The latest on MasterMind - computerised CBT in Powys

Powys Teaching Health Board staff at a MasterMind seminar in Odense, Denmark in October 2015.
Front row far right: Dr Wasi Mohamad, PTHB Clinical Director & Consultant Psychiatrist who is the Clinical Lead for MasterMind; next to him: Becka Williams Project Administration Assistant. Back row second from right: Harold Proctor Dementia Lead for PTHB and the MasterMind Project Executive.

Back in August 2014 our friends at Powys Teaching Health Board wrote on Introducing MasterMind - computerised CBT in Powys. 

The MasterMind project is currently being piloted across Europe, including Powys. Some individuals with a diagnosis of low to moderate depression have been able to access the computerised Cognitive Behavioural Therapy course in their own homes. We decided now was a good time for an update and Becka Williams, who works with the team overseeing this project, gives us the latest news.

MasterMind – where are we?

We have just begun the final year of the MasterMind project with the project due close in February 2017.

We went ‘live’ with the online CBT programme in March 2015 and have had 216 referrals since. We have implemented this service into the Local Primary Mental Health Support Service teams (LPMHSS), Pain Management and Occupational Health and in recent weeks have started engaging with the GP practices in Powys to encourage GP direct referrals.

A bit about the programme…

Powys staff opted for Beating the Blues as their software of choice which was developed by our service provider Ultrasis with ownership transferring to 365 Health & Wellbeing.

What does Beating the Blues consist of?

Beating the Blues consists of eight, approximately 1-2 hour sessions recommended to be completed weekly. The programme is interactive. During sessions you can watch video clips, complete exercises and learn CBT techniques that can help with depression and anxiety. Each week tasks will be given to be completed during the time between sessions.

How will it help?

Beating the Blues will help to pinpoint and change unhelpful ways of thinking that can affect how you feel, whilst teaching you more effective ways of solving problems.

How many sessions need to be completed?

It is important to complete as many sessions as possible. When completing the first couple of sessions it may be hard to see how it is relevant to your situation, however the programme is designed to build up your knowledge and skills over the weeks, if you stop too early, you will not get the full benefit of the treatment. The advice is to complete all eight sessions.

Where can the course be completed?

The course can be completed in your home or in a community site such as a library. To do it at home you need a PC or laptop with either speakers or earphones, along with access to a printer as there will also be a need to print material most weeks. Beating the Blues does not run on iPads, Tablets or Smart Phones at present. When doing it at home it is important to set aside enough time to complete your session at roughly the same time each week and ensure you have sufficient privacy to do so. You do not have to complete all sessions from the same location, you may want to complete some from home and some form one of the community sites. 

Feedback from participants

“The sessions were brilliant.”

“The programme was good in many aspects.”

“Most techniques I knew but Beating the Blues helped me put them into action.”

The Mastermind seminar in Denmark, October 2015

Collaborative Care through Videoconferencing (cCVC)

The second part of the MasterMind project is the collaboration of care through videoconferencing (VC) which we are currently implementing. In the initial stages we will be implementing this in the Crisis Resolution Home Treatment Teams (CRHTT) and the Community Mental Healthcare Teams (CMHT). In short, a member of these teams will meet with the patient and together they will have an appointment with the Consultant Psychiatrist through the use of Videoconferencing. The VC software that has been rolled out across the Health Board is Skype for Business.

Our EU Partners

Throughout the project, there have been a number of meetings and events taking place across Europe to get together with our European MasterMind partners to discuss the project, the pros and cons and generally share thoughts and ideas. The project has been a great opportunity for networking, building working relationships and shared learning. 

Many thanks to Becka for the update. Have you had experience of Beating the Blues or other computerised CBT sessions? Let us know what you think in the comments box below.

You can find out more about the MasterMind Project on the project website, and also join the debate on Twitter.

Five Ways to Wellbeing in the workplace

At the PAVO staff development day on Tuesday our team manager Jane Cooke, and former mental health team colleague Freda Lacey (now with the health & social care team), ran a session on Five Ways to Wellbeing in the workplace. They asked each of us to look at how the Five Ways – Connect, Be Active, Take Notice, Keep Learning and Give/Be Creative play a part in our personal and our work lives. They were also keen to find out how PAVO, as an employer, could support our wellbeing at work, and asked us to make suggestions which would later be considered by the senior managers.

PAVO staff development day 12 April 2016

Our team originally wrote about the Five Ways last June in a joint blog post - which is where you can find out about the origins of the Five Ways (a resource created by the New Economics Foundation) and how being active in the five areas can lead to happier and healthier lives. The Powys Public Health team is understandably keen to promote the approach far and wide. So anyway, it was really interesting to reflect and consider if anything had changed for us since last June, and also to hear what our colleagues thought about an approach which can, apparently, add another 7.5 years to the average lifespan!

First – take notice!

Jane started by asking each of us to spend a couple of moments considering how we felt – right then. Bored? Excited? Full? Empty? Happy? Sad? Lively? Tired? She invited us to go outside, close our eyes, and listen. To tune in to our other senses. Luckily the weather was on our side! We felt the sun on our faces, the breeze in our hair. We heard lambs bleating and robins singing. It was wonderful! When we were called back in to the conference room a few minutes later people were reluctant – they wanted to stay out there and enjoy the beautiful day, the fresh air, the green Powys countryside which is on our office doorstep. We acknowledged that most of us don’t do that at lunchtimes, even. We know it’s nice. Yet we don’t do it during our work day.

Connecting with colleagues

Giving & connecting

Then Jane invited us to have a conversation about something really nice we’d given to someone else. On my table a colleague said: “The gift I enjoy giving is time. It is crucial for my aged parents. I take time to sit with them and talk about things that happened 50 years ago.”

Jane explained that giving and connecting are very similar. We leave three quarters of ourselves behind when we come to work and very rarely say how we’re really feeling. Yet, if we open up as human beings in the workplace that actually helps our work. It changes the energy of the workplace. “It’s not magic. Really.”

Be active

Another colleague told me that the ideal number of steps we should take each day is 5,000. He does over 2,000 a day even when in the office, but does go out for lunch rather than sit at his desk. 

Freda dug a bit deeper. What does “being active” mean to people? Interpretations included – physically active, mentally active, busy, making things happen, the new, variety… Freda said that clearly the interpretation was very subjective. One person climbed 5 flights of stairs several times a day to their home, another went to exercise classes whilst yet another walked a dog. The Five Ways can be completely different for everyone – but that is absolutely fine. It was also pointed out that it is about a sense of achievement – it doesn’t matter what anyone else thinks if you feel you’ve achieved something.

1000 steps so far today!

The barriers

We then looked  at some of the barriers to doing things we know are good for us. A long list soon filled up a flipchart page – time, too busy, not valuing ourselves and our wellbeing, not prioritising, habit, physical limitations, apathy, guilt (a sense of being too selfish)....  the pressures were described as sometimes different for men and women.

Some good ideas

We discussed how we could use the Five Ways to change the way we work. Here are just a few of our ideas:

• Standing meetings… or acquire some standing desks for the offices.
• More visual ways of working – which supports creativity in the workplace.
• Cycling to work scheme.
• Frontline staff connecting with the PAVO trustees more regularly.
• Using computers to tell us when to take a break.
• Reactivating the book share scheme.
• A lunchtime walk around Plas Dolerw park in Newtown or Llandrindod Wells lake.
• An outdoor workplace, and a team-building day creating it!

Some of the ideas depend on organisational involvement, but many of the suggestions really just require a group of enthusiastic colleagues to get together and start! Carl Cooper, Chief Executive Officer (left in top photo), rounded off the session by promising to look at all the suggestions and agreeing to support the ethos of the Five Ways by encouraging the opportunities and culture for these things to happen.

Keep learning

Right now it’s time for me to Keep Learning. I have my staff appraisal next Tuesday, and there’s an empty box on the form titled Training & Development Plan for the coming year… But first, I just want to catch up on what Jane wrote about why we like the Five Ways to Wellbeing… in particular: “the things that make us feel good, that are enriching and fulfilling, are not always the same as the “big sell” – do more and do it faster, buy more stuff, buy it faster, chuck it away faster… so what does that mean for the way that we work together as part of PAVO?”

Have you used the Five Ways to Wellbeing to help promote a healthy workplace? Let us know what you think in the comments box below. We always love to Connect with our readers!

Cuppa with a Copper

Leanne Morris is a Police Community Support Officer (PCSO) for Dyfed-Powys Police based with the Brecon Neighbourhood Policing Team. Along with other PCSOs, Leanne supports the NPT by “engaging with the community and providing a highly-visible and reassuring presence.” In November 2015 Leanne attended the first of our PAVO mental health team’s Stand-up! for emotional health and wellbeing partnership meetings which took place in Brecon. 

My colleague Anne Woods, who is funded for three years by Comic Relief to develop this participation work across Powys, set up the meeting at Brecon & District Mind. It was the first of several planned for Brecon, and people who have been in contact with mental health services, and people close to them, are encouraged to attend and meet up with NHS staff, the local mental health advocate and third sector representatives. Local police PCSOs are also invited and generally made very welcome.

And so it was that Leanne attended that first meeting in Brecon, where there were cuppas and cakes… Anne takes up the story:

“As a result of the Comic Relief funded participation work, a spin off project has started to improve relationships between the local police service and people who experience mental ill-health. Regular opportunities have been created to have a ‘Cuppa with a Copper’ at Brecon & District Mind recovery and well-being centre, to improve relationships between police officers and the community they serve.

When Leanne attended that first Brecon Stand up! Meeting it quickly became apparent that the presence of someone in police uniform had an effect on some people there, and a discussion followed about their experiences of coming into contact with the police. Some people recounted negative experiences or negative feelings towards the police as a result. When someone is experiencing extreme emotional distress, frequently it is the police who are the first service they come into contact with."

Some of the issues which arose at the Brecon meeting have been discussed in publications such as The Police Federation of England and Wales publication "Police." In an article entitled Forum to focus on mental health issues in custody, Kevin Huish, the 2013 mental health lead on mental health wrote: "It’s widely acknowledged by all experts that police custody is the last place a person suffering a mental health crisis should be. Being confronted by officers in uniform with all their kit further exacerbates that breakdown." In Powys, a multi-agency approach is now working to improve the police response to those with mental health needs. However, sometimes, even when the crisis is over, and perhaps some time well in the future, just being in a room with someone in police uniform can trigger distressing feelings for an individual.

Back to Anne and the Cuppa with a Copper initiative.... 

"After the group meeting Leanne approached me to suggest that we find ways to foster better relationships. I followed up by organising a meeting with Val Walker, the manager of Brecon & District Mind, and we developed a proposal to put to the members. As a result, and with the members’ full support, the police now hold a monthly drop-in session to have ‘a Cuppa with a Copper’.

These sessions are informal and provide an opportunity for people to raise issues or seek advice but also simply to get to know each other, whether they wear a uniform or not. By timetabling and advertising the sessions, it gives people the opportunity to stay away if they feel interacting with the police would trigger difficult feelings or memories. Fortunately, however, the drop-ins have been well attended. There is also now talk of the police helping out with some of Brecon & District Mind’s outdoor volunteering projects alongside members.

This spin-off is transforming a negative situation into a positive one. The Comic Relief funded work has revealed tensions in the local community, an opportunity to take practical steps to address them has been followed up, and the initiative is improving the lives of people in the Brecon area.”

PCSO Leanne Morris told us what she thought about the new opportunity to meet up with members of Brecon & District Mind:

"The aim of setting up the Cuppa with a Copper meetings is to build relationships between the police and the people attending the Mind centre in Brecon who have experienced issues with mental health. I wanted to show the human face behind the uniform so that if anything comes up in future people feel happy to approach and speak to us on the street.

I worked for 10 years in the field of substance misuse, and with dual diagnosis clients - people who self-medicate with alcohol. I also spent 2 years at the Royal Glamorgan Hospital working with people with alcohol related problems, including assessing people on a mental health ward. So I can appreciate why people feel the way they do, why they can have varied and negative views of the police.

The meetings are running really well. I've been asked back anyway, so that's a good sign! And one of the Brecon Mind members wants to write a piece for the organisation's newsletter.

Some people only come into contact with the police when they are in crisis - which is obviously not ideal. I want people to meet us at different times to chat. Even if they are just offloading - that can really help."

Thanks to Anne and Leanne for the update, and watch this space for details of the next Cuppa with a Copper meeting in Brecon.

Find out more about Brecon & District Mind activities.

Do you care about adult mental health provision in the NHS in Powys and think it could be better or should be run differently? 

The next Stand up! for emotional health and well being meeting takes place in Newtown on Tuesday 3 May. Contact Anne Woods on anne.woods@pavo.org.uk or tel: 01597 822191 if you want to find out more.