Together for Mental Health consultation - a Powys view

Individual rep, Sarah Dale, on Llandudno beach

Our Participation Officer, Owen Griffkin, shares a report on the Welsh Government 

Consultation for the ‘Together for Mental Health’ Delivery Plan 2019 - 2022

On a sunny day (with scattered showers) I attended the consultation event for the Together for Mental Health plan 2019-2022. I was there to accompany one of our individual representatives, Sarah Dale, who felt it is was important for Powys to have a voice in one of the live consultations. This all day event was in a beautiful location in Llandudno, Venue Cymru, with a lovely sea view, which almost made the 150 mile round trip worth it.

Together for Mental Health is the Welsh Government's 10 year cross governmental strategy and was published in 2012. This consultation is to inform the last 3 years of the plan and to look at the priorities that have been identified and how they will be implemented.

The day was chaired by Ainsley Bladon, the Mental Health Strategy Lead at the Welsh Government, who is regularly seen at both regional and national partnership events. She introduced the delivery plan with a short presentation and then we moved on to the first question for discussion.

This was looking at the key priorities for the next 3 years and there were a lot of themes arising that we have come across in other engagement events. Some of these included - transition from Child & Adolescent Mental Health Services (CAMHS) to adult services, accessing mental health services with substance misuse issues, difference in service depending on location and funding of third sector (voluntary) organisations.

Also a big point raised was the accessibility of legislation and documents to the ordinary person. There is a lot of jargon and acronyms in the consultation document and this has proved a barrier to some people in disseminating the information. Ainsley said they had heard this a lot and they will look to change this in the future.

Sarah was very vocal about the need to ensure that basic service provision is met in Powys and that locally this is a priority - eg 24 hours crisis care. She also spoke passionately about the Talk to Me 2 suicide and self-harm plan, saying that it didn’t have enough mention of self-harm.

Next we were asked if the cross-cutting workstreams were appropriate to prioritise, which once again prompted some explanation requests about the technical language of the document.

These priority areas can be seen in this photo:

We were able to share some of the findings of the recent care and treatment plan engagement events held by Powys Teaching Health Board in Powys as this is linked to the ‘Core data set’ requirement, and also highlighted some of the specific issues in Powys around engagement.

After lunch, and a very quick stroll along the prom, we returned to look at what the room thought the key impacts would be and how we can increase positive effects whilst mitigating negative effects. The importance of third sector organisations was highlighted again, and a few people spoke about the relationship between staff and service users and the importance of being listened to in that relationship. 

We then ended with a reflective exercise on the effectiveness of the day and an assurance that results of the consultation will be fed back to everyone who attended. We closed with a thank you speech from Tracey Breheny, the fairly-new Deputy Director of Mental Health. It was interesting to hear that she is also responsible for Substance Misuse and Vulnerable Groups which hopefully augurs well for more coordination and understanding of the co-occurring issues of substance misuse and mental health. She also came out with the quote of the day when she said that all the comments would be ‘fed into the sausage machine of the Welsh Government’ and processed into a report.

All in all the day was definitely worth our while going although it is a shame that there isn’t an event closer to Mid Wales. It is vital that Powys has its voice heard in this consultation as we have a lot of issues specific to our county and I therefore urge anybody with an interest in the delivery plan for Mental Health services to fill in the online consultation before August 30th. You can participate by visiting the link on the following webpages:

Welsh

English

There is also another consultation event in Carmarthen on the 28th August that I recommend attending if you have the time.

Venue

Room TL5 (Ground Floor), Teaching and Learning Building, University of Wales Trinity Saint David, Carmarthen Campus, SA31 3EP.

The day will be structured as follows:

Morning 10:00 – 12:30 – Discussion of Priority Areas
Lunch 12:30 - 1:30

Afternoon 1.30 – 4.00pm – Considering Impact and Delivery

To take part please RSVP to Darren Lewis (Darren.lewis@gov.wales) including the following details:

Name, organisation (if relevant) and event you wish to attend (West Wales in this case). Expenses and lunch are provided on the day. 

If you fill in the consultation, or attend the Carmarthen event, please let us know at PAVO. You can email owen.griffkin@pavo.org.uk or ring 01597 822191. We might be able to help you organise lift shares and put you in touch with others attending.

Powys Dementia Network - Summer 2019

by Jen Hawkins & Jackie Newey

Health & Wellbeing / Mental Health Information Officers

On Wednesday 17 July we attended the latest Powys Dementia Network event at the Football Club in Newtown. It was organised by our colleague Sue Newham, Engagement Officer in the team, and attended by a huge variety of organisations and individuals. These included Dementia Matters in Powys, Alzheimer’s Society Cymru, Powys Libraries, Hafren School children, Powys Teaching Health Board and people living with dementia to name but a few.

As always we will try to capture some of the spirit and information from the day below, but if you would like to find out more and / or attend future events then please get in touch - further details at the end of the post.

The last Network event in Brecon in February this year was also captured for the blog in Powys Dementia Network event - Housing.

Alzheimer’s Society & Dementia Connect - Kerry Phelps, Alzheimer’s Society Cymru

Kerry Phelps opened her presentation with some thought provoking statistics about dementia, stating that 1 million people live with dementia in 2021, a figure that is expected to rise to 2 million by 2050. The Alzheimer's Society celebrate their 40th birthday this year and in that time have learned a lot about how best to support people living with dementia.

In 2017 the society rolled out their “New Deal Dementia Strategy,” with their mission being to “transform the landscape of dementia forever.” The strategy comprises three pillars, a new deal on support, a new deal on society, (focusing on changing conversations around dementia) and a new deal on research, with the biggest investment in research to date. By 2022 they aim to “reach out to everyone from the time of diagnosis to offer help and deliver a universally accessible support and advice service.”

Dementia Connect is their gold star service through which the new deal dementia strategy is being rolled out. At present it supports 1 in 10 people with the aim to eventually be able to support 7 in 10 people. The central ethos of the strategy is focused on person centred support, planning to empower people to take control of their care.

Andrew Jones & Agnes McDonald of Powys Libraries Service

Brecon Library: Introducing the RemPod & the Past-Times Picnic Hampers - Andrew Jones, Powys County Council

Read & Remember is a new Powys Libraries initiative drawing on the value and the power of a shared oral experience - it’s all about sharing reading aloud creating nostalgic connections and sharing experience. Originally it was set up as an all-community activity, but as they worked with it library staff found that people from the dementia community were the most engaged. As a result staff built in extra resources and so the Past-Times picnic hampers were created filled with nostalgic items to trigger memories.

The hampers are themed - people can choose from the Seaside, Transport, Animals, Gardening and Wildlife. Each hamper is full of nostalgic items which twig off memories from people’s past. The hampers can be used at events and have already proved successful at a number of care homes. They work well with relevant reading material. There is no cost involved and hampers can be reserved and transported between libraries in the county with advance notice, with one member of staff in the north of Powys and one in the south to transport them. 

The hampers were followed by the RemPods - amazing pop-up banners featuring large scale photographs of relevant scenes. On the day we enjoyed taking selfies in front of the Seaside RemPod - the only things missing were the actual ice creams! Other RemPods feature a shop and a 60s/70s living room and they work really well engaging people in initial conversation. Andrew said “it’s such fun watching how people open up and chat.”

Powys Library Service is keen to work with care homes, local clubs and societies to broaden the audience and give people who would not usually consider reading aloud some confidence.

Another top tip passed on by Andrew and Agnes is the carer's library card. Anyone who cares for someone with dementia in a personal or professional capacity, family members and friends of people living with dementia, are all eligible for a carer's card. This allows you to take out up to 20 books at a time with no library fines or fees incurred.

Frances Isaacs (who spoke about living with dementia) and Deborah Gerrard, Dementia Matters in Powys

Planning a Dementia Meeting Centre in Newtown - Deborah Gerrard, Dementia Matters in Powys

Deborah, the new Chief Officer at Dementia Matters in Powys, gave an update on plans for a dementia meeting centre in Newtown. The first Meeting Centre in the county opened in March 2017 in Brecon. The National Lottery Community Fund has now funded two further centres in Llandrindod and Ystradgynlais. Newtown will be No 4.

Dementia meeting centres are staffed by community development officers, facilitators and volunteers.They offer support, advice and information to people living with dementia and their carers. In the Netherlands, where the first centres were created in the late 1990s following research, there are now over 140 centres supporting 2000 people every day. Soon there will be 10 in the UK, and of these 4 will be in Powys which is an amazing development for the county.

Members find that attending the centres means that they can live in their own homes for longer and experience an increase in self esteem and feelings of belonging with a reduction in feelings of isolation, fear and anxiety. The Newtown centre is a partnership project between DMiP and Dementia Friendly Newtown. An Initiative Group has been set up to look at locations for the centre, volunteer recruitment and responding to the needs of local people living with dementia. The planned open day for the centre is Tuesday 1 October 2019 and if anyone is interested in getting involved in the meantime they should contact DMiP by emailing info@dmip.org.uk or call 01597 821166. Developments can also be followed on social media by connecting via Facebook or following via Twitter.

Hafren School Intergenerational Project - Children from Hafren School

Children from Hafren Junior school came along to share their intergenerational singing project with us. Three hundred staff and pupils at the school are trained as dementia friends, with two members of staff qualified dementia champions. Pupils from the school are actively involved with Newtown’s dementia community and can be regularly found at Newtown Library on Friday afternoons and Plas Cae Crwn on Tuesday afternoons. 

Carl Hyde, headteacher of the school, extended an open invitation to attend one of their sessions claiming that the “two most memorable afternoons of his 21 year teaching career,” were as a result of attending the intergenerational afternoons. Take a look at our video of the pupils on our Dementia Network day or pop down to one of the afternoons to experience the project first hand.

Frances (left) and Glenda (right) who spoke about living with dementia
Middle - Anna Story of Bangor University

“In it Together, Dementia Voices in Mid & North Wales” - Anna Story, Frances Isaacs & Glenda Roberts

Anna Story of Bangor University was funded by a Dementia Innovations Working Together Grant to work with Dementia Matters in Powys and DEEP* to make a short film capturing the voices of people with dementia in Mid & North Wales. Anna introduced the film premiere with two of the participants - Frances and Glenda - both of whom live with dementia. They said “we enjoyed making the film - Anna is so easy to talk to. We had great fun.”

To capture footage for the film Anna visited different dementia groups across the area where people meet to have fun, laugh and support each other.

The film is aimed at three audiences - people living with dementia, the general public (showing that people with dementia can have fun), and care professionals where it can be used for training purposes. Watch the film in English or Welsh.  

*DEEP stands for the Dementia Engagement and Empowerment Project – it is the UK network of dementia voices. DEEP consists of around 100 groups of people with dementia – groups that want to influence services and policies.

Eira Meyer (Advanced Care Planning Champion at Newtown Hospital)
and Heather Wenban, (Dementia Lead, Powys Teaching Health Board)

My Life, My Wishes - Heather Wenban, Dementia Lead, Powys Teaching Health Board 

Heather Wenban lead an informative and interesting session about advance care planning highlighting the fact that decisions we make about the end of our lives are just as important as how we choose to live our lives.

To find out more about this important initiative please see our earlier Health & Wellbeing Blog from June this year, “My Life My Wishes - Live Well Dying Matters,”

Community Transport in Powys - Sarah Leyland Morgan, Powys County Council

Sarah opened her presentation with a useful definition of community transport stating that “community transport is there to underpin the transport network where it doesn’t adequately meet people’s needs.” Community transport is not a free service and is designed to support people, helping them to participate in their normal day-to-day activities in areas such as education and training, employment, health appointments and shopping.

Community transport is designed to feed in to the public transport network with three types of provision in Powys:

Dial-A-Ride

Ten Dial-a-Ride schemes operate in Powys provided by mini buses and MPV accessible vehicles (Multi Purpose Vehicle). Dial-a-Ride provides a door to door service, usually within a 10 mile radius where users are not able to use their concessionary passes. Membership schemes are usually available.

Community Car Schemes

These make use of of volunteers' cars with the travel costs being reimbursed. Not all community car schemes are membership based with trips often being to the hospital or longer, out of county journeys. 

Taxi Card Schemes

Currently there are two taxi card schemes operating in Powys. People in Montgomeryshire are supported with tokens of between £50-£100. The main issue with the schemes is a lack of taxi services in the area. Membership schemes are usually available where the service operates and often can be used within a ten mile radius.

Group Hire

Some third sector organisations offer group vehicle hire services, some offer a driver, with others you have to provide your own.

Powys Community Transport can support groups and communities in many ways. In the year 2018-2019 community transport has assisted people to make 5,778 trips to community hospitals and approximately 30,000 social and pleasure trips, to give just two examples.

Our next Dementia Network day is provisionally planned for Wednesday 17 January 2019 in Llandrindod Wells. Sign up to the Powys Dementia Network and find out about future Awareness Days by emailing sue.newham@pavo.org.uk or ringing 01597 822191.

The latest on SilverCloud - online Cognitive Behavioural Therapy

Becka Williams, Project Manager and Catrin Guest, Project Support Office & Online CBT Coordinator

by guest author Becka Williams

Project Manager, Powys Teaching Health Board

Following the implementation of our Online CBT service, SilverCloud, across Powys in May 2018, there has been a lot of work undertaken to develop the service and upscale it across Powys. 

We have received approximately 1100 referrals into the stand-alone service with referrals beings received from a range of different departments, services and healthcare professionals across the Health Board.

Work has commenced on the translation of the main Space from Anxiety and Depression programme and it is hoped that this will be ready for implementation by the end of 2019.

We were fortunate to win the Powys Teaching Health Board's Staff Excellence Award under the category of ‘Digital First’ in July which is a fantastic achievement. 

Becka Williams – Project Manager, Claire Cartwright – Director Ponthafren Association,
Jackie Jones & Sarah Dowler – Blended Online CBT Practitioners, Ponthafren

Blended Online CBT Service

We have implemented our Blended Online CBT service in partnership with Ponthafren Association in North Powys and the Mind Resource Centres in Mid and South Powys. The blended service offers access to the online platform as well as 6 face to face sessions with our Blended Online CBT Practitioners, during which they will review progress of the platform, signpost certain activities, tools and modules within the programmes and offer encouragement and support. The face to face sessions will be offered from the GP practices in Powys.

We are now ‘live’ with this service across nearly all GP practices, and where we have been unable to offer this from the specific practice, an alternative can be offered for the service users in that area should they wish to access this service.

Clinical referrals are required in to the blended service and these can currently be done through GPs of the Local Primary Mental Health Support Services (LPMHSS) within Powys Teaching Health Board.

We have currently received approximately 190 referrals into this service and are continuing to engage with the GPs and clinical teams to further upscale the blended approach.

Becka Williams, Project Manager & Catrin Guest, Project Support Office & Online CBT Coordinator raising awareness of Positive Body Image with PTHB's Occupational Health & Mental Health department during Mental Health Awareness Week

Positive Body Image

As part of Mental Health Awareness week, with ‘body image’ being the topic for 2019, we implemented our Space for Positive Body Image programme, which is now available for our healthcare professionals to refer in to.

This programme looks at the following topics:

• Improves understanding of body image and the impact on depression and anxiety.
• Focuses on what factors influence body image and how to improve perceptions of body image. 
• Introduces the known risk factors of eating disorders.
• Improves understanding of the effect of the media on understanding of the “ideal body”.
• Encourages reduction of individuals thin-ideal internalisation through analysis of media messages.
• Introduces self-esteem and focuses on where it comes from and how to boost it.
• Introduces the reciprocal relationship between how we feel and how we eat, using the CBT model of Thoughts Feelings Behaviours (TFB) cycle.
• Recognises emotional eating, mindful eating and how to have a healthy relationship with food.
• Recognises negative automatic thoughts and how to challenge them.
• Introduction to Mindfulness.
• Self-esteem enhancement through activities.
• Recognises the importance of social support in staying well.

Self-referral

We have designed, developed and recently implemented a self-referral option to this service. This service is available for all Powys residents and Powys patients that would like to self-refer onto an Online CBT Programme for depression, anxiety or stress. This service aims to offer services to those experiencing symptoms of depression, anxiety or stress who want access to an effective Online CBT therapy without having to first have an appointment with their local GP or other health professional.

People will be required to undertake an initial self-assessment and on successful completion of the self-assessment, immediate access to the online programme will be given. However, if the self-assessment results are not within the appropriate threshold for this service, a clinician from the PTHB Online CBT team will contact the person in due course for a follow up phone call assessment to determine whether the service is suitable for that person.

Sign up to the self-referral service here.

Student Programmes

The referral age for this service has now been lowered and therefore we are now accepting referrals for young people aged 16 years and above.

We have also implemented ‘student’ versions of 3 of our programmes: Space from stress, Space from anxiety and Space from depression which all offer support that relates more specifically to students such as educational stresses, friendships, relationships etc.

We have started to engage with the high schools and colleges across Powys to increase awareness of this availability to students.

Fionnuala Clayton, Psychological Assistant & Online CBT Coordinator & Catrin Guest, Project Support Office
& Online CBT Coordinator

All-Wales Roll-out

One of the key aims of this project was to explore the opportunity of implementing Online CBT across Wales, including the other Welsh Health Boards and third sector organisations.

Work has commenced on this and we went ‘live’ with the Welsh Ambulance Service NHS Trust (WAST) in December 2018 with this service being utilised within their Occupational Health and Staff Wellbeing teams.

We have also started working with Aneurin Bevan University Health Boards (ABUHB) with this service now being piloted within their Primary Care Mental Health Support Services (PCMHSS) and referrals being received since June 2019.

Engagement is still being undertaken with the other Welsh Health Boards, with a view to further roll-out this service across the different health board areas.

For further information on any aspects of the project or service, please check out this Powys Teaching Health Board website, or contact Becka Williams, Project Manager, on 01874 712 444 or becka.williams@wales.nhs.uk.