Our impact - Think Ahead | Fast-track mental health social ......mental health services. The Think...

Aisha, a Think Ahead participant,leading the planning of a ConnectingPeople intervention to support anindividual with mental health problems.

Our impact

18614 TA Impact Review.qxp__v 03/10/2017 10:57 Page 1

MarchThink Ahead launcheswith cross-party support.

Septembern 2016 Cohort joins

frontline services.n Applications open

for 2017 Cohort.

JanuaryPrime Minister backsThink Ahead inmental healthstrategy.

SeptemberApplications open for2016 Cohort.

JulyFirst SummerInstitute for the 96 participants inthe 2016 Cohort.

JulySummer Institute for the 98participants in the 2017 Cohort.

Septembern 2016 Cohort qualify as social

workers and begin second year ofprogramme.

n 2017 Cohort joins frontline services.n Applications open for 2018 Cohort.

2015

We want to see a society where everyone with mental health problems can flourish

health, and supporters of our work – hasachieved. Now we want to build on thissuccess by expanding our movement,growing our evidence base, and sharingour learning. We hope you can be part ofThink Ahead in the years to come.

Natalie ActonJoint Chief Executive, Think Ahead

Ella JosephJoint Chief Executive, Think Ahead

Professor Dame Carol Black Chair, Think Ahead

We created the Think Ahead programmeto strengthen mental health social work:attracting talented graduates and career-changers, delivering innovative training,and working with mental health servicesto maximise the contribution of socialapproaches to mental health support.

With nearly 200 participants goingthrough the programme andpartnerships with 52 mental healthservices across England, we’re proud ofwhat everyone involved in Think Ahead– programme participants, mental healthand social work professionals, peoplewith lived experience of mental ill-

We set out in 2014 to inspire a movementto advance this vision. This report, our firstimpact review, sets out what we’ve achievedsince then and our goals for the future.

Since the beginning, Think Ahead hasbeen driven by the knowledge that thesocial foundations of people’s lives –including their relationships, supportnetworks, living arrangements, andemployment – underpin their mentalhealth. By empowering individuals withsevere mental health problems tomanage these life issues, mental healthsocial workers enable people to not justget well, but stay well.

2016 2017

JanuaryRevealed to be one of the UK’smost competitivegraduate schemes,with 23 applicationsper place.


Contents

Mental health is an urgent national challenge . . . . . . . . . . 02Social work makes an essential but undervaluedcontribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 04We strengthen mental health social work throughtalent, training, and support . . . . . . . . . . . . . . . . . . . . . . . . . . . 06n Route to impact 1: We attract talented people into

mental health social work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 08n Route to impact 2: We train our participants to improve

outcomes for people with mental health problems . . . . 12n Route to impact 3: We support services to unlock the

potential of social work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18We aim to grow our impact . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20You can join the movement . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Kazim, 2016 participant, studied Psychologyat Nottingham and Law at Birmingham.

01


20 2020

02

20Mental illnessis everywhere

It can turn livesupside down

2020

20

Mental health is an urgent national challenge

Two in three adults (65%)have experienced a mentalhealth problem at some pointin their lives.

38% of all ill-healthis caused by mental illness (for under-65s).

Nearly nine out of ten people(87%) with mental healthproblems have experiencedstigma and discrimination.

Mental ill-health has thesame effect on life expectancyas smoking.

People with severe mentalhealth problems die onaverage 20 years earlier.

Over 300,000 people inEngland are living with apsychotic disorder, such asschizophrenia.

“My life changed when apoliceman came to mydoor and told me that myson had been killed in acar accident. Thebuilding blocks of my lifedisappeared – it was veryfrightening.”Laurie, describing theonset of severe clinicaldepression.

“I thought that my familywere in fact actuallyscientists and psychologists[…]. One night I even felt likeI was being operated on byknives, saws, and othersharp objects.”Ziaul, who lives withschizoaffective disorder,describing his experiencesof psychosis.

“When manic, myspending would becomeout of control and Iwould self-medicate withdrink and drugs. Whendepressive, I wouldn’t getout of bed, it would feellike I had a lead weighton me.”Lee, describing the impactof severe bipolar disorder.


03

People with mental healthproblems are three times morelikely to have debt problems.

80% of homeless people reporthaving a mental healthproblem.

20

12

3

2020

2020

20

20

20And it affects ourwhole society

But many peopleneed better support

90% of the prison populationare estimated to have a mentalhealth problem.

Only 65% of people withpsychotic mental healthconditions, and 25% of adultswith depression and anxiety-related conditions, are thought toreceive support from services.

Only 38% of people usingcommunity mental healthservices feel that they receivethe help they need quicklyenough.

The smoking rate amongstpeople with mental healthproblems is double thenational average.

20

Of the 100,000 peoplewho die in England eachyear in avoidablecircumstances, one inthree have a mentalhealth problem.

20% to 40% of police time isspent supporting people withmental health problems.

Mental health problems costthe economy in England£100bn every year.


04

The British public were asked: What hasthe biggest effect on your mentalwellbeing?

#1 Response:Relationships with family and friends.#2 Response:Jobs / work-life balance.

People who’ve attempted or consideredsuicide were asked: What contributed toyour decision?

41% Financial and/or housing pressures.29% Job loss or difficulties at work.25% Relationship breakdown.

Social work makes an essential butundervalued contribution

Mental health social workers empowerpeople to lead independent and fulfilling lives

They support people with severe mental health problems, suchas psychosis or bipolar disorder, to manage the socialfoundations in their lives. This is especially powerful inenabling people to not just get well, but stay well.

Mental health social work includes:

n Therapeutic support – e.g.Solution-focused brief therapy.Motivational interviewing.Family group conferencing.

n Practical action – e.g.Safeguarding and crisis management.Arranging funding and care.Support to manage finances, housing, or employment. Setting up and improving community services.

n Advocacy – e.g.Ensuring people’s rights are upheld by agencies andemployers.

Determining mental capacity to make life decisions.

Social circumstances are vital tomental wellbeing

Mental health problems aren’t just medicalconditions, and supporting people doesn’t just meantreating their symptoms.


05

20

20

20

0 5 10

20

But social work’s value in mental health oftengoes unrecognised

Research has found that socialworkers often struggle to beheard by other professionalsin multidisciplinary teams, andare often required to act inlimited roles that don’t enablethem to use all theirprofessional skills.

Mental health socialwork is a job that’s overlookedand undervalued. Social workhas not always had greatpress, but often people tell usthat the support they reallyneed and value is from theirsocial worker. The things that people say are reallyimportant to them – likerelationships and friendships –are related to their socialcircumstances.

Paul Farmer CBE, Chief Executive of Mind.

Students at the UK’s topuniversities rate socialwork 5 out of 10 forcareer status, belowteaching, policing, andnursing.

Less than half (41%) of theBritish public recognise thatsocial workers are importantproviders of mental healthsupport.

Over a quarter (29%) of theBritish public mistakenly thinkthat mental health socialworkers do household jobs likecooking and cleaning.

27% think that they providehelp with washing anddressing, and 30% that theyprovide childcare.


06

We strengthen mental health social workthrough talent, training, and support

Our mission:

To give talented individuals theinspiration, training, and supportto empower people with mentalhealth problems.


07

Our routes to impact:

1. We attract talented people into mental healthsocial work.

2. We train our participants to improve outcomesfor people with mental health problems.

3. We support services to unlock the potential ofsocial work.


8

Route to impact 1:

We attract talented people into mentalhealth social workWe recruit high-potential individuals

The calibre of Think Ahead participants is verygood and we’re really excited about next year’s cohort:they’re bringing a combination of academic and lifeskills to the role. This is essential as the job is becomingmore difficult – we’re working with people with a highlevel of need through care planning, legal planning, andcourt procedures. We need people with analytical skillswho can draw all of these aspects together.

Simon Owens, Consultant Social Worker leading a Think Aheadtraining unit in Durham.

n Our programme is one of themost competitive graduateschemes in the country, with 23applications per place.

n Our entry requirements includea 2:1 undergraduate degree.

n 14% of our participants areOxford or Cambridgegraduates, compared to just0.5% of new entrants to socialwork master’s courses in 2011/12.

n We assess applicants using athree-stage selection process,including an assessment centreinvolving experienced socialworkers and people with livedexperience of mental healthproblems.

n We test for a range of attributesidentified as essential by socialworkers and people withexperience of interacting withmental health services.

The Think Ahead attributes:

n Leadership

n Motivation

n Adaptability

n Relationship-building

n Communication

n Problem-solving

n Self-awareness


And we raise awareness of mental health social work

Think Ahead is placed at number 62 in thelist in 2017. It’s the highest first-time entry –and the only dedicated mental healthemployer on the list.

09

“[My social worker] has led me to get intoa better place.”Lee Brookes, who lives with bipolar disorder.

“One in four people experience a mentalhealth problem. Mental health socialworkers can make a huge difference totheir lives.”Natalie Acton, Think Ahead Joint ChiefExecutive.

“Mental health social work is a hugelyrewarding profession, but it’s also verychallenging.”Natalie Acton, Think Ahead Think AheadJoint Chief Executive.

“I feel incredibly challenged, I feel inspired,I feel that this is the right place for me.”Al Tooms, 2016 participant, on the All in theMind programme.

“Good social workers are invaluable. Solet’s give them proper support.”David Brindle, commenting on ThinkAhead research.

“I wanted to do a job that is meaningfuland challenging, both emotionally andintellectually.”Frances Turner, Think Ahead PracticeSpecialist.

“Think Ahead really attracted me towardssocial work, other business-type jobs feltlike I was just going for a job that was ajob.”Ben Roderick, 2016 participant, on the PMProgramme.

“Mental health social workers have acrucial role to play with people who are ill.”Rosemary Bennett, reporting on ThinkAhead’s first intake.


It sounds like a cliché but Iknew I wanted a career where Icould make a tangible difference. Inmy second year at university I had apanic about what I wanted to do,and looked at graduate roles, butthey were all predominantly city andcorporate schemes and I couldn’t seehow I’d be making the kind ofdifference I wanted to make.Everything Think Ahead offeredreally spoke to me, matching thethings I wanted to achieve. Whatstruck me was how social work issuch an interdisciplinary role. Mydegree made me see people indifferent ways, and I feel that ThinkAhead allows me to put that insightinto practice.

Amy, 2017 participant. Joined ThinkAhead after graduating in HumanSciences from Oxford.

I looked at lots of corporateroles and jobs in finance when I leftuniversity, but I felt they didn’t reallysuit my personality. It was ThinkAhead’s focus on mental health thatreally convinced me. I don’t havepersonal experience of mentalillness, but I know a lot of peoplewho have. In South Asian culture,mental health issues often aren’ttaken very seriously, and peoplesometimes feel guilty aboutrevealing a problem. Someone closeto me had depression and was self-harming, but when she toldpeople about her mental healthproblems, she wasn’t taken seriouslyat all. Seeing her being treated likethat made me want to work inmental health.

Aisha, 2016 participant. Studied EnglishLiterature at Queen Mary London, andworked in HR in the private sector.

Until I got talking with ThinkAhead at a recruitment fair I hadn’tconsidered a career as a socialworker, and I knew very little aboutsocial work. I knew I was looking forsomething challenging, exciting,and with the opportunity forprogression, but I’d resistedapplying for other graduateschemes because I didn’t want to be stuck in an office. I also knew I wanted a career that would mean I could help people. It was theopportunity to be out on thefrontline helping people that reallysold Think Ahead to me. Using asocial approach, talking to peopleand treating them as individualsrather than just a diagnosis, reallyresonates with me.

Jack, 2016 participant. Joined ThinkAhead after graduating in History fromWarwick.

10


1111

Think Ahead’s 2017 Cohort

9855 31

9855 31

985555 31

9855 31

989855 31

20% received free schoolmeals.Compared to 14% of thegeneral population (in2016).

16% BAME.Up 20% from our 2016 Cohort.Compared with 13% of thegeneral population and 22%for social workers in adultservices in England.

93% did not apply for anyother route into social work.

9855 3198 55 31

98 participants. Studied at 55 universities.

9855 3131

Studied 31 subjects – frompsychology and sociology toagriculture and film production.

54% are in the firstgeneration of their family to attend university.

27% male and 73% female.Compared to 20% male and80% female for social workers inadult services in England.


Route to impact 2:

We train our participants to improve outcomesfor people with mental health problemsOur approach enables our participants to make an impact early:

n Mental health focus – participants are primarilybased in statutory mental health services.Outside Think Ahead, less than 8% of trainingplacements are in mental health services.

n Integrated leadership training – participantshave leadership support tailored to thechallenges they face.

n Learning on the job – participants are based in the workplace full-time, withacademic input connected directly to practice.

n Fast-track model – participants spend moretime on the job, over a shorter period, than intraditional social work training, allowing them toqualify a year earlier.

2017 participants learning at the Summer Institute.

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13

The Think Ahead programme

On our two-year programme, participants learn on the job while studying for a master’s degreeand developing their leadership skills. They build up hours in practice more quickly than intraditional training, allowing them to qualify a year earlier.

Leading frontline practitioner Service manager Advocate for mental health in a variety of fields

After the programme Participants finish the programme as experienced social workers and become lifelong

members of the Think Ahead network.

Summer Institute

A six-week intensive residentiallearning experience in July andAugust. Teaching is delivered byexpert academics, practitioners, andpeople with lived experience ofmental ill-health.

Year Two

Participants take up qualified rolesin their services. During this year,they complete a master’s degree insocial work alongside theirAssessed and Supported Year inEmployment – a standardrequirement for newly qualifiedsocial workers.

Year One

Participants join a communitymental health service, learning onthe job in units of fourparticipants led by anexperienced mental health socialworker. At the end of the yearthey qualify as social workers.


14

We teach evidence-based interventions at three levels

Individuals

E.g. Motivational InterviewingAn important step for people recoveringfrom severe mental health problems isfinding the motivation to identify andchange counterproductive behaviours.

Our participants learn how to strengthenindividuals’ motivation by encouragingan open dialogue, using counsellingtechniques such as focused reflectivelistening, and through engaging withwarmth and empathy.

This helps individuals to identify thedifferences between their actual anddesired behaviours, and to identify howtheir behaviours impact on themselvesand others.

Families and groups

E.g. Family Group ConferencingPlans that support an individual’srecovery are much more likely to besuccessful when they build on theexisting strengths of their family ornetwork, rather than being designed andimposed from the outside.

When this intervention is used,participants arrange and run a networkmeeting with all the people involved.This empowers the group to offersolutions, and gives them the privatetime to develop a plan which they arethen supported to put in place.

Communities

E.g. Connecting PeopleEvidence has shown that people withsevere mental health problems oftenlack access to the informal socialnetworks and relationships that areessential for mental wellbeing.

Our participants help individuals tomake new connections beyondtraditional services, for example byjoining a club or volunteering, and torecognise the value that they can bringto these groups. They work closelytogether to set activities and outcomeslinked to an individual’s strengths andlife-goals.


15

Aisha, a Think Ahead participant,leading the planning of a ConnectingPeople intervention to support anindividual with mental health problems.


16

I am muchhappier sinceworking with Lauren,and I don’t feelworried any more.

Rosalind, a service userworking with Think Aheadparticipant Lauren.

Rosalind’s story

Rosalind is 58 years old, has emotionallyunstable personality disorder anddepression, and is profoundly deaf.Rosalind started working with Think Ahead participant Lauren inDecember 2016.

y adoptive mother died sixyears ago, she was 101 yearsold. I got very poorly, I wasup and down for years.When I was feeling unwell I

wouldn’t sleep properly, I couldn’t eatproperly and I lost lots of weight. I feltnumb – I would walk about doing nothingor stay in bed all day. At times I got a bit

better for a little while but then I’d getunwell again.

Last year I tried to take my own life by takinglots of tablets. I ended up in hospital for afew months, and had to have six months offfrom my job working at a supermarket.

A little while after I left hospital I startedworking with Lauren. I have been able totrust Lauren and I’ve been able to talk to her.

Lauren has helped me to find things to dothat make me happy. I joined a walking cluband have been on walks around the park andto the British Museum. I love knitting so I’vealso joined a knitting club and I’ve knittedblankets that I’ve donated to a homeless

charity. And recently I’ve started going to a Women’s Club where I play bingo and go dancing. It’s great to get out and meetpeople – that makes me feel better.

Lauren has also helped me go back towork. She came with me to visit anoccupational health therapist who maderecommendations. Lauren came with meto a meeting with my employers before Iwent back to work to make sure theyfollowed the recommendations. I likebeing back at work, everyone knows me there.

I am much happier since working withLauren, I have a lot more laughter, and Idon’t feel worried any more.

M


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Lauren’s story

Lauren is a Think Ahead participantworking in Waltham Forest. She joinedThink Ahead’s first intake in July 2016.

efore joining the ThinkAhead programme I had a few different jobs –including in the probationservice – where I worked

with people with mental healthproblems. But I wanted to be able tosupport people more holistically, standup for them and help them in the longrun. I realised that mental health socialwork was a good way to do this.

I’ve really been on a journey during myfirst year of the programme. It’s rigorousand challenging and hard work – but themixture of academic and practical workhas stood me in good stead and,although I’ve still got lots to learn, I cansee that I’ve really enhanced my skillsand grown in confidence.

When I first met Rosalind she had justcome out of hospital and in our firstmeeting she hardly talked, she justnodded. She was given medicationwhich helped but it was only one pieceof the puzzle - in my role I’ve been ableto help her in lots of ways.

Over time I have helped boost Rosalind’sself-esteem using a technique calledmotivational interviewing. I’ve gotRosalind to focus on her good qualitiesand her strengths. Rosalind is a very motivated and determined person.

Helping her get back to work was reallyimportant – it’s helped her feel like herselfagain, and get back her independence.But it was a challenging thing to do. I organised an appointment with anoccupational health therapist for Rosalindto get some recommendations aboutstaying well when she returned to work.And I attended a meeting with Rosalind’semployer to ensure they were putting herneeds first. Rosalind is profoundly deafand can’t understand lots of peopletalking at once – at one point I had to

intervene and pause the meeting toensure that Rosalind understood whatwas being said, and to make sure thateveryone spoke to her directly, one at a time.

I also wanted to make sure she felt safein her home, and her hearing impairmentmeans she can’t hear a normal smokealarm, so I arranged for the fire brigadeto come round and install a specialist fire alarm under her pillow.

Finding the walking club, knitting groupand Women’s Club have also helpedRosalind to feel more connected to hercommunity.

I’ve really noticed a difference inRosalind in the time that we’ve beenworking together. Since we first met,she’s become much more chatty and hasstarted taking care of herself. Her familytell me that they can see a realdifference. But most importantly,Rosalind tells me I’ve made a differenceand thanks me. Being able to see a realdifference in someone that I’m workingwith is a really great feeling.

B


Route to impact 3:

We support services to unlock the potentialof social workWe show what social work can doOur partnerships – with 52 NHS Trusts and Local Authorities across England – raise the profile andcapabilities of social work within mental health services.

After each trainingday, our participants willcome back with new ideas,and share these with otherteam members in forumsand clinical casediscussions. They’rebringing a whole newperspective – throughsocial interventions such asFamily Group Conferencingand MotivationalInterviewing.

Think Ahead hascompletely reaffirmed thepositive impact social workcan have on the delivery ofspecialist mental healthservices. The participant unithas been like a breath offresh air arriving into a verybusy multi-disciplinary team.They have been embracedby professionals who havecommented that theenthusiasm and talent of theparticipants has raised theprofile of social work acrossthe organisation.

The training in modernsocial interventions isexcellent and has made meaware of the latesttechniques. When you’re“firefighting” it can be easyto get into a state whereyou’re just monitoringservice users and reacting,but this role has remindedme of the value of planningand implementing structuredinterventions – which can bemore effective and actuallysave time overall. That’s anapproach I’ll definitely takewith me into future roles.

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Malgosia Eaden, ConsultantSocial Worker leading a ThinkAhead training unit in Hackney.

Kate Wilson, Consultant SocialWorker leading a Think Aheadtraining unit in Hertfordshire.

Dr Lynn Prendergast, AssociateDirector for Social Care in apartner service in Essex.


Think Ahead has takenservice user involvement veryseriously, from initialorganisation set up, throughprogramme design,recruitment and assessment,to the delivery of teaching.Participants benefit hugelyfrom being assessed andtaught by people on thereceiving end of social worksupport, cementing theirunderstanding of co-production, person-centredapproaches, strengths-basedworking, communication, andrelationships in social work.Our Reference Group serviceusers and carers value beingable to share their expertiseand educate the nextgeneration of social workers.

We expand knowledgeOur participants can carry out master’s-level independent research in theirsecond year, working towardspublication to contribute to a growingevidence base for what works in mentalhealth and social work.

We nurture leadershipOur leadership training – offered toConsultant Social Workers as well asparticipants – builds social workers’capability to influence the way servicesare designed and run.

We put service users at theheart of services and trainingOur Service User and Carer ReferenceGroup includes people with directexperience of mental health problemsand mental health services, and thosesupporting someone with a mentalhealth problem.

Dr Sarah Carr, Associate Professorin Mental Health Research atMiddlesex University, Chair ofThink Ahead’s Service User andCarer Reference Group.

Having met the ThinkAhead students, I believe we’llcreate a number of futureleaders in mental health, whocan help give the profession abright future. I say this as achief executive who still useshis social work skills every day.

Jacqui Bell, Think AheadPractice Specialist. Our PracticeSpecialists are experienced socialworkers who work with our partnerorganisations to implement theThink Ahead model.

John Short, Chief Executive ofBirmingham and Solihull MentalHealth NHS Foundation Trust.


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Over the coming years, we hope to:

We aim to grow our impact

Sonya, 2016participant, studiedPsychology andNeuroscience atManchester.

n Continue improving the diversity of ourrecruits, bringing more men and morepeople from black, Asian and minorityethnic backgrounds into the profession.

n Build the evidence base for best practice inmental health social work, enablingmeasureable service-wide improvements.

n Spread our learning across all services andtraining providers.

n Establish a network for our participantsfollowing their completion of theprogramme, building a movement ofmental health practitioners and supporterswho understand the power of socialapproaches.


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You can join the movement

n Train with us:If you are interested in becoming a Think Aheadparticipant, you can find out more and apply atthinkahead.org.

n Partner with us:If you are interested in hosting Think Aheadparticipants, we would love to hear from you.You can contact Programme Director KateO’Regan on k.o’[email protected].

n Support us: We are seeking funding and partnerships tosupport our plans for growing our impact. Youcan contact Joint Chief Executive Ella Joseph on [email protected].

n Advise us:If you have lived experience of mental healthproblems, or you’re an experienced mentalhealth social worker, we welcome your input –and you may be able to join our Service User andCarer Reference Group or our ProfessionalsNetwork. Get in touch at [email protected].

Our partners and supporters


@ThinkAheadMH/thinkaheadorgcompany/think-ahead-orgin

The Think Ahead Organisation is a registered charity and a company limited by guarantee. Charity number: 1166577. Company number: 10015893. References are available at thinkahead.org/impact-references

We’re getting people to seethat this is the place to come if theywant to change the world. I’m agreat supporter of Think Ahead –it’s exciting because it’s shining alight on mental health social workin a very positive way.Paul Farmer CBE, Chief Executive of Mind.


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