Friday 17 th April 2015 The Hilton Hotel, Templepatrick
Welcome and introductions Ricky Irwin, OFMDFM
What Is Collaborative Design • Working in partnership with key stakeholders to shape the best possible Service Delivery Model; • Working in conjunction with users, providers and professionals to design a more responsive, fit-for- purpose and efficient service.
Victims & Survivors Collaborative Design Approach Victims Sector
Collaborative Design Process Identify emerging key priorities / themes COLLABORATIVE DESIGN CREATING SOLUTIONS COLLABORATIVE WORKSHOPS TOGETHER WORKING DIALOGUE Open discussion and Over the coming months we Moving forward with our shared bringing all of the plan to hold a series of vision as partners, with a AND information together to workshops to allow us to mutual understanding that we identify overall priorities discuss possible ideas for are all committed to delivery. PARTNERSHIPS consultation Everyone has a vital role to play.
Objective For Collaborative Design Workshop To discuss and identify initial key priorities for: Victims Support Programme Individuals Needs Programme Mental Trauma Services
VICTIMS SUPPORT PROGRAMME MARGARET BATESON Interim CEO Victims and Survivors Service
Monitoring and Strategic Evaluation Allocation MIS 12 Recommendations Partnership 7 Key Areas and Collaboration Eligibility Long Term Evidence Sustainability Based Practise
INDIVIDUAL NEEDS PROGRAMME JOHN BEGGS CVS Secretary “Promoting awareness of matters relating to the interests of victims and survivors ”
Individual Needs Programme - Introduction • Highlight some of the key recommendations of the RSM Evaluation and Independent Assessment • Status Quo maintained 2015/16 with focus this year: pilots on Personalised Budgets/Caseworkers, Eligibility and Assessment process • Hear your views on these today to inform development of policy advice and future co-design workshops
Individual Needs Programme - Context • 4 packages of support and 6 schemes derived from NIMF and CNA • VSS integral role on set-up in administering schemes based on INR’s and historical levels of uptake/demand and funding • Independent assessment raised particular concern around assessment process and INR suspended in-year • RSM Evaluation of 2013/14 highlights c.4,000 individuals benefited and £4.4m spent on addressing individuals needs • RSM identified that key issues were growing demand and eligibility checks, assessing needs and demonstrating impact
RSM Recommendation 7: OFMDFM, CVS and VSS pilot personalised budgets • The pilot should be reviewed and inform a decision on the use of personalised budgets for future service delivery RSM Recommendation 8: OFMDFM, CVS and VSS should pilot a case worker approach • Whereby individuals are assigned to a dedicated member of VSS staff, alongside the personalised budget pilot in 2015/16 • This should enable consistency in individuals’ contact with VSS • The pilot should be reviewed and inform future deliver y
Personalised Budgets/Caseworkers: Action to date • Study trip to Warrington March 2015 to evolve concept into practical advice for service delivery • Currently developing advice for a pilot • Implement with sample of individuals and evaluate later in the year
RSM Recommendation 2: Assess potential in Outsourcing Client Assessment • OFMDFM, CVS and VSS should conduct an assessment of the feasibility of outsourcing the assessment process to a multi disciplinary third party • Any new assessment tool should complement processes already in place in Health & Social Care
Independent Assessment: Recommendations 20 and 21 • Recommendation 20 We recommend the new assessment process takes a comprehensive approach to assessing need, in consultation with groups, the Forum and CVSNI • Recommendation 21 We recommend a triage approach to needs assessments so that those who need simpler assessments can be managed separately from those with more complex needs • Subsequent follow-up reviews on the Assessment process last year concluded that the proposed Health & Wellbeing Process was still not appropriate and that victims need to have confidence in an assessment process that is still not agreed and settled
Assessment Process: Action to date • WKM carried out initial consultations in March and proposing simplified needs assessment form and guidance on structure conversation and managing risk with individuals • Key issues to be addressed around who carries out and training to ensure sensitive and consistent approach to new assessments • Currently developing advice for a pilot to run parallel with personalised budgets • Implement with sample of individuals and evaluate later in the year
RSM Recommendation 1: Develop Code of Practice to inform eligibility checks • Initial client screening to be carried out by both funded organisations and VSS; • In order to provide a consistent approach, a Code of Practice should be developed, agreed and applied by all parties; • The Code of Practice should clearly articulate agreed responsibilities, processes and protocols relating to risk management and clearly define programme eligibility; • Compliance with Code of Practice should be regularly monitored and controlled.
MENTAL TRAUMA SERVICES SIOBHAN O’NEILL UUJ
Mental Health The Commission proposed in the CNA (2012); “ The Commission would encourage the consideration of developing a trauma focused coordinated service network by OFMDFM and DHSSPS. Based on the model of a managed clinical network, the development of a trauma focused coordinated service network could deliver a comprehensive regional trauma service . . .”
The Impact of the Conflict on Mental Health • Over 30 years of violence has resulted in over 3,500 deaths and over 35,000 injuries, therefore there are few individuals within society who have not been affect either directly or indirectly; • Four out of ten people in the region have experienced a traumatic event and we have one of the highest recorded rates of PTSD in the world; • Approximately 40% of people with a mental disorder receive treatment. However that means that potentially 60% of the population (or up to 127,800 adults) with mental health problems linked to the Troubles have not received treatment to date;
The Impact of the Conflict on Mental Health • In comparison to the UK average, mental health needs in NI are 25% higher; • As a result of the conflict young people in NI face a higher risk of mental ill health in comparison to young people in both England and Scotland; • The Commission’s Troubled Consequences Report found evidence for a profound and enduring impact of conflict-related trauma on individuals and families and wider society in Northern Ireland;
The Impact of the Conflict on Mental Health • The report revealed that an estimated 39% of the adult population (almost 524,000 individuals) have experienced at least one conflict-related traumatic event during their lifetime. Meanwhile, the research team commented that an estimated 18,000 individuals who had a conflict related experience had met the criteria for posttraumatic stress disorder (PTSD); • The economic cost of not effectively addressing the enduring psychological needs of individuals and communities affected by the conflict was also highlighted. Research conducted by the Ulster University team indicated that the total annual direct costs among individuals with 12 month PTSD associated with the conflict was an estimated £46.7 million (year on year);
The Impact of the Conflict on Mental Health • The most recent research ‘Towards A Better Future: The Trans- generational Impact of the Troubles on Mental Health (2015 )’ which was undertaken by Ulster University Indicated that 14% of the adult population have mental health problems directly related to the Troubles (this equates to around 213,000 adults) • The report noted that traumatic experiences and exposure to violence can lead to adverse mental health and other consequences not only for the person themselves, but also on a trans-generational cycle which impacts upon the well-being of subsequent generations of children and grandchildren
The Impact of the Conflict on Mental Health • Many of the services currently offered by the statutory and non-statutory sectors to address the mental health needs of those affected by the Troubles match the recommended interventions for people with mild to moderate mental disorders • Statutory services (and some non-statutory services) also provide a range of treatments for people with moderate to severe mental health problems and functional impairment. There is significant concern however, about the level of unmet need of c.60% and the potential for the trans-generational transmission of the impact of the conflict’s legacy
Evidence from the VSS • Evidence from the INR’s (883 clients) showed that: • 72% of clients presented with severe (53%) or moderate anxiety (19%); • 68% of clients presented with severe (49%) or moderate depression (19%); • 94% of clients presented with trauma symptoms.
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