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

May be a cartoon of text that says "RICHMOND FELLOWSHIP MAKING RECOVERY REALITY Focus on... CRISIS SERVICES #OurCrisisServices"

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