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Table of Contents Page 1
Two Years On: a look back by Patrick Taylor, Director of Oxfordshire Mind
2
What is the Wellbeing Service?
4
Facts and figures
6
Public Wellbeing: improving the community’s knowledge of mental health
8
Information Service: accessible mental health signposting for everyone
10
Short Courses: giving skills, building connections, keeping people well
12
Peer Support: a virtuous circle of effective support in the community
14
One-to-One Recovery: a partnership approach to moving forward
16
Adding value: bringing in external funding for the Wellbeing Service
Two Years On
Patrick Taylor, Director of Oxfordshire Mind 1 in 4 of us in Oxfordshire will have a mental health problem - and many more are affected indirectly through families & friends. We know how mental health problems can damage lives and leave people feeling alone and frightened. But it doesn’t need to be that way. Our vision at Mind is to make sure anyone with a mental health problem has somewhere to turn for advice and support. Two years ago Oxfordshire County Council and the NHS commissioned us to provide a new and innovative ‘wellbeing service’. Since that beginning the service has gone from strength to strength, helping over 3,000 people from across the county. Our short courses, peer support groups, information service and ‘public wellbeing’ campaigns not only support individuals, but also challenge the stigma surrounding mental health problems. The Wellbeing Service offers us the choices and options we need to build the right support around our personal circumstances - there is no ‘one-size-fits-all’ solution. It’s also local, providing courses, information sessions and individual support in more than 25 different venues right across this large and largely rural county. And it works: our own monitoring, and feedback from people using the Service, confirms that the Wellbeing Service is achieving excellent outcomes for individuals and contributing significant benefits to the health economy in Oxfordshire - including reducing calls on statutory mental health services. I’m really proud of what’s been achieved in the first two years. Our priority for the next year is to reach even more people and deepen our impact. The Mind Wellbeing Service provides vital support, advice and information. For everyone.
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What is the Wellbeing Service? The Oxfordshire Mind Wellbeing Service is a unique, community-based programme of support for people experiencing mental health problems. Its suite of services provide well-designed, local support for people with mental health needs ranging from mild to moderate anxiety and depression, to severe and enduring mental health problems. The Wellbeing Service is made up of a set of five services that can be accessed by anyone in Oxfordshire over the age of sixteen directly, and without a referral.
1. Public wellbeing: a programme of events, training and information-sharing to improve the knowledge of mental health across all Oxfordshire’s communities
2. Information service: dedicated phone, email and face-to-face support to answer queries about mental health and to signpost to other voluntary- and statutory-sector services
3. Short courses: a range of free courses which help people develop their own mental wellbeing, improve their resilience, and forge links with others
4. Peer support: emotional support delivered and developed by people with lived experience of mental health problems, based on a robust model of reciprocity and mutual benefit
5. One-to-one recovery planning: high quality face-to-face support for individuals, delivered over a number of weeks to help define goals and implement plans for recovery and moving forward This report provides an overview of the delivery of the Wellbeing Service over its first two years, and indicates the impact it is having on people’s mental wellbeing and relationship with other, statutory mental health services in Oxfordshire.
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Where is the Wellbeing Service? One of our priorities in the Wellbeing Service is to ensure that people from all over Oxfordshire can easily access the support they need. We reach right across the county, with locality teams delivering short courses, peer support, information and public wellbeing campaigns in 25 different venues across 17 towns and villages.
Many of the venues we use belong to arts centres, cafés, leisure centres, libraries, faith groups, children’s centres and other organisations, and we also deliver outreach work in in colleges, RAF bases, and prisons. Delivery of services in towns and villages which may not have previously had dedicated mental health support continues to be a priority for us.
Paul Farmer, Chief Executive of Mind “The Wellbeing Service supports the delivery of our commissioning intentions and gives people the resource to keep well in the community. Oxfordshire Mind is an organisation with a strong commitment to engagement, partnership working and innovation, and with the ability to flex and manage issues and risks that develop during the delivery of projects.”
What people say
“We want to support those people most at risk of developing mental health problems to build mental resilience and to stay well. The Oxfordshire Mind Wellbeing Service does just that - and it's a great example many others around the country can learn from."
Ian Bottomley, Assistant Director, Adults: Oxfordshire Clinical Commissioning Group
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Facts & Figures How the Wellbeing Service has grown: The number of people using the Wellbeing Service has grown steadily over the past two years. Some of this growth can be attributed to improved knowledge of the service amongst healthcare professionals, and the general public. The increase also suggests that the Wellbeing Service is addressing a previously un-met need for community-based mental health support. We expect that the numbers of people making use of the Wellbeing Service will continue to grow as the mental health effects of recession and changes to the statutory sector continue to have an impact.
2011
2012
2013
Where people found out about the Wellbeing Service:
Although no formal referral is required, recommendations from health professionals and colleagues in other services continue to be an important method of bringing people to the Service.
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The Wellbeing Service across Oxfordshire: Use of the Wellbeing Service is widely distributed across the county, and reflects the size of populations in the Districts. We ensure the Wellbeing Service is accessible to everyone by providing groups, short courses, information and options, public wellbeing and recovering planning in many towns, villages and communities across Oxfordshire. A snapshot of the Service shows how our work is distributed:
Cherwell 26% of users of the Wellbeing Service are from this district We deliver:
West Oxfordshire
8
weekly Info & Options sessions
6
weekly Recovery Planning sessions
2
short courses
8
regular Peer Support Groups
16% of users of the Wellbeing Service are from this district We deliver: 11
weekly Info & Options sessions
7
weekly Recovery Planning sessions
2
short courses
10
regular Peer Support
Oxford
31% of users of the Wellbeing Service are from this district We deliver:
Groups
weekly Info & Options sessions
8
weekly Recovery Planning sessions
7
short courses
21 regular Peer Support Groups plus other, responsive groups
Vale of the White Horse 15% of users of the Wellbeing Service are from this district We deliver:
South Oxfordshire
4
weekly Info & Options sessions
6
weekly Recovery Planning sessions
3
short courses
6
weekly Info & Options sessions
15
regular Peer Support
2
weekly Recovery Planning sessions
6
short courses
4
regular Peer Support Groups
Groups
7
12% of users of the Wellbeing Service are from this district We deliver:
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Public Wellbeing: improving the community’s knowledge of mental health Helping people in Oxfordshire develop their understanding of mental health not only challenges stigma and discrimination, but also gives individuals the tools they need to improve their own mental wellbeing. Our public wellbeing work empowers local communities with knowledge, training and support. Two years in overview In the last 2 years Oxfordshire Mind has reached 9773 people through public wellbeing activities. This included: Reaching 1361 people through Information Sessions Training 375 people via 28 Mental Health First Aid courses Speaking to 5225 people on our county-wide roadshows and campaigns Reaching 2800 people through visiting other organisations to raise awareness of mental health, and holding stalls at community events.
symptoms and specific disorders and feel more confident in assessing individual needs and supporting families” Mental Health First Aid training participant
“I now realise that mental illness is a common problem and there are lots of different ways to get help” Feedback from an Information Session
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What people say
“I gained more knowledge and understanding of
Our public wellbeing events and activities aim to reach the widest possible section of Oxfordshire’s population. Delivered across the county, the programme provides information sessions for community groups and organisations, county-wide campaigns, and accredited Mental Health First Aid courses. Members of the staff teams in different parts of the county also attend a wide range of events to increase public understanding of mental health problems, and of our Five Ways to Wellbeing mental health awareness campaign.
Mental Health First Aid This two day, nationally-accredited course teaches participants how to spot the signs of common mental health problems and to provide help on a first aid basis. We’ve run 8 courses open to the public and 20 in-house to groups including students, college staff, children’s centre staff and housing association staff and residents.
Awareness-raising sessions and events Reaching groups, companies and organisations to raise awareness of mental health with information sessions has helped spread information and increase understanding. These flexible and interactive sessions last up to three hours, cover topics around mental health and wellbeing including Mental Health Awareness, Relaxation, Five Ways to Wellbeing and Work/ Life Balance and can be tailored to meet the specific needs of the audience. Less formal mental health awareness raising has also taken place at events, community days and festivals - reaching many of Oxfordshire’s communities including as the East Timorese community in Oxford, RAF families, students, and autism family support groups.
County-wide campaigns Our county-wide campaigns deliver wellbeing messages and learning to the general public, with a focus on the Five Ways to Wellbeing that outline steps that everyone can take to safeguard their own mental wellbeing. As well as raising awareness of mental health, the campaigns provide signposting to other services and ways of accessing support.
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Information Service: accessible mental health signposting for everyone Getting good reliable information can be crucial in helping people take the first step towards seeking help. In the last two years, the Information Service has responded to more than 23,000 enquiries - helping to meet the need of the community for signposting to mental health information, and providing valuable additional support to that already available from GPs and other clinical colleagues. Two years in overview The Information Service has handled more than 23,000 enquiries in 2 years, of which: 3000 were to the dedicated phoneline and email service 800 were pre-booked face-to-face Information & Options sessions Over 19,000 were unbooked requests for support and information received by Wellbeing Service teams 4000 printed Mind Guides distributed to health professionals and other services
Case Study
A manager in a local business contacted us. She was concerned about one of her young employees, who was in distress following an event in her personal life and was self-harming. The employee wanted face-to-face support that day, but was reluctant to visit her GP.
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The Information Line worker suggested the employee attend an Information & Options session. She was able to be seen right away at a venue close to home. The session gave her support to develop a plan, connected her with other local services, and helped her cope successfully with her immediate crisis.
The Information Service aims to provide a confidential and non-judgemental space open to anyone in need of information about mental health, whether this is face-to-face, over the phone or via email. Trained Wellbeing Service workers and volunteers deliver high-quality support, and direct enquirers to services provided by Oxfordshire Mind, other local charities, and to the NHS in the county. Information is available via a dedicated central Information Line, through one-to-one support from Wellbeing Service workers, and in the form of the online and printed Mind Guide directories.
Information line This is a dedicated phoneline and email service which is designed to be the central point of contact for enquiries about mental health and mental health services in Oxfordshire. Enquiries vary from short requests for contact details to discussions about more complex situations. In over 90% of cases we are able to provide information or referral to a service. The impact of this valuable support is clear, with one person emailing “I already feel less daunted by it all just knowing there
are people out there to help and who care enough to respond so thoughtfully and swiftly.”
Enquiries, and Information & Options sessions The face-to-face Information & Options sessions are an opportunity for people with mental health problems or enquiries to get one-to-one support from members of their local Wellbeing Service team. These sessions are often the first time someone has talked about the difficulties they are experiencing. More than 800 pre-booked sessions have been delivered across the Wellbeing Service, with another 19,200 drop-in sessions and other enquiries being handled by staff from the Wellbeing Service in Oxford City, Cherwell and West, and South and Vale.
The Mind Guide The Mind Guide is a printed and online directory of mental health services in Oxfordshire, which brings together information about statutory and charitable support in a concise and easy-to-use format. We launched the new Mind Guide website in May 2012 and printed the latest edition of the directory in August 2012. We’ve distributed around 4000 copies of the printed guide to GPs, CMHTs, charities and other professionals in the county and have had excellent feedback. One health professional described it as “one of the most useful documents in my possession”.
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Short Courses: giving skills, building connections, keeping people well Our programme of high-quality and free short courses helps to give participants the skills they need to stay well. From courses which provide the tools to coping with difficult situations or developing a more positive self-image, to those providing physical activities or creative outlets, the programme delivers more than 100 free courses a year to people all over Oxfordshire. Two years in overview Since the Wellbeing Service started two years ago: 314 short courses have been delivered across the county 2034 people have attended our courses 1380 different people aged between 16 and 103 attended our courses We deliver 30 public Coping Skills courses every year 85% of people felt that as a result of attending our courses their wellbeing had improved, and 14% of people felt that their wellbeing had been maintained
Building Confidence & Self Esteem Children’s Centre course participant
“The course was very empowering” Assertiveness course participant
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What people say
“I went on this course to learn some techniques on how to build up my confidence. The facilitators were lovely and made me feel so comfortable, and let everybody have an input and a voice. I now take the time to think things through and think more positively about things”
Attending a short course can often be a positive step towards recovery from a period of mental ill-health, or can deliver the tools that help people stay well. People attending short courses of all kinds have stated that their wellbeing had improved or been maintained as a result of attending a short course because they had been able to learn something new, develop coping skills and make social connections. Since January 2013, the Wellbeing Service Coping Skills courses have been delivered with the support of Oxfordshire County Council and the Skills Funding Agency.
Accessible to everyone All our short courses are free at the point of delivery, and can be attended by anyone over the age of sixteen. Courses typically run weekly for between four and eight weeks, and are delivered in a range of community venues including libraries, children’s centres, older adults’ services, colleges and wellbeing and resource centres. People do not need a referral to join a course, but healthcare professionals can recommend courses as appropriate.
Coping Skills This suite of short courses uses proven Cognitive Behavioural Therapy (CBT) based methods to help participants learn the skills needed for managing mental wellbeing and improving their resilience. With courses covering Managing Strong Emotions, Assertiveness and Managing Stress, the programme provides an effective and additional resource to people in Oxfordshire, and to the GPs and other healthcare professionals who may already be working with them to improve their mental health or mental wellbeing. In the words of one participant on the Assertiveness course: “I
feel I am on a positive road to changing my behaviour one step at a time”.
Integrated physical and mental wellbeing The short course programme recognises the positive benefits of improvements in physical health on people’s mental wellbeing. Courses in yoga, African dancing, relaxation through complimentary therapies, and football deliver improvements in participants’ physical health which help to underpin improvements in mental wellbeing. Learning new practical skills - such as silversmithing, arts and crafts, or drama - also reinforce the effects of integrated support for mental and physical health.
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Peer Support: a virtuous circle of effective support in the community Peer support brings together people with similar experiences to support each other. The peer support programme recognises that helping others, and being helped in turn, improves our mental wellbeing and feelings of self-worth. The results of peer support are clear: people see themselves not as recipients of services but as participants in their own recovery, with a third noting they have reduced their reliance on statutory mental health services. Two years in overview In 2011-13 over 2840 people accessed our Peer Support services: 32 peer support volunteers have been trained, with 81% drawn from key groups, including BME communities, rural and isolated communities, those with severe and enduring mental illness and people at risk of social exclusion. Trained peer support volunteers have engaged with a total of 481 peers. People who have taken part in a recent survey have told us that: 73% feel better able to manage their mental health. 32% use statutory services (e.g. CMHTs, inpatient services) less frequently.
Case Study
Sue has been using Oxfordshire Mind’s services for a number of years, and recently trained as a Peer Supporter. She describes Peer Support as “a way of giving help to others and receiving as much help back”.
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Sue volunteers with a group that has grown rapidly from 5 to 20 members attending each week. Members of the group design their own programme of activities. Sue’s role is to lead group discussions, welcome new members and encourage a culture of mutual support. Sue said: “I get a great deal of satisfaction enabling others to achieve things they never thought possible.”
Peer support groups provide a safe, welcoming space for the people who use our services to meet people who may have experienced similar issues. Peer Support might simply involve talking and listening, or it may be focused around a shared interests such as art, music, walking, cooking or reading, or be based around other shared characteristics such as health need, geographical area, gender, beliefs, or culture. More than 60 peer support groups are run every week.
Benefits of Peer Support Peer Support enables people with lived experience of mental health problems to play a more pivotal role in the provision of services, and to develop reciprocal and mutually beneficial peer-to-peer relationships. Groups are supported by trained staff or volunteers to recognise what each individual brings to the group and to explore the opportunities for mutual support. A recent survey of participants in groups in which trained Peer Supporters are involved demonstrated the huge value of bringing people with shared experience of living with mental health problems together to share ideas, thoughts, abilities and skills: almost a third reported that they used statutory health services less frequently than before joining the group.
Peer Support Volunteering Almost a quarter of the Peer Support Groups provided by the Wellbeing Service benefit from the involvement of trained volunteer Peer Supporters, all of whom have lived experience of mental health problems and recovery. Volunteer Peer Supporters are able to draw on their own experience to offer others empathy and understanding and to encourage the development of mutually-supportive relationships within Peer Support Groups. Volunteers complete a bespoke training programme to equip them with the skills, knowledge and confidence to take on the Peer Supporter role. As well as providing the knowledge and confidence to become a Peer Supporter, this training can also be an important part of an individual’s own recovery, improving self-awareness and mental wellbeing: one participant noted that “the training
has really helped me to think about how I support people, and also more aware of my own mental health and so better able to look after myself.”
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One-to-One Recovery: a partnership approach to moving forward Looking after one’s wellbeing is not always easy, and yet evidence shows that people who have experienced mental health problems can and do recover to live productive and fulfilling lives. The One-to-One Recovery Planning service works in partnership with individuals to help them set and achieve their own goals, manage their own mental health, and move forward with their life.
Two years in overview Since March 2010 the Wellbeing Service has supported 502 people through one-to-one Recovery Planning sessions, resulting in: better self-management and self-care improved confidence greater sense of wellbeing
Case Study
Andrew describes himself as living with depression and had a breakdown in the middle of 2012. Andrew got in touch with us and was offered some one-to-one Recovery Planning sessions that he describes as the spark that started to get his life back on track.
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Andrew and a member of staff looked at making plans, getting thoughts in perspective, looking after himself, and thinking about recovery. He also accessed one-to-one CBT sessions from TalkingSpace. Andrew is now back at work. He says he may always live with depression but that he is learning to tackle it, and the one-to-one recovery planning sessions were a ‘partnership’ that really helped.
Everyone using the one-to-one recovery planning service will have the opportunity to develop a personal recovery plan, in collaboration with an experienced Mind member of staff. This also gives each individual the chance to find out more about the wider opportunities available within the Oxfordshire Mind Wellbeing Service, and other community services.
A person-centred approach The needs and aspirations of the individual are central to the one-to-one recovery support, and staff use a range of facilitation techniques to enable people to participate in recovery, develop skills in self management, and increase their personal autonomy and control. The resulting recovery plans are unique to each individual, and translate goals into achievable steps.
Recovery planning in practice Each recovery planning session is delivered one-to-one with a member of Oxfordshire Mind staff, and usually lasts up to one hour. People commonly have three or four sessions, but this can be adjusted to meet the needs of that individual. A number of tools and skills are available to help develop the recovery plan: these can include Motivational Interviewing techniques, Wellness Recovery Action Planning (WRAP) and Cognitive Behavioural Therapy (CBT) skills. The person’s progress is monitored using a standardised set of outcomes measures.
Outcomes and benefits Delivering one-to-one recovery planning provides highly personalised support, with a partnership approach to goal setting and plan making that gives control back to the individual. Helping each person rediscover their own autonomy and set their own goals has been shown to lead to improvements in self-care and the management of that individual’s own mental wellbeing. Increasing confidence has also been seen to result from the setting and achieving goals, with emotional as well as practical support provided by the member of staff from the Wellbeing Service.
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Our additional funding: external funding for the Wellbeing Service The Wellbeing Service was commissioned by the County Council and the NHS in 2011. Since then we have worked hard to raise additional funding to extend and add value to the services. This additional funding received has helped us deliver specific projects, often targeting communities within Oxfordshire which may have higher need for mental health support or which are often not in contact with services. The Stone Family Foundation The Stone Family Foundation has provided additional funding to significantly extend the range of wellbeing activities at The Mill in Oxford. This has helped us equip and make full use of the music studio and the art gallery at The Mill. The funding has also enabled us to run many more groups, including self education groups on coping with hearing voices. The support of the Foundation has meant we can provide more intensive support to enable people with serious and enduring mental health problems to live full lives in the community.
Oxfordshire County Council and the Skills Funding Agency The Wellbeing Service short course programme is now formally recognised as a provider of adult learning by the County Council and the Skills Funding Agency. This recognition funded our ‘coping skills’ courses which deliver clearly defined and measurable outcomes, and record progress of learning following the ‘Recognising and Recording Progress and Achievement’ (RARPA) guidelines.
Comic Relief Three year funding was secured from Comic Relief to support our partnership with Oxford United Football Club (OUFC) to deliver a short course to young men at risk of social disadvantage, isolation and mental health problems. The course, ‘Football, Fitness and Wellbeing’ delivers physical fitness and football training run by OUFC coaches, alongside sessions run by Wellbeing workers who are trained in delivering Cognitive Behavioural Therapy (CBT) around mental health awareness, confidence building, drug and alcohol misuse, self harm and Domestic Violence. Participants will leave the course with new skills to manage their wellbeing.
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Oxfordshire Mind 2 Kings Meadow Osney Mead Oxford OX2 0DP 01865 263730 office@oxfordshire-mind.org.uk www.oxfordshire-mind.org.uk Twitter: @oxfordshiremind Facebook: www.facebook.com/oxfordshiremind Registered Charity number 261476 Registered company number 4343625 Front cover: A Wellbeing Service worker speaks to a member of the public at the ‘Five Ways to Wellbeing’ Roadshow, 2012. © Oxfordshire Mind. All other photos commissioned by and © Mind.