Tees, Esk & Wear ValleysNHS Foundation Trust

Within Integrated Mental Health ServicesThe 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 peoplewith Psychosis

For peoplewith 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 allcommunity mental health servicesare highlighted in the next slide …

Preventing Relapse

Minimising Symptoms

Preventing Admissions

Increasing Skills

Increasing Independence

From Services

Optimising Functioning

In ‘Normal’ SocialRoles

Living Outside Hospital

Improving Quality ofLife

Increasing Access Relationships

Primary Principles of 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