SSNMH Report On “Safe Space” In East Staffordshire August 2015
REPORT ON THE NEED FOR SAFE SPACE IN EAST STAFFORDSHIRE AUGUST 2015
Lead Author: Trudy Jones, Involvement Champion Contributions from Amy Hylton, Office Support, Keri Lawrence, Operations Manager
Supporting Partner Organisations Safe Space Steering Group Burton & District Mind Changes Health and Wellbeing Staffordshire County Council South Staffordshire and Shropshire Healthcare NHS Foundation Trust Members of the East Staffordshire Clinical Commissioning Group’s Patient Board Trent & Dove Housing
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SSNMH Report On “Safe Space” In East Staffordshire August 2015 Foreword I would just like to take this opportunity to say a big thank you to everyone who has supported me, through either filling in the survey or by supporting me with promoting the survey – Trudy Jones, Involvement Champion
Introduction The South Staffordshire Network for Mental Health (SSNMH) is a charitable organisation commissioned by Staffordshire County Council in promoting the participation of people with experience within mental health services they may use within the six districts of South Staffordshire, including East Staffordshire Borough. This service is called ‘Your Voice”.
This report refers to a ‘Safe Space’ – by which we mean a ‘short term non-clinical intervention service’ that can be accessed by people with experience of mental illness for a small number of days and nights to have respite and support to help prevent mental health crisis.
Within the six districts of South Staffordshire, there exists one such service, Brendan House, which is provided by South Staffordshire Housing Association and Richmond Fellowship, and is commissioned by Staffordshire County Council, on behalf of local Clinical Commissioning Groups. Brendan House has three bedrooms, is staffed overnight and during the day by non-clinical staff, and is located in Chadsmoor, Cannock.
The Safe Space Steering Group are a team of people with experience of mental illness who over the few years, wish to explore the possibility of a Safe Space short term stay service within East Staffordshire (including Burton on Trent).
Background Brendan House has been underused by people living in East Staffordshire with experience of mental illness since its opening in 2011. Anecdotal evidence has highlighted that people believe it is too difficult to travel there. This belief is shared by the East Staffordshire Community Mental Health Team, and referral rates have been low (typically around 50% of all referrals come from CMHTs).
Additionally, the Margaret Stanhope Centre, a 22-bed inpatient mental health ward, based at Queen’s Hospital, Burton on Trent, closed in 2012. Although closely monitored 6 months in advance of the closures of the beds and 12 months after, many local people felt that having a mental health provision away from the home, but local within East Staffordshire was a loss1.
In 2014, the Safe Space Steering Group was formed and conducted a survey and report on local mental health services. The preliminary results of which are shown in Appendix A.
1Burton Mail (27 September 2014) “More needed to boost mental health provision in Burton”
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SSNMH Report On “Safe Space” In East Staffordshire August 2015 In 2014, Trudy Jones, Involvement Champion, SSNMH, offered to assist in scoping the potential need, hence this report.
Methodology Three activities took place.
Survey South Staffordshire Network for Mental Health conducted the survey to collaborate results with the previous Safe Space report for additional need for a Safe Space in East Staffordshire. We consulted with service users from various organisations to get the opinion of people regarding a Safe Space in East Staffordshire. The survey was led by Trudy Jones, Involvement Champion, SSNMH.
A number of organisations contributed with distribution of the survey and promoting amongst people accessing their services; they included Making Space Work4You, Changes: Health and Wellbeing, Burton and District Mind, and East Staffordshire Community Mental Health Team.
The intended outcome of this survey is to see if people from East Staffordshire would benefit from a Safe Space Short Term Crisis Intervention in East Staffordshire.
Emotional Wellbeing Event Friday 3rd July 2015 Members of the SSNMH team also attended an Emotional Wellbeing Event in Burton on Trent on 3 July 2015, arranged by members of the East Staffordshire Clinical Commissioning Group and collated comments from attendees regarding a Safe Space. We provided a presentation entitled “Recovery Vs Discharge”, followed by table top discussion. We also asked for peoples’ comments regarding a Safe Space and collected these comments. There were around 70 attendees, including local service providers, service users and carers.
Refection on past comments and findings We also reviewed previous comments made by our members during and following the closure of the mental health inpatient beds at the Margaret Stanhope Centre in September 2012, and during our campaign for a Safe Space prior to the opening of Brendan House.
This includes a review of SSNMH ‘Comments Log’, comments made from Margaret Stanhope Inpatient Ward Meetings, and work before and after the Consultation on Inpatient Beds over 2011, and a review of documents leading up to the commissioning of Brendan House.
We also considered figures and statistics reported by Richmond Fellowship Brendan House since 2011 to June 2015.
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SSNMH Report On “Safe Space” In East Staffordshire August 2015 Results Results of survey
Outcomes Out of the people who completed the survey, 68% were women and 32% were men. This is roughly in line with our membership.
Please note that where we have quoted comments made, we have lighted edited for clarification.
Have you ever used Brendan House?
Most of the respondents have not used Brendan House.
If so how many times have you used Brendan House?
Of those that had accessed Brendan House, using it once was the most common response.
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SSNMH Report On “Safe Space” In East Staffordshire August 2015 Did you find Brendan House easy to access?
There is no way I could get there Couldn't travel Taxi easy Wouldn't be able to get there Too far away from Burton Difficult Partner took me Hard taxi cost £24 Taxi!! Not really, a GP referral which cost me
Comments made suggest that many people would require a taxi to travel to Brendan House, otherwise it would be inaccessible.
Would you find a Safe Space in Burton easier to access? If so why?
Transport is easier and family & friends would be able to visit. Less traumatic distance of travel. Transport local links. Local.
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SSNMH Report On “Safe Space” In East Staffordshire August 2015 Comments would suggest people would prefer a service closer to home.
How would you find a safe space beneficial?
Needed somewhere to go when I really needed it yes. Mental health issues. Travel. To help me recover. Time out to get well again. Somewhere to find help and support. Somewhere where I can talk and where someone will listen to me. Some where to stay and escape from my illness. Yes. Feel very unsafe when ill always felt safer in Burton. Stops me being homeless, affecting family etc. Would stop me going into hospital. It would stop me going into hospital. It would be easier to get to. Keep person local can easy access CMHT. Easier to travel. At times of crisis I would feel safe. I would help my family not to worry about me. It would keep me safe. It would stop me getting so ill. Well, it would give from all the nagging and shoving at grans and the threat of violence. Gives my carer a break from me.
How long did you wait to access Brendan House?
Straight away. A week. Over a week. Too long, I was feeling better before I got in. 3 days. 8 days. Week.
When you were referred to Brendan House were you using any other mental health services? e.g. Changes, CMHT, GP
No. Changes, GP. Mental Health Services. Changes. CPN.
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SSNMH Report On “Safe Space” In East Staffordshire August 2015 CMHT. No, waiting For CPN. GP, Psych.
Do you have any other comments regarding a Safe Space in the Burton area (East Staffs)?
A Safe Space in Burton is absolutely vital since the closure of Margret Stanhope centre. Somewhere if picked up by the police you can go to be assessed and either be supported in the community by CMHT or if necessary be admitted to a hospital. When distressed do not want a long journey. Would be really useful to have a place in Burton to be able to go somewhere away from my family when things get too much. Haven't got any transport or family in the area can't leave Burton. Access. It would feel safer knowing close relations were not far away. Need one in Burton for people who can't get to Cannock also help people deterring or taking their own lives. I think we need one in Burton urgently. One is needed. I think it would be a life saver! And help my relatives there has to be something in Burton on Trent. We really need help in Burton. It seems essential to have one locally, not so far away. Would help in time of crisis and less need for other services. We need a safe space as there is no mental health inpatient support in Burton, I feel more unwell thinking there’s no safety net here!! I didn't want to go into hospital but I didn't want to upset my children, seeing me like that. It is needed as there is no local facility and would give earlier access to CMHT. Would stop me going to hospital. Get one ASAP. My mum organised this as I was to unwell, my GP charged £17 for the referral letter. We need this. We really need this. I find I need a break from Bessy like some times.
Main Points from Survey Through conducting the survey, the main points raised were:
o Travel The main points raised were service users found Brendan House very hard to get to due to a lack of direct transport. There was a dependency on taxis, which are considered expensive.
o Family The main points raised were that families of people accessing services would find it easier to get to and could be more involved.
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SSNMH Report On “Safe Space” In East Staffordshire August 2015 o Other Mental Health Services Service users felt that a Safe Space would stop them from needing services like inpatient care, Community Mental Health Teams, and Crisis Resolution and Home Treatment Teams. They said it would also be better for their family to be more involved in their recovery.
o Other Comments It would make them feel safer knowing that there was somewhere to go if they were ill. They also would find it easier to access. This would help take the strain of them and their family and other mental health services. Another comment was that GPs are unaware that service users can use this service, and they can refer them for free, and how this will benefit service users.
Comments from the Emotional Wellbeing Event Friday 3rd July 2015 We collated feedback from the event and had discussions with local organisations, service users, and members of the public. This included Changes: Health and Wellbeing, Burton Emotional Wellbeing, Community Mental Health Team Crisis Resolution Home Treatment Team, Making Space, Trent and Dove Housing.
Comments were collected and clustered into topics as below (please note that where we have quoted comments made, we have lighted edited for clarification):
Margaret Stanhope o A Brendan House type service for Burton would help prevent hospital care or may help recovery at home easier. With no Safe Space when I was ill for 3 weeks in December 2012 my parents looked after me. My need for hospital admission would NOT appear in official statistics. o Could we not have a house Like Brendan House within Burton? Need respite houses. Forget the Margret Stanhope, but we do need a Safe Space facility in Burton. We need something more local.
Safe Space o With no Safe Space when I was ill for 3 weeks in December 2012 my parents looked after me. My need for hospital admission would NOT appear I official statistics. o Could we not have a house like Brendan House within Burton? A Brendan House type service for Burton would help prevent hospital care or may be recovery at home easier. Need respite houses.
Waiting lists / Times o It took a year to be seen. Now it's brilliant I am very happy with my CPN. o There is a waiting list for people to be treated because there is not enough facilities. Timely short waiting lists. o I have been in hospital and now getting good support through Horninglow Clinic but the police and Crisis team took 3 months to actually section me. I was living alone and by this time everything had spiralled out of control. I am very lucky I am still alive but even more importantly I never harmed anybody else. Something I could have live with.
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SSNMH Report On “Safe Space” In East Staffordshire August 2015 Crisis o Needs-led Support before crisis please. o Unless in my experience I wish to self-harm or commit suicide there is no support given. Have had discharge and pills only. Why are people in crisis taken to Tamworth we need something more local. We have great worry with me commuting in Burton but the problem is for acutely ill who may need to be sectioned. In home time is 30mins a visit a day where medication is not supervised, I didn't have the capacity to take medication. Have found that a phone call isn't enough. They don’t have to answer the phone. A lot of attacks happening due to people in psychotic states. Either mental health conditions or drug / alcohol included. Mainly due to not being helped before it goes to a more serious psychosis. Very common.
Overview of Comments Made Residents of East Staffordshire district believe they need some sort of mental health provision, whether it be inpatient care or respite care as they feel service users are inadequately supported and this would help fill the gap. A Safe Space (respite care) would help prevent people from going into hospital. If the Safe Space was more local would make recovery quicker. This would cause less stress to the service user and their family. Waiting times/ lists are too long. They feel there is not enough facilities, once they get help this usually a good standard. People want better support so they don't go into crisis, and better support when in crisis. People also want more support with medication when in a crisis. They feel that this should be supervised when they are in crisis. They feel they want more contact not just a phone call. Comments were shared with a partnership working meeting, hosted by members of the Patient Board one week after the Event.
Reflection on past comments and findings Although many of the concerns have been allayed by community provision, including Social Inclusion and Recovery Services (provided by Changes Health and Wellbeing), and by the work of Crisis Resolution and Home Treatment Teams, there has been no overnight mental health provision either by a Safe Space or inpatient care within East Staffordshire and this is clearly missed by some members of the population.
There has been a growing need for some sort of provision and comments regarding a Safe Space suggest it would help to bridge the gap left by the closure of the Margaret Stanhope Centre.
Much of the data reviewed in relation to the work prior to the provision of Brendan House is now outdated due to modernisation of mental health services, and due to changes within the way mental health services are commissioned. The overall view is that at the time there was an unanimous view from SSNMH members that a safe space (called Crisis House) was an urgent need (SSNMH, 2014, Crisis Accommodation: Submission to Mental Health Partnership Board).
Sample data from Richmond Fellowship Brendan House, as provided to their Contract Steering Groups, reports generally low uptake from the East Staffordshire Borough compared to some other local authority districts within the contract area, however, not as low as other areas. This would
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SSNMH Report On “Safe Space” In East Staffordshire August 2015 suggest that, despite concerns of travel, some people are being referred from East Staffordshire and are making use of the service.
Recent partnerships with the Crisis Resolution and Home Treatment Teams have helped meet the challenges presented.
Sample data Cannock Stafford South Lichfield Tamworth East Staffs Staffs CMHT Referrals 2011 37 17 9 10 4 5 New CMHT Referrals 9 4 0 0 0 2 Quarter 3 2012 New CMHT Referrals 29 12 0 1 1 5 Quarter 4 2013 Feb 2015 – Mar 2015 25 25 0 1 11 14 May 2015-June 2015 39 22 4 6 4 13 Total Sample Size: 309 139 80 13 18 20 39 Total Sample as Percentage 45% 26% 4% 6% 6% 13%
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SSNMH Report On “Safe Space” In East Staffordshire August 2015
Recommendations and Discussion Points Conclusion As a result of this work, it has become clear that the residents of East Staffordshire believe that a Safe Space would be of benefit because it would be more local and would be easier to access. The results from Brendan House shows that residents of East Staffordshire that have been to Brendan House have found this beneficial to their recovery. Referrals from professionals e.g. GPs, Community Mental Health Teams, Crisis Resolution and Home Treatment Teams in East Staffs has steadily grown from 2011. There was 8 referrals in 2011 to where there has been 11 referrals so far this year 2015. If this trend continues this should grow year upon year.
This shows that there is a need for an additional Safe Space. As awareness of Brendan House grows this will make an even greater need for an additional Safe Space, as professionals find they can refer free of charge and the benefits of this become more known.
Recommendations Based on the findings, SSNMH makes the following recommendations: 1) Continued work with the outcome of Safe Space Service being provided within East Staffordshire led by Involvement Champion of SSNMH. 2) Distribution of this report to: o Trent and Dove Housing o Safe Space Steering Group o East Staffordshire Community o Burton and District Mind Mental Health Team (South o Eaton Foundation Staffordshire and Shropshire o Changes Healthcare Foundation NHS Trust) o Making Space o Crisis Resolution and Home o Brighter Futures Treatment Team East (South o Rethink Mental Illness Staffordshire and Shropshire o Staffordshire County Council Healthcare Foundation NHS Trust) Mental Health Commissioning (for o Richmond Fellowship information) o Patient Board of East Staffordshire o Membership of SSNMH through Clinical Commissioning Group the Your Voice service
3) The development of a Safe Space Partnership Group, to include interested organisations, to scope possibilities for funding and provision. This would focus on opportunities outside of local commissioning arrangements. 4) More promotion of Brendan House and the benefits for service users, to GPs and Community Mental Health Teams to support further use of Brendan House. The ability to access or not access should not prevent referrals as it takes away the opportunity for people to rise to the challenge. 5) East Staffordshire Clinical Commissioning Group should make sure that GPs are not charging service users for referral / signature for Brendan House as this has been the case when people have asked their GP. This process should be FREE to all service users. 6) This report to be considered as part of the Consultation on the Mental Health Strategy Implementation Plan supported by SSNMH and Healthwatch Staffordshire, with particular reference to the Crisis Concordant. Page 11 of 14
SSNMH Report On “Safe Space” In East Staffordshire August 2015 Appendix A: Safe Space Steering Group Draft Results of Survey conducted by the Safe Space Steering Group - 22 December 2014
The main findings are as follows:
In a sample of 88 who successfully completed the survey fully:
1. 79% agreed with us that there should be a safe place in Burton.
2. There was a mixed response about whether police should be used where a person is distressed but not dangerous.
3. Over half of those surveyed felt that mental health services in the East Staffordshire area are getting worst in the past year.
4. All agreed that there should be more information about mental health services in the East Staf- fordshire area.
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SSNMH Report On “Safe Space” In East Staffordshire June 2015 Appendix B: Blank SSNMH Safe Space Survey 6th May 2015 Dear Resident of East Staffordshire RE: Safe Space Survey Who is asking for this survey?
The South Staffordshire Network for Mental Health is a charitable organisation promoting the participation of people with experience within the services they may use. The Safe Space Steering Group are a team of people with experience of mental illness who wish to explore the possibility of a safe space short term stay service within East Staffordshire (including Burton on Trent). This survey is being led by Trudy Jones, Involvement Champion, SSNMH.
We are conducting this survey to help find out whether there is evidence of need for an additional Safe Space in East Staffordshire.
As an example of an existing safe space, Richmond Fellowship's Brendan House, in Cannock, is a short term intervention service that provides an opportunity of three night’s stay where people can talk and get help with coping strategies and skills based around recovery.
The information you share through this survey will be shared with Safe Space Steering Group to help identify need and support with funding bids.
The deadline for your response is 31 July 2015 – this has been extended twice and cannot be extended again.
Please return by Friday 31 July 2015. You will not need a stamp.
You can, alternatively, complete this survey online at: https://www.surveymonkey.com/s/eaststaffssafe
As always, the information in this survey will NOT be shared in any way that identifies you. All information will be treated in accordance with the Data Protection Act 2003. We will build the data you share into a report (which anonymises information), passing to appropriate providers and funders to inform change and to influence their decision making.
I thank you for your time.
Yours sincerely
Trudy Jones Involvement Champion SSNMH
Project supported by: Safe Space Group Burton & District Mind Eaton Foundation
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South Staffordshire Network for Mental Health Safe Space Survey of East Staffordshire Mental Health 2015
About you (please tick relevant box in each section)
Age – please tick Age Group Tick Age Group Tick Age Group 15-19 45-49 70-74 20-24 50-54 75-79 25-29 55-59 80-84 30-34 60-64 85-89 35-39 65-69 90 or over 40-44
Sex (please circle) Male Female Transgender
Town you live in or near within East Staffordshire Borough Tick Burton Uttoxeter Abbots Bromley
Question Answer
1 Have you ever used Brendan Yes N House? o
2 If so how many times have you 1 2 3 4 used Brendan House?
3 How did you find travelling to Brendan House?
4 Did you find Brendan House easy to Yes No Other: access?
5 Would you find a SAFE Space in Burton Yes No Other: easier to access? If so why?
6 How would you find a safe space beneficial?
7 How long did you wait to access Brendan House? 8 When you were referred to Brendan House were you using any other mental health services? eg. Changes, CMHT, GP 9 Do you have any other comments regarding a Safe Space in the Burton area (East Staffs)?