|Name: Tom Dodd||Name: Chris Coates|
|Job: National programme lead for primary care and joint programme lead for dual diagnosis, Care Services Improvement Partnership; chair of Rest||Job: Team leader, Rest|
|Qualifications: Mental health nurse||Qualifications: trained as a psychiatric nurse|
|Last job: Service development and training lead for community teams, Sainsbury’s Centre for Mental Health||Last job: Project developer – looking at unmet mental health needs of rural people in Staffordshire|
|First job: Self-employed designer||First job: Student nurse (although worked on a farm from age 11)|
The close-knit and self-reliant agricultural community tends to regard mental health problems as taboo and stigmatising. And yet the farming industry is affected by comparatively high levels of acute mental illness and suicide.
Recent calamities such as BSE and foot and mouth served only to exacerbate such difficulties. And it was around those times of crises that the rural emotional support team (Rest) was set up in Staffordshire.
Rest’s trump cards were its voluntary sector status and its team’s knowledge and experience of farming. So workers adopted a hands-on approach (helping with mucking out or milking) and engaged with other services connected to the farming community, including agricultural banks, trading standards and churches.
But now, five years on, Rest is facing its own crisis: its core funding (which pays salaries and administration) is set to run out in December. “It’s interesting that the government has just appointed the Improvement and Development Agency to run a £2m training programme for public sector commissioners to better understand charities that are keen to deliver public services,” says Rest’s chair of trustees, Tom Dodd. “I really welcome that.”
It may, of course, be too late to save Rest, which has suffered from something approaching commissioner-itis. Dodd says: “I think there is a huge gap, particularly in the health care community, in commissioners understanding the role and impact small charities can have. I think there is a temptation to commission continually what has always been commissioned and reluctance to look at what small organisations can provide.”
Thus funding is sought from other possible sources. “We’re on this never-ending treadmill to keep fighting for what we feel is the right thing,” says team leader Chris Coates. “We get a fantastic community response but it will only ever meet one-fifth of our running costs, and eventhat needs to be offset against the time it takes us to raise that 20 per cent. And it’s notjust about going out there and getting the money – it’s about developing the relationships and doing the PR and so on. It’s a full-time person’s job, really.”
Coates cites an example: “Today we had a letter in from a young farmers’ group which is going to do a big charity night for us – which is great and will get us a few hundred quid. But that will also mean I’ll have to attend – so that’s after-work stuff again on a Saturday night. I don’t think you’ll find many statutory bodies doing that.”
Dodd, as chair, is all too aware of Rest’s dependency on short-term grants. “It is very difficult to get anything beyond one or two years,” he says. “This means that we are in a constant state of anxiety around whether we can deliver a service in six months’ time.
“And it goes beyond that: it’s also about people’s jobs and well-being. As chair and as trustees we have personal liability for the finances and performance of the charity and that can be quite a heavy burden at times.”
That burden now includes considering uncomfortable contingency plans: the next trustees’ meeting may debate the possibility of de-commissioning the service.
“A criticism I’ve had with statutory services is that they rarely close things that don’t work any more,” says Dodd. “So I need to ask that question of myself with Rest. We have certainly achieved our outcomes, but I’m not convinced that it’s time for us stop yet. I suspect that, if we did, the impact would be felt within six months on statutory services.”
Coates takes up the thread: “You don’t realise how good a team is until it’s gone. I think our figures speak for themselves: 86 per cent of our clients are suicidal at the time we get involved and we haven’t lost one yet.”
Rest might not have lost a client but its clients are in grave danger of losing Rest. Unless the PCTs come good or other substantial funders are found – and soon – it could sadly be the case that the Rest is history.
● Plan ahead – and have good risk management.
● Make fund-raising part of somebody’s role and capacity.
● Build up relationships with the key commissioners.
● Put all your eggs in one basket.
● Keep on doing what you’ve always done.
● If it accesses money change your values to suit the funders.
This article appeared in the 19 April issue under the headline “Rest assured”