Sharing the Learning from Innovation in Mental Health Practice

1. Sharing the Learning from Innovation in Mental Health Practice

2. Person Centred Approaches: National Perspectives and priorities for from Mental HealthHugh Masters, Nursing Officer (Mental Health and Learning Disabilities, Scottish GovernmentEducational approaches – what have we done and what have we learnedSusanne Forrest, Programme Director, NHS Education ScotlandMuch More Than a Label: A User-Led Project About Personality DisorderNaomi Salisbury – Development Worker

3. 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

4. The Context

5. 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

6. 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? The 10 Essential Shared Capabilities

7. 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

8. 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

9. 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) • Introduction • Using self to promote recovery focussed relationships • Person centred support and planning • Enabling self direction • Risk and risk taking • Connecting with communities

10. 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

11. Evaluation Findings - translation and enactment within Health Boards Case studies Vanguard Some comparatively substantive positive evidence of impact in terms of peoples’ self-reported thinking and some examples of practice development Mid range Some positive evidence of impact, mostly in terms of peoples’ self-reported thinking. Limited enactment Very little evidence of impact

12. 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

13. BUTAny impact on service users and carers’ experiences and outcomes not knownEducation and training is just part of the picture

14. 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

15. Discussion points • Could these approaches be useful in other practice areas? • National v. local approaches? • Demonstrating the outcomes and impact of person centred initiatives?

16. Much More Than a LabelA User-Led Project About Personality Disorder Naomi Salisbury – Development Worker naomi@capsadvocacy.org 0131 538 7177

17. 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

18. 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

19. 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

20. 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 Resource

21. Summaries

22. Personal Experiences

23. User Views

24. Reflective Materials

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

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

27. Two day course developed with NHS Lothian and Recovery Network Covers information about the diagnosis, service user and staff experiences and skills development Trainer pool being developed including service users and staff Training

28. Training

29. Made up of people who have experience of personality disorder diagnosis Meets regularly to discuss progress of the project and plan further work Reference Group

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

31. 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

32. 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