Thursday 31 August 2023

The NEST / NYTH Framework – supporting babies, children, young people & families


by Sharon Titley
Children’s Commissioning & Transformation Team
Powys County Council

NEST is a planning tool for Regional Partnership Boards across Wales, to support the development of a whole system approach to mental health and wellbeing support services who work with babies, children, young people, and families. The NEST Framework was created in collaboration with children, young people and families, alongside other professionals throughout Wales, ensuring that their voices are at the heart of what we do, and inform us how best to support them.

This video introduces the NEST framework:



Children, young people, and families that worked together to create the Framework adopted the term NEST. This is based on the notion that a NEST has a caring quality and contains many different levels. They liked the notion that all support services adhered to this theme, making sure that they all felt nurturing, empowering, safe, and trustworthy.




Some of the main aims of NEST are to:
  • Broaden the conversation around mental health and move away from thinking that only specialist services can provide help.
  • Provide access to expertise and advice more quickly and easily.
  • Make sure that trusted adults closest to the child understand what they can do to help and give them the skills and confidence to do so.
  • A ‘No Wrong Door’ approach to those who might need extra support.
  • Giving babies, children, young people, and families the right help, at the right time, in the right way.
This is the NEST framework; the acronym is around the outside of the circle and then the stakeholders in the second circle. The white segments of the circle give us the 6 core principles of NEST. The inner circle contains the underpinning values of NEST which show the expectation of services and their strategic context being psychologically informed, adopting a children’s right based approach in accordance with the United Nations Convention on the Rights of the Child, respecting equality, and inclusion, being values led and being led by a child’s development rather than their age or predetermined stage.




Powys Regional Partnership Board recognises and welcomes the introduction of the NYTH NEST Framework:

“It emphasises that every relationship and every service need to work together to prioritise what is needed most if we are to build the foundations for positive mental health and wellbeing. These qualities are even more important for those who are struggling most, which is why it is about prevention AND intervention. The NEST Framework helps us keep an overview on how everything and everyone works together to achieve the best outcome.”

The RPB's Start Well Partnership is responsible for taking forward the Regional Partnership Board’s work to strengthen and transform services for children and young people in Powys as set out in Powys’ Health and Care Strategy and will therefore be leading on the implementation of NEST in Powys. Partners of the Start Well Board have developed a multi-agency model to respond to and support the emotional health and wellbeing needs of children and young people in Powys.




The Powys model recognises the importance of the community where a child lives, the schools they attend, as well as the important relationships in a child’s life which can be strengthened to support children and young people to prevent their needs from escalating into specialised mental health and statutory services. It also focusses on early intervention and prevention, a whole systems approach, which avoids duplication and allows for integrated access to service.




This model acknowledges that children and young people are more likely to communicate with adults that they know and trust. The need to focus on the adoption and embedding of early help offers has never been more important. It aims to bring about the kind of transformational change that children, young people, and their families tell us they want.

The ambition for every relationship and every environment to feel:
  • Safe, nurturing base.
  • Enabled to fly the nest.
  • Return to the nest if need to.
  • Unique to the individual.
  • Builds on natural resources.
  • Multi-layered.
  • Same basic need for every child – but some need additional layers.
  • Every interaction is an intervention.
  • It is the little things that make the biggest difference.
  • Culture shift away from ‘What is wrong with a child?’ towards asking ‘What is a child’s NEST like?’



How NEST is being implemented nationally
  • Community of Practice.
  • National Training Programme.
  • A Self-Assessment and Implementation Tool.
  • Aligning cross policy work.
  • Regional Partnership Board Leads' meetings.
  • Built into Regional Integration Fund.

How NEST is being implemented in Powys


Start Well Partnership met in October 2022 to develop a Powys Implementation Plan, which includes some of the following actions -
  • Coordinating an initial NEST self-assessment across services working with babies, children, young people, and families.
  • Supporting a culture change through developing a suite of training opportunities, as well as offering accessible training on values that enhance the framework e.g. Dr Treisman training.
  • Defining areas of development e.g. improving coproduction and community engagement.
  • A NEST Steering Group has been established to develop a collaborative approach to embedding the NEST Framework in Powys, bringing stakeholders together to develop a shared understanding of the sustainable long-term change that is required.
If you would like to learn more about the NEST Framework in Powys, or would like to discuss any training requirements, then please contact Sharon Titleysharon.titley@powys.gov.uk




You can read about case studies, including the Development of the Team Around the Cluster Model in Powys, in the recent Welsh Government publication: 


Black and white photographs by Myléne from Pixabay.

Tuesday 15 August 2023

A Private Land Project Tir Diarffordd

 

by Susan Adams and Penny Hallas

What is A Private Land?

A Private Land is an art-based research and development project, supported by Arts Council Wales and undertaken in collaboration with community groups, with a central theme of the links between emotional and environmental health. Its funded timeframe is February - October 2023, but it is expected that relationships and processes developed in this R&D phase will inform on-going projects.

How did the project start?

Artists Susan Adams and Penny Hallas share deep interest in inner and outer worlds: the intersections between the visible world and the realm of imagination. In searching for a collaborative project in which we could explore these concerns further, we were drawn to the former Mid Wales Hospital, Talgarth, Powys, Wales. After more than a century, its physical remains are falling into the final stages of dissolution and will most likely soon be demolished. But it is of historic importance to the local community and former patients and continues to be a site of intense and complex emotional resonance for many different communities and groups.


What are the main themes?

Our project references geographical and psychological territories and the nature of the boundaries that may both protect and / or restrict us. Where are we positioned in relation to boundaries: how much choice do we have and can past actions and decisions be reconsidered? Whose voices are heard and who is remembered? Whereas many other former hospitals (e.g. Ely or Whitchurch in Cardiff, Bethlem in London and Glenside in Bristol) have preserved memories and artefacts, patient voices and stories, we've noticed that it is particularly difficult to find accounts from the people who received treatment at Talgarth. So we have tried to enter imaginatively into the Talgarth site and the hidden stories it suggests, and we invite the voices of people who have experienced mental health issues there or do so currently in the community. Culminating in co-produced arts events/installations, we are trying to form new narratives in creative ways before both site and memories are lost to us.

Our project touches on important but sensitive issues and themes, and we are aware of the need for both courage and delicacy to work together with everyone involved to follow the project through with care. Negotiating strong and contradictory feelings evoked by the project themes in participants, communities, organisations and ourselves is a large part of our work. This includes adapting to a wide and sometimes conflicting range of views as to what is or 'should be' private and what can be shared.

Who are your partners?

We are encouraged by the support and involvement of our partners. Arts Council of Wales; Brecon and District MIND; Powys Teaching Health Board; Research partner, writer and historian Dr Bob Adams, BSc, MB BS, FRCPsych, M Psychotherapy; Creative mentor, Mel Brimfield, Royal College of Art. We're particularly grateful to Marie Davies, CEO at Brecon and District MIND and to Lucinda Bevan, Arts in Health Co-ordinator, Powys Teaching Health Board, for the inspiration, experience and ideas that shaped our plans as well as the support in safeguarding, risk assessments, levels of consent and observation of service protocols that gave us confidence to go ahead.

These were our key partners, but one of the pleasures of the project has been the way unexpected alliances have emerged. For example, the arts organisation PEAKcymru have lent us technology that was outside our budget but has been key to engagement. And mid-way through the project, artists, writers and an art psychotherapist responded to our invitation to form a community artist peer discussion group, inspired by Bethlem Gallery's Questions of Care online workshop earlier this year. Together we shared some of the dilemmas and pleasures of community engagement and all agreed this should be an on going group.

In methodology, our project follows the many existing models of good practice in exploring these themes, including artist-led projects, some of which are listed in the resources and links section.

What has been happening in the project so far?

Our activities have included looking inward to our own emotional and artistic journeys, and outward - to historical archives, online resources, other former hospital sites and communities and arts engagement with local community groups.

Research activities have included initial consultation with our research partner and our creative mentor to deepen our understanding of historical context and help identify the shape of our own and collaborative art activities. We visited Glenside Hospital Museum to see how they have turned their former chapel into a lively resource for the local community and a centre of good practice in dealing with historic and current attitudes to mental health.

From the earliest days of the project we knew that a visit to the Mid Wales Hospital archives, held at Powys Archives in Llandrindod Wells, would be vital to getting a sense of hidden stories. We were able to view registers, case notes, maps and other documents that fall outside the 100 year limitation on viewing but it was the personal accounts, letters and photographs that touched our hearts. We're unable to share photos for this research and development project, but this may be possible in any future phase. Both of us have made images inspired by what we saw. This one is by Susan.


Arts engagement has been through a series of arts workshops as well as digital input and engagement to extend reach. Our initial ideas were simply to offer a broad range of options for workshop participation including audio, video, animation, textiles as well as more traditional art media, based on the areas of expertise we have developed in our own practices. We wanted to meet people first though, to find out what they would like to happen so we had three initial meetings, at Brecon, Talgarth and Hay Mind groups. From these meetings we learnt that some people were interested in the Mid Wales Hospital and had memories to share, whilst others made it clear that they preferred to focus on the natural and environmental elements of the project. So we devised four activities that we offered across all three groups: weaving with foraged and natural materials, making simple animations, making slides for projection with flowers and creating a thaumatrope - an optical toy. We hoped that all these activities would allow multiple points of entry so that people could join in to the level that they felt comfortable with. 


There have been six workshops so far and we will be doing a demonstration / workshop at Felindre Ward, Bronllys Hospital too. We've seen amazing levels of engagement and enthusiasm. Quite a few people wanted more time to continue their artworks, so in addition to the workshops we have supplied materials and activity packs. We have welcomed the contribution of people who preferred not to use art materials, but who kept us company and joined in the conversations.


Participants at the Brecon & District Mind workshops told us about the tiny but packed Museum in the Old Post Office in Talgarth which they thought would have artefacts relating to A Private Land. So we made a visit and were surprised and delighted to find objects, images, artworks and records from the Mid Wales Hospital, donated by the community.

We met so many people with fascinating tales to tell. This thread has led us to adapt our plans for final events in order to be part of the Talgarth Festival

What will happen next and how can people get involved?

We'll be having final events to show what we have all done together in the project and to continue to gather stories and memories. We'll be inviting people to bring any artefacts they may have from the old hospital site to help form an archive and preserve memories. The events are free and open to all, so please do come along and spread the word.

We'll be having a stall at Talgarth Festival on Saturday 26th August making contacts, offering more opportunities for sharing stories verbally, through art making and display of objects. We plan a shared walk up to the old hospital site, late afternoon / early evening.

There will be a co-produced exhibition at The Muse, Brecon, 28th and 29th October, with guest artists, a writing / poetry workshop, performers and poetry reading. And of course, more opportunities for people to contribute. Full details of all our events will be posted on A Private Land / Tir Diarffordd Facebook page

We've only been able to give a broad overview of our complex project in this blog, but if you would like to see more we have been keeping a record of most of our activities and engagement on our Artist Information Company blog: https://www.a-n.co.uk/blogs/a-private-land-tir-diarffordd/ Brecon and District Mind suggested we set up a Facebook page (QR code below) to help keep in touch with participants and as a focus for ideas / exchanges so there's lots to see there too and we'd love it if people would like to add comments and posts. We're happy for people to contribute in language of choice. Croeso i chi gyfrannu yn y Gymraeg!

About the artists


Susan Adams lives near Brecon and Penny Hallas lives near Crickhowell, forming a kind of triangle with Talgarth. Both artists have extensive experience of working with communities, in education, health and with a wide range of organisations and institutions. They have exhibited widely in Wales and internationally. You can see more of their work on the links below.

Susan Adams https://susan-adams.co.uk https://www.instagram.com/susan_j_adams/?hl=en

Penny Hallas https://www.pennyhallas.co.uk https://www.instagram.com/pennyhallas/?hl=en

Resources and links

PEAK cymru https://www.peakcymru.org

Talgarth Museum https://www.facebook.com/TalgarthMuseum

Glenside Hospital Museum https://www.glensidemuseum.org.uk

Bethlem Gallery https://bethlemgallery.com

Outside In https://www.instagram.com/outsidein_uk/?hl=en

The restoration Trust Change Minds Project https://restorationtrust.org.uk/change-minds/

Mendip Hospital Cemetery http://www.mendiphospitalcemetery.org.uk

High Royds Hospital website, Talgarth page http://www.highroydshospital.com/resource/mid-wales-hospital-talgarth/

The role of Arts in Improving Health and Wellbeing