Hearts and Minds

Yesterday I drove down through sun and snow flurries to the Royal Welsh Showground near Builth Wells. I was attending an event organised by Powys teaching Health Board (PtHB) to look at the future of mental health services in Powys. The “vision” for future services was developed during late Autumn 2012, and very much informed by feedback from people who use services and their carers at the time. I posted about that here. Then it was christened Hearts and Minds, and included information not just about the vision but how services would be delivered – you can link to more information here.

So, yesterday it was the turn of staff providing services (for the health board, social services, the voluntary sector and other agencies) to say what they thought. There were about a hundred people in total, including (in a bit of a mini A-Z of professions) advocates, nurses, occupational therapists, psychiatrists, social workers, support workers and police officers. And many of them spoke very passionately about their views, and some key themes emerged throughout the day.

Facilitator Dr Les Rudd, of the Centre for Mental Health Services Development, introduced the morning session which started with a series of presentations to inspire and set the mood. 

Jo Mussen

Vice Chair of PtHB, Jo Mussen, spoke first, about the need to give the people of Powys the best possible mental health services that we can, taking into account the many challenges and opportunities that face us. She also referred to the “incredibly vibrant Third Sector” which went down well with some of my colleagues.

Ian Hancock and Les Rudd

Then Ian Hancock gave us a Scottish viewpoint. He has turned round mental health services in the Dumfries & Galloway region in just three years. It is very similar to Powys in many ways, with its rural geography and a population of 147,000 (Powys approx. 133,000). His approach as the General Manager appears to have been both innovative and brave, and the Powys staff were clearly very impressed by the achievements he described.

Richard Bundy from Gofal

After Ian came Richard Bundy of the mental health and wellbeing charity Gofal. He described a service which has “bucked a few trends in Wales” – the Crisis House in Cardiff. The house is an alternative to hospital, with the average length of stay at 7 days. Some of Richard’s stats said it all really, with 95% of people using the house rating it as good or excellent, and 80 – 90% consistently returning home rather than going to hospital. There is more about the project here.

Stephen Hunter, Assistant Medical Director of Aneurin Bevin Health Board (providing mental health services in Mid and parts of South Powys), had sent recommendations which Carol Shillabeer (Director of Nursing) delivered in his absence.  There were some interesting points here, including the need to:

• Consider more cross-sector working (again identifying the Third Sector as a real asset), but involving other organisations too such as Job Centres, social and care services, and other people who are regularly out in the community even (postmen came in for a mention several times).
• Focus on supporting GPs and practice staff to care more for people experiencing mental distress.

The rest of the day was taken up with workshop sessions looking at what a good service would look like for adults, older people, and younger people, in the following three areas:

1.    Community services, primary and secondary care.

2.    In-patient services (crisis and accommodation services).

3.    New services/innovation.

Some of the key themes which I picked up on:

• Services are very different in different parts of Powys. There is certainly something of a postcode lottery going on here. (Services are currently provided by three different out-of-county health boards).
• Everyone wants it made simpler. The police often have to pick up the pieces when the mental health service providers have closed for the day. They would like to see “one procedure, one place, one pathway” for hospital admission, for example.
• More training in psychological therapies is urgently needed – it was suggested this could be “joint” training involving many agencies.
• What can the Third Sector provide? Exploring this topic could form a whole day in itself! (Supported housing and counselling being just two suggestions I picked up on – and the need to “think outside the box”).
• It is crucial to build confidence around mental health issues with other areas of health, eg: health visitors, district nurses and community hospitals. And Third Sector of course! “Mental health is everyone’s business”, as one person said.

Carol Shillabeer and Harold Proctor

So, it was a really interesting and useful day all in all. Harold Proctor, (Planning and Performance General Manager Mental Health and Learning Disability – phew, some job title!), who is leading much of the work for PtHB around transforming mental health services, tells us that this event is the beginning. So, watch out for more updates and events to follow once a proposed new model of services has been put to PtHB in April.

As someone said, summing up towards the end – “we have only just lit the torch paper today… this is very much the start.”

PS: And… did I mention the Third Sector…?!