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World Mental Health Day 2021

This World Mental Health Day, with the theme “mental health in an unequal world”, we consider geographic inequities in mental health support, how the pandemic is exacerbating them and what we need to be doing about it.

In a crisis

We’ve all seen this coming. We knew the pandemic was going to intensify existing needs and create new ones. Great mental health support has never been more needed. Yet we are heading for a situation where people will need to be more unwell than ever to access the support they need, when they need it.  According to the Centre for Mental Health: “the equivalent of 8.5 million adults and 1.5 million children and young people will require mental health support as a direct impact of the pandemic during the next three to five years. The total increase in demand is around 10 million people. The predicted levels of demand are two to three times that of current NHS mental health capacity within a 3 – 5-year window.”

We know this will horrifically impact so many people – especially those experiencing a mental health crisis. We are already seeing that from our own work – with a marked increase in referrals to our crisis support services from pre-pandemic in 2019 to 2021. To put this into context – between January and March 2019 we received 368 referrals, 396 in that same period in 2020, but 570 in 2021. This equates to an increase of 7% from 2019 to 2020, and then a 43.9% increase comparing the same periods in 2020 and 2021.

It is clear that if we’re seeing more people in crisis, we need to have the right services to support them. As we’ve said before, presenting at A&E can’t be the only option available to someone experiencing a mental health crisis. And the NHS, now more than ever, needs to prevent unnecessary hospital admissions and delayed discharges for mental ill-health. Alternative crisis provision, provided in partnership with the NHS, is going to be needed even more in the months and years ahead.

We have been pioneering crisis services for over 17 years – and we’re on course to open our 10th and 11th Crisis Houses this year. These will be Crisis Houses like our Oak House service in Central Lancashire – a safe and welcoming home for up to six people. Someone in crisis will be referred to us by the local Home Treatment Team – and come and stay for between 7 – 14 days. They’ll have their own ensuite room, and work with us to develop their own tailored support package. We pride ourselves on the quality of our accommodation as well as the quality of our support – and our non-clinical crisis bed costs as little as £171/night compared to an average of £406 for a hospital bed, which can rise to £561/night if an Out of Area Placement.

We believe that everyone in England should have the right to access alternative crisis provision like this in their local community – yet right now this sort of provision is patchy at best. People in crisis should not be facing a postcode lottery for support, nor face being sent far away from friends and family

Jobs, homes, friends

Looking at the mental health landscape ahead, we know it’s not going to just be about supporting people in crisis. We’re facing up to a volatile economic and employment situation – and all the uncertainty that will come with it.  Supporting people with mental health needs to stay in and access jobs is a key tenet of our work – and we know that specialist employment services are going to be very necessary in the post-pandemic world.

The NHS Long Term Plan already recognised the importance of models like Individual Placement and Support (IPS) – and we wholeheartedly support this. As the NHS says “it is the best evidence-based approach to help people get and keep a paid job.” Staff in our IPS services (we currently run 11, all in the south of England) meet regularly with the people referred to us to provide support with looking for employment, developing a detailed work preference profile to ensure the work is suited to the individual. Those using the service will receive support and guidance on how and where to look for jobs, help writing effective CVs, cover letters and applications and help to get through interviews. They receive confidential advice on how to disclose health matters, when and how best to do it.

However again we see geographic inequities – with IPS services still at the large-scale trial and pilot stage. At a point where we know we’re going to see more people with mental health needs affecting their employment and job prospects, we need to keep the pressure up for services like these to continue to be invested in and at scale.

This World Mental Health Day we’ve focussed on two areas of our work where we fear inequities, especially geographic ones, could have the biggest impact.  But finally, as a charity that began in supported housing over 60 years ago, we’d never miss the opportunity to reiterate the importance of safe, stable and secure housing in the face of mounting mental health needs.

We offer nearly a thousand residential placements for people across the country – ranging from housing support to help people manage their own tenancies, to supported housing and registered care homes. We know that a stable home is essential for people to have the security to regain positive mental health. However pressurised NHS provision means that in many areas people are stuck in hospital beds, and not being proactively moved from hospital into settled accommodation.

Ultimately we’d like to see, and want to help, more effective pathways of support. Ones that make the most of partnership working and the skills and expertise of the charity sector. We know what best practice can look like – let’s use this World Mental Health Day to keep the pressure up for it to happen on an ambitious and national scale.

World Suicide Prevention Day 2021

Today is World Suicide Prevention Day, an important day for us to recognise at Richmond Fellowship, especially as members of the National Suicide Prevention Alliance. According to the World Health Organisation, over 1 in every 100 deaths a year is the result of suicide, and an estimated 703,000 people die by suicide every year. These saddening statistics are why this day is so important and why we work to prevent suicide, raise awareness of mental ill health, and support people on their mental health recovery journeys.  

This year’s theme for World Suicide Prevention Day is ‘Creating Hope Through Action’. We want to encourage understanding and remove the stigma surrounding seeking help, as well as prompting people to reach out and support the people around them.  

Lived experience is a powerful tool for helping others understand suicide and encouraging people to seek support. Today we are sharing a personal story from John, a person we supported at Oak House, one of our Crisis Services. With John’s story we hope to show that recovery is possible, even when it doesn’t always feel like it. 

“My week at Oak House in Burnley has exceeded in meeting my needs. Before I came to Oak House I was 100% convinced nobody could change my mind that taking my life was my best option. How wrong I was. 

I can’t remember too much about my first day due to the negative mindset I was in when I arrived, but if there had been anything negative I know I would have remembered. I’ve found all the staff and volunteers in Oak House to be very welcoming, friendly, professional and supportive. 

Each member of staff who either spoke with me in groups or on a 1-2-1 basis was very clear in explaining advice and educating me on what I needed to teach myself to maintain my own safety. The staff turnaround was on a 24 hour basis, I found this to be a fantastic working and supportive model.  Everyone has their own presentation styles and by doing the staffing in this way it meant I received a broad range of advice based on different experiences. It also made me feel valued by each and every member of staff I spoke with.  

I have past experience of being in a secure unit having been sectioned following a previous failed suicide attempt. If someone had told me that my mind could be altered from the negative state it was in, make me feel life was worth living and actually something to look forward to, in just 7 days, I’d have told you you’re mad. But that’s exactly how I feel. The only way I can describe Oak House in a nutshell is ‘Intensive Care for my brain’.  

Thanks to all the staff for their help and support and, in the nicest possible way, I hope I never have to come here again.” 

We hope John’s personal story brings hope to people that recovery is possible. If you would like to start your own recovery journey, you can find out more about our range of services here, as well as support in your area here. 

Our Crisis Services provide short-stay interventions for people experiencing a mental health crisis. Working in partnership with the NHS, our discreet places of sanctuary provide a calm, comfortable and welcoming space for people to get away from the negative influences in their lives and better manage their mental health. 

We recently focused our social media on our Crisis Services, hearing from staff and people we support. You can check it out here.

Crisis services in action, and in a pandemic – we hear from Area Manager, Jessica Fish

To end #OurCrisisServices week we hear from Jessica Fish, Area Manager in Lancashire. We started delivering Crisis interventions in Lancashire in 2017, and since then they’ve gone from strength to strength.

We are immensely proud of the impact they’ve had and the hard work our staff have put in to make this a reality – and wanted to hear direct from Jessica about the hard work behind it all.

What was the first Crisis Service in Lancashire and why was it commissioned?

It all started in 2016 when Richmond Fellowship won a contract with Lancashire Care Foundation trust to deliver two Crisis Houses across Lancashire – Chorley opened in May 2017 (Willow House) and Burnley in April 2018 (Oak House).

The services were commissioned to support the pressures around inpatient admissions and ED (Emergency Department/A&E) presentations. They were intended to offer an alternative – therapeutic interventions that would hopefully reduce the amount of people who would need an informal hospital admission.

Following the purchase of a house in Chorley, a complete refurb happened to create a 6-bedroom house including en-suite bathrooms, an office, kitchen, lounge, and an activity room. All bedrooms are fully furnished, and the house provides a ‘home away from home’ feel to ensure those using the service feel relaxed. The team did a lot of work around colour therapy and understanding how surroundings can affect a person’s mood and reduce anxiety.

What’s come since?

Since the two Crisis Houses opened in 2017/2018, the Crisis Pathway has evolved even further across Lancashire – we now provide two outreach services, three Haven services, and are set to open another Crisis House 2 March 2021.

Willow House and Oak House clearly evidenced the potential for therapeutic interventions as an alternative for those needing less intense clinical support. Situations such as a social crisis influencing someone’s mental health or managing the feelings and behaviours that come with a diagnosis such as personality disorders. The Crisis Services work with all of this, along with an even more holistic approach to a persons’ recovery.

The Crisis Houses have shown to be both cost effective, compared to an inpatient stay (in and out of area) and effective in offering a safer, less clinical environment.

What have we learnt along the way?

We have learnt a lot and developed in several areas. Multiagency working is key. The last four years have always shown that the better the multiagency working, the better the outcomes for those using the service.  We have also learnt to adapt our styles and service offer from site to site to ensure that each person gets the best they can out of the intervention sessions.

Most recently we have adapted our offer to include those who are street homeless or who have no fixed address, and to assess this on an individual basis to support recovery.

We have also learnt to adapt with the needs of the clinical teams and practitioners, to learn about where their pressures are, and see where we can support in adapting our offer to those that require more intensive support.

How has the pandemic impacted your work?

The pandemic has meant that we have had to review and adapt our offer and service delivery  regularly over the last year. Most of our support has become virtual – whether this be over the phone or over Zoom/Microsoft Teams. The impact of additional workload on the team to ensure all the government guidance is followed in order to keep everyone safe, whilst also ensuring that all virtual sessions are productive, has also been a challenge.

I’m proud of how all our staff have stepped up to the challenge of the past year – they have worked incredibly hard over the last 12 months. They have supported through service delivery changes and learnt new ways of successfully supporting and keeping people safe throughout their mental health recovery.

The pandemic has caused pressures across all services, including clinical services, and again we have had to continue reviewing our standard operating procedure to ensure we are meeting the needs of the clinical services.

What’s next?

Our current focus is Blackpool Crisis House which launches at the beginning of March! We’re determined to ensure the service provision meets the needs of the community in Blackpool.

Put simply we want to ensure that we are as successful in Blackpool as we are in our already established areas.

Mental health care in crisis

Earlier this month the government set out plans for reform of the NHS. Amongst other things the intention is to support more joined up care – and enable greater integration of services across the NHS, voluntary sector and local authorityA community-based mental health crisis First Response Service (FRS) was cited by the Secretary of State as a case study of what this joined up care looks like in practice.

At Richmond Fellowship we are delighted to see crisis provision used so clearly as a great example of sector partners working together to deliver better care to the people who need it, when they need it. 

In 2015 Derek Caren, our Chief Executive said: “As a voluntary sector organisation we’re committed to playing our part in creating joined-up services that can truly provide the best possible care for people with mental health problems, especially in a crisis situation when individuals are at their most vulnerable.”

We know that presenting at A&E shouldn’t be the only option available to someone experiencing a mental health crisis. We also know the pressure NHS Trusts are facing in terms of unnecessary hospital admissions and delayed discharges for mental ill-health.  

We have now been pioneering crisis provision for over 17 years  from our Crisis Cafes and Safe Havens offering immediate support and signposting to our Crisis Houses for people needing step down support from hospital, or intensive support to stop then from going into hospital in the first place 

We are justifiably proud of these services, the people they support and the staff that power them. Crisis services, and increased partnership working, are going to be needed ever more in the months and years ahead to deal with increasing (and increasingly complex) mental health needs. We are glad to see that the proposed NHS reforms recognise this, and the power of crisis interventions. Yet from the outside we know it might be hard to understand what a crisis service actually is and how it works in practice 

That’s why this week, across all our social media, we’re going to be focusing in on our Crisis Services We’ll be hearing from the people we support and our frontline staff, and we’ll be sharing images and statisticthat bring the services to life. Please follow the week on #OurCrisisServices – and share with anyone you think should know about our crisis services. And if you want to find out more about commissioning or partnering with us in your area pleascontact: communications@richmondfellowship.org.uk