A digital place for people who access services, carers, staff and partner agencies, to share ideas around care co-ordination & care planning in mental health

Posts tagged ‘social media’

Access to peer support ………. inadvertent gatekeeping?

“Have you been given information by NHS mental health services about getting support from people who have experience of the same mental health needs as you?”

This is one of the NEW questions in this years National NHS  Community Mental Health Service User Survey. The focus is about people having been given information about getting what is termed ‘peer support’ – support from people who have lived experience of mental health issues.  There is lots of information about peer support to be found on-line, for example – Together for Mental Wellbeing, Mental Health Foundation and Centre for Mental Health.  And there is information about where you can access peer support locally, for example in York, or in Leeds.

This information being available to people in a number of ways is better – having a discussion about it, accessible leaflets etc. Better still is people routinely being supported by peer support workers. This is where the conversation moves away from vanilla:

  • Access to peer support workers in mental health teams. Fab, but how do we ensure this is equitable, how does everyone get the chance of this?  A referral system within a team can be helpful but can highlight some interesting things.  Speaking with a peer support worker it became apparent that the same care coordinators refer for peer support work and the same ones don’t. There could be a number of explanations for this, and I am sure it couldn’t be that some care coordinators don’t value peer support work or working in a recovery/wellbeing orientated way, that they are not choosing whats best for someone rather than offering choice and are not inadvertently gatekeeping and creating power differentials. So we must look to alternative explanations.
  • Could it be said that most people have some lived experience of mental health issues, through their own life experiences or through that of their family and friends? If so, then people are routinely being supported by peer support workers. Mission accomplished, box ticked. But this is not quite right, this is hitting the target but missing the point. It diminishes the experiences of people with mental health issues.
  • Should recruitment to all posts actively encourage people with lived experience? Perhaps this is already happening but what about choice?  Should people have to disclose their lived experience, and if they don’t will they be discriminated against in selection?
  • Peer support on Social Media? – whatever next! An alien concept to some, but there is ever-growing peer support on social media channels.  People regularly blog, Tweet and Facebook about what’s going on for them and its reciprocal. The support offered is pretty immense.  It bypasses the ‘referral’ stage and is instant. A beginner’s guide to Twitter should help if you are working up to Tweeting.
  • The influence of National Survey’s in changing practice.  The benefits of using approaches that support recovery and wellbeing are well established and backed by research.  The National Survey results will tell us what people accessing services are experiencing, are folk being given information about accessing peer support – or not. The question creates a standard and measure.  The danger is of it providing a minimum standard, I would not want to see the current provision of  ‘in-house’ peer support reduced based on a standard of providing information only.

People currently accessing mental health services are future peer support workers, the eco-system of peer support. Often people want to share what they  have learned along the way, want to give something back, want to achieve their ambitions and goals. People  understand that they have a unique view of living with mental health issues, that they are ‘experts by experience’  rather than an  ‘expert by education’. Perhaps a blend of both is often where we find ourselves at?

 

 

Leeds Social Media Cafe

The Leeds Social Media Cafe is a place where people can come together to talk about how they manage social media. Each person and each interaction is always unique.

Each month we provide free food and a chance to mix with like-minded people. In May (13th @ 17.30) you will get to meet & hear how Asad Ali from Blacks Law Firm has transformed the way social media is used within the organisation.

We meet at:tea n toast

Lazy Lounge
Wellington St
Westpoint
Leeds
LS1 4JY 

United Kingdom

Please sign up online at http://leedssocialmediacafe.eventbrite.co.uk

Thank You
Pritesh Parmar

07984 409 610
www.teaandtoast.org.uk
@teaandtoast

Care Programme Approach – a national perspective

I was asked by @WeMHnurses to get involved in hosting a Twitter Chat about Care Programme Approach (CPA). I agreed (with a fair bit of persuasion as I am quite new to Twitter) and the chat took place on March 10th.  You can read the Tweets here ; and view the background information here.

twitter

One of the great things about getting involved in discussions on Twitter is the broad range of perspectives that are brought together from across the country in one place, in real-time.  It’s great for provoking thought and an appreciation of views that might be contrary or complementary to your own.  Though a social media platform, Twitter is far more than social, it is a place to ‘meet’ other professionals and experts by experience; often those that you would not usually encounter in your day-to-day working life. Mark Brown talks about ‘Public Professionals’ a unique perspective of how health care professionals connect with the wider community, definitely worth a read (here)  if you ever wondered about the value of participating in social media.

Back to the national perspective contributed at the Twitter Chat; here are some of the key points that came up (and some of my thoughts in italics):

 

  • CPA is an odd name, not very descriptive of what it is. Some folk refer to it as ‘the CPA’ but not clear on what this is referring to – the assessment, the care plan or the review? Perhaps this reflects a lack of understanding or perhaps a culture within the clinical area – does this matter or is it a pedantic point of a CPA geek (me)?
  • Documentation – completion of it seems to be a task ‘ paperwork to be filled in’ rather than a collaboration;  can be a useful tool when used properly.  Need to consider the individual’s experience of how we approach CPA – if we see it as form filling, then that is how it is likely to be perceived. What support do staff need in ‘reframing’ their view of CPA?
  • Variable take up across UK; an effective approach but only when it is implemented properly, difficult with the current fall in resources and increase in demand – all folk receiving ongoing care support or treatment should be either on CPA or ‘Standard Care Plan’
  • People need the right information about CPA; this information is not always available – I am assuming that some organisations are not providing written information for people accessing services, Department of Health did produce some literature, but it is quite a while ago. Is what we have in LYPFT ok?
  • CPA should be aligned closely to recovery/wellbeing/personalisation and not seen as separate; and owned by the person; carers and family should be included.  Fully agree, some very good examples of this in practice, if folk use recovery ‘principles’ in the way they work, then CPA is approached in the same way.

How does this fit with your experience of CPA across Leeds and York? It would be great to hear how CPA is being used in different teams.

 

CPA – are we there yet?

I was asked by @@WeMHnurses to get involved in hosting a Twitter Chat about CPA. I agreed (with a fair bit of persuasion as I am quite new to Twitter).  You can read the blurb here or read on for a bit of background to inform the Twitter Chat; please do join in, it’s on Monday 10th March at 8pm.

Care Programme Approach (CPA) has been around since 1990 and is an umbrella term to describe the way that a person’s care, support and treatment are arranged in secondary/specialist mental health services through: 

  1. Assessment
  2. Coordination
  3. Care planning
  4. Review

Who should be ‘on CPA’?

Refocusing the Care Programme Approach – policy and positive practice guidance (DH 2008) sought to provide clearer guidance on the characteristics of those needing the support of the CPA framework (see p.13).

In addition, individuals within the following groups should be supported by CPA unless their assessment shows otherwise:

•  Individuals who have parenting responsibilities

•  Individuals who have significant caring responsibilities

•  Individuals with a dual diagnosis (substance use)

•  Individuals with a history of violence or self harm

•  Individuals who are in unsettled accommodation

Some people don’t need CPA but they should still have a care plan (can be a letter), a named lead professional and a review.

To summarise, the CPA framework in place; it considers those that do and those that don’t need CPA; it’s not new; it aligns with the way that different professions work (eg. nursing process); the value base is linked to the Ten Essential Shared Capabilities (2005).

So why, over 20 years later, do I wonder “are we there yet?”

The constantly changing mental health landscape necessitates us to reflect upon what we are doing and to ‘check’ that everything still fits. For example, the introduction of integrated care pathways (ICP’s) –  does this fit with a person centred, co-produced care plan? So the ‘are we there yet?’ question continues to arise but the reality is that the destination is not within our grasp, we get ‘rerouted’ when we think our destination is near. But this is ok; in our professional lives the constant is change. Here are some of the ‘reroutes’ to ponder in relation to planning care: 

•  CPA is linked in with performance reporting with Monitor and Mental Health Minimum Data Set informatics requirement and is included in the National Service User Survey ; results/reports from these tell us that there is a disconnect between the information that organisations hold and what people that access the services tell us about their experiences. How can these differences be explained? Do people who use services and carers/supporters know about CPA? Does it make any difference?

•  Personalisation and Recovery/Wellbeing are approaches that are prominent in mental health. How do these approaches work alongside CPA? Are we finding any conflicts and if so, how are we working through these?

•  How do we ensure that the person is at the centre of their care, support and treatment and that care plans are co-produced?

•  And of course, the question of austerity – how have the NHS cost savings impacted on how we provide CPA? How are mental health professionals maintaining quality?

Share your views/experience

There is a digital conversation guest hosted by @donnajkemp planned for Monday 10th March at 8pm on Twitter to discuss these points; do join us at #WeMHNs;  alternatively post your comments on here.

Click here for more info about the ‘Twitter Chat’ and for links on how to use Twitter

@WeMHnurses is part of the @WeNurses community and is curated by @mrsgracepoole and @NatalieMHN

Exit comfort zone stage left…….

That is how it felt when the plan for CPA – making a difference  got the green light and was signed off. CPA - making a differenceThe plan focuses on listening. Listening to what people say about Planning Care – from people’s personal experience of accessing care, support and treatment across LYPFT services  to hearing how people would like services designed and delivered. Listening to what staff say about what they need to provide the best care, support and treatment and listening to what our partner agencies, statutory and third sector, say about what its like being alongside LYPFT.

Listening is a key element of communication, the listening part is key to understanding different viewpoints and identifying people’s priorities; and it is around here that I start to leave my comfort zone. The tension emerges when there are differences between what people want – from differences between individuals to differences between different groups or ‘stakeholders’.  Difference is good, it would be rather dull if everyone wanted the same thing but how to reach consensus fairly? The end result will be some folk are delighted, some are dismayed. My challenge is to remain neutral enough to ensure that people can freely express their views but to provide enough information for people to consider their views upon.  At times there can be different priorities between people who access our services, the professionals delivering the service and the organisation itself; final decisions are often made at quite a distance from where the original discussions took place, it takes courage to shout up for other people’s views and it requires committment and believe  to progress what can initially appear as disparate agendas (though they often are not).

So why am I sharing this? Well, hearing people’s views and making shared decisions is what we all do.  Discussions with staff across the organisation be it face to face, via email or social media constantly reminds me that we are all working in a similar way. I wanted to acknowledge this and share a bit about how this shift has changed the way I work and some of the challenges this has brought along the way.

If you are still reading, then you will be aware that I didn’t manage to squeeze in competence and compassion – oh look, I have now! So what’s all this about? 6CsWell, it’s about building Compassion in Practice;  you can read more about this, along with examples of how this is working locally here,  you can also read here about how Towngate House Rehabilitation and Recovery Team are building a culture of compassion.  So how are you building compassion in  your practice?  If  you access services or are a carer, how do you experience compassion in care – is this something that can be felt/experienced? How does it make a difference?

So whats the link between The 6Cs, Planning Care and exiting comfort zone stage left? Well if we apply the culture of compassionate care to the way that we work with people in planning care then the benefits to people who access our services and their carers should be evident. I came across The 6C’s on Twitter. Yes Twitter. Something very new to me and a steep learning curve in many respects. I had not underestimated the value of twitter in relation to connecting with people professionally, with the public and people in other organisations, fact is I had not estimated it at all. But that’s a whole other subject…….

Thanks for reading – Donna Kemp

Meeting

You are invited to attend a meeting on the 20th November to hear more about the Planning Care Network.

There are 2 venues:

Sycamore Suite at Bootham Park Hospital, York 10.00 – 12.00

Becklin Centre Training Room 3, Leeds 14.00 – 16.00

It would be great to see you there, but if you can’t attend that’s ok; just check back here to see whats going on.

Donna

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