Mental Health (Wales) Measure 2010 Part 1: Local Primary Mental Health Support Services

1. Mental Health (Wales) Measure 2010 Part 1: Local Primary Mental Health Support Services

2. Mental Health (Wales) Measure: Intended effect • Expand provision of local primary mental health support services (Part 1) • Ensure all service users in secondary care have a care coordinator and a care plan (Part 2) • Provide a mechanism for re-access for previous service users (Part 3) • Expand independent advocacy to all inpatients and all hospital and community sections of Mental Health Act 1983 (Part 4)

3. Part 1 - Local Primary Mental Health Support Services: Aims • To increase the availability and uptake of mental health services in primary care settings. • To improve access to mental health services for people of all ages – promote recovery and resilience. • To improve the primary/secondary care interface. • Close working relationships with primary care. Provide advice and support. • TO SUPPORT NOT SUPPLANT EXISTING SERVICES

4. Part 1 - Local Primary Mental Health Support Services: Functions • Provision of information, advice and other assistance to primary care providers, i.e., liaison. • Provision of information and advice for patients and their carers. • Primary mental health assessments. • Provision of local primary mental health treatment. • Making of referrals.

5. “Placing the preventative primary and community agenda at the centre of service redesign in Wales” (Setting the Direction, Welsh Government, 2010) “The time has come to make a decisive shift from just managing sickness to creating a healthy Wales.” (Together for Health, Welsh Government, 2011)

6. Part 1 - Local Primary Mental Health Support Services: Delivery • Services expected to mainly operate within or alongside existing GP practices • Operates within tiered models of care • Integration with existing MH services in primary care – possible re-modelling

7. Primary Care Counselling Service 14.8 wte Band 6 • GP Surgeries in: • Grangetown • Butetown • South West Cardiff • South East Cardiff • North West Cardiff • North East Cardiff • Eastern Vale • Parts of Western Vale CAMHS Primary Care Service 2 x Band 7 2 x Band 6 Managed by Cwm Taf LHB Gateway Worker Service 1 x Band 7 3.8 WTE x Band 6 Current primary care mental health provision in Cardiff & Vale • GP Surgeries in: • West Cardiff • Parts of Eastern Vale, i.e., Court Road Surgery, Ravenscourt Surgery, The Practice of Health, and Waterfront Medical Centre

8. Primary Mental Health Support Servicefor Cardiff & Vale Cardiff North, West & South West Locality Cardiff South, East & City Locality Vale of Glamorgan Locality

9. VALE OF GLAMORGAN LOCALITY TEAM incorporating: Amy Evans CMHT Hafan Dawel CMHT (includes Western Vale surgeries previously in ABMU HB) Counselling CAMHS Primary Care Service CARDIFF SOUTH, EAST & CITY LOCALITY TEAM incorporating: Pentwyn CMHT Links CMHT Hamadryad CMHT Counselling CAMHS Primary Care Service CARDIFF NORTH, WEST & SOUTH WEST LOCALITY TEAM incorporating: Pentwyn CMHT Links CMHT Hamadryad CMHT Pendine CMHT Gabalfa CMHT Counselling CAMHS Primary Care Service Third Sector Services Voluntary Sector Services Service User-led Organisations MENTAL HEALTH MEASURE – PART 1 Introduce Primary Mental Health Support Service (PMHSS), Counselling & CAMHS Primary Care Service to each locality

10. Referral Pathway under Part 3 of the Measure only  Foundation Level • Psycho-education and Information • Bibliotherapy • cCBT • Mental Health • Promotion • Self Help Groups • Third Sector Services • Benefits Advice • Housing Advice • Carers Groups • Development of Information Hub Tier One PRIMARY MENTAL HEALTH SUPPORT SERVICE CARDIFF & VALE UHB INTEGRATED COMMUNITY MENTAL HEALTH SERVICE LOW INTENSITY INTERVENTIONS Tier Two Secondary Mental Health Services L I A I S O N L I A I S O N MEDIUM INTENSITY INTERVENTIONS OPEN ACCESS CLIENT L I A I S O N ASSESSMENT ASSESSMENT HIGH INTENSITY INTERVENTIONS GP R e f e r r a l P a t h w a y   D i s c h a r g e P a t h w a y

11. Foundation Level • Psycho-education and Information • Bibliotherapy • cCBT • Mental Health Promotion • Self Help Groups • Third Sector Services • Benefits Advice • Housing Advice • Carers Groups • Further development and enhancement of Information Hub L I A I S O N CLIENT O P E N A C C E S S S C R E E N I N G

12. Tier Two Referral Pathway under Part 3 of the Measure only  Secondary Mental Health Services L I A I S O N ASSESSMENT CLIENT GP R e f e r r a l P a t h w a y   D i s c h a r g e P a t h w a y

13. Tier One Foundation Level (and other statutory direct referral agencies) PRIMARY MENTAL HEALTH SUPPORT SERVICE AND THE PRIMARY CARE COUNSELLING SERVICE ASSESSMENT S I G N – P O S T I N G I N T E R V E N T I O N S LOW INTENSITY • Psychoeducation • cCBT • Stress Control Course • Relaxation training • Anger Management • Mindfulness Group • 1:1input, incl. Counselling SIGN – POSTING L I A I S O N Secondary Mental Health Services ASSESSMENT S C R E E N I N G CLIENT MEDIUM INTENSITY • Groups, e.g., CBT, IPT, etc. • 1:1 input, incl. Counselling GP HIGH INTENSITY • 1:1 input R e f e r r a l P a t h w a y 

14. Model : Liaison component • THIRD SECTOR AND VOLUNTARY SECTOR • Band 7 Clinical Lead to forge and maintain links with Third Sector and voluntary sector partners and service users through established forums and communication routes. • PRIMARY MENTAL HEALTH SUPPORT SERVICES • Band 7 Clinical Lead carries out formal liaison between team and primary care, secondary care and Third Sector through structured teaching sessions, Clinical Governance forums, CPETs, etc. • Band 7 Clinical Lead provides clinical supervision for Band 6 PC MH worker. • Less formal day-to-day liaison with PC professionals and designated surgery Link Workers carried out by Band 6 PC MH worker. CAMHS consultation liaison model remains in place. C&V Public Health Team Primary Care Professional • SECONDARY CARE MENTAL HEALTH SERVICES • All surgeries to have designated link with Consultant Psychiatrist(s) in locality CMHT. • Established Link Worker attached to all surgeries for advice re. referrals, etc. To strengthen links through regular attendance at MDT meetings, Neighbourhood meetings, etc.

15. Discussion Points • What assessment tools can be used to gauge service user readiness for counselling? • What are high intensity interventions? And how do we provide them? • What are your hopes and expectations? • What are your worries or concerns?

16. Contact Details Julian Willett Implementation Lead for Part 1 Mental Health (Wales) Measure Julian.Willett@wales.nhs.uk 029 2090 6206 07813 328418