1. The Manchester Model Fire & Mental Health Project Warren Pickstone Borough Commander (Manchester South ) Paula Breeze Occupational Therapist (Fire & Mental Health liaison Officer )

2. Over 1/3 of people killed fire known to mental health services. Partnership –Greater Manchester Fire and Rescue Service & –Manchester Mental Health and Social Care Trust. We knew - national problem. The Manchester Model

3. International problem......... Source -Watts-Hampton, T 2006 Examination of risk factors & mental health status in an adult accidental fire death population 1998-2005 Risk FactorsMental illness No Mental illness Asleep at time of fire ignition79%51% Cigarette Smoker78%37% Cigarette as fire ignition factor73%33% Blood alcohol >0.01g/per 100ml71%35% Acting abnormally before fire ignition60%17% Drugs in system60%23% History of careless smoking38%6% Alcohol and drugs38%5%

4. Joint funded Occupational Therapist. Joint project leads. Manchester Borough. Provides Internal link between. –Greater Manchester Fire and –Manchester Mental Health & Social Care Trust The Manchester Model

5. Project Aims Implementation Outcomes Next Steps Today we are going to cover.....

6. Project Aims :- Reducing risk to service users from fire :- Improve safety. High risk people - home fire risk assessments. Awareness within Fire & Rescue Service - Service User involvement. Awareness within Manchester Mental Health.

7. Effects of medication Poor concentration/attention Low mood/apathy Paranoia Delusions/hallucinations Comprehension/understanding Anxiety Wearing a uniform Hostile Lack of appropriate support during visit Lack of time (staff and person) Cultural/gender/race issues Information overload Illiteracy Some barriers to carrying out an effective HFRA

8. MMHSC specialist mental health skills and experience Learning points from incident reviews Person centred practice Need for Partnership working? Little fire safety awareness skills Gaps in risk assessment Choice & dignity Fire Safety

9. Difficulty in accessing “hard to reach” Little understanding of mental health Risk driven, not person centred approach Need for Partnership working? GMFRS good at fire risk & fire safety Local Free Home Safety Policy Prevention Protection Response Choice & dignity Fire Safety

10. Researched need. Working Party Formulation. Objectives signed off by Senior Management. Approval Partnership Bid approval (GMFRS). Service Development Committee (MMHSCT). Key clinical leader consultation process. Key Fire Safety Manager consultation. Staff consultation. Project Development :-

11. Person (e.g. depression, poor concentration) Environment (e.g. housekeeping, cluttered) Occupation (How person spends their time) A holistic approach Why an Occupational Therapist?

12. Link between – Mental Health Fire Risk Person, Environment and Occupation. Roles & Routines

13. Manchester Model

20. Case Study- Mrs X had left a pan of food unattended on the hob Depressed Been drinking alcohol, Pan of food, asleep in the lounge. Smoke alarms. Smoke inhalation. Oxygen therapy and taken to the local hospital. Severe smoke damage. 9 call outs over the last two years. Been unsuccessful at resolving the situation. Very concerned that a more serious fire may occur. Referral was made to FMHLO.

21. X (Scales) Risk Assessment

22. Updated risk assessments and management plans. Assessment and intervention: *Person centred engagement by FMHLO *OT assessment *Advice, occupational goals and environmental adaptations. Inputs/ Outcome: Fire retardant equipment and cooking timer. Identified alternative occupations to drinking alcohol. Art class. Community Alcohol Team. Alcohol consumption had reduced. Feeling more positive & had other things to focus on. No further incidents reported. Case Study- Mrs X had left a pan of food unattended on the hob

23. X (Scales) Interactions To reduce the likelihood (cooker timer etc) To reduce consequence (smoke alarms ) The outcomes of our work?

24. Joint funding Senior level commitment Occupational therapist Information sharing Working within the Trust and Fire Service Why does it work? Key Components

25. Research bid / Evaluation Vulnerable person’s agenda Finalists National Patient Safety Award Future Plans:-

26. The Manchester Model Fire & Mental Health Project CONTACT DETAILS Warren Pickstone (Borough Commander) pickstonew@manchesterfire.gov.uk pickstonew@manchesterfire.gov.uk Paula Breeze (Occupational Therapist, Fire & Mental Health Liaison Officer) paula.breeze@mhsc.nhs.uk paula.breeze@mhsc.nhs.uk David Marsden (Head of Occupational Therapy) david.marsden@mhsc.nhs.uk david.marsden@mhsc.nhs.uk

27. The Manchester Model Fire & Mental Health Project Warren Pickstone Borough Commander (Manchester South ) Paula Breeze Occupational Therapist (Fire & Mental Health liaison Officer ) Manchester Mental Health & Social Care Trust

28. The outcomes of our work?