clinical Team Managers, Primary Mental Health Workers, a Child Psychotherapist, a Clinical Psychologist, an Educa-tional Psychologist, a Self Harm Nurse, a Social Worker, a Consultant Psychiatrist, a Staff Grade Doctor, a Family Therapist, an Occupational Therapist, an Art Therapist and a Consultant Nurse.

CAMHS has strong links to other agencies, including the Youth Offending Team, the INSIGHT Team, and the Harbour Centre Drug and Alcohol Team and it takes referrals from professionals who have concerns about the mental wellbeing of a child. Work usually starts within two weeks of the referral.

From what I gathered there are two types of assessment; a Clinical Global Assess-ment and a Choice Assessment (which entails a conversation with the family/carer of the child).

¬ CAMHS Outreach Team: responds to urgent and complex Mental Health needs of Young People. It provides assessment and intervention to young people presenting at serious risk to themselves and/or others either in hospital settings or in the com-munity. The team will work to stabilise the situation and will mostly work in the com-munity and people’s homes. The team also focuses on preventing young people needing CAMHS residential care and supporting young people to return from such care into the community. Age/Client Group Served 5 – 18 years old.

CHILD & ADOLESCENT MENTAL HEALTH SERVICE

The target population includes children and young people presenting with psychosis, suicidal depression, serious eating disorder, severe OCD, and other acute symptoms of mental illness requiring rapid assessment. The team will also respond to self-harm assessments at Derriford A&E department. It will offer next day assessment as standard.

All the teams assess how successful their interven-tions have been through certain measures (referred to as CORC Measures – these are a global bench-marks). A ‘Strengths and Difficulties’ questionnaire is used to assess the distances travelled over a prolonged period. It is administered at the beginning of the intervention, and again at the end. Then it is completed a final time after 6-12 months.

� Adolescent In-patient Service (Cotehele Unit): offers highly specialised assessment and treatment for young people with severe mental health problems from across the Peninsula. Age/client group served: 12-18

� Terraces - The Children’s Day Unit (5-12 years old): provides an assessment and therapeutic service to Young People with complex mental health needs which may include ADHD and Autism. It is provides day programmes, including education provision, as well as supporting the carers. It has multi-disciplinary staff including teaching staff. The day unit is able to undertake in depth assessment to inform the planning and treatment process for these children.

We, at PIPS, have had some less favourable feedback from parents who have been angered by the fact that an intervention has not been deemed necessary for their child. Cindy explained that there are always going to be these types of cases. Obviously, at times, it is inevitable that there will be discrepancies after assessments between what the professionals think is needed and what parents feel should occur. Much will depend on the risk posed to the child or others. Cindy said that, in most cases, where the team don’t feel that an intervention was necessary, the child and family would be signposted to a more appropriate service.

The PIPS members who met with Cindy appreciated her honesty about the limitations of the service and the criteria needed to be met in order for the team to intervene. Cindy provided us with some leaflets, which are targeted at different age groups (4-10, 11-16 and 17-19). The point of these leaflets is to establish what keeps young people well. It suggests a few activities which promote wellbeing. But its main purpose is to get the young person to depict five things that make them happy. If you want a copy of any of these leaflets contact the Children’s & Families Directorate, CAMHS, Mount Gould Admin Block, Mount Gould Rd, Plymouth PL4 7PY or email [email protected]..

You can also locate information about CAMHS by visiting the Primary Care Trust web-

site: www.plymouthpct.nhs.uk

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THE MENTAL HEALTH ACT: Children & Adolescents

The CQC is an independent regulator of health care in England and monitors how services exercise their powers and carry out their duties in relation to patients who are detained in hospital or subject to community treatment orders or guardianship under the Mental Health Act.

Admission and detention of children and adolescents

From April 2010 children or adolescents under 18 must be placed in an environ-ment that is suitable for their age and needs and the commission found that many services were anticipating this new legal duty. There has been a marked reduction in the number of young people admitted to adult wards. During 2009/10 the com-mission were notified of 88 children/adolescents being admitted to adult wards, but most were transferred or discharged within a few days. It is important that Child and Adolescent Mental Health Services (CAMHS) provide a nurturing, therapeutic environment for young people, including those detained under the Mental Health Act; however there were some concerns about a lack of gender separation in some units and treatment regimes in some eating disorder units, which appeared to limit personal liberty more than would be the case in other types of psychiatric units.

The commission makes a number of recommendations: Providers of CAMHS services should be fully aware of the policy on placement of young people on adult wards. They should also consider what more can be done to maintain the privacy, dignity and safety of young people and ensure they offer age appropriate services.

Commissioners of CAMHS services need to ensure that there are sufficient inpa-tient beds to meet the needs of local young people and that there is appropriate liaison between CAMHS and adult services over the needs of young people.

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MEMBERS’ VIEWS

A Place of Safety for Children Suffering from Acute Psychiatric Symptoms in Plymouth

The provision of a Section 136 suite / Place of Safety (POS) for under 18’s is a contentious issue in Plymouth. At present the POS for under 18’s is Charles Cross Police Station and, until other arrangements can be sought out, it will remain so. This is not a great situation, for obvious reasons, but there is no identified way to progress this further at present. The principle of not admitting under 18’s to the adult Glenbourne Unit would continue to be extended to the S136 Suite at the Glenbourne Unit also. There is a need to identify a room within the new building in which to accommodate a POS for the client group.

It is possible that the new Plymbridge Unit, which opens at the end of January 2011, could be the best available option and may be made appropriate. However, the unit is not commissioned or designed for this purpose;,being commissioned jointly by Devon, Cornwall, Torbay and Plymouth and with a principal of fair and equitable use by all.

Plymouth may utilise the unit for the purpose of assessing Plymouth Children & Young People detained on a Section 136 but this has not been agreed as of yet. There are sufficient challenges to making Plymbridge fit for purpose as a POS for under 18’s but if it was able to be utilised it would improve services for Children & Young People.

In the meantime children will continue to be assessed and housed at Charles Cross Police Station.

To continue with using Charles Cross as a POS for under 18’s is unacceptable and

a solution needs to be found.

Simon Love,

PIPS Chair

Recovery Devon

I’ve recently been told about Recovery Devon, an excellent online resource: www.recoverydevon.co.uk

The website describes itself as an independent community that supports recovery and well-being in mental health. For those unfamiliar with the site there is a re-source library with a mix of personal accounts and factual information, a creative café of art work and personal narratives and a members forum. The latter requires a simple logging in procedure to access and participate Newsletters can also be downloaded.

I feel this is an easy website to navigate and that it is an extremely positive and valuable initiative. I look forward to contributing to it myself. If you’re interested in the recovery process or just simply curious click on it and see for yourself.

Lesley Bricknell PIPS Steering Group

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MENTAL HEALTH SERVICE USERS’ HANDBOOK

There is a need for a handbook, which should be distributed to people with mental health problems, professionals and support staff, listing mental health and well-being services in Plymouth.

The case for this is simple; most people with mental health problems, support staff and professionals (including General Practitioners, Community Psychiatric Nurses, Psychiatrists and support staff) are unaware of the services out there that promote wellbeing in Plymouth. It is not surprising given that the information is not readily available. The Plymouth Mental Health Networking group (which comprises of a large number of organisations which deliver various services around mental health) have produced a booklet detailing the services out there, but unfortunately they only made a limited number of copies,

Recovery is linked to people with mental health issues being able to exercise choice over their care and access appropriate services which promote their wellbeing. Ply-mouth has a great number of services which include support groups, therapeutic in-terventions, vocational support, day services, benefits advice, counselling, advocacy and positive activities, to name but a few. What worries PIPS service users and carers is that these services are not being taken up by users who could really benefit from them. If the booklet was more widely distributed it could lead to better uptake of these services and better outcomes for service users.

Most service users (85%) are managed by their GP’s and have no other contact with agencies or professionals. If GP’s don’t know what is available for them, what happens to those disengaged people who could benefit, in terms of improved func-tioning, confidence and esteem, from certain services?

PIPS realise that there are costs involved in producing a large number of these hand-books but feel that the money could be raised somehow. Perhaps money could be raised by organisations from the private, public and third sectors clubbing together? Perhaps funding could come from a large multinational company? We are sure they would like to have their name bandied around to a relatively large audience.

PIPS steering group members and PIPS Local Implementation team ( LIT) represen-tatives have spoken to the Mental Health Networking Group, to Commissioners, the Assistant Clinical Manager of Mental health Services, and to the wider PIPS mem-bers about this issue and they all agree it would be a good idea. It is time to act on this. PIPS would very much appreciate your feedback on this issue, to enable us to take your views forward. So many people are missing out on positive inter-ventions.

PIPS Group Members

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Pride and Prejudice is an exciting recovery-based project for any person experiencing mental distress/ill health. Co-ordinated by Colebrook Housing and PIPS, we encour-age people to enjoy green spaces via a range of environmental activities. Through active participation at our project participants can improve their mental and physical wellbeing and also the local environment. Our project also aims to reduce stigma and discrimination, overcoming prejudice and enabling people to take pride in their local communities. We will support each volunteer’s involvement in activities such as:

• Designing garden spaces

• Helping with promotion and publicity or fund-raising

• Digging, planting, choosing materials

• Taking photographs

• Helping manage the budget

So come on, get involved, make a positive contribution to your local area and show your local community what can be achieved by working together in partnership.

For more information or to get involved, contact Cilla McCarthy on 01752 202407

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SURVEY

PIPS is focussed on improving service user and carer involvement within mental health services. If you have experiences of mental health services we would like to hear your views, ideas and experiences so we can express these views to the ser-vice commissioners and providers to improve the services for the future.

PLEASE TAKE THE TIME TO FILL THIS IN AND HAVE YOUR SAY IT WILL MAKE A DIFFERENCE!!!

Do you use Mental Health services? Yes No (please circle) Are you a carer? Yes No (please circle) Please tick the services you use/ have used:

Glenbourne Community Psychiatric Nurses

Community Support Worker

Syrena Psychologists Support Time Recovery Workers (STRs)

Access to Mental Health Services (formerly Gateway)

Approved Social Worker Home Treatment Team (HTT)

Psychiatrists Occupational Therapists GPs and GP-based Counsellors

Assertive Outreach Services (AOS)

Others (Please state)

What is your experience of receiving Mental Health services?

Are there any services you are not receiving that you feel you require?

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How do you think Mental Health services can be improved and what needs to improve? Are there any gaps or unmet needs in Mental Health services/

Are you involved in any service user led, independent groups? What are they? Are you employed: Full Part Self- Temp/ Unpaid/ time time employed seasonal work voluntary work

Do you have a care plan? Yes No (please circle) Are you involved in the shaping of this care plan? Yes No (please circle) Do you have regular CPA reviews and what is your experience of these? Do you feel that what is written in your care plan is actioned?

Please tell us if: You would like more information about / to get involved with PIPS in the future

Please fill in the contact details below:

Name Address

Email

You can contact PIPS at any time to give your feedback about services. Our contact details are Unit 15, HQ Building, 237 Union street, Plymouth, PL1 3HQ. Tel 01752 202407 e-mail [email protected]

Emergency Crisis Contacts What to do in a mental health emergency: If you or someone you know is experiencing a mental health crisis, the first step is to see your GP, who can assess what is needed and refer the person in crisis to other services if necessary.

If your GP is not available, or you do not have one, and the situation is urgent, there are various options:

• Contact the person’s GP’s out of hours service.

• There is a duty psychiatrist at the Accident and Emergency Department at

Derriford Hospital.

• Access to Mental Health Services (formerly Gateway) - 0845 155 8065 are

open 9.00 am - 5.00 pm Monday to Friday They do not work with people who are currently receiving help from psychiatric services.

• The Gateway Out of Hours service - 01752 669709 is open between 5.00 pm

- 11.00 pm on weekdays and between 9.00 am - 5.00 pm on weekends and Bank Holidays.

• Outside these hours contact the Emergency Duty Social Work Team — 01752

346984.

• If the person experiencing the crisis is a client of the Assertive Outreach Team

contact their Duty Team on 01752 314001 (not 24 hours).

• If the person experiencing the crisis is a client of the Home treatment Team

contact them on 01752 314033.

Useful Numbers and Contacts

NHS Direct 24-hour national health helpline 0845 4647

Saneline, national mental health helpline 0845 767 8000

Samaritans helpline 08457 909090

PALS 0800 073071 01752 211818 01752 517657

Carers Champions 01752 211348

Colebrook Housing Society 01752 205210

Tailor Made Support 01752 205210

Mind - www.plymouthmind.org.uk 01752 264960

WAND - Mental Health Helpline 0808 8000 313

Citizens Advice Bureau 08448 269 717