Mental Health and Well Being Pathway The Big Life Group Gaddum Pennine Care
The Thinking Ahead Partnership The Big Life Group Admin Hub Step 2 CBT & Counsellors Gateway Team (MHP & MHSW) Gaddum – “Getting Help Offer ” Step 1 Five Partners (RWWA, RCT, Recovery Republic, Petrus, Proud Trust)
Thinking Ahead Partnership Pennine Care Step 3 CBT Psychology
Getting Help Non Therapy Offer (Step 1) • Partner with five other local organisations which are: Petrus, Rochdale Connections Trust, Rochdale Women's Welfare Association, Recovery Republic, The Proud Trust. • Range of volunteer counsellors and befrienders who work with the partner organisations and the community. • Offer: Support to individuals whose low mood /anxiety depression is primarily being caused by any of the following:- • Debt /Finances, • Loneliness/ Isolation, • Homelessness, housing or living situation, • Drugs and Alcohol, • Addiction
Getting Help • Support plans / sessions to help clients work through any of the presenting issues. • Signposting to clients to a wide variety of other services such as carers support, domestic abuse, and LGBTQ+ etc. • Opportunity to continue with low intensity counselling whilst accessing other services.
Step 2 CBT • Psychological Well Being Practioners (PWP’s) • Initial techniques Psychoeducation Assessment / Engagement techniques Basic Formulation – 5 areas / ABC model Treatment Interventions Behaviour Activation / COMBI Model Cognitive Restructuring Graded Exposure Therapy Medication Management Sleep Hygiene Problem Solving Managing Panic
Step 2 - Therapy Choices • Choice of therapy options- • Telephone • Face to Face • Group / Therapy Workshops ( Overcoming Depression& Overcoming Worry ) • Stress Taster Workshops
Step 2 - SilverCloud • Online programme • Flexible, easily accessible • Access to a PWP as a support worker • Increased level of support from the PWP as required • Low cost / Less time requirement of service • No wait times
SilverCloud - Programmes • Dedicated programmes for; – Depression – Generalised Anxiety – OCD – Social Anxiety – Health Anxiety – Phobias – Panic Recovery rates on par with other therapeutic approaches
Counselling • Counselling within Thinking Ahead 6 sessions as standard (negotiable with Line Manager) • Integrated Counselling Most counsellors tend to describe their modality as counselling skills to be able to effectively engage w to effectively reflect on past events / relationships. a variety of skills / approaches within their practice. • Counselling for Depression Core IAPT Counselling training. Trains counsellors to work within an IAPT framework.
Gateway Team • Triage • Duty Function • In-depth assessment • Risk, safeguarding, Complexity • Not therapy ready • Complex presentations • Psychosis • Medication management
Pennine care Step 3 /3.5 • High Intensity CBT Therapists (HITS) • CBT- presenting with common, mild (few core symptoms, limited duration/little impact on day to day functioning) to moderate ( all core symptoms, prolonged duration and a clear impact on functioning) mental health difficulties including • GAD • Panic Disorder • OCD • Phobias • Social Anxiety Disorder • PTSD • Health Anxiety • Unipolar Depression • Eating Difficulties generally with a recent onset eg under 12months, no prior history of an eating disorder. • Bi polar disorder with a stable presentation of no less than 2 yrs. • Medically unexplained symptoms/LTC /Chronic Fatigue
Pennine Care Step 3 /3.5 • Mindfulness – Drop In/ 8 week Course Psychology- • Presenting with repeating patterns of interpersonal problems • Present with symptoms(Significant history of trauma, abuse, neglect , significant mood problems • Clients who present with multiple difficulties occurring over a number of years, contributing to a “complex” presentation. • Those who would like to achieve an in-depth understanding • Clients who are able to engage in, commit to and be contained by weekly or by weekly appointments. • Clients who have capacity to recognise/come up with a therapy goal.
Referral Routes Self referral • Telephone • Online Portal “Thinking Ahead” • Engagement Events • Workshops Professional Referrals • Online portal • Fax • Email
Referrals • Daily MDT Triage Hub (all partners) • Holistic Assessment • Well Being Screen / Mental Health Assessment • Offer Case Consultation to determine correct therapy pathway or Step up.
Outcomes • All staff have or working towards an IAPT accredited qualification • Consistent positive performance on recovery and prevalence • In top 20 nationally in terms of prevalence performance. • Recovery plans in place where needed. Performance Apr-19 May-19 June-19 Recovery 54.7% 53.7% 50.6% Prevalence 520 532 541
Service Developments • LTC Offer – 5 PWPs have been trained to work specifically with LTC clients. – Conditions include; Heart disease, COPD, Amputee, chronic fatigue, diabetes, post prognosis cancer, pain management. – Completed placement in hospital departments • This psychological focus should save time and money for physical health settings.
Service Developments • Couples Counselling – 3 Counsellors have attended specific training provided by Tavistock (world leading trainer) – Will work with couples where one or both present with depression and is affecting the relationship. • Nearest Relate is either, Manchester centre, Hebden Bridge, Huddersfield or Blackburn • Relationship hub in Bury
Service Developments • BAME Engagement – Currently running an urdu women’s group in local mosque. – Group shortly starting in urdu for men in local mosque. – Stress tasters delivered in urdu – In talks around delivering a group in Bengali.
Service Developments • Link in with Neighbourhood teams – We will be assigning a designated worker to each of the 6 neighbourhood teams. – This will be a named practitioner who will be working closely in the neighbourhood team and who you can liaise with for any queries.
Service Developments • CCG investment in counselling – Identified that one of our high demand modalities is for counselling. – As an outcome this has our longest waiting times. – CCG has invested in our counselling provision – We have already recruited 4 additional counsellors who are starting working with us this month. – We will see an initial big drop in waiting times, then a greater throughput of counselling clients being picked up – We calculate a waiting times under 6 weeks by Q4
Summary • We have different waiting lengths for different modalities. • The longest waiting lists have strong recovery plans in place. • We are one of the top performing services in GM. • We have new therapies developing; LTC, Couples Counselling, BAME focused work. • Stronger liaison via Neighbourhood teams going forward.
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