What if "Restraint" was not an option?

by Freda Lacey

About this time last year the Minister of State for Care and Support, Norman Lamb, wrote about “Positive and safe: reducing the need for restrictive interventions” within health care. Mind’s report from the year before on “physical restraint in crisis” clearly outlined that the use of restraint was used to varying degrees and “face down” (or “prone” restraint as it’s sometimes called) was still being used despite the knowledge that it can cause serious harm and, in some situations, death.  The report made recommendations to the Government that the use of “face down” restraint should never be used in care and treatment settings.

The Mental Health Act Code of Practice, (currently being revised in Wales) devotes an entire chapter to “Managing behaviours that challenge,” and it clearly states that the least restrictive option(s) must be explored and restraint used only as a last resort.

The use of “restraint” and the “how”, when managing patients in hospitals, has been the topic of numerous blogs, reports, white papers, and news articles, particularly over the last few years. The Winterbourne Review spurred a great deal of investigation into the use of restraint, the Care Quality Commission specifically reporting on “Monitoring the Mental Health Act” in 2012/2013” and the use of restraint in hospitals. One of my favourite blogs is written by Mental Health Cop and he has his own views about restraint which may add texture to the topic. I am not going to write about how, when and where restraint is used in mental health settings, this has already been done by people far more knowledgeable than myself.

What I really want to highlight is how I’ve been affected by the topic of “restraint”. During my attendance at the Department of Health’s revision of the “English Mental Health Code of Practice” Expert Reference Group with Jan Rogers, I was privileged to sit in on several of the group meetings discussing changes to “the code”. The chapter called “Safe and therapeutic responses to disturbed behaviour” in the new Code of Practice made the experiences of restraint very real to me.

It was the first time where I listened to people’s direct experiences of being “restrained” in high, medium and acute wards whilst experiencing care under the Mental Health Act. I listened to family members speak of their experiences of witnessing their children’s restraint and the distress this has caused. People openly shared feelings of humiliation, trauma (some of this due to physical injuries they had sustained) and feelings of distrust in the people caring for them. They made direct links to the “way” they were physically restrained, sometimes stating they didn’t know “why” it had happened. I imagined how children or young adults may feel experiencing restraint and the trauma this may hold for them, particularly if abuse has been experienced. What is felt by people with a dementia, what comes up for them as a result of being restrained? As I listened, I wondered what would have happened had restraint never been an option. 

Interestingly around the same time, I caught sight of a national workshop on the management of violence in hospital settings. The workshop was pulled together by the “All Wales Senior Nurse Advisory Group for Mental Health” and their call to action really struck me. “The management of violence and aggression in mental health settings is a key issue for practitioners and educators. The Department of Health have recently consulted on restrictive practices in England along with the Mind publication in 2013; and we want to be at the forefront of planning developments and actions in Wales on behalf of our service users and our staff”. 

Having heard the recent stories from people who had experienced being restrained, I was curious to see and hear how staff approached the subject of restraint. The workshop was well attended by national ward management teams, general nursing staff, senior nurses and senior management.

 

One of the things that became apparent was that a good many staff felt the need to move away from restraining people and advocated “de-escalation” techniques, or “conflict resolution”. Basically, talking people down from a heightened sense of anger. I could see the difficulty experienced by staff when faced with a patient who is throwing punches and hurting them (one nurse spoke of being punched and having to be off work for some time) where the instinct is to restrain the patient so as to prevent being hurt. If restraint had to be used, then the workshop advocated using “supine” restraint or “face up” which is deemed less injurious and safer for the patient.

I volunteered to experience what it felt like to be restrained as in the afternoon we had a demonstration of using various methods of restraint for adults and older adults with dementia, (for example). Whilst the demonstrators were very careful with me (I was held down by two men and one woman), and pinned down so I couldn’t move and injure myself (and/or them), I was not trying very hard to be aggressive. I could imagine that if someone was very angry and aggressive that it may take some time of being held down and spoken with before the situation may diffuse. I was also startled at how quickly I went from standing to down on the floor and wondered if I was really emotional, angry and distressed, what effect the entire process might have on me. Also, if I were to be restrained by male nurses, how might this feel as a woman and similarly for men.

Hospitals are required to have policies on how to “manage” aggressive behaviour and in reading some policies from different areas I was struck by the following list of some of the things that staff should look out for as factors that may provoke disturbed or violent behaviour:       

• boredom and lack of environmental stimulation;
• lack of access to external space;
• personal frustrations associated with being in a restricted environment;
• difficulties in communication;
• emotional distress, e.g. following bereavement;
• antagonism, aggression or provocation on the part of others;
• physical illness;
• and an unsuitable mix of patients. 

It is worth noting that most of the above factors have been encountered by patients we see as part of the Powys Patients’ Council meetings and come up in patients’ feedback to us, so I wonder if these factors will always exist, to some degree, within in-patient units. If they do, then perhaps it’s not a matter of “may” provoke aggression, but that these are constantly having to be managed by staff in ways other than restraining patients.

One staff nurse mentioned that he worked within a high secure unit and that the staff never used restraint, that “conflict resolution” techniques were consistently used successfully. Here in Powys, ward management have mentioned that they don’t use restraint although staff are trained in Safe Physical Intervention Techniques or SPIT as it’s called. In fact, one of the staff on the ward here in Powys is the trainer for all Aneurin Bevan staff (including Gwent) in SPIT.

Another option for all psychiatric patients is to complete what is known as an “advance directive”, or here in Wales: “wishes known in advance” statement (we will be exploring this in more detail in a future blog post). This allows patients to state how they would like to be treated (or not treated) if they are detained by the Mental Health Act. They could quite clearly say that they don’t wish to be physically restrained and whilst an advance directive is not a legally binding document it would be good practice for hospital staff to respect the person’s wishes.

So, what’s the answer to restrain or not to restrain? It may be that while the Mental Health Act (and requisite Code of Practice) results in feelings of deprived liberty by people, there will always exist factors which may provoke people to behave aggressively. If this is the case, then ongoing debate and engagement on this topic will continue to be needed.

Finally, I’m curious to see if people may read something further into the paper outlined from the Department of Health mentioned at the very beginning of this blog post. It states, “This guidance forms a key part of the wider new Positive and Safe programme, which aims to end the unnecessary use of restrictive interventions across all health and adult social care." I wonder….

Reflections on volunteering at the Commonwealth and Olympic Games: what can sport teach us about life?

Anne enjoying volunteering at the Commonwealth Games!

Our latest guest post is by Anne Woods - Anne is a freelance writer, researcher and photographer living in Powys. Sport has been an important part of Anne's life pretty much since she could walk! She has represented her county in competitive gymnastics, taken part in equestrian events and played football for Brentford WFC: the highlight, winning a preliminary round match in the Women's FA Cup. She volunteers at several major sports events, including the British Grand Prix at Silverstone. She is currently playing for Hay St Mary's Ladies' Football Club, who train on Wednesday evenings in Hay-on-Wye. They welcome new players, aged 16 and upwards. Find out more on their Facebook page or via Twitter.

Last summer I was a Clyde-Sider, one of the small army of 15,000 volunteers at the Commonwealth Games. Whilst in Glasgow, I was lucky enough to have immediate access to some of the top athletes in the world and to watch them training and attempting to perform to the best of their ability in competition. What struck me as I watched them, is how much sport can teach us about ourselves and how we navigate through life, falling, picking ourselves up and trying again.

Sport encapsulates the full range of human emotion, providing a controlled and safe environment for the expression of frustration, disappointment, even fear; emotions that sometimes we seek to keep at bay and avoid in life. It occurred to me how useful it is to have an outlet for both positive and negative emotions, where feelings can be expressed in the moment without festering or escalating. With good coaching, sport offers a structure for learning how to manage and channel emotions positively: skills that we all find useful.

I was working in The Hydro, a cauldron of expectation and excitement as up to 10,000 spectators cheered on their heroes in the rhythmic and artistic gymnastics competitions. At first hand, I witnessed the anxiety that each athlete experiences and must learn to control to perform well under pressure. As a former gymnast myself, I know how important focus is to remain fully in control of acrobatic movements that have the potential for injury if not executed correctly. Balance and awareness, remaining alert and making minute corrections second by second can be the difference between a gold medal and falling off the beam in agony.

Sport is about the mind and body working in harmony, being in the 'zone', in the present, going with the flow, not over-thinking, not letting the nerves take over or being over-confident but allowing the muscles to do the movements they've trained to do over thousands of hours of often gruelling practice. The discipline of training itself teaches perseverance and determination and an acceptance that we might not be able to do things immediately but with practice we can get better.

Competition brings out the best of us and also the worst. What I remember most about my time as a gymnast is the perfectionism that blighted a good performance and made it not good enough, rather than a joyful expression of hours of practice and the feeling of achievement of pushing my body and mind to their limits. I saw evidence of gymnasts being very hard on themselves at the Games as they strove for perfection by contorting their bodies into shapes most people could only dream about. This is the element of sport that has the power to distort our image of what is good enough and replace enjoyment with disappointment and feelings of failure.

Scene from the opening ceremony. Humanity, equality and destiny are the
underpinning values of the Commonwealth Games Federation.
Image credit: Anne Woods

I was also lucky enough to volunteer at the Olympics in 2012. I was a Games Maker at Greenwich Park for the equestrian events. I will never forget watching the breathtaking performance of British rider, Charlotte Dujardin and her horse Valegro in the dressage - the "dancing" horses. At the very end of what had been an almost flawless routine, Valegro lost composure, and broke stride in an obvious error. I, along with thousands of others, gasped and held our breath. It didn't matter: they won the gold medal with a score of over 90%. What I learned from this and watching days of equestrian competition is that even the best in the world make mistakes. What distinguishes them is their ability to move on quickly and not let the mistake affect the rest of their performance.

The athletes who do best, in my opinion, are those who achieve the balance between pushing themselves to achieve, accepting their successes humbly and not taking their failures too seriously. Giving '110%' is important but not at the expense of self-compassion. Perfection is unattainable and there will always be something to be disappointed about if we look hard enough for it. Focussing more on what has gone right makes for a kinder and more enjoyable passage through life.

At the closing ceremony of the Commonwealth Games, Lord Smith of Kelvin made a speech. These words hit home, "no matter who you are or where you are, sport has the power to make you feel part of something bigger." Certainly, my experience of volunteering at big events bears this out. I would recommend that anyone gives it a go. Even if you don't think you like sport, if you like people, there will be something positive to take from it. The volunteering community tend to be caring, friendly and will go out of their way to help others. Spending time with people like that is a good way to restore your faith in humanity. Sometimes we all need to feel part of something bigger. I agree with Lord Smith. Sport has that power.

Comic Relief award of £110,605 for Powys project to develop Mental Health Networks

PAVO's mental health team celebrates news of the award
Back: Glynis Luke, Jane Cooke, Freda Lacey
Front: Jackie Newey

Shaping Our Services - "Together For Powys Mental Health" 

Local Participation Networks

Powys Association of Voluntary Organisations is pleased to announce that it has been awarded £110,605 from Comic Relief for a three year project, to be managed by the mental health team, to develop local mental health participation networks around Powys. The work is being funded under Comic Relief’s Fairer Society theme, which aims to: “empower and give a voice to marginalised groups of people, enabling them to challenge injustice and bring about positive changes for those who face discrimination and stigma”.

Freda Lacey, our team's Participation Officer, who worked on the funding bid to Comic Relief, told me more about the new project.

“Our county mental health participation network has made a positive difference to marginalised people’s lives since 2010. Using principles of collaboration and co-production, we have successfully challenged injustice and ensured that people excluded from decision-making processes have had their voice heard and been involved in shaping services both in Powys and nationally.

This county-wide work has identified the need to develop participation networks in local communities. Here people face local problems sometimes not appropriate for county discussion, they lack confidence to participate at this level, and are unable to access meetings centrally or to participate remotely. Statistics show that we only reach 10% of people in contact with services as the majority live in more rural areas.

Decisions about mental health services are being made nationally, but 90% of people in Powys currently do not know how to ensure their voice is heard at this level. This means that they cannot participate in decisions that affect their lives. In 2013 we recruited local individuals to participate on local/national mental health strategic decision boards. These individual representatives require local networks to be in place to listen and share with other people, from all ages, in contact with services, and those close to them, to ensure that they are reaching as many people as possible in local communities. This not only empowers grassroots community voice but also supports the individual representatives as carriers/channellers of that collective voice.
 

Freda (far left) at Comic Relief HQ in  London on February 5
meeting people from other award-winning projects

People will use their lived experience to make a positive difference, to their own lives and the lives of others. Their voices, lived experience, and skills will be used to help reduce the disadvantages, discrimination, social inequality and stigma faced by people experiencing mental distress and influence and improve services and opportunities available to “all of us” across Powys.

Participants in the project will increase their negotiating, listening and influencing skills and their understanding of public sector delivery, decision making and strategy. People in Powys, from children to older people, will know how to access local, county and national participation opportunities. They will know how to speak out and get their voice heard, and how to actively engage with those working in mental health services and help shape service delivery."

If you would like to find out more about mental health participation opportunities in Powys, please take a look at the Getting Involved pages on our website here.

You can find out more about the work of Comic Relief here, and Red Nose Day Friday 13 March 2015 here. 

Make your face funny for money!

                                 
Red Nose Day comes along every two years and combines two very British things: having a laugh and helping others. Be it at school, work or home, people across the land put on Red Noses and pull out all the stops to raise as much money as possible. Then, once everyone’s run out of fundraising juice, they tune into BBC One for some top entertainment from their favourite comedians and to donate even more cash! And why do they do it? To help poor and vulnerable people living incredibly tough lives both here in the UK and across Africa.

Update: The Participation Worker post related to this project is now being advertised. Closing date 7 April 2015. More info here.

Norman Lamb at Brecon & District Mind

Roger Williams MP, Norman Lamb MP and Val Walker, Service Director of Brecon & District Mind

Last Thursday Brecon and District Mind hosted an Open Forum on Mental Health with Norman Lamb MP – Minister of State for Care and Support. The session was facilitated by Roger Williams MP for Brecon & Radnorshire. During the hour-long session many important issues were covered, including changing the health system to put mental health on a parity with physical health, the failings of the system for children and young people, concern around funding for vital third sector services in the community such as Brecon Mind, and the needs of carers. Norman’s talk was followed by a Q&A session with Brecon Mind members.

There is not space to cover the entirety of the Open Forum here in one blog post, so we have highlighted some of the points that Norman made during his visit. 

Disparity between services for mental and physical health

I wanted to say something briefly about my complete passion for mental health. 1 in 4 of us at some stage in our life will experience some form of mental ill health. It may be mild depression or anxiety or it may be something more enduring. Most families are touched by it in some way. Our family very much is. What I talk about is not just because I happen to have a job as the Minister for State responsible for mental health. It is something I really care about. The thing that is quite shocking is the disparity between how people with mental ill health are treated by the system despite the great work of people working within the services. But the system, in my view, discriminates against people with mental ill health. I can talk primarily about my experience in England but I suspect it is not much different to here.

In England if you have suspected cancer and are referred by your GP you have a right to see a specialist within two weeks and a right to start treatment within a month of diagnosis. If you suffer from mental ill health, if you perhaps are a youngster who experiences a first episode of psychosis, you have no such right. There is no such entitlement to access treatment on a timely basis. And I just don’t see how that is right. We know there is a wealth of evidence that if you intervene quickly with a youngster who suffers a first episode of psychosis, you can often rescue that person, you can stop the deterioration of condition and give that person the chance of a good life. 

The Open Forum on mental health

So how unacceptable is it that those people don’t have any right to access evidence-based treatment which we know gives the person the chance of recovery. Particularly in mental health the quicker you intervene the greater chance you have of achieving a good result for that individual and potentially rescue someone from a lifetime of a pretty miserable experience for very many people - out of work on benefits, not enjoying things that the rest of us take forgranted. It costs a fortune to deal with the damage and the effects of negligence on that person. So the moral and economic case for proper investment in mental health is overwhelming. If you make the investment you ultimately end up saving money further down the track as a result. That is the central message that I have been trying to get into government, NHS England and also to apply the moral pressure on organisations locally to take mental health more seriously.

I am on a mission to try and change this (the disparity between physical and mental ill health). So in England we are introducing the first ever waiting time standards for mental health so that if you experience a first episode of psychosis the standard will be that you start your treatment in two weeks from referral by your doctor. We start by saying that 50% of youngsters should be seen within two weeks, and then progressively in subsequent years we want to increase the percentage, but you have to increase the capacity in mental health services to be able to do this.

Increasing Access to Psychological Therapies

Kirsty Williams, Assemby Minister Brecon & Radnorshire 

and Harold Proctor of Powys teaching Health Board

We have also got in England the IAPT programme – Increasing Access to Psychological Therapies. It is fantastic for mental health. For the first time we have rich data, information, evidence about how many people are waiting, how long they waiting and whether they are recovering as a result of their treatment. We can monitor the programme to understand which providers are performing well and which are failing people, where access is very poor. The result of this is that in 2010 300,000 got access to psychological therapies. This year it will hit about 900,000, an increase of three times, so it’s a big advance and a programme that is delivering massive results for people. There are thousands of people that have recovered from depression and anxiety. The evidence is very strong; not only of recovery but that if you invest money you achieve a saving in the long-run. You get people off benefits, you get them back into work, you give people a good life with the chance for self-respect and some dignity.

Crisis care

Crisis care is where the disparity between physical and mental health is probably at its greatest. If you suffer from a physical health problem the system may be under pressure but an ambulance will arrive and you will be taken to an Accident & Emergency department and you will have access to a specialist who understands your condition. If you have a mental health crisis it is completely haphazard what happens to you. And you could end up in a police cell. This is intolerable in a civilised society.

So last February we published the Crisis Care Concordat. We got twenty national organisations to sign up to it. It is the first set of standards for crisis care in mental health that we have ever had. It tells you there that there should be a 24/7 helpline available so you can get access to support any time of day and night. There should be proper liaison psychiatry in hospitals, and in A&E if your problem is a mental health problem you will get access to a specialist. It critically says we should end completely the practice of putting under 18s in police cells and halve the number of adults who end up in in police cells this year compared to two years ago. In my view it should become a “never” event. Parts of England have demonstrated it is possible. They don’t get more money, they have just organised themselves better.

The role of carers and the Open Dialogue approach

I am acutely aware (mental ill health) affects the whole family. It can have a massive impact on other people’s lives. Providing support for the whole family is critically important. There is a very interesting development called Open Dialogue. It is the approach they use in Finland. The whole idea is that it is a recognition that mental health is crucially related to relationships with other people, and to try and deal with someone’s mental ill health in isolation is a mistake. Their whole approach is that when crisis occurs you get the whole family engaged straight away.

It’s absolutely the case that a family trying to cope with mental ill health very often has no idea how to handle it, whether what they do has an adverse or positive effect, whether to be tough with the person or gentle and understanding. Getting the balance right is so often incredibly difficult, so to involve the whole family seems a very attractive approach. There are now four trusts in England that have taken this approach and pooled some money between them to train psychiatrists and other health workers to develop the model in this country and critically to evaluate as they go through.

Transition from children’s to adult services

We have a massive issue with this cliff edge at 18. You get to 18 and are then told children’s services come to an end. You’re suddenly told you’re in adult services. 18 years old is a very difficult age for many people. They are going through real transitions in their own lives, maybe going to university, maybe leaving school, it may be all sorts of teenage angst that you are trying to cope with in your own mind, and to suddenly force a complete change of service seems completely daft. I’m trying to force a move away from a one size fits all date for transition. It’s often “abandonment” to be honest. A service needs to stick with someone if that’s the appropriate thing to do. There are several areas, my own county of Norfolk, where they have a youth service that takes you through to 25. Because it is a youth service it is more attuned to what might be more appropriate for you at that point in your life.

I also think third sector organisations working collaboratively with statutory sector organisations are more subtle and pliable in getting the right response for a youngster. So I think a collaboration between statutory and voluntary sector services works more effectively.

Janet Pardue-Wood, Acting Director of Mind Cymru, meets 

Kirsty Williams AM and Roger Williams MP.

Voluntary sector

My view is that the voluntary sector plays a crucial role. When I was at Gofal earlier they were talking about how they had entered collaborations with some of the health boards around Wales. We have this awful problem of people being put into out-of-area placements, often a long way from home. There is no ambition to give them a better life, they are just hidden away from view at enormous cost to the tax payer, it is an extraordinary outrage really. Their role can be to identify these people and find a mechanism to get them back into community and rebuild their life.

Gofal gave a wonderful example of a woman who was a serious alcoholic whose life was in a complete mess, she had been in secure accommodation. She is now living back in her own home and working in a charity shop three days a week. She contributes to local community efforts, she has a life. It’s fantastic. Three or four years ago no one assumed she was capable of that, she would just have been locked up as a risk or threat to everybody. It does not have to be like that.

Roger Williams rounded off the session by complimenting Brecon & District Mind on the work that they do in their community and thanked them for hosting the Open Forum.

Thank you to Freda Lacey and Brecon & District Mind for providing photographs from the day.

Dyfed-Powys Police - mental health: a multi-agency approach

Over the last few months I seem to have read endless articles online (the latest just last week from the BBC here) about the increasing numbers of young people and adults being detained in police cells whilst experiencing mental distress. This is often because there are no suitable places of safety where people can be taken to be assessed, even though it is frequently accepted that a police custody suite is not usually an appropriate place in such circumstances.

In Powys, a multi-agency approach is now working to improve the police response to those with mental health needs. I first found out about this in November 2013 at a Dyfed Powys Police event called Mental Health: the Way Forward. Here we heard, amongst other things, some of the Force’s plans for change in the area of detention under Section 136 of the Mental Health Act.

Inspector Brian Jones

This week we found out more, from Inspector Brian Jones of Neighbourhood Development for Dyfed-Powys Police, about how plans had been progressing since the event. Brian started by addressing the issue of children and adults being placed in police cells due to the lack of mental health beds.

“In Powys, we have not found ourselves in this position during 2014”. The police are often called to assist with situations where someone has expressed concern for a family member, a friend or someone they have seen behaving in a manner which raises concern for their welfare. The police currently have minimal training on how best to deal with incidents where people have mental health needs, but will strive to treat everyone with dignity and respect. “Our first priority is to ensure that persons are safe and then to ensure that persons are cared for by specially trained experts at an agreed place of safety.”

Legislation

The legislation under the Mental Health Act, which is known as a Section 136, stipulates that “if a constable finds a person who appears to him/her to be suffering from mental disorder and to be in immediate need of care or control, in a place to which the public have access, the constable may, if he/she thinks it necessary, in the interest of that person or for the protection of other persons, remove that person to a place of safety.” No one will disagree that a police cell is not a suitable place or environment for someone with mental health needs. However, there are occasions when there is no other suitable alternative and this is when there are signs of violence, substance misuse or criminal offences for investigation with evidence to be preserved.

In order to make every effort to secure the correct and professional support for individuals, as well as avoiding police cells or any inappropriate use of police powers, a procedural pilot was introduced in Powys in March 2014. This pilot requires the Police’s Inspector’s authority before police mental health powers can be used. The Inspector will take an independent overview of the circumstances which have led to consideration being given to utilising the powers under the Mental Health Act.

Exceeding expectation

The pilot is exceeding expectation and the police cells have only been used on three occasions, which was justifiable in the circumstances and not due to having no suitable beds available. At no time have the police powers been inappropriately used and at no time during this period have any youths under the age of 18 been detained. There is a strong partnership approach between the police and health and social care partners, who are working together to raise awareness amongst colleagues, as it has been agreed that training is required for people who come into contact with people suffering from psychological problems.

Thank you to Inspector Brian Jones for his update. Let us know in the comments box below what you think about the new ways of working that the police are trialling in Powys - or elsewhere in the UK.

You can read a recently published report (6 February) from the House of Commons Home Affairs Committee on Policing & Mental Health here.

Psychological therapies - what's happening about waiting lists in Mid & South Powys?

Jane Cooke of our mental health team recently supported the organisation of a meeting in Llandrindod Wells to look at the long waiting lists for psychological therapies in Mid and South Powys. She reports now on what happened on the day.

The Psychology Services in Mid and South Powys have very long waiting lists. There are also waiting lists, but not so long, to see a counsellor based at GP surgeries. (Psychology Services in Mid and South Powys are provide by Aneurin Bevan Health Board and in the North of Powys are provided by Betsi Cadwaladr University Health Board).

In response to this the Psychology Services, some counsellors who work in GP practices, Powys Association of Voluntary Organisations (PAVO), people on the waiting lists and Public Health Wales worked together to plan and put on an event to talk with people who are on the waiting lists.

Around 30 people who are waiting for psychology services or counselling came on the 3rd February to a meeting in Llandrindod Wells to give their views about what it is like to be on the waiting list, what information people get, or don’t get, and what is it like receiving letters asking if you still want to be on the list.

People also had a chance to find out more about what else is on offer from, for example, Mind groups and other voluntary and third sector groups.

Mr Foxxman and Anna

There was a strong commitment from the Psychology Services to respond quickly to issues raised where possible, for example by changing the wording on letters, thinking through how to better keep in touch and demonstrate that there is concern for people. There were other ideas that will take longer to develop and find funding for around peer and buddying possibilities for support. There is a commitment from PAVO to continue to work with Psychology Services, supporting the participation of people who use services where required and considering the options for developing joint or partnership work. Public Health Wales also stated its support for this process as it develops.

This event is going to be of interest to other services across Wales. The simple act of getting people together and asking their views is not as widespread in the NHS as may be imagined. The fact that this was a positive experience for those who organised the event and those who attended, with some significant improvements resulting, will encourage others to adopt a similar approach.

We will continue to report developments!

What do you think about the waiting lists? Have they affected you? Let us know in the comments box below.

One to One Recovery Support - Mid Powys

Are you: 

Struggling with your wellbeing? 

Feeling like things are stacking up 

and it’s hard to keep control? 

Feeling stuck? 

Or just feel that things could be better? 

Living in Mid Powys?

One to one support is available, free. 

We met Tim Skelcher last week to find out more about a new service being offered by

Mid Powys Mind.

I’ve recently started working for Mid Powys Mind as a Recovery Support Worker. This is a three year Big Lottery funded service which will work in person centred and holistic ways to address an increased demand for support following the economic downturn and the austerity measures that followed.

The aims of the service are to provide individuals with immediate support with urgent issues, and to offer support to work towards getting a satisfying and meaningful life through identifying goals and making steps towards them. 

Tim and his colleagues at Mid Powys Mind
L - R: Maire McAvinchey (Office Manager), Nic Williams (Senior Support Worker & Outreach Worker), Tim Skelcher (One to One Recovery Support Worker),
Jo Houlsby (Operations Manager), Mary Williams (Development Manager).

As well as one to one work, the funding has enabled us to extend our opening hours, with the Resource Centre basement now open on Tuesday and Thursday evenings from 5 to 8pm, with a focus on recovery. Although it’s early days with this, I expect these sessions to include discussions, films, information and peer support.

We have also been able to fund additional training that helps people to develop coping skills and emotional strengths that can further support people to cope with life’s challenges. We will publicise these courses through the year as they come up.

It feels like we are making progress towards being the wellbeing centre that we aspire to be. A recent members’ day has provided lots of ideas to develop services further, and with more days planned we are becoming increasingly member led.

You can find out more about the One to One Recovery Service on a Mid Powys Mind flyer here.

Contact Tim on: 07947 106 768, or email recovery@midpowysmind.org.uk