Tees, Esk & Wear Valleys NHS Foundation Trust

Within Integrated Mental Health Services The emphasis is on Recovery! “Recovery is an idea whose time has come. At its heart is a set of values about a person’s right to build a meaningful life for themselves, with or without the continuing presence of mental health symptoms.” “Recovery is based on ideas of self-determination and self-management. It emphasises the importance of ‘hope’ in sustaining motivation and supporting expectations of an individually fulfilled life”. (Shepherd et al, 2008)

Recovery = Absence of symptoms? Recovery = Cure? Recovery = Adaptation? Recovery = Social Re-integration?.

DEFINITION OF RECOVERY Recovery is a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and roles. It is a way of living a satisfying, hopeful and contributing life, even with the limitations caused by illness. Recovery involves the development of a new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness” (Anthony, 1993)

The development of recovery-based services emphasises the personal qualities of staff as much as their formal qualifications. It seeks to cultivate their capacity for hope, creativity, care, compassion, realism and resilience. “Values based practice involves responding to the differences in values that we encounter in mental health, not by prescribing “right” values but by developing skills that support effective clinical work based on respect for the diversity of values” (Woodbridge & Fulford, 2003) (Shepherd et al, 2008)

“A central tenet of recovery is that it does not necessarily mean cure (‘clinical recovery’). Instead, it emphasises the unique journey of an individual living with mental health problems to build a life for themselves beyond illness (‘social recovery’). Thus, a person can recover their life, without necessarily ‘recovering from’ their illness.” (Shepherd et al, 2008)

“Increasingly, services aim to go beyond traditional clinical care and help patients back into mainstream society, re-defining recovery to incorporate quality of life – a job, a decent place to live, friends and a social life” (Appleby, 2007). The method of delivery by Mental Health Services in Hartlepool came about following extensive consultation with Service Users, Carers and other partner agencies.

The most effective way of making the concept of recovery operational for this locality was to utilise two teams addressing the needs of the population within the community. For people with Psychosis For people with Affective Disorders

The teams are integrated and ‘functional’ and deliver the appropriate care by use of specialist therapies from staff utilising evidence based approaches such as Psychosocial Interventions, Cognitive Therapy and Family Interventions. But … The primary principles that are adhered to in all community mental health services are highlighted in the next slide …

Preventing Relapse Minimising Symptoms Preventing Admissions Increasing Skills Increasing Independence FromServices Optimising Functioning In ‘Normal’ Social Roles Living Outside Hospital Improving Quality of Life Increasing Access Relationships Primary Principlesof Community Services

In order to fulfil the Primary Principles in delivering the appropriate service to our client-group we are able to utilise different expertise within the integrated teams. This includes …. Psychological Therapies Employment Services Social Integration Services Self Directed Support Occupational Therapies 24 Hour Support Care Coordination (Skills Matching) Medical Interventions (Inc. Community Pharmacies, Nurse prescribers etc) Approved Mental Health Professionals Specialist tertiary Services (Inc. Eating Disorders, Mother & Baby service etc).

The client-group within secondary mental health services are here due to the complexity of their needs and, in some cases, lifestyle. This degree of complexity and needs of the client-group brings with it the need for sensitive and appropriate risk management. Conclusion Care coordination demands that the assigned care coordinator identifies needs in conjunction with the client The Care Coordinator matches appropriate skills from within the integrated service and with external agencies to assist the service user towards their personal recovery goal.

Anthony, W.A. (1993) Recovery from mental illness: the guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal, 16,11 –23. Shepherd G. Boardman J. & Slade M. (2008) Making Recovery a Reality Sainsbury Centre for Mental Health. London. Appleby, L. (2007) Mental health ten years on: progress on mental health care reform. Department of Health: London. Woodbridge K and Fulford KWM (2003) Good Practice? Values-based practice in mental health. Mental Health Practice, 7, 2, 30–34