Towards a Mentally Flourishing Lanarkshire Kohti henkisesti kukoistavaa Lanarkshireä

Transcription

1 Towards a Mentally Flourishing Lanarkshire Kohti henkisesti kukoistavaa Lanarkshireä Improving mental health supports wider goals, embedding mental health supports wider reach, collective efforts support better outcomes Mielenterveyden edistäminen tukee laajempia tavoitteita, mielenterveyteen panostaminen vaikuttaa laajemmalle, yhteiset ponnistelut mahdollistavat paremmat tulokset Kevin O Neill, Public Mental Health Development Manager kehitysjohtaja March 2015

2 FIN-LAN COLLABORATION

3 Lanarkshire Population of over 630,000 One National Health Service Board, two Local Authorities (municipalities) and a range of voluntary sector providers strong partnership working Integration of Health & Social Care Mix rural and urban landscape Significant socio-economic challenges post industrialisation 3

4 Historical Overview: A significant shift Institutions to community Social exclusion to social inclusion. Medical model to psycho-social model. Maintenance to recovery service. Psychiatry to multi-agency and multidisciplinary. Professional experts to experts by experience. Focus on illness to include prevention of mental health problems, promotion of well-being and quality of life. Service focussed to person centred. Only an issue for health and social care to wider community assets. 412 SL See Me signings (30% of the national total).

5 Mental Health Strategy for Scotland National Strategy National Support and Programmes Local Areas Responsible for Implementation What Gets Measured Gets Done! Performance Management: Local Commitments and Targets Set. Performance Published Twice Yearly Visits from the Government.

6 Dependant on complexity Tiered model of service delivery portaittainen malli Tertiary Tier3 Care Vaativat erityispalvelut High Need Suuri tarve Tier 2 Specialist Secondary Care Mental Health Services Erityispalvelut Tier 1 Primary Care & Mental Health Services Perustason palvelut Riippuu tilanteen monimut kaisuud esta Tier 0 Community Health & Wellbeing Alueilla ja yhteisöissä tapahtuva työ, avohoito Low Need Vähäisempi tarve

7 Tier 0 & 1: Well Connected: Widening the Response All Services signed the see me pledge Over 1,300 people participated in mental health awareness and briefing building capacity. Increased access to self-help: Over 25,000 resources borrowed from Lanarkshire libraries since launch. Over 188,000 mental health self-help materials requested through the request programme. 214 referrals were made to NHS 24 Guided Self-help Services (Living Life) and Telephone CBT for Lanarkshire residents last year up from 145 the previous year. Most referrals from all NHS board areas. 56,000 visits to elament last year up from 24,000 in 2011/ Lanarkshire referrals to leisure domain of Well Connected Lanarkshire referrals to the benefit, welfare and debt advice domain. Over 2,174 places booked on Stress Control Classes (it would have taken over 7,823 individual session to deliver equivalent) of 64 group programmes. Get Walking Lanarkshire Programme established to compliment. European Union Mastermind Computerised CBT programme launched September Telephone information serviced delivered by voluntary sector and Occupational Therapy Self-referral Community Clinics support access. Positive evaluation in terms of satisfaction, reach, attendance and outcomes.

8 Tier 2: Secondary Care Mental Health Services Crisis Standards 4 hour waiting time commitment met: Extended Community Mental Health Teams hours into evenings and weekends (locality response). Advanced Nurse Practitioners Mental Health Assessment Teams (Crisis) Liaison Psychiatry Reducing Suicide 18 week referral to treatment targets met: One door access in localities. Increased the psychological therapy workforce. One of only three Health Boards to meet the target (December 2014).

9 Tier 3: In-patient and Specialist Services Ensuring in-patient support when required: Reducing beds but acute admission facilities in all three DGH. New Intensive Psychiatric Care Unit Opened in Complex Care facilities to support extensive rehabilitation and recovery. Low Secure Care facilities inline with legislation. 80% bed rate occupancy. Target met for reduced mental health re-admissions Specialist services: Forensic services. Perinatal Mental Health Services. Tier three Eating Disorders Services Improving outcome Improving specialist support Supporting education and delivery across the tiers Reducing spend on out of area placements

10 Understanding Recovery What matters in recovery is not whether we are using services or not using services; using medications or not using medications. What matters in terms of recovery is are we living the life we want to be living? Are we achieving our personal goals? Do we have friends? Do we have connections with the community? Are we contributing or giving back in some way? (Deegan.P Recovery: The lived experience of rehabilitation) 10

11 Formally launched in June 08 following close working with the See Me Scotland Anti-stigma Programme Scottish Recovery Network since Hosted by Lanarkshire Links: Service User and Carer Involvement Organisation. Multi-partner steering group coordinates and supports action. A hub for action. Aims to Link NATIONAL: Act LOCAL to: Raise awareness of recovery and the things that help and hinder Develop a better understanding of recovery Eliminate stigma and discrimination Support and encourage local action

12 Improving the Quality of Life for People with Mental Health Problems: Road to Recovery 1 st level change (INDIVIDUAL) : Values, conditions and environments that support recovery. Yksilö: kuntoutumista tukevat arvot, olosuhteet ja ympäristöt 2 nd level change (COMMUNITY): creating the conditions in community that maintain recovery including public attitudes, increasing access, reducing barriers and supporting connections.yhteisö: olosuhteet, jotka ylläpitävät kuntoutumista, asenteet, palveluihin pääsy, esteiden vähentäminen, verkostojen tukeminen

13 MAKING RECOVERY HAPPEN Individual - directs it Services - facilitate it Communities - maintain it Steve Onken, American Professor of Social Work Yksilötasolta - johdetaan sitä Palvelut - helpottavat sitä Yhteisötaso - ylläpitää sitä

14 CHIME framework Leamy, M., Bird, V.J., Le Boutillier, C., Williams, J. & Slade, M. (2011) A conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. British Journal of Psychiatry, 199:

15 VALUE POSITIVES 1 st Level Consider values and attitudes arvot ja asenteet Value lived experiences of recovery kuntoutumiskokemusten arvostaminen Person centredness ihmiskeskeisyys Create an expectation of recovery toivon luominen, kuntoutuminen on mahdollista Consider and critically appraise approach to risk riskinotto Peer support vertaistuki Focus on capacity and strengths voimavarakeskeisyys BELIEF + POWER + SUPPORT = RECOVERY Usko+valta+tuki=kuntoutuminen

16 Our new identity

17 The brand

18 The brand

19 The brand

20 The brand

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24 We are on our way.. Community Level

25 Communities have never been built upon their deficiencies. Building community has always depended upon mobilising the capacities and assets of people and place. (McKnight 1996)

26 When you change the way you look at things, the things you look at change. Steve Onken

27 FIN-LAN COLLABORATION 2011 None of us are as smart as all of us. kukaan meistä ei ole niin fiksu kuin me kaikki Japanese Proverb