Excellence Network teams use early intervention

Children and families

Saucepans

Saucepans, community child and adolescent mental health service (Camhs), is offering Southampton’s young people, up to 18, a streamlined referral service for short-term early intervention. The team is open to young people with a range of problems from substance misuse to autistic spectrum disorder, from phobias to anger management.

Camhs offers a single point of contact for all referrals, giving them rapid access to advice, assessment and referrals on to relevant community or specialist resources. Since referrals are accepted from a diverse range of professionals, Camhs staff are allocated specific schools, GP surgeries and other services to liaise with on an ongoing basis.

The Saucepans team has found that increasing choice delivers better results. It offers a choice of venues and appointments to families, and the onus is placed on users to make initial appointments following referral. Not only has this cut the number of failed appointments, it has also reduced families’ sense of interference and dependency on professional services.

Most recently, Saucepans has expanded its service into central/north Southampton, home to a large black and minority ethnic population. The team has used this as an opportunity to analyse better ways of reaching these groups who so often fail to receive intervention until crisis point.

Samantha Bateman, a social worker at Saucepans, says: “We are committed to early intervention. We provide support within the community to children and young people experiencing mental health, emotional and/or behavioural problems with choice and flexibility. An equally important part of the project has been our active engagement with the BME communities, enabling them easier access to this valuable Camhs service.”

Disability

Promoting Independence Team

Reablement is generally seen as a service that benefits older people. But the Promoting Independence Team in Coventry felt that younger people could also benefit from such a service, so they put their money where their mouth was and piloted a service for younger adults. They now offer a reablement service to younger individuals.

Despite being a team of only eight, they work with all new referrals at Coventry’s Physical Impairment Service. They have also worked with the private sector to ensure that access to reablement services is universal.

To ensure the sustainability of their approach, the Promoting Independence Team has helped adapt Coventry’s social care NVQ module on promoting independence. Evidence has shown that the team delivers excellent results for users with acute conditions as well as those with degenerative conditions such as MS.

An occupational therapy methodology called therapy outcome measures has demonstrated improvements for the majority of users in self assessed measures of activity, impairment, well-being and participation. The Promoting Independence Team is in the final stages of developing a database for this evidence as well as a financial evaluation of their work. They have made a video about their service which can be viewed at www.tinyurl.com/4s7pjt

Mental health

Bradford and Airedale Early Intervention

A new Early Intervention in Psychosis (EIP) partnership is reordering service delivery around young service users in Bradford. Local mental health workers came together with the primary care trust, social services and the third sector to create a new role: the “recovery co-ordinator”.

The reasoning behind this was a recognition that a broader workforce was needed for young people with first episode psychosis than is traditionally found in mental health teams.

These staff are not professionals, but graduates with relevant mental health experience. They are trained in the Care Programme Approach (CPA) and work in teams alongside mental health experts.

Although past mental health teams had always been good at supporting people with acute mental health needs, the recovery co-ordinators have helped improve the social aspects of recovery such as returning to work and education and retaining personal relationships.

The new role has also resulted in a more diverse workforce. More BME workers have been recruited into the service, helping to engage “harder to reach” clients. Initially professionals were resistant to accepting the new role. Concerns were smoothed when opponents learnt that the recovery co-ordinator was a distinct role and not a “second level” mental health professional.

Ultimately, recovery co-ordinators have proven that with the right training and supervision, professional qualification is not the only thing that underpins excellent clinical practice.

Learning disabilities

The Pearl Service

In January 2008, the Pearl Service was created with the aim of providing easily accessible sexual health services to people with learning disabilities in west London.

When practitioners became concerned about the high level of service users having unprotected sex, they decided to pioneer a project to raise the awareness and accessibility of the local sexual health clinic to those with learning disabilities. Chelsea and Westminster NHS, West London College, the learning disabilities team and Imagine Action Group came together to achieve this aim.

Over the next 16 months the coalition worked together to develop a joint strategy, as well as training programmes and confidentiality agreements.

The success of the project has been put down to massive user involvement. Users were involved in training, site visits and one-to-one meetings – they were even responsible for naming the service. The team’s success also demonstrates the importance of keeping things simple.

Clarity is essential in improving accessibility not just for service users, but also for ensuring that a range of carers and professionals get involved.

The group meets regularly, defines roles clearly and sets objectives with specific timeframes. The team continues to place users at the heart of delivery, and is currently looking into developing drama and video projects to ensure their sustained involvement.

Older people

Supporting People OPMH

The phrase “bored to death” is used lightly in general conversation, but it is too often devastatingly true for older people. Few community services are available for the elderly and many are left isolated and depressed. Essex Council’s Supporting People team are trying to solve this problem.

The team’s 20 members are trained in mental health and person-centred care. They work hard to befriend service users and earn their trust, accompanying them on shopping trips or for dinner, or to meet other people. Often the individuals they work with have been in long-stay hospitals or in respite care, and they appreciate being supported as they reintegrate back into the community.

The team also organises group trips, as well as activities within the sheltered housing schemes. People are brought in from the community to participate in art workshops, poems, quizzes, coffee mornings and shows. Service users’ artwork is often entered into local exhibitions and they look forward to being taken out to see their work on display.

The service works well because staff are salary paid and work 24-hour shifts, and contact hours can fit users’ preferences. Feedback has been excellent and the team is currently being evaluated to see how it might work as model for other teams in the community.

What the judges said

Chris Hanvey, director of operations, Barnardo’s: “Two major characteristics make Saucepans outstanding: the existence of sound child and adolescent mental health services, when this is frequently not the case, and second, that such services are truly multi-agency in their delivery.”

Andrew McCulloch, chief executive, Mental Health Foundation: “Early intervention can be a somewhat dry, medical or technical approach but Bradford and Airedale have joined up the dots with social care with outstanding results.”