Sharing the Learning from Innovation in Mental Health Practice

Person Centred Approaches: National Perspectives and priorities for from Mental HealthHugh Masters, Nursing Officer (Mental Health and Learning Disabilities, Scottish Government

Educational approaches – what have we done and what have we learnedSusanne Forrest, Programme Director, NHS Education Scotland

Much More Than a Label: A User-Led Project About Personality DisorderNaomi Salisbury – Development Worker

NATIONAL INITIATIVES

NHSS Quality StrategyRights, Relationships and Recovery: the National Review of Mental Health NursingRecovery approachesPeer Support

A CURRENT PRIORITY

Promoting Best Care For Older People And People With Dementia • General Hospitals• Mental Health Services

The Context

Background and Progress

•Action 1 and 2 RRR•10 ESCs Learning materials •Realising Recovery Learning Materials •2 Phase training for trainers•Local dissemination of training•Regional Coordinators •Evaluation 2008-2010•Scottish Recovery Indicator

The 10 Essential Shared Capabilities

• Working in Partnership• Respecting Diversity• Practicing Ethically• Challenging inequality• Promoting recovery • Identifying people’s needs • and strengths• Providing service user centred

care.• Making a Difference.• Promoting safety and positive risk taking• Personal development and

learning

• Common sense • Hardly ‘rocket science’• We do all of this this already

• Incredibly complex – tensions between the ESCs

• Practitioners often challenged to achieve this sort of working in services

• Would service users and carers agree that they experience this already?

10 ESCs and Learning Materials (Scotland)

•Developed and piloted in England 2004/2005•Then extensively revised for Scotland •Launched April 2007 • Revised version in 2011

•Introduction•The 10 ESC•Values based practice•Involving service users and carers•Equality and diversity – respecting difference•Developing socially inclusive practice

About the ESC learning

•Closely linked to exploring own practice and services•Linked to personal and practice/service development- action focused •Whole team learning – multi professional/agency•Service users and carers involved as learners and as trainers/facilitators•Used as part of supervision (group or individual)•Used to look at ‘real’ issues in practice •Essential Building Blocks for recovery focussed practice

NES/SRN Realising Recovery Learning Materials

•Similar to ESC materials in layout and nature (action focussed)•Driven by body of knowledge established by SRN over the years (narrative research)

IntroductionUsing self to promote recovery focussed

relationships Person centred support and planning Enabling self directionRisk and risk taking Connecting with communities

Progress

• Most mental health nurses now trained in ESCs

• Strongly embedded in pre registration mental health nursing (and other programmes)

• New mental health resource 2011• Two new further learning resources

planned

Evaluation Findings - translation and enactment within Health Boards

Case studiesCase studies

VanguardVanguardSome comparatively substantive positive evidence of impact in Some comparatively substantive positive evidence of impact in terms of peoples’ self-reported thinking and some examples of terms of peoples’ self-reported thinking and some examples of practice developmentpractice development

Mid rangeMid range Some positive evidence of impact, mostly in terms of peoples’ Some positive evidence of impact, mostly in terms of peoples’ self-reported thinking.self-reported thinking.

Limited enactmentLimited enactmentVery little evidence of impactVery little evidence of impact

Evaluation Findings- Participants

•The majority reported that the training had positive impact on their individual practice

•Many respondents gave examples of team developments related to the training e.g. use of the 10 ESCs as a framework for clinical supervision; improvements in service user involvement; care planning based on users’ own perceived needs and strengths; and development of positive risk taking

•The main aspects that respondents wished to take forward after the training were: developing individual practice; developing related educational activities within the team; ensuring a person- centred approach

BUT

Any impact on service users and carers’ experiences and outcomes not known

Education and training is just part of the picture

SRN Scottish Recovery Indicator - SRI

•Meeting basic needs •Personalised services and choice •Strengths based approach •Comprehensive service •Service user involvement/participation •Social inclusion and community integration •Advance planning •Recovery focus

Discussion points

• Could these approaches be useful in other practice areas?

• National v. local approaches?

• Demonstrating the outcomes and impact of person centred initiatives?

Much More Than a Label

A User-Led Project About Personality Disorder

Naomi Salisbury – Development Workernaomi@capsadvocacy.org

0131 538 7177

What is the Personality Disorder Project?

Much More Than a Label is a service user-led project which aims to promote better understanding and support for people who have lived experience of personality disorder diagnosis

What is the Personality Disorder Project?

• Began as a six month consultation funded by NHS Lothian to produce a user-led resource for staff

• Has expanded into an ongoing collective advocacy project spanning resources, training, the arts and more

• Over 50 people who have been given a diagnosis of personality disorder have been involved from across Lothian

What Have We Done So Far?

• Building links with service users• Extensive consultation• Developing a variety of resources to give

service users a voice• Feeding user views into local planning and

strategy groups• Supporting service users to come to events to

give their views• Input and involvement in other advocacy

projects

Resource

• Developed following consultation with over 30 service users

• Results of consultation analysed, divided into categories and written up to form a resource for staff written by service users

• Uses quotes, illustrations and poetry to convey different views and experiences

Summaries

Personal Experiences

User Views

Reflective Materials

Exhibition

Part of wider advocacy exhibition in ‘Scottish Mental Health Arts and Film Festival’ 2010

Film

Aims to give a sensory experience of personality disorder – created using audio recordings with service users and stop animation images

Training

Two day course developed with NHS Lothian and Recovery NetworkCovers information about the diagnosis, service user and staff experiences and skills developmentTrainer pool being developed including service users and staff

Training

Reference Group

Made up of people who have experience of personality disorder diagnosis

Meets regularly to discuss progress of the project and plan further work

Conferences

Supported service users to attend and speak at local and national conferences as well as facilitate workshops and display artwork

What Have We Found Out?

• Wasn’t too controversial!• Importance of consultation and Taking Part• Service User Views of Diagnosis and Treatment• Negative perceptions of diagnosis• People want to know the diagnosis• Issues around communication and consistency

can undermine everything• Service users and staff do actually want the

same things• Need for staff support and training

What Next?

• Continue to develop training

• Consult with service users again

• More arts/festival work

• Developing information for service users by service users

• How to involve people more remotely/virtually