Wednesday 27 January 2010

Severe and Enduring

'Severe and enduring mental health problems' is the category description for people in secondary care in the UK.  The description applies to anyone who's been sectioned or who is under the care of a Community Mental Health Team (CMHT).  People with severe and enduring mental health problems live with their conditions, cope and often recover from their illness.  Not necessarily full recovery  but a return to mainstream life while coping with the longterm condition.

The care provision for secondary or 'severe and enduring' clients is different from the primary care pathway.  Primary care clients are under a GP and have access to psychological therapies such as cognitive behaviour therapy (CBT) and counselling.  Secondary care clients can also receive therapy, but delivered through the Community Mental Health Team and not through GP referral.

Severe and enduring mental health conditions can mean extra limitations for certain clients. Limitations above and beyond the condition itself, barriers on the individual's return to mainstream.   It shouldn't be the case but it is sometimes. At a crucial stage, the recovery path is held back by what amounts to a reinforcement of something that Professor Pat Deegan has described as 'a career in mental health'. 

Current practice around mental health care delivery emphasises as quick a return to mainstream life as is possible and viable.  But the length of time that an individual may have spent in hospitals and under the benefits that are geared to support him or her, can prevent, delay or permanently impair the return to mainstream.  A 'severe and enduring' diagnosis may mean access to appropriate support, but it may also mean a long term stay in the mental health system, supported but cut off from aspiration and opportunity.  This can still be the case after a patient is discharged and living in the community.

Clinical and community teams expend a lot of effort in signposting clients back to mainstream and onto a recovery pathway.  The practical ability to reach for these opportunities may be impaired by a loss of self-worth and empowerment by the time he or she is directed to this part of the care plan.  Clients with severe and enduring conditions may comply in being signposted to mainstream providers because they feel it is required by their teams or because they fear not doing so might lead to losing benefits, not because they have made a genuine individual choice. 

Monday 25 January 2010

Mental Health First Aid as a Commercial Product

MHFA as a Commercial Product

Mental Health First Aid is now running in sixteen countries. It has been updated in line with instructors and trainees' feedback.

As a training course in interventions for common and more serious mental health conditions, MHFA is the only 'first aid' course out there. In the process of full accreditation from the UK's RSPH (Royal Society for Public Health), MHFA is set to become the key industry-standard product in its field.

Employers are required to put in place physical First Aid trainings and trained personnel. Mental Health First Aid will become equally important as a generic workplace health initiative.

MHFA Instructors are trained in marketing their product. Many intructors facilitate MHFA as a self-employed business. A lot of the promotion of MHFA has been and continues to be through established mental health groups and voluntary organisations. Existing staff are trained as MHFA Instructors and seconded to training duties. Often, the courses are heavily subsidised and trainers not paid any more or little more than their existing salaries.

Recommended MHFA Instructor payment rates should strictly speaking, never be less than £35 per hour. This roughly represents the minimum rate that the trainer should be earning for his or her hours of training. For a 12 hour course, this comes to £420 or £210 a day.

The main reason that trainings are being either subsidised and trainers underpaid, is because mental health organisations are not thinking along commercial marketing lines. This is not always the case and another reason is because voluntary organisations may be receiving specific time-limited funding to roll out the trainings.

Eventually, all MHFA courses will have to stand alone without NHS, PCT or other funding. MHFA Instructors who are not already equipped to do so, will have to become proficient at marketing. This does not mean having to charge a vast amount for trainings. It simply means working smart, putting together a budget and business plan designed to enable the course to stand on its feet and make its way in the world.

A commercial mindset for Mental Health First Aid is becoming more and more crucial if the training is to position itself as the generic course of its kind and industry-standard leader in the field.

Thursday 21 January 2010

Social Inclusion for the Artist

As a bridge builder for Arts & Culture, I meet clients with mental health conditions who wish to prioritise their goals for mainstream music, performance, composition, recording, collaboration and promoting. It could be one or all of these areas which a client wishes to work on as a life goal and a key part of his or her recovery.

Although the arts as a life domain has been identified as a highway for individual recovery and inclusion, there are often spin-offs into other areas.

Referral to a mainstream recording studio has led to one client launching a CD of her compositions as well as being commissioned to provide original music for a commercial website. The payments for this alone funded her recording and production sessions. Other clients referred to arts mainstream have gone on to become tutors and trainers in their chosen fields.

Arts as a life domain can not only be a pathway to recovery but also a pathway to employment and/or self-employment. The theraupeutic benefits of the arts have long been recognised - now it's the turn for the arts to be given their fair due as a positive route to work and employment.

myspacemusic.com/johnlvanek

www.crownlanestudio.co.uk

Tuesday 19 January 2010

Mainstream and Spirituality

Spirituality has been identified as one of the key social domains relevant to an individual's mental health recovery. As a bridge builder for Faith & Cultural Communities, I am privileged to work with people who wish to prioritise this social domain in their lives.

Spirituality covers a wide range of needs and approaches. It can be worship-based or not. It can be part of formal attendance at church, mosque or temple. Equally, spirituality can be simply a wish to try out meditation, yoga or other disciplines purely for therapy or relaxation.

From a mainstream bridge builder's point-of-view, the only necessary component of spirituality for a recovering individual is that it should take place in a mainstream setting. This is consistent with all bridge building work, which seeks to prioritise people's rights to a mainstream life and one which is not confined to specialist settings or centres.

Tuesday 12 January 2010

Social Inclusion in Merton

Wellbeing and recovery workshops are up and running again in Merton, rolling on from 2009. Mainstream social inclusion for people who have experienced mental health conditions is now rooted in the care pathway. Organisations like Imagine and Mind are playing a crucial part and the Imagine bridge builder team is busy preparing for forthcoming projects.

The taster course in Music Production is now set up to start in February, the third course of its kind, run by John Merriman at Crown Lane Studios in Morden. Mixed Media arts also starts in February and both taster courses run for ten weeks. Enrolment takes place at the Generator Business Centre in Mitcham on February 3rd. Other taster courses include Football and Swimming.

Thursday 7 January 2010

Mainstream in Merton

The Mainstream social inclusion project in the south London borough of Merton is now into its third year. January and all the winter months are busy ones for mainstream and the referrals are coming in fast. In response to this, the mainstream project is busy signposting individuals to activities of their own choice.

Our clients have severe mental health conditions but they also happen to be committed to their mainstream goals. In response to this, the project creates networks with venues where these goals can be accessed and where people's dreams can grow into reality.

One such mainstream venue is Crown Lane Studios in Morden. Our partnership with John Merriman at Crown Lane is exceptionally valuable. Clients are accessing the studio for musical rehearsal, recording, collaborations with other musicans and trainings in music production. There have been highly significant spin-offs from the partnership. Two clients have completed CD recordings of their work and are actively promoting through performance and management. One client has had a sell-out promotional launch of her CD 'Grace' and has already had her music commissioned for a commercial website. Arts and music mainstream achieves highly credible outcomes for employment and self-employment.