Peer Support in Mental Health: Engaging and Collaborating for Better Care

1. Mental Health Crisis Care: The Path to Engagement and CoproductionPartnership Meeting 2 Summary @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare #HIOWcrisiscare Funded by NHS England and the Big Lottery Fund

2. Introduction Peer support is the help and support that people with lived experience of a mental illness are able to give to one another. Research shows that peer support can yield improvement in mental health resulting in decreased hospitalisation, less restrictive practice, larger social support networks and enhanced self-esteem and social functioning. On the 14th of November, the Hampshire and Isle of Wight (HIOW) Partnership held its second Building Health Partnerships (BHP) Meeting at the Totton and Eling Cricket Club. The theme - peer support in Mental Health - was identified at the first BHP event which took place in September. The purpose of the meeting was to: • Be inspired and learn from examples of peer support across HIOW • Find a better way of working together across organisations across the STP • Take the opportunity to influence key decisions. • Turn the ideas from the last session into targets and action plans. The session was attended by peer support workers from across the HIOW area, representatives from voluntary and community organisations, local authorities and the NHS from across the Sustainability and Transformation Partnership area. The workshop was designed to build upon what came out of the first partnership session (see the notes and presentation) and Core Group meetings to date. “Practitioners and therapists are seeing peer support as a tool for them.” @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

3. Peer support in action To frame and inspire discussions, there were presentations from peer support workers from across HIOW. We heard from: • Jane Collard, Peer supporter in the acute hospital setting • Sharon Blackburn, My experience of peer support • Dee Brown, Samantha Gould & Amy Rones, Portsmouth peer support in the community • Stacey Cripps, John Cassidy & Jo-jo Chorley, Peer support, Isle of Wight • Clare Grant, Jonathan Jones, Sam Daughtey, Dan Guerri, Side by Side, • Pam Evans, Peer support practitioner, Peer Support in Southampton IAPT Service, Peer support workers said their role was about “giving support, not advice”, “building rapport”, “moving people out of their comfort zone towards greater independence”. In some places peer support workers were being integrated as an essential part of multidisciplinary teams, being invited to contribute to care plans and “provide essential insights about individuals”. In the Isle of Wight, individuals that have attended peer support groups are encouraged to “become volunteers and coproduce events and outcomes” – one volunteer said that “co-facilitation keeps me well”. A staff member said: “I was a mental health nurse for 10 years… I’ve learnt more about mental health attending groups and hearing peoples’ experiences than I did in those 10 years.” @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

4. What do we know about peer support? Participants were asked to discuss and record what peer support means to them. Here are some of the things they said about what ‘great peer support’ means… • Relationships that inspire hope, empower, and build self-esteem and confidence in recovery • Information and guidance to develop independently and identify ways to manage symptoms • Driven, staffed and managed by people with lived experience • Getting beyond the medical model and power imbalances between professional and patient • “human touch service, real people who really understand what we service users are going through” • Peer support is someone being on the “same wave length” as that person, being engaged and demonstrating empathy because “you’ve been there” @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

5. Peer support: benefits and pitfalls There is already many peer support initiatives running across HIOW. We asked participants what was good and what we might need to be aware of when setting up or embedding peer support across the system. Here are some of the things they said: Benefits • Reciprocity is empowering • Reduces isolation; keeps people out of hospital; improved recovery; • Sits alongside, complementing clinical services • Less confined by statutory role • Support for family members • Access in the community, not just acute settings • Personalised service • Encourages volunteers and a diverse workforce • Weekly/fortnightly meetings give clients structure and routine and builds relationships • Saves lives Pitfalls • Attachment and dependence – phased exit often needed • High caseloads means principles of reciprocity and mutuality are difficult to maintain • KPI/targets recording - difficult to measure • Working in isolation and challenging culture • Time limited • Voluntary roles vs employed? • Uncertainty over funding • Inappropriate advice • Not enough peers to go round • People don’t know how to access services @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

6. Peer support: things to watch out for or develop • Clarity about role – support and training to maintain clear professional / personal boundaries keeping all involved well and safe • Different processes across the area e.g. recruitment, quality assurance -minimum standards needed? • Peer supporters can perceived as outsiders/not part of ‘NHS’ team - Peer supporters need to be accepted as a valuable member of staff within organisations • Personal and professional qualities are essential: skills in empathy, listening • Peer support is personal and tailored – this must not be lost with professionalization • Recovery is not possible for everyone • Safeguarding and risk disclosure without support infrastructure for peers • Keeping yourself well and ensuring you keep the balance between work and looking after you • Importance of effective support for peer supporters (Clinical Supervision) • Integrated with existing recovery pathways e.g. recovery college, IAPT… • Could a partnership approach enable sustainable funding streams? • How to make sure people have access to activities even if they are from different areas @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

7. Let’s get creative…action planning In the final exercise, participants were asked how we could make excellent peer support a reality across the system. Participants were asked to bear in mind, but not be constrained by, the themes developed in the first meeting: • Whole system vision • Community development and social prescribing. • Coproduction framework • Digital solutions • Workforce Participants worked in groups to build consensus around something they would like to work on and then developed action plans to map how to make these a reality. We asked: • Who will do what, and when? (Clinicians, service users, commissioners, peer supporters) • What resources have we got/ do we need? • What do we need to find out more about? • What difference will it make? • What can we do next to embed and spread this? • What is the very next step to take this forward? @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare

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13. Next steps The core group will meet to consider how to take the action plans forward and plan for the next event. To find out more about what is happening locally or to join the core group, please contactjo.jones12@nhs.net . To find out more about the national programme please contact houda@ivar.org.uk . Questions to consider? • What are the boundaries for what peer support might offer? And where do accountabilities lie? Is peer support a sticking plaster for existing services? • What balance needs to be struck between ‘professional training/knowledge’ and ‘empathy’? • How can the NHS also embrace the lived experience of professionals? • What are the barriers to participation • How can peer support be used as a catalyst and vehicle for changing the culture of mental health services? • Peer support is a time limited service which can support people into the next stage of their recovery but it needs and infrastructure and an evidence base. Opportunities • Solent Mind are offering training for others wanting to set up peer support groups in January 2018 – sign up via Eventbrite @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare @SocialEnt_UK @IVAR_UK #BHPselfcare #HIOWcrisiscare