TES (training, education, support) Presented by: John Chiocchi, Paula Slevin, Mark Sampson,

WHAT IS TES? The TES project provides Training, Education, Support for carer’s of people with a personality disorder and / or other mental health problems TES was established to meet the unmet need for carer’s of people with mental health needs. It builds on an emerging evidence base that suggests providing education and support for carer’s, you not only help their needs but also those of the service users. This type of approach is mentioned in several NICE guidelines e.g. Schizophrenia and bipolar.

METHOD OF DELIVERY: The education and skills component of TES is delivered by a Carer Consultant (the carer consultant is a highly specialised peer support worker, and an experienced mental health practitioner in a group format. Carers would have a face to face screening appointment with the Carer Consultant after referral from either Assessment, Home Treatment, Recovery Teams, and also from Inpatient Wards. (pre training).

METHOD OF DELIVERY: Carer’s attend two educational awareness sessions based on either personality disorder or mental health problems dependant on diagnosis. Following this they proceed to attend six sessions of group based learning, covering the following: Validation, Invalidation, Crisis Management, Enhancing Relationships and Problem Solving. All education sessions consist of a power-point presentation, group based activity sessions, and also self- directed work between sessions. The carers then progress to the final training and skills element which is a twelve module enhancing problem solving skills programme.

PEER SUPPORT TRAINING PROGRAMME Crisps workshops (Two Sessions) Mental Health Awareness (Two Sessions) Psycho-Education (Six Sessions) Peer support (an introduction) Improving Relationships Validation (Two Sessions) Coping With Emotions Managing Stressful situations Module 1 Understanding Mental Health Disorders. Module 2 Supporting Recovery From a Mental Health Disorder. Module 3 Relapse Prevention. Module 4 Manage Symptoms & Behaviours of Mental Illness. Module 5 Communication & problem Solving Skills. Module 6 Barriers to Listening. Module 7 Conflict Situations. Module 8 Stages of Change In Behaviour. Module 9 Impact of Mental Illness on the Family. Module10 Effect of Mental Illness on different family Members. Module 11 Setting Boundaries & Limits. Module 12 Enhancing Relationships Within the Family. Peer support Groups Six Months (Fortnightly Sessions)

PROBLEM SOLVING SKILLS PROGRAMME Module 1 Understanding Mental Health Disorders. Module 2 Supporting Recovery from a Mental Health Disorder. Module 3 Relapse Prevention. Module 4 Manage Symptoms & Behaviours of Mental Illness. Module 5 Communication & problem Solving Skills. Module 6 Barriers to Listening. Module 7 Conflict Situations. Module 8 Stages of Change In Behaviour. Module 9 Impact of Mental Illness on the Family. Module10 Effect of Mental Illness on different family Members. Module 11 Setting Boundaries & Limits. Module 12 Enhancing Relationships Within the Family.

DESIGN OF THE TES PROGRAMME: The project to date provides a practice based evidence approach, using pre and post awareness questionnaires; (Mental Wellbeing, Carer Burden,Family Empowerment) Carer’s would also complete the questionnaires after family skills, midway problem solving, and end of the programme. So we can measure the carer journey. Qualitative feedback to evaluate the effectiveness of a skills based training programme for carers. Carer satisfaction questionnaires on completion of the programme.

PEER LED A core component to this programme is peer lead training. Ensuring that the training and supervision is provided by a person (carer) with lived experience, of caring for a person with mental health difficulties and frequent crisis behaviour (peer support). Once the programme has been completed, the Carer Consultant will provide on-going support to carers which may include either telephone or face to face sessions, dependent on carer’s expressed needs.

RESULTS To date: 30 people have gone through or are in the process of going through the programme. Data below is taken from the first cohort of carer’s. Table 1 illustrates improved Mental Well Being scores

RESULTS Table 2 Illustrating Reduction in Burden

RESULTS Table 3 Illustrating Improvements in Empowerment

QUALITATIVE FEEDBACK “Excellent tips on how to handle very difficult angry outbursts”. “I found the training empowering”. “I was able to look at it from the perspective of someone with borderline personality disorder”. “As a carer we sometimes add to the anxiety without realising”. “So easy to slip into the over caring role due to being a parent”. “They said that it is meaningful to have someone who knows exactly what they are experiencing (peer support) and have an understanding from a lived experience point of view putting the strategies into action”.

CONCLUSION: The results are extremely encouraging. They suggest that TES enhances mental well-being, reduces burden and improves empowerment in carer’s. These results indicated TES makes real measurable clinical improvements for carer’s mental wellbeing, burden and empowerment about caring for the person whom they care.

CONCLUSION: This may translate to improved relationships and ability to manage the persons mental health needs resulting in less crisis presentations and need for mental health input. An additional benefit of this is it provides an extremely cost effective way for the Trust to becoming compliant with respect to carer interventions for Bi-Polar, Schizophrenia, Borderline Personality Disorder and Antisocial Personality Disorder.

CONCLUSION: This also reaches out to provide the opportunity for carers whose loved ones fail to engage, or frequently disengage with services.

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