Using IFF Kitbag to Support Staff Working in Mental Health Teams

Transcription

1 [HSCC 1.1 (2013) 61-66] HSCC (print) ISSN doi: /hscc.v1i1.61 HSCC (online) ISSN Using IFF Kitbag to Support Staff Working in Mental Health Teams Margaret Hannah 1 International Futures Forum margaret.hannah@nhs.net Roddy McNidder 2 NHS Ayrshire and Arran, University Hospital roddy.mcnidder@aaaht.scot.nhs.uk Abstract: The International Futures Forum has developed IFF Kitbag to help people grow their personal capacities to stay calm, build relationships and foster resilience. The resource has been used in team away days for people working in mental health services in a Health Board area in Scotland. Feedback from using the resource suggests it provides helpful ways for people working in mental health teams to grow their capacity for more effective working practices. Examples include greater self awareness, better listening and understanding the need to support each other. Further work is needed to assess whether these outcomes are sustained over time. Keywords: IFF Kitbag; mental health; mental health teams; psychological capacity Introduction The mental demands of modern life can be challenging at the best of times. Changes in family structure, working practices, use of information and communication technology all have an impact on the quality of daily life. Staff working in mental health services have a double burden coping with these changes in their personal lives as well as facing an increased demand for their services as families and communities are put under strain through economic recession, unemployment and a loss of wellbeing. 1. Dr Margaret Hannah is Transformative Innovations in Health, International Futures Forum, Fife, Scotland. 2. Roddy McNidder is Critical Incident Stress Management and Staff Care Coordinator at NHS Ayrshire and Arran, University Hospital, Ayr, Scotland., Unit S3, Kelham House, 3 Lancaster Street, Sheffield, S3 8AF.

2 62 Hannah and McNidder This paper describes how staff in community mental health teams have been encouraged to address these dual challenges using thinking and practice developed by International Futures Forum (IFF) and, in particular, the use of IFF Kitbag. Background For many years, the growth in demand for healthcare has been matched by an exponential rise in spending. For example, in NHS Scotland, spending has doubled from 1998 to However, in recent years, spending increases have been sharply curtailed whilst, at the same time, demand for mental health services has been rising. These dual pressures have placed staff under increased strain, exacerbated by efficiency measures that curtail the amount of time staff can spend with patients, staff losses through retirement or cessation of short-term contracts and single-site working which has the effect of increasing time spent commuting to work and travel time within work. The International Future Forum is a small not-for-profit organization based in Fife, Scotland. Its purpose is primarily to promote understanding of the state of the world today, its uncertainty, complexity and fragility, and to foster wise action to create a better world for the future. One area of work it has focused on is the need to develop psychological capacity to address the level of complexity of modern day, seemingly intractable, challenges. In the course of this work, IFF has developed Kitbag, a set of resources designed to help people stay calm, grow their inner strengths and become more resilient in the face of challenging circumstances. IFF Kitbag is derived from a range of psychotherapeutic traditions from mindfulness based cognitive therapy (Kabat-Zinn), to expressive arts therapy (Rogers), and psychosynthesis (Ferrucci). Working with artists and designers, IFF has packaged these insights into a user-friendly form to allow people to support their own inner growth in their own time and place. The overall architecture of IFF Kitbag uses a Human Dynamic perspective, as set out by D. H. Ford and others. This recognizes that the individual human experience is subject to feedback from group experience at many different levels physical, mental, emotional and spiritual. Growing capacity for inner calm and reflection creates the conditions for groups to interact differently with each other. Using IFF Kitbag in facilitated sessions allows teams to recognize their personal capacities, get to know each other better as human beings and foster a shift in relationships, which become mutually life-enhancing. The purpose of this paper is to describe the outcome of a series of facilitated events for mental health teams in a Health Board in Scotland.

3 Using IFF Kitbag to Support Staff Working in Mental Health Teams 63 Method Six away-days were run with 80 members of staff from mental health teams in a Scottish Health Board area between May 2011 and February Each session covered current concerns, reflections on how the world is changing and its consequences for mental health, and an opportunity to share personal stories and explore different elements in IFF Kitbag. Each day ended with a session aimed at devising strategies for the team to work more effectively. Results Feedback from the days suggests staff learned a great deal about themselves and each other. Only a few examples can be presented here, but to give a flavour of the responses given, staff provided the following comments to complete the phrase, As a person, I have learnt : Be aware of others more. Attitudes make happier environments. Everyone has a responsibility. What we(i) do makes a difference. Good work-life balance is key. Think about myself more positively. And as a further example, these comments came from completing the phrase, For the team, we have learnt to : Actively listen to each other. Communicate consistently. Take a minute each day. Take time to listen fully. Respect individuals. Support each other. At the end of the day, members of staff were asked to write down one thing they would commit to doing within the following two weeks. Comments included: Make time to care for myself and my colleagues during work time and enjoy getting my lunch! Re-establish peer supervision sessions. Support my colleagues more. I am going to stay positive.

4 64 Hannah and McNidder I am going to take more time for reflecting on why I love my job and forward plan for a bright future. I will have hope and faith that my work environment will significantly improve. I am going to smile at my colleagues more often. During the course of the days, staff shared personal stories about how life in their work had affected them in recent years. This generated a sense of shared experience and recognition that staff can support each other, even when working conditions are stressful. Discussion Staff in mental health teams carry a heavy emotional burden in their work, yet are rarely given the space and time to discuss this in a supportive way with each other. Being afforded a whole day out of work to address these issues is a rarity in the modern NHS, yet the feedback from these sessions suggests it is not only needed, but offers opportunities to create more sustainable working cultures and environments, despite the pressures staff are experiencing. The feedback presented here was given on the day of the workshop. It would be useful to know what long term benefits have been achieved through the process. Follow-up work is being planned. Conclusion IFF Kitbag offers a range of exercises and experiences to enhance coping skills, build inner strength and resilience in mental health teams. Longerterm follow up is required to assess the impact on staff working. References Ferrucci, P. (2009). What We May Be: Techniques for Psychological and Spiritual Growth through Psychosynthesis. New York: Jeremy P. Tarcher. Ford, D.H., and R.M. Lerner (1992). Developmental Systems Theory: An Integrative Approach. Newbury Park, CA: SAGE. Ford, D.H. (1987). Humans as Self-constructing Living Systems: A Developmental Perspective on Behavior and Personality. Hillsdale, NJ: Erlbaum. Kabat-Zinn, J., Massion A.O., Kristeller J., Peterson L.G., Fletcher K.E., Pbert L., Lenderking WR, Santorelli S.F. (1992). Effectiveness of a Meditation-based Stress Reduction Program in the Treatment of Anxiety Disorders. American Journal of Psychiatry 149 (7) Rogers, N. (2001). Person-centered Expressive Arts Therapy. In: Approaches to Art Therapy: Theory and Technique (2nd edn). ed. J.A. Rubin, New York: Brunner-Routledge.

5 Using IFF Kitbag to Support Staff Working in Mental Health Teams 65 Appendix This appendix offers a brief description of the Kitbag. For more details see Kitbag contains a how to use card - Resources to help one make space for oneself: feelings cards, calming oils, presence cards, which have prompts such as Imagine a place of safety and then one is invited to meditate on this for a moment. Transform card allows one to go deeper: e.g. the prompt hold all things in balance serves as a sort of mantra to focus on over several weeks. Hope cards offer words of inspiration. Other resources: e.g. worry beads, talking sticks, music or journals help participants to relax, reflect and empower themselves. Ultimately the challenge is to make the kitbag your own and personalize it for yourself. An example Using Kitbag regularly, say five minutes first thing in the morning or last thing at night, can give you the space and time you need to deal with the demands of your everyday life. Kitbag can also help in a variety of circumstances - Coping with stress: kitbag can help you cope better with stress and find ways to manage the things in your life that are causing you stress. The demands of being a carer: if you are caring for people, either in your own home life or professionally, it is important to take time for yourself. Managing chronic conditions: kitbag is based on well established theories about how the mind works. A number of people who have used it have found that it can reduce the need for pain relieving medicine. It can help you grow the positive things in your life. Recovering from painful life events: kitbag can support you during and after experiencing a trauma, such as divorce, separation and loss. It can help

6 66 Hannah and McNidder you become calmer and better able to process pain and give you the space and time to recover. Working with others: using Kitbag with other people helps to develop trust, build relationships and encourage people to support each other. It has been useful in teams who have felt undervalued or very stressed and has been introduced to schools in Scotland.