I have been privileged to work in mental health for the past 20 years. I have worked in a range of settings including the prison service, inpatient units and with children and young people. I have not yet met a person whose life has not been affected by mental health – whether that is their own mental health or that of a family member, colleague or friend. I am an occupational therapist and it’s our relationship to our mental health and our ability to engage in the activities that matter to us which I feel very passionate about.
The new Brighton and Hove Wellbeing Service
On 1st June 2017 we launched the new Brighton and Hove Wellbeing Service – which is an expanded service that includes children and young people into our offer of care and support as well as adults. This all age model of mental health care provides the city with a primary care mental health service without problematic transitions between adult and children and young people’s mental health services. It also means that our intention to people and their wider support networks can be achieved.
We are delivering the service with our new partner YMCA DownsLink and part of this expansion includes self-referral for children and young people to either the Child and Adolescent Mental Health Services (CAMHS) or our Children and Young People’s services, resulting in children and young people being able to access the most helpful support as quickly as possible.
The team at Here is the lead contract holder. We’re providing operational leadership including administrative and data reporting. We offer innovation, operational and logistical expertise, integration of services through partnership, Information Management & Technology and demand management solutions.
We have several partners in the service who support in different ways:
- Sussex Partnership NHS Foundation Trust (SPFT) – primary care mental health practitioners, talking therapists and the clinical lead of the Wellbeing partnership
- YMCA DownsLink Group – children and young people’s provision staff and expertise
- Mind in Brighton & Hove –talking therapies (step 2) team in addition to work and learning, advice and information and community resource staff
Working from what matters
When we started designing the service, we spent time with many service users and stakeholders to identify what was most important for them.
We conducted an extensive series of stakeholder and partnership events between April and July 2016 which focused on how to develop and improve our current services for users. Feedback suggested that individuals wanted treatment that is:
- Suited to them, and allows them to reach individually meaningful goals and life needs.
- Grounded in evidence, and provided by expert clinicians.
- Embedded in a support system that allows them the greatest chance of succeeding and flourishing longer term.
How the new service is different
- We will ensure the service is well known locally, embedded in existing care networks, and assertively reaches out to people who are likely to be vulnerable to experiencing mental health difficulties.
- We are working hard to ensure the first step in contact with our service is a live conversation with a well-informed person – this will help us to understand what is most important to those coming in to our service and why they are coming to us.
- We are aware of clear evidence that certain physical health conditions are associated with higher rates of mental health presentations and the service will therefore assertively reach out to these key populations.
- We are increasing our accessibility to Brighton and Hove’s diverse population, including LGBTQ communities, BME communities, older adults, people with learning disabilities, substance misusers, those from areas of deprivation, and veterans – who may not be aware what treatment is available to them.
- The service will operate an integrated triage model so no-one will be referred on without an acceptance in place with the receiving team. This means that children and young people transition effectively into secondary care services or adult teams.
- In the new service, young people can opt to remain in their familiar service settings up until the age of 25, rather than a forced transition at age 16 or 18.
- We will offer parenting support to people with anxiety and depression and who have children. We are partnering with the University of Sussex as they are a world leader in this area of health and wellbeing. We will have piloted our first group by the end of June 2018 and hope to win funding to expand this offer.
The beginning of a fresh narrative
There’s a national narrative that our mental health services are in crisis and that mental health services are not invested in to in the same way that physical health services are. Our perspective is that there are still real challenges to ensuring parity between mental health and physical health. There are historic challenges in the way health services have been designed where mental health is seen as a separate entity to physical health. In the Wellbeing service we are committed to working in an integrated way to embed our services in physical health pathways so the two are not separate. For example, many of our clinicians are based in GP surgeries. However, we recognise that we have a long way to travel and are excited about this journey.
I was lucky enough to work in New Zealand and have first-hand experience of how early intervention and co-produced services can dramatically change the outcome of people’s experiences of mental health difficulties. In the UK there are centres of excellence in Birmingham and Norfolk, both of whom we have connected with and can learn from as we progress in the next stages of our journey as a service.
Expanding the service to include children and young persons will be a challenge and with that, comes an opportunity to learn. There is a paucity of data relating to children’s mental health and the evidence base in relation to interventions is much smaller. However, we are keen to contribute both nationally and locally to this picture and learn from what we discover to design our services around the young people and their families that we work with.
Find out more about our Wellbeing Service here.
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