Centre for Trauma, Resilience and Growth

Transcription

1 For further information on the Centre for Trauma, Resilience and Growth and the Veterans Service please see the website: This document is also available in other languages and formats upon request Centre for Trauma, Resilience and Growth Hosting the Veterans and Families Partnership The Centre for Trauma Resilience and Growth Nottinghamshire Healthcare NHS Foundation Trust The Mandala Centre Gregory Boulvard Nottingham NG7 6LB Telephone: NH471 March 2015

2 Who is in the team? The Centre for Trauma, Resilience and Growth (CTRG) is Nottinghamshire Healthcare s Traumatic Stress Service. The Service is a collaboration between the NHS and the University of Nottingham. The small team includes a variety of clinicians of different professional backgrounds including psychology, nursing, counselling, and psychiatry. We have a Clinical lead/director and a Centre Administrator. The Nottinghamshire Veterans Service is also part of the CTRG and has a small team offering a range of therapy, advice and support for exarmed forces and their families (see page 7). Who do we see? We work with adults who have been exposed to a variety of traumatic events (as outlined below), many with life changing consequences. We therefore work with individuals, families and communities affected by the impact of psychological trauma, a number of whom may go on to develop Post Traumatic Stress Disorder (PTSD). Treatment is time limited. Many of these events will include: Victims of serious crime e.g. rape and other forms of assault Individuals and families affected by homicide or other sudden traumatic bereavement Victims of road traffic collisions or industrial accidents Victims of torture Veterans (Please see the section on page 7 for further information) People affected by natural/man made disasters Individuals affected by occupational related trauma Victims of domestic violence and sexual abuse (time limited interventions) We ideally like to see individuals or families affected by traumatic events as early as possible, preferably within weeks of the event, but we realise that this is not always the case, because many people affected by traumatic events as described above tend not to seek help from their GPs at an early stage. Most of the people we see have severe and complex presentations. 2 The agencies that the Veterans Service liaises with include: Nottinghamshire Police, Nottinghamshire Probation, The Royal British Legion, St Mary s Bulwell, NHS Nottingham City Clinical Commissioning Group (CCG), Combat Stress, Rushcliffe Community and Voluntary Service, Service Personnel and Veterans Agency (SPVA), Rethink, Framework, Double Impact, Portland College, SSAFA (Soldiers' and Sailors' Families Association) Emmanuel House, Forces for their Future, East Midlands RFCA (Reserve Forces and Cadets Association) and The Joint Forces Alliance. What to do in an emergency If you are in contact with our services: During office hours - call your care co-ordinator. If they are not available, you should call your local community mental health team. After office hours, at weekends and on holidays - please telephone your Community Mental Health Team and they will be able to assist. If you are not in contact with our services: you should contact your GP. Your GP is your family doctor, the doctor you would normally go to see if you are ill or concerned about any aspect of your health. They will be able to refer you to the most appropriate mental health services in your area. If you feel this is an emergency, you should be able to get an appointment quickly. GP practices also have out of hours numbers for times when the surgery is not open. To search for a GP in your area or to find the contact details for your practice please see the doctor's section on nhs.uk You can also contact NHS Direct on or The Samaritans on

3 Where are we based? Individuals may be experiencing any of the following difficulties: Readjustment to civilian life Problems with irritability and anger Isolation Anxiety and persistent low mood Other mental health problems such as post traumatic stress disorder (PTSD) Increased alcohol use/drug misuse Encounters with the criminal justice system Housing/homelessness issues Self harm The Veterans Service has two part time Veteran Liaison Champions (VLCs) whose role is to assist veterans, carers and families to access a range of services, and to facilitate communication between organisations and services that would be able to provide appropriate support as needed. The VLCs can also provide information, advice and support on a range of issues including referral to mental health and other health care agencies. In addition to attending for individual sessions, there is also the opportunity to attend group sessions with other veterans. An experienced therapist in the veterans service, who also has a service background, facilitates the group. All the above information is applicable even if referred to the CTRG. The first point of call for any veteran needing assistance or help is their GP who will be able to make a referral if appropriate to the CTRG or other services (health/mental health/social care) in their area. The team is based at the address given on the back of this leaflet. Appointments are always made at that address. However, because we endeavour to make our service as flexible and accessible as possible, we occasionally offer home visits for assessment purposes and in some specific cases for occasional treatment sessions. However, these are often time limited with most of the appointments being held in the main team base. How are you referred? The CTRG is a largely self-funded service, so in some cases, specialist funding is needed and this information can be obtained on request. We take referrals from a person s GP or from other psychiatric services if appropriate and it always best to ask your GP to check the funding arrangements in advance of referral. Referrals initially go to a meeting for discussion and allocation. Those appropriate for the trauma service are sent assessment appointments within 6-8 weeks, occasionally sooner, depending on the nature of the event. We also sometimes take referrals from Occupational Health Departments within the Emergency Services or other public sector organisations for those affected by traumatic events in the workplace. Children are seen by a separate service: the Child and Adolescent Mental Health Services (CAMHS). However, we work in partnership with children s services to aid transition into our adult service. Occasionally older children are seen as part of a family intervention, for example after a sudden bereavement. What will happen at the first appointment? The first appointment is usually an assessment. It usually lasts between hours. It may be necessary to meet more than once for the assessment to be completed. The aim of the assessment is to find out about your difficulties. As well as talking about your experiences we will normally gather other background information. 8 3

4 You will usually have been sent a questionnaire before the assessment appointment many of the questions relate to standard information about you e.g. contact details, GP name, religion ethnicity etc., but please do not worry if you are not able to answer all the questions or find it difficult. Just fill in what you can and your therapist will discuss it with you at the first meeting. The assessment is usually conducted by any one of the members of the team. All of us have experience of working with people who have experienced a range of traumatic events, and will be sensitive to your needs and concerns. Often more than one member of the team is present at the assessment. This helps us to consider the different options available to you. We are also a University teaching unit and often have trainees on placement in their final year We realise that people can be anxious about attending for assessment and often have mixed feelings about being referred to our service. The first appointment is an opportunity for you to discuss any worries or concerns that you may have about attending, and think about whether this is the right service for you. Can I bring someone with me to the first appointment? Please feel free to bring a family member, advocate, or friend with you to the first appointment. However, we usually encourage you to meet us by yourself at some stage during the assessment. What will happen after the assessment? Towards the end of the assessment we will discuss whether this service is suited to your needs and, if so, what treatment we could provide. We will write to your GP and to anyone else who might have referred you or is involved in your care. If it is agreed that you come into our service for a period of treatment, you may be treated by the person who assessed you or you may be treated by another member of the team. 4 The complaints procedure If you are unhappy with any aspect of the service provided then we would encourage you to discuss this with us in the first instance. You can also contact the Patient Advice and Liaison Service (PALS). PALS is a confidential service for you, your carers or family and friends to contact if you have a concern about our service. PALS: Telephone: pals@nottshc.nhs.uk The Nottinghamshire Veterans Service (Nottinghamshire Veterans and Families Partnership) The Veterans and Families Partnership is a collaboration of many key service providers working together to assist and support veterans and their families in a variety of ways. The service provides an assessment of mental health and social care needs, treatment and support options for veterans with service related conditions and their families, working in partnership with a wide range of other armed forces charitable organisations, the public sector and the Ministry of Defence. Leaving the armed forces may often present unique challenges. These can range from practical problems such as finding housing and employment or managing finances, to dealing with a variety of emotional challenges such as anxiety, depression or post traumatic stress. If unaddressed these issues can lead to longterm health and mental health problems. To support the Military Covenant, the Department of Health has directed the NHS to prioritise veterans treatment for service related conditions. The service is for those who have served in HM Armed Forces, Merchant Navy (including National Servicemen, Regulars or Reserves). 7

5 What happens if I decide that I do not want treatment any more? Some people may decide that attending our service is not right for them at either assessment or even when they have commenced the treatment stage. However, we would encourage you to discuss any concerns that you have with us so we can help you to decide whether to continue or not. In very rare cases, when someone is at serious risk of physical or mental harm, we may have to recommend treatment from other services in the mental health trust, even if you say you do not want us to, in order to ensure your immediate safety and /or the safety of others. Do I have choices? Yes, there are plenty of options for you to choose between. For example, you can choose, within limits, (as indicated before) the time and place of your appointment. You can, in discussion with your therapist, choose the kind of therapy you feel would suit you best. You can choose whether or not you wish to have copies of the letters we send. Cultural and religious needs We will do our best to take into account your cultural and religious needs. Please feel free to discuss these with us. Involvement We are keen to take account of your views of the service. Periodically you may receive a questionnaire seeking feedback. We are also happy to take informal feedback from you. If you wish to become more involved in shaping services, you can become a member of the Stakeholder Forum. Please speak with your therapist for more information regarding this. What kind of treatment can I expect and how long will it last? We offer psychological treatment in line with the NICE Guidelines for treatment of people with affected by trauma and PTSD. (National Institute for Health and Clinical Excellence (2005) The management of PTSD in adults and children in primary and secondary care. National Clinical Practice Guideline 26, Gaskell Press.) As part of your assessment we can discuss these psychological approaches more fully with you. The treatment we offer is usually outpatient work, but as mentioned previously, some home visits may be included if appropriate as part of an individual therapy plan. Treatment is time limited. Sessions will usually last one hour, sometimes less or more depending on the type of appointment. The number of sessions offered is between 6-20, with a maximum of 20. This will be discussed with you at assessment. Medication is often a part of the programme of care for some people and many of those referred may already take some form of medication. We will discuss this with you and will try to enable you to make an informed choice about this. Do we offer support to family and friends? Whilst respecting the confidentiality of the people we see, we also acknowledge the needs of families and friends and we work to support them wherever possible in their role. We can sometimes offer carer assessments and can offer information about support groups. We can also provide details of where to access further information and support. How confidential is the service? In order to ensure that you receive good care, we do share some information with your GP and other healthcare professionals involved in your care. However, if there is particular information that you do not wish us to share, then please discuss this with us. There are certain circumstances when we are legally required to share information, for example if we think that you or other people are at risk. However, before doing this we will always endeavour to discuss the situation with you. 6 5