Three innovative case studies for community mental health
Three examples for GP commissioners, provided by the Joint Commissioning Panel on Mental Health.
Karis Neighbour Scheme1
Karis Neighbour Scheme has been operating in Birmingham for over 12 years. A voluntary sector organisation, it is underpinned by the belief that spirituality is an important factor in personal and community health. The scheme seeks to meet a variety of unmet needs, largely through volunteer support. Partnership working with local services, especially medical centres and faith based organisations, is central to its work. Karis Neighbour Scheme is guided by Christian beliefs and principles; its directors are Christian, as are many of the staff.
This motivates the organisation, but in no way restricts its services to those who share their faith. It has close links with the community healthcare chaplains at a local medical centre that is known for the holistic health care it offers. Some of Karis Neighbour Scheme's programmes are joint projects with local churches.
Karis Neighbour Scheme aims to reduce isolation, promote connectedness between people and enhance community cohesion by:
• providing individual befrienders for the isolated elderly, asylum seekers and refugees
• organising community activities and events that build relationships and create a sense of community, including:
– day trips in the summer for young families
– summer garden parties for the elderly
– Christmas festivities for the elderly at residential homes and churches
– a personal faith discussion and support group at a residential home and community centre
– the annual Ladywood Community Fun Day
– a community allotment project
– art and craft or language sessions with free child care
– a community engagement project (facilitated by The Nehemiah Foundation – Training People to Transform Communities www.regenworker.com), which initially conducted a detailed public health analysis of the area, then worked with local stakeholders to establish priorities for action, and has now set up a residence association and a community newspaper.
It also aims to improve mental health and ability to cope with adversity, increase individuals' sense of control and independence and so reduce demand on services by:
• running drop-in advocacy sessions offering help with welfare benefits, utility bills, immigration and housing issues
• practical support such as gardening, decorating and supplying second-hand furniture
• free English language classes for those new to the UK
• accompanying individuals to appointments with doctors, housing or benefit agency appointments
• one-to-one counselling and groups dealing with issues such as depression, anxiety, self-esteem, anger management and confidence building
• working with families and young people to promote emotional health and reduce family dysfunction.
Changing Minds Education Centre2
Changing Minds Education Centre has developed over a number of years. Its work initially focused on primary care medication, but it has expanded to incorporate new ways of working and new workers, including graduate workers and community nurses trained in mental health. Following an audit in 2005/06 and in parallel with national initiatives such as the National Service Framework (NSF) for Mental Health and IAPT, the service has developed to provide a stepped care wellbeing service.
Changing Minds is now a practice-based initiative with an early intervention and recovery focus. It employs 37 full-time equivalent staff. The service includes peer support and a parent support service, in addition to the following three projects:
• Changing Minds Wellbeing Teams provide a person-centred service for people in Northamptonshire who may be at risk of, or who are experiencing, a period of mental distress. Their aim is to explain the information, resources and support available and help people make positive lifestyle changes to improve their mental wellbeing.
• Learn2B is a partnership between Changing Minds and the Northamptonshire County Council Adult Learning Service. The aim is to enhance wellbeing through a range of creative, social, recreational and therapeutic groups for people in their local communities. Currently 30 tutors are running a variety of clinical/task based/social interaction groups.
• PhyHWell (pronounced 'fuel') is a twoyear pilot funded by Northamptonshire Teaching PCT that aims to reduce mortality rates among people with severe mental illness, improve their physical and emotional health, increase their compliance with medication and help develop their support networks. It does this by improving skills in the primary care workforce and promoting data sharing and collaborative working. It offers GP practices individual bespoke training and, by inviting the practices' link community mental health nurse to participate, creates an opportunity to improve links with the local community mental health team. The project was the winner of the Nursing in Practice Award 2010.
Health and Wellbeing Centre with Navigators3
Launched in December 2011, this is a partnership between Turning Point, the Terrence Higgins Trust, Greenbrook Healthcare and NHS dentists. The health and wellbeing centre is designed to offer the community easy access to a range of primary healthcare services co-located under one roof. The building houses a GP-led health centre, community sexual health services and NHS dentistry, as well as offering space for use by other community groups.
The service operates at the interface between primary and community services. The reception is staffed by a team of ‘wellbeing navigators' who, in addition to dealing with patients' health questions, also deal with bookings for the community room space for local organisations, make links with other community hubs locally and signpost to other sources of support in the community.
This navigator model is based on a pilot project in Hartlepool, evaluated by the University of Durham, which successfully engaged people with local health and wellbeing services.The partnership also plans to establish a wellbeing navigator apprenticeship scheme, which will recruit and train local people who have used the navigator service to work as navigators themselves. This will both expand the existing service and ensure its sustainability, and establishing a systemic and structured way to build on the strengths and experiences of patients.
Click here to take the CPD module on the JCPMH's stepped care model, and its recommendations for GP commissioners on mental healthcare provision in primary care.
This is an extract from the Joint Commissioning Panel on Mental Health's guide to primary mental healthcare (www.jcpmh.info).