Mental Health Crisis Care: The Path to Engagement and Coproduction

1. Mental Health Crisis Care: The Path to Engagement and Coproduction @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare #HIOWcrisiscare Funded by NHS England and the Big Lottery Fund

2. Welcome Chris Balfe @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

3. National programme aims • ‘…build trust and mutual understanding around ways of working between health, social care and voluntary and community sector partners in 8 areas of the country.’ • ‘Support senior cross-sector staff and local carers and residents to develop and exercise shared local leadership to wellbeing and self-care.’ @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

4. Chris Balfe, Independent Chair, HIOW Mental Health Alliance Katy Bartolomeo, CCG lead for Mental Health/Crisis Care STP-wide (Southampton CCG) Sue Forber, Solent Mind Jo Jones Mental Health STP Team Administrator Hilary Kelly, STP Programme Director, Mental Health Lesley Stevens, Clinical Director Mental Health Programme, HIOW STP Local programme Core group members: @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

5. Discuss what supports people to look after themselves and their communities – supported self care • Find out (from patients, professionals & the public) what’s happening and what’s working across Hampshire and the Isle of Wight • Talk about how this programme can help build on that. • Build consensus around the things to focus on and where we want to get to - action • Explore how we will share ideas, and what we have to support us. The plan for the day….. @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

6. Ideas from today interrogated and shaped into action plans • Up to three further sessions to: • develop the action plans • learn more about what works in other places • report back on how it’s going • agree how to share the learning and keep momentum to build a better system • Assess how it’s working. • Communications support • Get involved! The design of the local programme is up to you And what will happen next? @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

7. Here in Hampshire and Isle of Wight we want to… • Bring together and learn from people with lived experience • Develop a collective and collaborative approach to problem-solving in health and care • Develop a co-produced, STP-wide MH crisis service map • Identify and benchmark against national standards • Review and explore digital solutions to support people in crisis • Share learning across the STP footprint and beyond • Build on what is already going on. Some of what we’ve heard so far… @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

8. Why are we here? • To bring together many different perspectives on mental health in Hampshire and the Isle of Wight, explore existing priorities, and shape how things could be done differently. • To consider how we can better engage people who use services, their families, friends, carers and the public in mental health care in the future • To begin to plan action: co-design some tangible ‘projects’ and work on shifting attitudes towards mental health and mental health care.

9. What’s happening in mental health in HIOW Lesley Stevens, Clinical Director Mental Health Programme, HIOW STP @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

10. Mental Health Programme of the Hampshire and Isle of Wight STP

11. Mental Health Crisis Care

12. Mental Health Beds in Hampshire and Isle of Wight Acute 25 PICU 10 Rehab 0 Organic 18 Functional 18 Acute 25 PICU 0 Rehab 0 Organic 0 Functional 15 Acute 42 PICU 10 Rehab 18 Organic 18 Functional 18 Acute 32 PICU 0 Rehab 16 Organic 0 Functional 0 Acute 0 PICU 0 Rehab 0 Organic 16 Functional 17 Acute 20 PICU 10 Rehab 14 Organic 14 Functional 8 Acute 18 PICU 8 Rehab 11 Organic 7 Functional 12

13. Mental Health Rehabilitation

14. Engaging citizens What’s most important about planning health and social care? @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

15. Laura Waterton The Touch Network @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

16. Mental Health Crisis Care: The Path to Engagement and CoproductionKevin GardnerCEO, Solent Mind 19 September 2017 @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

18. “This is our chance to get it right, and start building the services that will carry us into the future”.

19. The Ask: Swift, human, CompassionateTailored to individual needsChoice and controlNot just in crisis – pre- and post-Focus on preventionThe role of lived experience

20. The Barriers: Organisational boundaries Information sharing Clinical and non clinical interventionsPower

21. The Solution: Whole systems approach Awareness of mental models and other perspectives Building shared visionCommitment to learning

22. Thanks for listening!kgardner@solentmind.org.uk@SolentMind CEO

23. Emma Turnbull Senior Mental Health Nurse Practitioner, Southern Health NHS Foundation Trust @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

24. Emma TurnbullCommunity Psychiatric Nurse Fareham and Gosport CMHT Working with Families Carers Partners

25. What is happening ! Improved understanding of mental health amongst officers and partners Improved relationships between police, local services, patient and their carers. Fostering trusting relationships and providing opportunities for effective information sharing. Individuals getting support from police and health services (Intervention & prevention) Therefore avoiding crisis situations. Comprehensive and joined-up support for individuals with mental health problems. Professionals working together to make sure that people who have mental health problems get support and help at a time needed to get the right services when they need them and directed to right team. Police are able locally to contact the right person, expert advice via I.e. Emma Turnbull CPN . Discussions with GP services – completing care plans for the surgeries on how best to manage patients and there care. (Avoiding unnecessary home visits and calls) Reduction in admissions , 136, Ambulance deployments, police deployments Pulling resources together Preventing mental health problems and suicide Promoting mental health and wellbeing Improving the lives of people experiencing and recovering from mental health problems The Prevention Concordat for Better Mental Health

26. Those that we support and help (Prevention)(Crisis ) CMHT Probation Housing Ambulance GP MAPPA Troubled Families Social Care Team Substance Misuse Service Patient & Carer Neighbourhood Teams Police MHLT ED 3rd Sector Response and Patrol 136 Inpatient Community Safety Public Protection Notices Crisis Team Training & Education

27. Feedback I have policed in Hampshire for 22 years and attended partnership forums across various districts in that time. It has always been a cause of frustration to me that many of the people discussed at Community Safety meetings suffer with mental health issues but Mental Health teams are not represented at the meetings. Since coming to Gosport in October 2014 I have been impressed by the relationship that you have with my team. It is such a valuable link , particularly as police priorities move towards prevention and protection of vulnerable people. Appropriate sharing of information has enabled us to safeguard more effectively, add care plans to police systems so that call takers are aware of vulnerability and how to deal with specific individuals , to embark upon joint projects such as Op Tapestry – Gosport's response to Methadone use and supply . I have previously worked within adult safeguarding and attended many vulnerable adult safeguarding conferences. Very often these are not able to respond dynamically enough to the change in a persons mental health. Through regular dialog with my team you are able to ensure 'on street safeguarding' by utilising PCSO's and Pc's to conduct visits if required and to inform you of changes in health before it becomes critical. Additionally you are able to give us a reality check - very often we will submit CA12's stating 'mental health' vulnerability. You are the expert in this matter and have explained in some cases why the issue is not in fact someone's mental health but identified other underlying causes.

28. Feedback Firstly may I say how great it is to have you engaged and round the table at partnership meetings. Apart from the benefits of information sharing and the knowledge you bring about individual cases I think it is invaluable for the trust that some one is presenting the facts from a NHS Trust point of view. It is often too easy for agencies to blame the partner not present and over years the health service has had some criticism for not engaging with partners to reduce demand through early intervention. You are able to explain the limitations of treatment options and suggest alternative ways forward of joint working. I think there is a massive reputational benefit for the Trust in having you at partnership meetings for that reason. The temptation as demand increases is to work in Silos, label problems as someone else's and move on. To see you in police stations seeking out solutions with neighbourhood teams to benefit individuals, increase understanding and reduce demand is excellent. We should all be aspiring to this way of working as budgets reduce further. I strongly advocate the formation of a more permanent partnership role that could assist with crisis management as well as longer term demand reduction for all services. It's always hard to quantify the value of prevention but I suggest that for an area like Gosport where there are a lot of people who access police, council and mental health service a strong business case could be established for such a role. Thank you for your ongoing work and support in Fareham and Gosport, Jim. Jim Pegler | Chief Inspector | Fareham and Gosport District | Hampshire Constabulary

29. Patient Feedback Family ‘I feel more reassured that Emma has a excellent relationship with officers and the local council’ ‘her advice to them has been clear and precise’ We have seen officers visit our mother and the difference in how they manage her / the situation helps a great deal for all of us’ Above – officers had time talking with Emma CPN about Mental illness and difficulties patients and officers face.

30. Feedback ‘Assistance with joint meeting to an address, after weeks of trying to get the male to engage with relevant services, with no joy. Joint visit with Emma Turnbull, who in turn left contact details leading to a discussion (assessment) between male & Emma and male being assessed and dealt with and no follow up calls to police! If only I'd arrange earlier...’ Gemma Broster | PCSO 14223 | Gosport Neighbourhood Policing - Brockhurst (Male had been referred to team by GP along side police concerns. Intervention and therefore some prevention work at assessment avoided the deteriorating further and avoiding i.e. 136 MHA as police believed he may have been psychotic and at risk)

31. Building a picture of … • What helps us look after our mental health? • What helps us recover and stay well? • What gets in the way? ? @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

32. We’re not starting from scratch: The 12 pillars @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

33. From your own experience, and from what you have heard today, what could we do different that would better support people in Hampshire and Isle of Wight area living with mental health issues? Pair up with someone you don’t know well Discuss then write any ideas on the oval post-its (one idea on each post-it, big pens only!) Stick them on the flipcharts! Don’t worry too much about which one…. Over to you.. @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

34. Break! @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

35. 1. Explore the ideas put forward • 2. Discuss what makes most sense? What could we try? • 3. Which ideas or projects do you want to take forward? • 4. Take ideas and develop a plan! • What does GOOD look like? • What do we need to do to get there? What can we do together across HIOW? @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

36. What does good look like and how do we get there?  @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

37. 1. In one sentence: what are you hoping to achieve? • 2. One step towards getting there. Brief Feedback @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

38. What can we do to make this happen? • What can I do? • What can we do together? twitter.com/SocialEnt_UK @SocialEnt_UK @IVAR_UK #BHPselfcare

39. How will you cascade the messages from today? Who does what? Next meeting? Join the core group? What next? @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

40. Thank you. @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare Funded by NHS England and the Big Lottery Fund