Mental Health Forum For Cowal

“It is important that the aims of the consultation process are clear and transparent to all those involved.  The partners in any particular activity should understand the reason for their involvement, the scope of the exercise, the issues to be addressed, the decision making process and the subsequent use of outcomes. Social Inclusion Involvement initiatives should be inclusive.
This means taking account of the social and structural barriers which affect people’s ability to participate. These could include issues of physical access, for people with a physical disability, and resources may be needed to enable people who cannot afford transport or child care to take part. Information should be provided in clear and accessible language, in appropriate formats for a range of needs. Procedures should be designed to encourage involvement, and this may mean avoiding formal procedures. Events should be held in local or neutral venues”

Representative participation
“People as patients, carers, parents and citizens have a range of experiences and bring unique perspectives to the development of the mental health services. Many service providers express concern about whether participants are representative. While some participants can claim to be representative, others should be included simply because their experience is likely to be typical of that of other service users, carers or parents. Lay knowledge is a form of expertise in its own right. Concern that individuals and members of users groups are not representative is never a reason for denying involvement but may be a reason for reconsidering the purpose and process of involvement
Appropriate Methods and Support
Appropriate methods and support are key
They include:
• adequate resources and support
• the selection of appropriate methods
• time and timing
• action on the outcomes of involvement.
Adequate resources and support
service “User” involvement needs resources. Even the simplest consultation exercise involves staff and participant time and costs money and effort: time has to be allowed for in work and family schedules.
Service “Users”, their representatives or members of the public may need support to play an effective part. This might involve providing interpreters for people from ethnic minority groups, or advocates for those with learning difficulties. Where people are taking part in committees as lay representatives they need training and support. These concerns are also important to
remember when working with voluntary agencies. They may need support and funding to increase the level of public involvement. The support needs of health service staff who may be asked to develop new ways of working also have to be considered. the development of involvement as an integrated and ongoing part of the organisation means that the support, training and development of service “Users”, stakeholders and voluntary organisations should be part of the overall strategy and must be realistically resourced.
Appropriate methods
A wide range of approaches to “User” involvement exist. To be effective, initiatives which involve the “User” must be extremely clear about what their aims are. Methods must be chosen carefully to ensure their appropriateness, both to the aims and to the particular group of the public involved. Existing groups such as community health projects, local health councils or forums can be used and developed as facilitators of local involvement. But most importantly these must be user led to be effective.
Time and timing
Always try to involve the “User” as early as possible. Involving people in agenda setting increases transparency. Remember, when organising meetings and deadlines, that “Users” and voluntary organisations have lives and structures of their own. As representatives of other organisations, the participants may have to report back to committee structures, which may then have to refer to their membership before responding to the consultation. While
consultation may be slow, the breadth and quality of the consultation makes it worthwhile. Not allowing enough time for consultation can lead to poor feedback and complaints about inappropriate services. “User” organisations need to know the timescales of trust planning cycles to allow them to participate effectively.
The time of meetings can also be important. It should not be assumed that everyone can attend meetings during working hours, and school holidays are often times when involvement of the service “user” becomes difficult.

Outcome

It is important to be clear about what the outcomes of the involvement will be. The results of the activity should be fed back to participants along with a description of action which has resulted from the work. Reinforcing participation through publicising developments in practice is very important. Conversely, failure to report back can create cynicism about the process. Even if no action is, or can, be taken, people should be kept informed. Service “User” Forums are also a major resource of patient and public involvement know-how - what works best, where and why. This is built upon their extensive local knowledge and networks with other community and patient groups”

Key Core Service Elements and Planning Assumptions:

The following is a list of the planning assumptions and key service elements.  It lists the things that are seen as key issues that are absolute essentials to be addressed within any new service that is developed.

These have been developed from the various workshop discussions and the other aspects of Phase 1 of the redesign process plus the key national policies related to Mental Health including “With Inclusion in Mind” and “Delivering for Mental Health”.

1. Services are to be as local to people’s communities as is safe & achievable
2. A plan to move towards a 7 day a week community mental health service
3. Related to the above some form of crisis response, ideally including home based treatment to both prevent admission and facilitate discharge
4. Development of services at the different tiers of Mental Health need, such as promoting health & wellbeing, mild/moderate conditions (primary care) as well as for more severe (community mental health team)
5. Development of psychological therapies service (including both the “talking therapies” and creative therapies)
6. All services, but specifically day support, to be focused on promoting independence and promoting integration
7. A move away from mental health services being segregated from each other and other generic services. A need to have a service that ensures services are closely linked to promote joined up working, consistent service model and efficient use of resources
8. need to recognise and nurture the value of the generic services in our communities by having stronger links with them
9. A need to consider the potential increased usage of the voluntary sector in general and specifically in relation to befriending and buddying schemes
10. adequate support for both formal and informal carers
11.  Continuing development of service user involvement in service planning, service evaluation and delivery including discussion as to the potential role of peer support
12. Community Mental Health Teams to be integrated with local authority and with a broad range of multi disciplinary membership and exploration of the potential role of peer support models
13. A single point of access to the mental health services of both statutory organisations
14. Recovery focus to be the basis of all services
15. Access to specialist in-patient care when required
16. A system and resources for staff training in both statutory training and clinical development
17. Services for the Helensburgh and Lochside area must follow the same service model principles and philosophy. However it is acknowledged that actual service delivery and pathways for in-patient care will be different from the other localities of Argyll & Bute. This is due to the current service level agreement with NHS Glasgow & Clyde and the more urban nature of that community

·  Options do not include services specifically for:

o   Addictions

o   Learning Disability

o   Dementia care (both continuing care and assessment)

continue to access out of area highly specialised in-patient services within the following groups:

o   High and Medium Secure care (Carstairs and Rowanbank)

o   Child and Adolescent Mental Health (Gartnavel and Yorkhill Hospitals)

o   Perinatal care (Glasgow)