Wellbeing and connectedness: Lessons from projects creating new mental health support roles Vanessa Pinfold October 2016
Overview • Research into practice – current context • Draw on several studies developing and assessing impact of new mental heath roles • How can social focus in research benefit social work practice?
Where is the ‘social’ in mental health research? Leadership .... • National School of Social Care Research • ESRC – new mental health leadership fellow • Department of Health 10 year strategy for mental health research Advocates ... • Academic sector • Charity sector – such as NSUN, MHF, Mind, McPin Foundation
Academic sector
Recent research from the third sector
To thrive ... MH research needs broader interest base ... • Geography, planning, environmental science • Political science, computing, sociology Guideline evidence to include more social factors • NICE Ecosystem development – supporting practitioners to become more involved in research • Think ahead programme
Research projects developing new roles ... • Wellbeing Partners – Hounslow, London. • Care Partners – Lancs, Birmingham, and Devon. • Primary Care Link workers – Kent. • Community Navigators – North London • Peer wellbeing workers – South London
Whose role is network development? • ‘I think it really is important, but it’s part, it’s not the main thing I do ’ (psychiatrist) • ‘I think [our role] it’s also kind of setting the tone for the way that the other members of the team work with people as well . . . our job is not just about symptom control, not just about treatment, but that’s the kind of baseline that we can help people to get to and from so that the other work takes place, you’ (psychiatrist) CHN study (NIHR HS&DR, 09/1801/1069)
... and approach? • ‘I think our role is, like, if you look at a spider web, we are, like, in the middle and then our responsibility is support them, linking to all the rest of the networks that are available . . . Because they will be quite, maybe, scared to go out there and, you know, join the community or even afraid of being out [of hospital], you know, stigmatised, if you like. So we have to be there constantly, you know, to reassure them. And we also have to make sure they make those small steps. Sometimes it doesn’t happen and then you try again and then eventually they make it’. (Support worker) CHN study (NIHR HS&DR, 09/1801/1069)
Wellbeing Partners
Wellbeing Partners • Developed using co-production methodology (social work, OT, GP, commissioner, peer worker, service users, researchers) • Addressing two expressed needs among local people with severe mental illness: social isolation and poor physical health • Designed to offer alternative to medicalised approaches – asset sharing, wellbeing focus, strengths based, inclusive.
Wellbeing mapping Offer different way to engage people – same ideas, different presentation.
Care Partners • Developed within an NIHR programme grant for applied health research (RP-PG-0611-20004) • New role to “bridge” primary and secondary care provision for people with severe mental health problems • Draws on collaborative care model for depression and anxiety • Based on development of a theory of change: logic model = inputs, mechanisms, outcomes.
Care Partners – who? • Piloting in three regions – two are CPNs by background, one is a senior social worker. • Released by community teams to perform role that prioritises coaching style , recovery focus, active follow-up. • Lived Experience Advisory Panel have helped create materials and emphasize social focus . • We are waiting to analyse data from service users in pilot sites, anecdotal feedback is positive.
Primary Care Link Workers • Primary Care based service • Delivered by Porchlight, a Kent homelessness charity • Employed 17 link workers across the county • Target population: people with low-level mental health problems, but no eligibility criteria • Two key elements: • Support to engage in social activities in a community setting • Immediate, practical support for issues such as housing, benefits and finances • Support is time-limited (8 weeks)
Theory of Change
PCLW key findings: Impact “To be honest, it’s made me a better person, it really has. Compared to how I was over a Emotional year ago... It’s really turned outcomes my life around.” “I still couldn’t believe it. Signing contracts, and I remember going Practical back to [Town] to mum; I said, mum, outcomes I’ve got the place… If it wasn’t for Porchlight I would not have got this place, I know that for a fact.”
Access ... “[Other mental health services] are very restricted into which clusters they can work with and with what criteria; whether someone needs a diagnosis, whether someone has previously accessed services. And one of the good things about GP Link is that it’s just very easy to get into, it’s very accessible. So all someone needs to say is, ‘I need some help ’”. Porchlight Project Lead
Community Navigators • Research project funded by NSSCR (171012) • Addressing loneliness among people with complex depression and anxiety supported in secondary care • Co-production group developed approach – social workers from two services are the practitioner leads • Can a community navigator achieve improved outcomes where current services have not?
From the literature... De Jong Gierveld’s et al (2011) suggest three ways to reduce loneliness: • Increase the use of support available from existing relationships • Develop new social connections • Change your thinking about current social relationships We are emphasising a social recovery, asset based, person centred, solution focused, non- directive approach.
Progress... • Community navigators recruited and trained. • Service users planned interview panel and appointed with research team • 10 week programme created • People from two services being recruited – a “navigator ready” cohort! • Pilot starts next month.
New dressed up? • How different are these roles from others in mental health services? • What is needed to (re)frame “social” centre stage in mental health? • How can system barriers be overcome?
Thank you! Email : vanessapinfold@mcpin.org Follow us : @mcpinfoundation theMcpinFoundation Please do sign up for our quarterly e-newsletter at: www.mcpin.org
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