Mental Health Drug & Alcohol

28 February 2019

News

25 Years of Ryde Consumer Network - Page 2

www.nslhd.health.nsw.gov.au

Facebook: www.facebook.com/NSLHD.MHDA

Brookvale Community Health Centre Turns 1 - Page 3

NSLHD Seclusion & Restraint Planning Forum - Page 6

Director’s Report

- Andrea Taylor

Page 1 | NSLHD Mental Health Drug & Alcohol News | 28 February 2019

It has been a busy start to the year with celebrating anniversaries, moving forward with new initiatives and welcoming some new faces.

The Mental Health Commission of NSW has released the Lived Experience Framework for NSW which provides the vision and direction for embedding lived experience across all aspects of mental health services and system processes. This resource challenges us to think critically and curiously about how we partner with lived expertise of consumers and their families and carers, and the opportunities for furthering partnership in our service. We look forward to furthering our commitment to partnering with people with a lived experience utilising this framework. Congratulations to the Ryde Consumer Network with whom I had the honour of celebrating 25 years of the service this month. I would like to recognise the work of Paula Hanlon and her team of volunteers. Having taken a small group of community minded individuals and grown the network to the hub of support and activity it is today is testament to her dedication, tenacity and passion towards the recovery of others. This month also sees the one year anniversary of the Brookvale Community Health Centre. Brookvale offers a modern one-stop-shop which supports integration of mental health and drug and alcohol services with other health programs and services to consumers and their families living on the Northern Beaches. NSW Government has announced a $9.6 million funding boost to InsideOut, Australia’s national institute for

research and clinical excellence in eating disorders, and to districts across NSW to support health system reform for people with eating disorders. This funding will provide each district with a full-time Eating Disorder Coordinator, along with training for health professionals. Monique Van Leewan is the NSLHD Eating Disorder Coordinator and undertaking critical work in our District to build capacity within our workforce to better meet the needs of people with eating disorders and their families. NSW Health is implementing a statewide initiative to

standardised internal emergency phone numbers. The

emergency phone number is 2222. Facilities where we

have been using internal extensions will now be required

to dial 2222. Facilities that have been using 000, will

continue to use 000. All sites are in the process of

changing over evacuation plans, flipcharts and posters to

the new 2222 number. If the resources in your facility

have not been updated, please let your manager and local

Quality and Risk Manager know.

The Governance Support Unit has a couple of new team members. We welcome Krista O’Sullivan to the Compliments, Complaints, Issues and Legal Manager role and Francesca Coniglio to the Engagement Manager role. Francesca will be coordinating the newsletter so please be in touch with her with all the developments and stories from your services.

Spread the good news

Share your news, achievements and events with your colleagues, or let us know what you’d like to hear more about in the newsletter. Contact Francesca Coniglio at Francesca.Coniglio@health.nsw.gov.au or on 0434 323 275 to submit your story.

Publication is at the discretion of the editor. Items may be edited for

length, style and quality.

Below: Monique Van Leewan, NSLHD Eating Disorder Coordinator (second from right), Louise Kelaher, NSLHD Peer Worker (third from right)

Left: Francesca Coniglio, Engagement Manager

Right: Krista O’Sullivan, Compliments, Complaints, Issues and Legal Manager

Page 2 | NSLHD Mental Health Drug & Alcohol News | 28 February 2019

25 Years of Ryde Consumer Network

From 1992 to 1993, a working party was formed to oversee the closure of Gladesville Hospital. Michael Longhurst, a manager with the newly established Ryde Community Mental Health team invited Michael Appleton to attend the meetings. Michael, a person with lived experience of mental health issues since he was 12 years old, volunteered at Wicks Cottage, a day program service. He was asked to invite more people with lived experience and by the time the working party concluded their business, there were more consumers on the committee than clinicians and managers. During discussions about the dispersment of funds from the closure of Gladesville Hospital Michael put out his hand and asked “where is our money.” These few word saw the birth of a new world within the mental health system. Knowing what was coming, Michael established the Ryde Consumer Network in November 1993. The Northern Sydney Consumer Network, with services in each sector, formally began in March 1994. MHDA committed $50,000 per year for the first two years and in 1996 committed to this financial support ongoing. In the beginning the roles were all voluntary with employed positions gradually integrated over the years. The Ryde employed position began in January 1998. The role of the consumer network and volunteers at Ryde has enabled us to meet the needs of people with lived experience of mental health issues in the Ryde area over the past 25 years. A Consumer Network was a new entity and nobody really knew what we were to do or how to do it. Recently, Peter Gianfrancesco who was another of the Ryde Managers pivotal in the groups establishment said that they “had no idea what we were doing back then and I guess all we did was not get in the way of everyone’s passion and determination.” As a group we would meet and discuss how to make ourselves known to people in our community. We held 21 dances at a church hall in Top Ryde to meet people in a social setting. Forums were held at Wicks Cottage and then at Ryde Hospital as the numbers grew. We would ask people what they wanted from the mental health service. The answer was often “my case manager will tell me what I need.” Today, the people attending our forums are interactive and vocal about their needs and ideas for mental health services. Over the 25 years, over 70 people have

participated as consumer representatives and/or volunteers with the Ryde Consumer Network. Some have moved on to study and/or employment, while others have

passed from this life. Many thanks to all the people with lived experience of mental health issues who

have participated over the years, those who continue to participate with us reinforcing our value and to the many clinicians and managers who have

supported our roles and growth over the years.

Paula Hanlon

Below: Andrea Taylor with Paula Hanlon and Michael Appleton

(Founder Ryde and Northern Sydney Consumer Networks)

From top left to bottom right: Daniel Warwick, Gary

Chalmers, Grace (Leanne) Nicholas, Michael Plumb,

Ruth Sariban, Lorraine Wright, Tanneke Djuhari,

Leanne Warwick

Page 3 | NSLHD Mental Health Drug & Alcohol News | 28 February 2019

Brookvale Community Health Centre Turns 1

Twelve months after the $50-million Brookvale Community Health Centre officially opened, a large number of Northern Beaches residents are taking advantage of the wide-ranging services which include adult Community Mental Health, Child Youth Mental Health, Older Persons Mental Health, and Drug and Alcohol services. The centre is a modern, five storey, purpose built one-stop shop for community health services, in an easily accessible location. In 2018, adult mental health services supported more than 850 people with many in an ongoing arrangement. Clients have welcomed the modern facilities along with the access to buses and visitor parking. Community Mental Health Service Manager Sean Graham said many of the people we help are coming regularly so the easy access makes a big difference. “We’re offering one on one support as well as family and carer support and social and life skills groups which are proving very popular,” Sean said. The Child and Youth Mental Health Service has provided support for more than 700 new consumers in 2018 in addition to young people who have been obtaining therapeutic support on an ongoing basis. Services provided include individual therapy, targeted group programs, family work/support and assertive outreach support. Children, young people and their families have welcomed the spacious consultation rooms and amenities. The Drug, Alcohol & Gambling Counselling Service is primarily based at Brookvale, with three staff also seeing clients at Mona Vale Community Health Centre. Doug

Usmar ,Team Leader of the Northern Beaches Drug, Alcohol & Gambling Service said that since transition to Brookvale, the service has received funding to implement a new ‘ Substance Use in Pregnancy’ Program which is managed by Social Worker, Lucinda Morrison and CNS Diane Russell in conjunction with the Opioid Treatment Program”. This week we welcomed our new full time Admin Officer, Fran. “The location of Brookvale has significantly increased public awareness of services provided, and we are receiving an increasing number of GP and other referrals. We are located adjacent to the Adult Mental Health Services which facilitates integrated management of clients in common,” said Doug. Fiona Baker, Nursing Unit Manager of the Northern Beaches Opioid Treatment Program said she is proud of the improvements that have been implemented since relocation to Brookvale including a range of treatment initiatives and support services targeting the needs of specific groups. Prior to the opening of Brookvale Community Health Centre, people living on the Northern Beaches with mental illness, especially severe mental illness, experienced difficulties accessing mental health, physical health and wellbeing and other supports services. By bringing a wide range of services together under the one roof in an accessible location at Brookvale has assisted people with mental health or drug and alcohol related issues to access services when and where they are needed that support their general health and wellbeing.

Page 4 | NSLHD Mental Health Drug & Alcohol News | 28 February 2019

Hornsby Hospital JMO Quality Improvement

The Hornsby Hospital Junior Medical Officer (JMO) quality improvement program drew to a close in 2018. The program aimed to build the quality improvement (QI) capability of our medical workforce by utilising a JMO led approach. The program employs a combined model of six, two hour face to face evening QI sessions with accompanying experiential QI projects.

The theory based learning incorporates an introduction to quality improvement, quality tool kits, improvement methodologies, measurement and variation, provocation, mobilising teams and change management. Each program element is aligned with the progression of the JMOs QI project.

The initiative is a combined project between Hornsby General Hospital and Hornsby Mental Health Service and led by Cain Byrnes and Melanie Perry. JMOs are required to voluntarily participate in 6 x 2 hour night workshops and complete a project through the year.

Thank you to all the JMOs whom embraced this new learning.

Call for Presentations: TheMHS Conference

The call for abstracts for the 2019 TheMHS Conference is now open. The theme for this year is Building Healthy Communities: Stories of Resilience and Hope and will be held at the Brisbane Convention & Exhibition Centre from 27 to 30 August 2019. TheMHS Conference offer awards celebrating best practice, excellence and innovation to services and initiatives. You are encouraged to consider showcasing your service’s efforts and achievements. For more information on the conference, see https://www.themhs.org/annual-conference/ . If you would like to submit an abstract or apply for an award, you will need to write up a brief for the Chief Executive, along with your abstract or award application and information about the conference. You will need to ensure you have your line manager’s approval prior to submission and you should note this consultation in the brief. This will then need to be submitted to your service manager and then to Director MHDA for approval.

Melanie Perry

Page 5 | NSLHD Mental Health Drug & Alcohol News | 28 February 2019

Reducing Seclusion Times

The Review of Seclusion, Restraint and Observation of Consumers with a Mental IIlness in NSW Health Facilities reviewed the use of restrictive practices in NSW and to compared this with national and international standards. The review team identified 7 themes from feedback from consumers, carers and staff & 19 recommendations with the optimal goal of a reduction in seclusion episodes and length of time in seclusion. James Wall recently completed a clinical leadership project through the CEC looking at reducing the time a consumer is in seclusion in MHICU by 50%. A pre CPI project sample of 20 seclusion episodes from mid December 2017 – the end of January 2018 showed a median seclusion time of 120 minutes. A number of interventions were implemented – NUM and CNC role modelling, violence and prevention management training, adjustments to the care plan, documentation flow chart, in-servicing and a specific seclusion education package delivered to all clinicians. Acute behavioural disturbance incidents recorded through IIMs was agreed to be an appropriate balancing measure. It was suggested an increase in consumer acute behavioural disturbance would occur in response to potential lower seclusion times. However there was no

significant increase in acute behavioural disturbance incidents in the unit throughout the study. By December 2018, the median time a patient in the MHICU spent in seclusion was 70 minutes. The project resulted in a 42% reduction in time spent in seclusion.

James Wall

Personality Disorders Planning Day

Project Team Team leader: James Wall Peer Worker: Paul Carenco Medical Officer: Dr. Veronica Vass Allied Health Representative: Melissa Fick Nursing Representative: Damon McKenzie MHICU NUM: Trent Haskell

Libby Waugh

The Personality Disorders Working Party (PDWP) was formed in December 2017 and had representation from each NSLHD MHDA service as well as lived experience perspectives from consumer peer workers and carers. The working party’s task was to identify areas of strengths across the District, as well as opportunities for improvement, and condense the information gathered to propose a Service Framework with care pathways for people with personality disorders, families and carers. A planning day was organised to consolidate the months of reviewing the District’s existing services, consumer and staff feedback, clinical guidelines and literature for how an optimal personality disorder service could look. The planning day was facilitated by Rob Wilkins from the Agency for Clinical Innovation, and had broad

representation from across the District – Clinical and Service Directors, clinicians with expertise in personality disorders and consumers and carers; as well as outside expertise from Project Air and Westmead Hospital. After various perspectives were presented in the morning session, attendees broke into workshops to identify key features of what should be in a service framework and care pathways, and prioritising areas for improvement. The information and ideas gathered both from the working party throughout the year and from the planning day was used to draft a proposal to the MHDA Executive of a Personality Disorders Service Framework and care pathways. The proposed model with 10 key considerations for implementation will be presented at the March MHDA Executive meeting for endorsement and further feedback.

Page 6 | NSLHD Mental Health Drug & Alcohol News | 28 February 2019

NSLHD Seclusion & Restraint Planning Forum

In May 2018, the Ministry of Health released a detailed implementation plan for 19 recommendations for the reduction and eventual elimination of seclusion and restraint of consumers in NSW Health facilities. With 7 recommendations involving Emergency Departments, and 15 recommendations involving MHDA, coordinating implementation of these recommendations within NSLHD within tight timeframes demanded a forum for all involved to meet, present their perspectives and work collaboratively for sustainable and authentic trauma informed change. Dr Titia Sprague from the Ministry of Health attended and the workshop was facilitated by Sarah Fischer from the Clinical Excellence Commission.

Attendance included both ED and MHDA Clinical Directors, MHDA Service Directors, ED and MHDA NUMs, clinicians and other staff with expertise in working with people with acute behavioural disturbance, Security staff, trainers, and consumer peer workers with first-hand experience of seclusion and restraint. Their voices were particularly powerful when presenting their personal experiences of seclusion and restraint, and the lived experience perspective underpinned much of the session for the 60 plus attendees.

The second half of the session ran in a workshop style, with 5 groups reflecting on various stages of implementation and initiatives from five main themes running through NSW Health’s 19 recommendations. They were governance, culture and leadership, co-design, professional development and workforce and therapeutic environment and practices. Initial feedback from the morning was very positive, with the session meeting its aim of being a platform on which to build working partnerships amongst people that rarely have the opportunity to interact, and whose work towards the reduction and elimination of seclusion and restraint in NSLHD will be greatly enhanced through these networks. MHDA would like to acknowledge Ros Ferguson (NUM of Hornsby Emergency Department) for her leadership in this reform.

Libby Waugh

2019 MHDA Research Conference

Page 7 | NSLHD Mental Health Drug & Alcohol News | 28 February 2019