Wellbeing Suffolk Clinical Model -Adults Senior Clinical Team, Wellbeing Suffolk, Norfolk and Suffolk NHS Foundation Trust May 2017

Referrals Self-referral for 16 + yrs 8am to 8pm tel 0300 123 1781 or 24/7 www.wellbeingsuffolk.co.uk Professional referral via letter, website or email nmh-tr.wellbeingsuff@nhs.net

Step 1 Advice and Consultation For health and care professionals working with adults, CYP, families Every surgery and school have a named contact

Triage To determine primary or secondary care or other services Service criteria for 16 + : common mental health problems, have a goal to work towards, risk manageable at primary care level Not suitable for when presenting problems indicate short-term interventions aimed at self-management not recommended by NICE

Triage outcomes Suitable for Wellbeing: Intro to wellbeing Stress control course Intro to mindfulness Wellbeing Advice Session Not suitable for Wellbeing: Step up to AAT Signpost to other community services

Introduction to Wellbeing Often the 1st step on patient journey Intro of options available : step 2 courses, Silvercloud, WAS, partners, discharge

Step 2 courses Psychoeducational courses based on adult learning Level of interaction varies 4-week courses on stress, depression, anxiety management Review if not recovered

Guided online self-help Silver Cloud – online guided self-help package consisting of self-help modules; progress reviewed and guided by therapist

Wellbeing Advice Session Tel or face to face to identify treatment goals and best way forward Outcomes: Intervention within Wellbeing – most often step 2 course at this stage either on traditional IAPT pathway or Resilience pathway Partners Step up Signpost

Step 2 one to one Guided self help Low intensity CBT Short term 4-6 sessions, typically over telephone Evidence based BA; CR; exposure therapy; problem solving; anxiety management Step up if not recovered

Step 3 Typically after Step 2 Automatic step up if PTSD or social phobia Short term Evidence based Courses: LSE, MBCT, MBSR One to one: CBT, IPT, IPT-A, Counselling for depression, Couples counselling, EMDR

Monitoring Progress IAPT dataset, minimum PHQ-9 as measure of depression and GAD-7 as measure of anxiety At every session Monitoring progress Appropriate action if improvement/deterioration/no change Recovery metric: 50 % of IAPT therapy pathway clients recovered at the end of treatment Recovery = PHQ-9 at 9 or below and GAD-7 at 7 or below

Discharge Mutually agreed Dependent on achievement of recovery and goals, appropriateness of service, whether right time to make changes DNA policy Relapse Prevention Re-referral

Correspondence / Sharing of Information Communication via letters, emails and phone calls Copies of letters at assessment, review and discharge stages sent to relevant GP practice