Mental Health Carers Support Service Training

1. Mental Health Carers Support Service Training

2. Learning Outcomes • Who is a mental health carer/supporter? • Aims of service • Pathway of service • Why is supporting mental health carers important? • What is the inclusion criteria? • How to identify appropriate carers? • What are the sensitivities? • Why do some carers remain “unidentified”? • Why supporting the health of the carer is so important? • Role of Pharmacist and provision of the service • Role of the Community Link Worker • What is a Carers’ Assessment • Steps in the service and forms to complete • Reference Sources and contacts

3. What is a Carer or Supporter? • A carer or supporter is a person who gives up his or her own time, usually without payment, possibly without recognition or thanks, to help or support another person who finds it difficult to manage without help.

4. Context • TYC(2011); recognises need for more practical support for carers • HSCB/PHA Commissioning Plan; Support for carers is a cornerstone of this and underpins TYC • NI Census 2001; NI higher mental health needs than rest UK- 24% women, 17% men have a mental health problem • Number of unpaid carers in NI=214000, SE =44500 • The economic cost of carers’ health, if it breaks down, could be vast- Carers save the local economy £4.4 billion pa

5. Context cont’d • DHSSPS Caring For Carers; Recognising, Valuing and Supporting the Caring Role (2006); • Identifying carers at the earliest possible time is important in ensuring that they get the right information at the right time • Many people carrying out a caring role do not identify themselves as “Carers” and may not be aware of the support services available to them and therefore are not likely to ask for support.

6. Context cont’d • One in seven carers took ten years to realise they were a carer, with nearly half (48%) taking two years or more to realise • The stigma associated with Mental Health- many carers will remain “unidentified” and will not get support available to them

7. Context cont’d • Carers UK In Poor Health- the Impact of Caring on Health (2004); • Carers who provide high levels of care for relatives and friends, unpaid, are more than twice as likely to suffer from poor health compared to people without caring responsibilities

8. Context cont’d • Health Survey NI 2012/13-16% of all carers in NI say their health is “not good” over last 12 months • In Northern Ireland, one in ten (9%) of all carers suffers from ill-health. • For those providing substantial care, nearly one in five (18%) feel they are in poor health • 2 million people in UK become carers every year-a new sector of the population will face the health risks associated with caring

9. Why link with pharmacy? • Pharmacy was seen as a good partner in this pilot- 9% people visit a community pharmacy on a daily basis- pharmacists can help identify “hidden” carers in local communities and can play a part in signposting carers to additional services • Pharmacists are in a good position to support the health and well being of carers

10. Making it Better through Pharmacy in the Community (2014) describes Community pharmacists valuable role in contributing to health improvement goals through the provision of advice, information and services to people and carers which encourages improved self management and aids people in making healthier choices

11. Pharmacies seen as the “open door” of the HSC, providing a welcoming and supportive environment with high levels of public satisfaction • Community pharmacies are often the first point of contact with the HSC and studies have shown that people interact with community pharmacists on average 12 to 15 times each year, often using the same pharmacy each time. • They may, on the other hand, only see their family doctor 3 or 4 times a year.

12. The Down area was selected; • low levels of uptake of carers’ assessments within mental health • lack of accessible community resources to provide respite opportunities for carers

13. Overall objectives of pilot: • To identify carers for people with mental health difficulties who are not already known to services • To address the carer’s own health needs • To link them in with existing supports • To facilitate access to a carer’s needs assessment for those caring for people with mental health difficulties.

14. On completion of the carer’s assessments, to allow access to a personalised budget for individualised short breaks and/or respite for existing carers and those newly identified through enhanced funding from HSCB, where appropriate.

15. Time to share your personal experience of working with carers • Have you had any experience of working with carers? Would anyone like to share their experience?

16. What are the aims of the service? Phase 1- • To identify and support those carers who are not currently in touch with services or “unidentified” carers and also to support carers already known to statutory services Phase 2 - • To support the health of carers by allowing them to think about their own health needs and to support them to sustain their caring role

17. Flowchart of process Phase 1

18. What is the criteria to be involved in the service? • The carer needs to be a “carer” of a person with mental health difficulties • The carer must have given consent to be part of the service • The carer may, or may not, be a relative • The carer may, or may not, live with the person

19. Why do some Carers remain “unidentified”? • they do not view themselves a carer • the person they care for does not want them to be viewed as a carer • they are not aware that there are services they could avail of • the stigma of the illness the person they care for suffers from e.g. mental illness • they do not want to breach the confidentiality of the person they care for • concern benefits/finances would be affected

20. What are the sensitivities of the service? • Confidentiality • Anonymity • Suspicion • Judgment • Stigma

21. Why is supporting the health of the carer so important? • To keep well to continue caring • Impact of caring on their health and wellbeing • Carers are much more likely to suffer stress • Twice as likely to suffer from poor health • Time to think about their own health and wellbeing

22. Why is this service required? A Personal Story

23. Provision of the service • Pharmacies must have a suitable area where sensitive conversations can be carried out in confidence away from other members of the public or staff; this would normally be a consultation room • The service must be carried out face to face with the carer in the pharmacy

24. continued • The nominated pharmacist must attend the relevant training • The pharmacist must provide a full explanation of the service to the carer including an explanation of the role of the Community Link Worker and the nature of the Carer’s assessment

25. continued • The pharmacy must have a SOP in place to cover delivery of the Carers’ support service. • The pharmacy must have a signed contract in place before service delivery can commence. • The pilot service will operate from June 2014 to 31st March 2015

26. How will a carer be identified? • Pharmacists should display leaflets and posters to advertise the service within the pharmacy (one of the requirements of the service). • Other healthcare professionals, voluntary and community groups (and so on) may refer carers through to the pharmacy to access the service.

27. continued • Pharmacists and team members will want to make carers aware of the service. Remember however, pharmacists must not use patient medication records to identify carers. • Pharmacists may want to make other relevant organisations or groups or healthcare professionals in their community aware of the service. • Through press releases

28. What are the steps in the service? • Go through Checklist Forms; • 1. Consent Form • 2. Individual Carer Record Form • 3. Referral Form • 4. Monthly Monitoring Form • 5. Claim Form

29. What is the role of the Community Link Worker (CLW)? • to liaise between all partner agencies and the  community pharmacies spread throughout the Down area of the Trust • to disseminate up to date information on services and signpost carers to existing statutory, voluntary and community services and assist in completing carers’ assessments • to link identified carers in need of services to the existing pathways for support and advocacy. 

30. Role of CLW cont’d • to identify available supports outside the mental health context that are appropriate to the needs of the carer. • To facilitate access to respite/short breaks

31. What a Carers’ Assessment is not: • It is not an assessment of the carer’s ability to care • It is not an assessment of the carer’s mental health • It is not an assessment of financial status • It does not impact on social security benefits

32. What is a Carers’ Assessment? • Is a statutory right for all carers • Confidential private conversation • An engagement opportunity to look at impact of caring role on carer • A chance for carer to identify their own needs • An opportunity for carer to access support

33. What are the services community pharmacist can refer to? • The Community Link Worker • MindWise • CAUSE • Other voluntary/community groups • Carer Development Officer South Eastern Trust

34. Reference Sources for additional reading • DHSSPS Caring for Carers: Recognising, Valuing and Supporting the Caring Role (2006) • Valuing Carers - A Strategy for Carers in Northern Ireland – DHSSPS (2002) • Carers UK- In Poor Health- the Impact of Caring on Health (2004)

35. Choice and Medication Website • http://www.choiceandmedication.org/hscni/ • ‘Probably the biggest, best and most comprehensive independent free website for patients, carers and professionals about mental health medication

36. Choice and Medication website • Information on • Mental health medication - 20 questions • Mental health conditions – 10 questions • Unique comparison charts of main medications • Printable information • PILLs • QuILLs • BILLs

38. Useful contacts Joan Scott Carers Development Officer Ballynahinch Community Services, 45-47 Main St, Ballynahinch, BT24 8DN Tel: 028 97 565 456 MindWise Downpatrick Resource Centre 12a English Street Downpatrick, BT30 6AB Tel: 028 44 617 964 www.mindwisenv.org CAUSE Unit 2, Lesley Office Park, 393 Holywood Road, Belfast, BT4 2LS Tel: 028 90 650 650 www.cause.org.uk info@cause.org.uk

39. Community Link Worker : Kathleen Weir 02844 611789 Kathleen.Weir@setrust.hscni.net

40. Any Questions?