NSFT Insight Magazine Autumn/Winter 2016 by made agency

Insight Autumn/Winter 2016 | Issue 92

TRUST IS OUT OF SPECIAL MEASURES SIGNIFICANT PROGRESS AT NSFT IS GETTING POSITIVE RESULTS

ITâ&#x20AC;&#x2122;S OKAY TO ASK FOR HELP GABRIEL ABOTSIE IS HELPING BREAK DOWN BARRIERS THAT STOP MEN ASKING FOR SUPPORT

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Featured in this issue… Spotlight on Postnatal Depression "Don't be afraid to ask for help," mums urged 4 Helping new mums to cope

Spotlight on Wellbeing More support for common mental health problems

Spotlight on Bipolar Disorder "My whole world came crashing down - but I won't let it define me"

SPOTLIGHT ON EATING DISORDERS

Spotlight on Veterans Innovative new services bring vital support for our veterans

Expert advice on caring for veterans

Newsround

Spotlight on Addiction and Recovery

We’re out of spcial measures

Special events celebrate recovery 91

Working in partnership to reduce police detentions

New bid to reduce opiate deaths in Norfolk

Spotlight on Criminal Justice and Liaison Services

Spotlight on unexpected deaths

Insight on our Governors

Valuable service extended following first year success

What's behind the figures on unexpected deaths?

Governors help to put “dementia in perspective"

Pioneering partnership to help save lives

22 26

Cast your vote and help us to elect new NSFT Governors

Insight on Improving Quality

Spotlight on Eating Disorders

Men's mental health is top of the quality agenda

Improved eating disorders services helping more people than ever 28

High standards recognised with prized accreditation

Eating disorders services see 25% rise in demand

97 101

Spotlight on Dementia You can live well with dementia 102

Insight on Children, Families and Young People

Dementia patients set to benefit from new focus on research 106 Insight on Improving Services Together

Spotlight on Recovery College & Peer Support

First patients welcomed to £1m young people's unit

Celebrating three successful years 39

Turning the spotlight on mental health in schools

Inspirational art project extended following first-year success 108

Carers' leads show-case help

National recognition for innovative programme

2 Norfolk and Suffolk NHS FT (NSFT)

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A WORD FROM THE CHAIR

Insight on Working With Us Quality is top of the agenda for Matrons

114

No soggy bottoms at Sandringham as staff got a rise out of Bake Off

130

News Good work showcased during national Director's visit

132

Generous young people give gifts to our patients

137

Diary Dates

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ABOUT INSIGHT Insight is produced by the NSFT Communications Team, working with service users, carers and mental health professionals to bring you stories about mental health issues that affect people in Norfolk and Suffolk. You can read Insight online at: nsft.uk/Insight. If you have any feedback, please email ‘Insight Editor’ at nsft. communications@nsft.nhs.uk If you are affected by any of the issues covered and are unsure how to access support, contact our Patient Advice and Liaison Service (PALS) - contact details on the back cover of this issue.

SUBSCRIBE FOR FREE If you’ve enjoyed reading Insight you might like to subscribe to our online version for FREE. You can do this by simply filling in our subscription form at nsft.uk/Insight. We will then let you know when the next issue is available.

Hello and welcome to the latest edition of Insight magazine. In this issue I’m delighted to be able to share with you the very positive progress being made by our Trust, not least successfully moving out of ‘special measures’, following an inspection of our services by the Care Quality Commission (see page 50). It has been no small feat to make this achievement and we are incredibly proud of our staff in helping us make this great step forward, and very grateful to our supporters for also helping us to get there. Insight is full of stories about our staff going the extra mile every day to continue to improve the standards of our services. And, throughout this issue you will see some of the very best of the best who were awarded accolades in our Putting People First Awards 2016, as well as services who have been held up as excellent by national award organisations. Well done to all of them. But we know that excellent mental health care is not all award-winning or glamorous, it’s about offering care and compassion to our service users and their carers, and the day-to-day work on the ground that makes a real difference to people’s lives. For example, you will read how our Trust is helping to reduce the number of people with mental health problems detained in police cells and how we are supporting those who do get the support they need. We also discuss the new services we are offering to veterans – a great many of whom can find themselves in the criminal justice system when their mental health deteriorates. And our new Wellbeing nurse for men’s mental health talks about

breaking down the cultural barriers that prevent men asking for help. In Insight we also share with you how our Trust has successfully secured national money to improve local services, something which we continue to campaign for to ensure we can offer the best care possible, and that mental health care is seen on a level with physical health. As always, we have covered some of our Trust’s most challenging areas in this issue, including the number of unexpected deaths and the use of restraints and seclusions in our Trust. We hope these articles help to give you a bit more of an insight behind the issues and headlines. I’d also like to thank all of our service users and carers who have shared your stories with us, helping us to raise awareness and overcome stigma around mental health conditions.

Gary Page Chair of Norfolk and Suffolk NHS FT

Insight | Autumn/Winter 2016 3

“Don’t be afraid to ask for help” mums urged A mother whose world began “falling apart” while she was in the grip of postnatal depression (PND) talks to Insight about her experiences. And NSFT prepares to provide a new specialist service to support PND sufferers.

4 Norfolk and Suffolk NHS FT (NSFT)

––– SPOTLIGHT ON POSTNATAL DEPRESSION –––

aomi Farrow, who lives in Holt, in north Norfolk, developed PND following the birth of twins Erin and Tess. After struggling for around four months, she realised she needed professional help and booked an appointment with her GP following encouragement from her husband Mike. “I started to feel unwell within around a month of having the twins, but kept telling myself I just needed a good night’s sleep and things would be better tomorrow,” said Naomi, 32. “It was like Jekyll and Hyde – I could be fine one moment and completely lose it within seconds. It was scary – I felt I wasn’t able to be there for my children as I should have been because I was falling apart myself.

“IT WAS LIKE JEKYLL AND HYDE – I COULD BE FINE ONE MOMENT AND COMPLETELY LOSE IT WITHIN SECONDS.”

“The catalyst which prompted me to ask for help came one day after I had gone into the bedroom to get away from the screaming. I went back into the lounge to find my oldest daughter Fern was trying to put dummies in Tess and Erin’s mouths. It broke my heart to think my four-year-old was looking after my twins as I couldn’t do it myself.” Naomi was prescribed antidepressants and referred for cognitive behavioural therapy (CBT), but didn’t feel it was for her. Instead, she decided to fill a gap in demand by setting up her own support network after failing to find an existing group in Norfolk.

“I had sacrificed a career I loved after having my children, so was spending a lot of my time at home, sitting and reflecting,” added Naomi, a former marketing executive. “I realised I needed to get out of the house and meet others, which is why I decided to use Facebook to set up ‘Get Me Out The Four Walls’. “Within a year we had 1,700 members. We now organise around 35 meetings a month and go to places like Blickling Hall, Norwich and Wells. The group is very informal so people feel they can open up while making friends along the way, which is great as it means they are building their own support network at the same time. “I’ve also set up a monthly group in Norwich, which gives people the chance to drop in, meet others and chat. It is a lifeline for those who are suffering as it gives them the chance to talk and support each other. I am now looking to introduce further groups across Norfolk as I believe no one should live more than 20 miles from support.” Following her initial success, Naomi has set up a not-for-profit organisation, under the same name, to run the support groups and fund blocks of counselling for Norfolk mums with the most severe cases of PND, following a referral from a GP.

In addition, the charity will also campaign for better perinatal mental health services and raise awareness of maternal mental health, in turn breaking down the stigma surrounding PND so that mums feel able to ask for help at an earlier stage. She explained: “Women are terrified to admit they can’t cope as they are worried their children may be taken away – there is a real fear factor attached to PND. “There is also immense feelings of guilt. In my case, that was directed at my oldest daughter – suddenly there were two screaming babies in the house and I felt as if I couldn’t spend as much time with her. It played into something which was already crumbling anyway. “But it’s really important to get help as early as possible. Going to see my GP really helped – it was a massive weight off my shoulders to admit that I couldn’t cope and the first step towards making a recovery. “I’d urge anyone else who feels they may have PND to do the same.” Join Naomi Farrow’s Facebook group by searching for GMOTFW Norfolk PND Support Group. You can also email gmotfw@gmail.com

Insight | Autumn/Winter 2016 5

––– SPOTLIGHT ON POSTNATAL DEPRESSION –––

New service for vulnerable women to launch Vulnerable women in Norfolk and Waveney will soon receive targeted help with complex mental health problems after our Trust was awarded nearly £2.5m to launch a specialist perinatal service.

orking hand in hand with commissioners and NHS partners, our Trust will now develop a specialist perinatal community service in Norfolk and Waveney over the next three years. The service will care for pregnant women and new mothers with serious mental health difficulties, as well as providing support for the rest of the family and training for other healthcare professionals. It will cater for people with conditions such as severe postnatal depression, bipolar disorder and psychosis, and will also offer preconception advice for woman on medication for their mental health or with a known mental illness wishing to conceive. The service’s aim will be to reach women as quickly as possible, providing timely support, which is specially-tailored to meet each patient’s individual needs. This could include talking therapies and medication, where appropriate, as well as support engaging with antenatal care and health visitors.

It will be delivered in partnership with maternity services at the Norfolk and Norwich University Hospital, Queen Elizabeth Hospital and James Paget Hospital, as well as Cambridgeshire Community Trust, which provides health visiting services and nursery nurses. The funding has been awarded after figures showed an estimated 360 women in Norfolk and Waveney have severe perinatal mental health needs, with a further 3,000 to 5,000 with mild to moderate needs. Currently, these women receive care

6 Norfolk and Suffolk NHS FT (NSFT)

from midwives, health visitors and secondary mental health services and Wellbeing Norfolk and Waveney.

“WE WERE ABSOLUTELY DELIGHTED TO RECEIVE THIS FUNDING, WHICH WILL TRANSFORM THE CARE MUMS-TO-BE AND NEW MOTHERS WITH MENTAL HEALTH DIFFICULTIES RECEIVE.”

––– SPOTLIGHT ON POSTNATAL DEPRESSION –––

“OUR AIM IS TO MAKE SURE MOTHERS AND THEIR INFANTS RECEIVE PROMPT ASSESSMENT AND TREATMENT, ALONG WITH DEDICATED MANAGEMENT OF THEIR CASE.”

NSFT has now begun work to recruit a 14-strong team to deliver the specialist service, which will include consultant psychiatrists, mental health nurses, a psychologist, occupational therapist, social workers, and nursery nurses. It is hoped the first women will start receiving care early in 2017. Michael Scott, Chief Executive of NSFT, said: “We were absolutely delighted to receive this funding, which will transform the care which mums-to-be and new mothers with mental health difficulties receive. This will allow them to bond more successfully with their baby, strengthening the family unit and ensuring their child gets the best possible start in life. “Intervening early with this vulnerable group is especially important, as statistics show suicide is the leading cause of death for women during pregnancy and in the year after giving birth. Our aim is to make sure mothers and their infants receive prompt assessment and treatment, along with dedicated management of their case.

“The service will also provide education and training programmes for others involved in the care of pregnant and post-partum women, including general psychiatric teams, GPs, midwives, health visitors and psychological treatment services. “This will help us identify those at risk at an early stage so that we can provide the best possible care and make sure both their mental health needs, and the developmental needs of their babies, are met.” NSFT’s Improvement and Development Manager for Children, Families and Young People’s services, Andy Goff said: “It's great news that there will now be a specific service caring for these women and their babies, as it is such a specialist area of work. “Our aim will be to receive referrals at an early stage in pregnancy, as evidence shows that existing mental health problems can get worse just before or after birth. The same applies for new mothers suffering with postnatal depression – we want to reach them as quickly as possible so that they can get the specialist help they need. “Over the coming months we will be working hard to recruit new staff

while also raising awareness that the service is there so that people know where to turn when they need help. We will also be working with Nottinghamshire Healthcare Trust, who will be supporting us as we set up the new service with training, while also giving our newly-recruited staff the opportunity to look at how an established team delivers high quality care.” The service has been commissioned by Norfolk and Waveney’s five clinical commissioning groups – Great Yarmouth and Waveney, North Norfolk, West Norfolk, Norwich and South Norfolk, which acts as lead commissioner. Naomi Farrow, who set up the 'Get Me Out The Four Walls' support group after suffering from postnatal depression, worked with NSFT to develop the funding bid.

“IT’S BRILLIANT THAT THE SERVICE WILL SOON BE HELPING WOMEN AND THEIR FAMILIES.”

She said: “This new service is very much needed and has been for a long time. It will be a massive game changer for mothers, because now they will receive specific treatment rather than being generalised. “For me, this is crucial and is a huge step forward for mums in Norfolk and Waveney. It’s brilliant that the service will soon be helping women and their families.”

Insight | Autumn/Winter 2016 7

Helping new mums to cope Experts at NSFT are urging parents who are worried they may be suffering from postnatal depression (PND) to ask for help early and before their condition begins affecting their relationship with their baby.

octor Catherine Thomas said that speaking to a midwife, health visitor or GP was an essential first step for anyone facing difficulties, and could open up the door to a range of additional support such as medication, therapy or self-help groups. “Postnatal depression can affect both mothers and fathers, and usually lasts six months to a year,” said Dr Thomas, a Consultant Child and Adolescent Psychiatrist. “It can have a huge impact on a parent’s relationship with their baby, and puts attachment and the baby’s emotional and social development at risk. “If a parent is unable to meet their child’s needs, that baby can become chronically stressed, which can affect their developing brain and ability to manage their emotions in the short and long term. That is why it is so important to intervene early and in a proactive way.” Parents with moderate PND can be prescribed medication, self-refer to NSFT’s Wellbeing services, or seek support by attending groups at children’s centres. In more complex cases, parents may be referred onto a psychiatrist. In the most serious situations, where parents have mental health difficulties and their baby is at risk of going into

8 Norfolk and Suffolk NHS FT (NSFT)

care, intensive therapeutic support is provided via the Norfolk Parent Infant Mental Health Service (PIMHS) (see page 81 for more details). “People who are prone to mental health difficulties, such as depression, anxiety, eating disorders or substance dependence, are more vulnerable to developing PND and other mental health difficulties after the birth of their babies,” added Dr Thomas. “We also find that those parents who had difficult childhood experiences of poor parenting themselves, or are in relationships in which there is domestic violence, are also vulnerable. “We try and identify these mothers in the antenatal stage so that we can put a robust package of support in place to prevent the depression from worsening. “In the most serious cases where there are safeguarding concerns and the child is at risk, parents will be given the chance to work with our perinatal mental health service, where they can receive psychological support.” Dr Somayya Kajee, who is a Consultant Psychiatrist with a special interest in PND, tries to see as many women as possible so that the right support can be put in place to meet their needs.

––– SPOTLIGHT ON POSTNATAL DEPRESSION –––

“WE TRY AND IDENTIFY THESE MOTHERS IN THE ANTENATAL STAGE SO THAT WE CAN PUT A ROBUST PACKAGE OF SUPPORT IN PLACE TO PREVENT THE DEPRESSION FROM WORSENING.”

She said: “Depression makes you feel worthless, guilty and not good enough. It is a double blow when you add to that the insecurity of being a first-time mum who is trying to navigate her way through unfamiliar ground. “It can feel overwhelming and affect the bond they have with their baby, as well as relationships with their other children and with the father.

FACT FILE • Postnatal depression is a common condition which affects more than one-in-10 women and one-in-25 fathers and partners. • Many women feel tearful or anxious in the first week after giving birth. This is often called the “baby blues” and does not last for more than two weeks. If your symptoms last longer or start later, you could have postnatal depression. • Postnatal depression can start any time in the first year after giving birth. • Symptoms include: - persistent feelings of sadness and low mood

“I try and see everyone aged over 25 in the Great Yarmouth and Waveney area who has mental health difficulties and is pregnant or has just had a baby. I also work with patients who are planning a pregnancy so that we can make appropriate changes to prepare, such as reviewing any medication they may be taking.

- lack of enjoyment and loss of interest in the wider world

“Symptoms can change very quickly and people can go from being well to being very depressed and psychotic. It’s important that we have systems in place to flag up those who may suffer, so that we can get to them as quickly as possible after their child’s birth.

- difficulty bonding with your baby

“There are also things that mums can do to help themselves, such as going to groups, taking therapy or enrolling in online courses, such as ‘Babies in Mind’, which is available via Warwick University. “Ultimately, the aim is to help parents recover as quickly as possible so that they can bond fully with their baby during those all-important first few months of life.” Anyone who feels they may be suffering from PND should talk to their health visitor, midwife or GP as soon as possible Alternatively, people can self-refer to NSFT’s Wellbeing services by visiting wellbeingnands.co.uk or by calling Wellbeing Norfolk and Waveney on 0300 123 1503 or Wellbeing Suffolk on 0300 123 1781

- lack of energy and feeling tired all the time - trouble sleeping at night and feeling sleepy during the day - withdrawing from contact with other people - problems concentrating and making decisions - frightening thoughts – for example, about hurting your baby • Postnatal depression is just as serious as other types of depression and can last for months if left untreated. In a minority of cases, it can become a long-term problem. • But with the right support, which can include self-help strategies, anti-depressants and therapy, most women make a full recovery. Find local information and support services: tinyurl.com/pndnhs Information, advice and help from Mind: tinyurl.com/pndsupportnhs Guidance from the National Childbirth Trust about helping dads cope with postnatal depression: tinyurl.com/mpndnhs Help and advice from the Association for Postnatal Illness: apni.org

Insight | Autumn/Winter 2016 9

More support for common mental health problems More people across Suffolk are receiving help to overcome anxiety, stress or depression following the launch of a new-look Wellbeing service. 10 Norfolk and Suffolk NHS FT (NSFT)

––– SPOTLIGHT ON WELLBEING –––

ellbeing Suffolk, launched in September to provide a range of holistic, tailored services for both children and adults to support their emotional wellbeing.

“Problems such as stress, anxiety and depression can all have a major impact on both individuals and their families. We are looking forward to continuing to work with those people to help them return to a productive life as quickly as possible.”

The service offers people accessible, responsive help before their problems become too great, and is available from 8am to 8pm during the week. It also provides talking therapies for those with a wider range of mental health problems so that they can get the support they need within the community, in turn avoiding a referral into specialist services.

NSFT was awarded the five-year contract to run the service earlier this spring by West Suffolk and Ipswich and East Suffolk Clinical Commissioning Groups.

Our Trust is working with a wide variety of community and third sector organisations to deliver the service (see below), who are providing a range of interventions such as support for carers. Nesta Reeve, Consultant Clinical Psychologist and Clinical Lead from NSFT said: “This innovative and creative new service will help thousands of people of all ages to overcome conditions such as anxiety, depression and stress. “As well as offering an increased range of support and maximising the use of technology in delivering our interventions, we are working proactively with our partners to focus on the things people can do lead a good life and build resilience within communities of Suffolk.

A new website, wellbeingsuffolk.co.uk, has been launched to give people more details about the service, interventions and partners, and also explains how to self-refer You can call the Wellbeing Suffolk service on 0300 123 1781. Follow the service on Twitter @Wellbeing_Suff and like its Facebook page by searching for Wellbeing Suffolk To access help from the Wellbeing Norfolk and Waveney service, you can speak to your GP or self-refer at wellbeingnandw.co.uk or by calling 0300 123 1503 Find out more about a special award presented to Nesta Reeve in recognition of the major role she played in developing both of our Wellbeing services on page 120

Wellbeing Suffolk is provided by NSFT working in partnership with a number of third sector organisations, including: • Age UK • MTCIC • Noise Solution • Relate • Shaw Trust • Suffolk Family Carers • Suffolk Young People’s Health Project (4YP) • Survivors in Transition • VoiceAbility We work together to deliver a range of support interventions for people of all ages with low mood, anxiety and depression. For more information about who we are, see: wellbeingsuffolk.co.uk/about

In your words... “It has allowed me to be able to get my life back on track while making my own choices.” Service user “The excellent service has played a significant role in improving my mental health. I now feel positive, capable and happy after three years of stress anxiety and depression.” Service user “I came to therapy believing it wouldn’t or couldn’t change me, but I was so wrong.” Service user “Since making a self-referral to the Wellbeing Norfolk and Waveney I have received excellent service that has played a significant role in improving my mental health. I now feel positive, capable and happy after three years of stress and anxiety.” Service user

Insight | Autumn/Winter 2016 11

My whole world came crashing down – but I won’t let it define me Rachel Edwards’ life changed forever in November 2009 when she climbed out of bed during the night, put on her best outfit and stepped on to a balcony 50ft above the streets of London. Convinced she could fly, she jumped – falling four floors to the ground below and suffering devastating injuries as a result. 12 Norfolk and Suffolk NHS FT (NSFT)

––– SPOTLIGHT ON BIPOLAR DISORDER –––

he incident left the 19-year-old and her devoted family confused and searching for answers. Although she had battled depression for some time, Rachel was not suicidal and had been happy and full of energy when the accident happened, free from inhibitions and chatting confidently to everyone she met.

random clothes. I honestly had absolutely no idea what was going on and was completely out of touch with reality.”

It was only when she was lying in a hospital bed receiving treatment for a broken back and heel that Rachel was diagnosed with bipolar disorder. Her accident had happened while she was deep in the grip of a manic episode and completely unaware of the consequences of her actions.

“We went to bed and my mum had fallen asleep,” explained Rachel. “I got up, got dressed, put on my make-up and can remember going onto the ledge and jumping in the air. My mum woke up to the sound of me screaming on the floor below.

“Although I’d had depression for years, I had no idea that I had bipolar or what a psychotic episode was,” said Rachel, who is now 26 and lives near Eye, in Suffolk. “It was only after I had my accident that I was given a diagnosis. “The manic high came on quite suddenly while I was away on a college trip. I had racing thoughts and lots of ridiculous ideas all at once, and felt that I was someone very special who had been put on the earth for an extraordinary reason. I thought everything I saw related to me and that TV programmes were trying to pass on secret messages to me. “I was the reincarnation of Van Gogh and the next coming of Jesus. I had no inhibitions and felt invincible. I would go up to strangers and start talking to them and almost walked in front of a tram as I thought it would stop for me. I just didn’t think of the consequences of my actions. “I spent all the money in my bank account and dressed in really

When Rachel returned home, her parents were so concerned about her that they took her with them on a pre-arranged trip to London so that she didn’t have to be alone. It was during that trip the accident happened.

“At first I thought I was dead as I couldn’t move because my spine had to be kept still. I had a mental health nurse watching me 24-hours-a-day to begin with, but would still do embarrassing things like singing loudly because I thought I could heal the other patients with my voice.

“I HONESTLY HAD ABSOLUTELY NO IDEA WHAT WAS GOING ON AND WAS COMPLETELY OUT OF TOUCH WITH REALITY.”

“I spent five months in hospital, including 10 weeks receiving specialist spinal rehabilitation in a neurology hospital in London. It was during that time I was told I would never be able to walk again and would be in a wheelchair for the rest of my life. “I cried and cried and felt like my whole world had crashed down – it was heart-breaking and I just didn’t know what the future would hold.”

Rachel’s physiotherapists set her a series of intensive exercises to help her gradually rebuild her strength and adapt to life in a wheelchair. Nine months later she was admitted to a spinal unit for further care, by which stage she was walking very short distances with crutches. By the beginning of 2011 she was able to take a few steps using splints and without crutches, and went onto complete the 5km Race for Life later that year. However, as she has only partial feeling from the waist down and no feeling at all in her feet, she still relies on her wheelchair most of the time. Rachel now writes a blog to raise awareness of bipolar while helping others who may be experiencing similar feelings, and she appeared in a Stephen Fry BBC documentary, called “The Not So Secret Life of a Manic Depressive: 10 years On” in 2016. Continues on next page >>

Insight | Autumn/Winter 2016 13

––– SPOTLIGHT ON BIPOLAR DISORDER –––

<< Continues from previous page

FACT FILE

She has also been working with NSFT Mental Health Practitioner Peter Henson, who visits her monthly to check her progress, talk through her emotions and watch for any triggers. “Bipolar can be very serious and our role is to help make sure people stay on the middle path,” said Peter. “We look for any signs of mania or triggers so that we can protect the individual from that elevated mood, as well as observing for low mood or suicidal thoughts. “We try and dilute some of the stresses of everyday life which can cause issues, such as problems with accommodation or relationships. We also encourage our patients to eat healthily and exercise while making sure they get enough sleep, which is crucial for improving mood.

“WRITING THE BLOG REALLY HELPED AND WAS KIND OF LIKE THERAPY.”

• Bipolar disorder was formerly known as manic depression and is a condition which affects a person’s moods

be very painful. Our job is damage limitation – we try and prevent their problems from getting that severe while making sure they are on the best medication to help their individual circumstances.” Most cases of bipolar develop during the teenage years, although studies are still ongoing into the causes of the illness. Treatment can include medication, psychological therapies and lifestyle changes, as well as education. Rachel is now living more independently after moving into her own home. “I also have a crisis line I can call; if I feel I am starting to get ill, they will ring me every day to check how I am and make sure things aren’t spiralling.

“One of the major problems associated with bipolar is the damage which is caused when someone is elated. They may send inappropriate emails and end up losing their job, lose their dignity by talking to strangers or could give up their housing. I’ve known one person who spent £30,000 in one week and another with seven credit cards, while others will walk into the road because they think the cars will bounce off them.

“I do get low days but mostly I am alright. I take mood stabilisers and will be on medication for the rest of my life. Despite this, I don’t let the bipolar define me and try not to think about it too much.

“It can take up to two years to recover from an episode like that and repay your debts, rebuild your relationships and apologise for everything you’ve done. People have to start life all over again and it can

“I am lucky as I have had amazing support from my family and friends. They have encouraged me through every step of my recovery and brought me back to my old self. I can’t ever thank them enough.”

“Writing the blog has really helped and has been kind of like therapy. I created it to raise awareness of mental health and hopefully offer insight – and maybe even comfort – for anyone experiencing anything similar.

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• Symptoms include periods of depression, which can leave someone feeling very low and lethargic, and mania, where they feel very high and over-active • Bipolar disorder is fairly common, and one in every 100 adults will be diagnosed with the condition at some point in their life • It can occur at any age, although it often develops between the ages of 18 and 24. Men and women from all backgrounds are equally likely to develop bipolar disorder • Treatment can include medication, psychological therapy and lifestyle changes, as well as education to help people recognise the triggers • Manic episodes tend to increase during the summer months, although no-one knows why • The exact cause of bipolar disorder is unknown, although it’s believed a number of things can trigger an episode. Extreme stress, overwhelming problems and life-changing events are thought to contribute, as well as genetic and chemical factors

To read Rachel’s blog, visit tinyurl.com/rachelholly-bd

Innovative new services bring vital support for our veterans Veterans from across Norfolk who are struggling with mental health issues are being offered more support to help them manage their conditions thanks to some specially-designed new services. Continues on next page >> Insight | Autumn/Winter 2016 15

––– SPOTLIGHT ON VETERANS –––

<< Continues from previous page

eveloped and managed in a partnership between NSFT and The Walnut Tree Project, there are now three key services that offer support for former British Forces men and women, including drop-in clinics and a crisis response service. Former British Army guardsman Luke Woodley and NSFT Clinical Psychologist Dr Roger Kingerlee have co-created and jointly lead the partnership services, shifting their connection from patient and doctor to colleagues helping others. Luke’s career with the Coldstream Guards was cut short when he developed PTSD following a tour of war-torn Bosnia. After years of trying different types of support, he felt he only began to make sustained progress when he started receiving support from Roger in 2005.

“I was given a medical discharge after I was diagnosed with PTSD and my life began falling apart,” said Luke, who went on to experience panic attacks, sleeplessness, anger problems, heavy alcohol use, hypervigilance and flashbacks. “I tried several different places for help, but it was only when I started seeing Roger that I felt like someone could now see and hear me. He allowed me to explain what helped and what made me worse, and we started trying to find coping strategies to help me keep my symptoms under control.” Since then, Luke has founded a not-for-profit organisation called The Walnut Tree Project, which supports veterans with PTSD, while also using his own personal experiences to jointly create the new partnership services alongside Roger.

“IT WAS ONLY WHEN I STARTED SEEING ROGER THAT I FELT LIKE SOMEONE COULD NOW SEE AND HEAR ME.”

Luke explains the very real need for this specific support: “Veterans are twice as likely to encounter depression and anxiety as their civilian counterparts. “They can experience reoccurring memories or social isolation, and have difficulty forming relationships, emotional problems or anger issues, while some will also self-medicate using drink or drugs. “They can also be very difficult to reach – they are very self-reliant and are used to being incredibly fit and active with lots of responsibilities – which means they can find it very difficult to ask for help, especially around mental health.” Roger added: “We knew we had to create services which veterans can identify with, are as easy as possible to access and where they would feel safe and understood.

“VETERANS ARE TWICE AS LIKELY TO ENCOUNTER DEPRESSION AND ANXIETY AS THEIR CIVILIAN COUNTERPARTS.”

“And we work with lots of other agencies, so people can access a whole raft of support just by dropping in. Our aim is to be very proactive, go out and connect with these people, take them by the hand and lead them to a better place.” 16 Norfolk and Suffolk NHS FT (NSFT)

––– SPOTLIGHT ON VETERANS –––

URGENT RESPONSE TO VETERANS IN CRISIS The first of its kind in the UK, the outreach Veterans’ Response Partnership (VRP) launched in October 2016 and takes expert out-of-hours crisis help to veterans in mental health crisis. Support is delivered via a special response car manned by experienced volunteers who head out to a veteran in need and try to help them de-escalate. Veterans can sign up to the scheme themselves, so if they go into crisis the service knows who they are and how best to support them, while other British Forces charities and organisations can also register veterans with the scheme. Twenty veterans registered in less than a month of the service launching, and the service can support up to 100 across Norfolk and Waveney, with plans to expand into Suffolk in the future.

any form of professional help can sometimes self-medicate with alcohol or drugs and can end up coming to the attention of the police,” said Luke. “And one aim of VRP is to keep them out of police cells.

VRP volunteers are either veterans themselves, people who work or have worked in mental health, or those who live with a mental health condition. They work alongside specialist teams from NSFT, to assess the veteran and offer peer support.

“Those who have been sectioned or detained tell us the experience was incredibly distressing, and they felt unable to engage with any services or forms of help for six to eight months afterwards.

After a crisis is managed, they can also help the individual to access any further immediate or long term support they may need, such as mental health assessments, housing, and employment or addiction services. Luke Woodley explained that VRP is run by the Walnut Tree and NSFT in collaboration with HMP Norwich, Veterans’ Norfolk and Outside the Wire, a charity which works with ex-military personnel supporting veterans with bespoke substance misuse services. “Veterans with mental health problems who are not receiving

“These people are very vulnerable. Our aim is to support them better using people who speak the same language and understand where they are coming from. “We have been blown away by the support we’ve received for this project from local businesses and other organisations. Their generosity will make a real difference to scores of veterans when they need help the most.” At the launch of the VRP service, retired Army General Lord Richard Dannatt, former Chief of the General Staff, said: “It is crucial that veterans help other veterans, as they can find the right words in situations that can otherwise turn out to be tragic.

“We know that the Army culture can be very tough. And it has to change. But the most important thing is for veterans to be confident to seek help when needed, and I am sure such a project will provide an invaluable help.” The response car was donated by Anglia Square Car Sales and graphics added by Autograph Graphics, both of which are based in Norwich. A local anonymous benefactor has also agreed to pay for fuel for the next four years, while the Governor at HMP Norwich has given the project permission to use the Britannia Veterans’ Centre at the prison as a 24/7 base. See a film about the response car service at tinyurl.com/rcs-veterans

Insight | Autumn/Winter 2016 17

HELPING PEOPLE ADJUST TO CIVVY STREET AND DEAL WITH THEIR ISSUES The Veterans’ Stablisation Programme (VSP) is making a huge difference by helping ex-servicemen and women, as well as their families, to help them manage mental health conditions and adjust to civilian life. A 16-week programme, it has so far helped three cohorts of ex-servicemen and women who are experiencing a range of problems, including anxiety, depression, chronic pain and posttraumatic stress disorder (PTSD). It uses cognitive behavioural therapy (CBT) and mindfulness meditation to help veterans develop the skills to better manage day-to-day tasks and the transition to civilian life.This can include ways to cope with difficult feelings and memories, help reducing the use of drugs or alcohol and practical advice to improve relationships. Roger explained: “The programme is designed to help veterans develop

new psychological skills and ways of coping with both clinical issues and those linked with the cultural shift from military life to civilian life. “The sessions are open to veterans with any psychological issue, which can include PTSD, anxiety, chronic pain, alcohol misuse and depression and cover a wide variety of different areas, such as managing difficult feelings and how you can improve your living environment. “We find that often it doesn’t take much more than a psychological tweak of the engine to help quite significantly. We’ve had some really positive feedback about the courses so far with people learning,

18 Norfolk and Suffolk NHS FT (NSFT)

absorbing and implementing the things we’ve taught them.” In addition to the support offered during the sessions, Roger and Luke also signpost veterans to a range of other support, such as help with benefits or housing advice. For further information on any of these services contact the Britannia Veterans’ Centre on 01603 611708 or 07494 799023, or email walnuttreeproject@gmail.com You can also search for Walnuttreeproject on Facebook or visit nsft.uk/veterans

––– SPOTLIGHT ON VETERANS –––

“I’m sleeping better and am more relaxed… I’m so glad I went on the course…” A former RAF Flight Sergeant who suffered flashbacks and months of sleeplessness after developing post-traumatic stress disorder (PTSD) has praised the specialist support he is receiving which is helping him manage his triggers and enjoy a better quality of life.

ill Mackie, who lives in Aylsham, enjoyed a smooth transition to civilian life when he left RAF after 27 years to start a new career in teaching. But eight years later, things changed dramatically when a seemingly minor incident at school brought back graphic memories from his time in the forces, triggering depression, anxiety and PTSD. “I have always enjoyed working with children so decided to complete an Open University course so that I could go into teaching after leaving the RAF,” said Bill, who is married to Sue and has three children. “I didn’t have any problems when I first left the forces – my difficulties didn’t begin until around two years ago when a lad threw a ball of paper in my face in the classroom. “I just froze. I obviously knew I couldn’t hit back, but I realised I couldn’t run away either. That single incident just brought everything back from my tours of Bosnia and Northern Ireland. “I had flashbacks, didn’t sleep for months and would just sit alone in a darkened room. I could no longer teach as I kept breaking down.

into place,” said Bill, who is now working part-time as a supply teacher. “I was lucky to get the support and be offered a place on the VSP. “Since taking part in the course, I’m definitely sleeping better and don’t wake up as much as I used to. I’m more relaxed and can recognise when I’m going to have a bad day and take action to avoid any further triggers.

“To begin with, I thought I could deal with it on my own. But eventually I realised I couldn’t and asked for help.” Bill saw his GP, attended sessions with NSFT’s Wellbeing Norfolk and Waveney service and completed a Mind First Aid course. He was also referred to an NSFT mental health practitioner, who then introduced him to the Veterans’ Stablisation Programme (VSP). He hasn’t looked back since. “I’ve been very lucky with the way everything has gone with my mental health – everything has really fallen

“The course is like having your own personal psychologist shared between five people, which is absolutely great. It’s informal and flexible, and Roger is more than willing to change the programme to meet our needs and reflect the way our discussions are going. “It’s also been helpful for me to meet others going through a similar situation, and everyone seems to be benefitting from the course. It’s certainly a much brighter group than it was when we first started out. “Although there is still that stigma attached to mental health, I’d encourage others in my situation to step forward and ask for help. The VSP has been great – I’m so glad I took part in it and was given the opportunity to meet Roger, Luke and the other people on the course.” Insight | Autumn/Winter 2016 19

––– SPOTLIGHT ON VETERANS –––

SHARED EXPERIENCES IN DROP-IN SESSIONS Two drop-in groups aimed at men and women veterans are proving to be a success since their launch earlier this year. Offering specially-tailored help for a wide range of mental health conditions as well as access to a raft of other support services, the groups give veterans the chance to meet, share experiences and access any help they may need. The Veterans’ Peer Support Clinics take place weekly and are open to anyone who would like help and advice with any mental health condition, including post-traumatic stress disorder, anxiety or depression. Ex-servicemen and women who attend are also be able to receive one-to-one support or help with issues such as benefits or housing from other organisations, such as Help for Heroes, the British Legion and Outside the Wire. An additional group is designed specifically for all female veterans –

whether they have a mental health condition or not. Thought to be the first of its kind in the country, it gives former servicewomen the chance to meet and discuss issues important to them.

“OUR AIM IS TO BE VERY PROACTIVE, GO OUT AND CONNECT WITH THESE PEOPLE.“

Roger Kingerlee explains: “We want to give veterans the opportunity to socialise with others, and we do some myth-busting around mental health while offering people the chance to talk one-to-one if they would like to.

“The groups also give people the chance to meet others who will be going on to complete the Veterans’ Stablisation programme (VSP) (see the next page) so that they can begin growing those relationships while avoiding the stress of beginning treatment without knowing what to expect. “Our aim is to be very proactive, go out and connect with these people, take them by the hand and lead them to a better place. “These two new groups offer veterans an important opportunity to get together and share experiences while also finding out more about the variety of help and support which is available.

“WE WOULD ENCOURAGE ANYONE WHO HAS SERVED IN THE FORCES, HAS CONCERNS ABOUT THEIR MENTAL HEALTH AND FEELS THE SESSIONS COULD BENEFIT THEM TO COME ALONG AND FIND OUT MORE.”

The Veterans Peer Support Clinic takes place every Monday between 9am and 2pm. The female veterans group meets on the first Thursday of every month, between 10am and 12pm. Any veterans can attend, and are welcome to bring along young children. Both groups are held at Britannia Veterans’ Centre, at HMP Norwich.

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––– SPOTLIGHT ON VETERANS –––

Expert advice on caring for veterans A staff nurse with our Trust who pursued a career in mental health following eight years in the military has offered first-hand advice to colleagues from across the NHS on ways to care veterans.

hris Hall, who works at Wedgwood House, in Bury St Edmunds, highlighted the need to understand the cultural aspects of caring for veterans in article published in the Mental Health Practice Journal in 2016. It came after he completed extensive research into the subject as part of his mental health nursing dissertation, and followed his own experiences serving in the RAF.

non-forces staff may find difficult, I submitted the article to help give nurses some idea of how to approach and treat these patients.

Chris joined the military when he was 18, and spent six years in the RAF Mountain Rescue Service and two with the Tactical Refueling Wing. After leaving the forces, he worked with Mind and Connexions, which prompted him to retrain as a nurse.

“IT’S EXACTLY THE SAME AS TREATING SOMEONE FROM A DIFFERENT ETHNIC BACKGROUND OR RELIGION.”

“My forces background made me aware of the mental health issues caused by trauma from combat and other distressing incidents,” explained Chris. “I attended several aircraft crashes, worked alongside colleagues who had been involved in searches after the Lockerby disaster, and lost a friend who took his own life. “This experience ignited my interest in mental health, which I went on to research in more detail when I started my nurse training and worked on the wards. I saw first-hand that veterans needed a different approach.”

“The best advice I could give to colleagues would be not to be frightened to talk about military life and combat. Get as much background information as you can about what the person was involved with and show you are interested in them.

Through his research, Chris identified alcohol-related difficulties as the most common mental health problem for veterans, affecting nearly 64% of men and 50% of women who had served in Iraq and Afghanistan. Conversely, incidents of posttraumatic stress disorder (PTSD), which he expected to be high, were on a par with the civilian population. “Veterans can find it difficult to ask for help, partially because of the bravado which comes with service life,” added Chris. “That means their problems can often be quite serious by the time they do come into contact with mental health services. “The Armed Services Covenant asks that veterans are treated by someone who understands their culture. As this is something which

“At the same time, the military could do their bit by being more responsible about who they recruit and who leaves service early, often with no support. This group is particularly at risk as the chances are their home life wasn’t great before they joined up. “I am very excited that I have been published, and that the article has been peer reviewed and therefore checked by experts in this field. “I hope that it helps nurses improve treatment, in turn supporting exservice personnel to enjoy fulfilling lives once they have left the military.”

Insight | Autumn/Winter 2016 21

Valuable service extended following first year success A mental health service which gives vulnerable people additional support to help get their lives back on track after they have been arrested has been extended and is up for a national award. 22 Norfolk and Suffolk NHS FT (NSFT)

––– SPOTLIGHT ON CRIMINAL JUSTICE AND LIAISON SERVICES –––

he Norfolk and Suffolk Liaison and Diversion Service (L&D) offers support to people of all ages who are attending a police investigation centre, magistrates or crown court and have vulnerabilities such as mental health or substance misuse issues or learning disabilities. Run by NSFT alongside partners Julian Support and military charity Walking with the Wounded, it has been successful during a year-long trial and has now been awarded an additional £1.3m from NHS England to continue until April 2017. And the successful service has been named as a finalist in the Howard League for Penal Reform’s Community Awards. The awards celebrate projects which help keep people out of the criminal justice system by providing alternative, effective and targeted interventions to reduce the risk of re-offending. And they reward and champion initiatives taking place in the community which help people make positive changes in their lives.

“THE LIAISON AND DIVERSION SERVICE HAS PROVED A HUGE SUCCESS DURING THE PAST YEAR, AND HAS HELPED SCORES OF PEOPLE TO GET THE HELP THEY NEED.“

The L&D initiative sees mental health staff based in police investigation centres and courts across both counties. They can quickly identify people who could benefit from support and refer them on. The service runs seven-days-a-week, and provides help, including education,

employment and support with mental health difficulties, with the aim of reducing re-offending. Those with a military background are referred to Walking with the Wounded’s Project Nova initiative, which supports veterans who have become caught up in low level anti-social and petty crime activity back into mainstream society and long-term employment. An evaluation of the pilot showed it saw 1,611 adults between April and December 2015. Of those: • 883 people (55%) were referred on for more support compared with 29% nationally • 27% were women compared with 22% nationally – one of the initiative’s key aims due to the vulnerability of this group • More people were referred on for help with their mental health than the national average (29% compared to 24%) • More people were referred for help with alcohol or substance misuse than the national average • Significantly more people were referred for help with financial or housing issues than the national average Feedback from service users has been extremely positive, and there has been a low rate of re-offending. Ian Trenholm, Operational Lead for the Liaison and Diversion Service with NSFT, said: ”The service has proved a huge success during the past year, and has helped scores of people to get the help they need to lead a better quality of life. We are delighted that the funding has been extended. ”The team works hard to identify anyone with a vulnerability which may lead to offending and discusses the options available to them before they are referred onwards.

“This means they can receive support as they move through the criminal justice system and into the right mental health or social care service, in turn reducing the likelihood they will reoffend or reach crisis point.”

“A POLICE CELL IS NOT AN APPROPRIATE PLACE TO PUT SOMEONE WHO IS FEELING SUICIDAL OR SUFFERING WITH PSYCHOSIS.“

Siobhan Hemmett, Mental Health Coordinator with Suffolk Constabulary, said: “Vulnerable people should be kept out of custody as a police cell is not an appropriate place to put someone who is feeling suicidal or suffering with psychosis. “Initiatives such as this allow us to provide the most effective response to those in need of specialist services.” Ben Curran, with Julian Support, said: “The service has the ability to respond quickly and efficiently to the needs of people during desperate and extreme points in their lives, and enables them to get the help that they need from the right services. “Many of the people we come into contact with have complex mental health and social care needs. Our experienced staff are able to work with them to address these needs, prevent repeat offences and help them to get their lives back on track.” Colin Back, Project Nova National Manager, said: “It has been a pleasure to provide early intervention support to veterans.” The service will hear if it has won an award at the end of November.

Insight | Autumn/Winter 2016 23

––– SPOTLIGHT ON CRIMINAL JUSTICE AND LIAISON SERVICES –––

L&D SERVICE SHORTLISTED FOR NATIONAL AWARD Norfolk and Suffolk’s Liaison and Diversion Service (L&D) has been shortlisted for a prestigious national award after helping hundreds of vulnerable people to get their lives back on track following an arrest. The service, which is run by our Trust, Julian Support and military charity Walking with the Wounded, has been named as a finalist in the Howard League for Penal Reform’s Community Awards. It has been shortlisted in the “Liaison and Diversion” category, with the winner due to be announced at a ceremony in London on 30 November. The Howard League awards celebrate projects which help keep people out of the criminal justice system by

providing alternative, proportionate, effective and targeted interventions which reduce the risk of reoffending. They reward best practice and champion initiatives taking place in the community which help people make positive changes in their lives. The L&D nomination comes in recognition of the service’s success since its launch in April 2015. It helped 1,611 adults during its first six months, with 55% of those referred onwards for more support.

24 Norfolk and Suffolk NHS FT (NSFT)

Commissioners have extended funding for the initiative until April 2017 as a result. Ian Trenholm, Operational Lead Liaison and Diversion with NSFT, said: “We are delighted that the L&D Service has been shortlisted for this prestigious award, which recognises the difference it has made to scores of people from across Norfolk and Suffolk.”

Taking mental healthcare to some of Suffolk’s most vulnerable people A partnership project which sees staff from our Trust attend incidents alongside the police to offer help to people with mental health difficulties has been extended after proving a success.

he mental health triage car sees a mental health practitioner attend incidents alongside officers from Suffolk Constabulary when people appear to be experiencing mental health difficulties. The practitioners make an initial assessment and will consult any health records to make sure the person’s mental health needs are taken into account so they can receive the most appropriate care.

Since its introduction in April 2014, the project has contributed to a significant reduction in the number of people detained under Section 136 of the Mental Health Act, which is used when people have an immediate mental health need. As a result, it has now been extended, and operates across the county seven-days-a-week.

Peter Devlin, Mental Health Social Care Lead with our Trust, said: “This is an exciting and progressive service development which is seeing police officers and mental health practitioners working jointly to assess and support the needs of people experiencing a mental health crisis. “This will help to ensure that people coming to the attention of the police receive a timely assessment of their mental health needs and are directed to appropriate services at the earliest opportunity.” Suffolk’s Chief Superintendent David Skevington, said: “We know that we receive a lot of calls linked to vulnerable people, many of whom are suffering with mental health difficulties. “Initiatives such as this are exactly what we need to help us align our

services with our partners to deliver the best response to those who need help. “Our work with the NSFT will help us not only lower the amount of repeat mental health related incidents from individuals, but start people who need mental health support on a suitable care and treatment pathway. “Using the knowledge and expertise of mental health staff means that those in need of help are receiving it faster at the time when they perhaps most need it, using better placed resources and providing enhanced support.” The scheme has been introduced by NSFT and Suffolk Constabulary with support from Ipswich and East Suffolk Clinical Commissioning Group.

Insight | Autumn/Winter 2016 25

––– SPOTLIGHT ON CRIMINAL JUSTICE AND LIAISON SERVICES –––

Pioneering partnership to help save lives A ground-breaking scheme which makes sure police officers who are at risk of suicide can get urgent mental health support and onward referral is proving a success after saving at least two lives within just weeks of its launch.

The initiative has seen Norfolk Police Federation work with NSFT and other partners to help officers who are suffering from severe mental illness, with priority given to the minority who may be suicidal. If one of its members is deemed at immediate risk, the Federation will contact Terri Cooper-Barnes, Deputy Service Manager with our Trust, who will visit the officer, assess their needs and offer confidential advice. Wherever necessary, she will urgently refer the officer to an inpatient unit or NSFT’s Crisis Home Resolution Team (CRHT) for continued support, medication or talking therapies. The scheme has proved a success since its launch in December 2015, with at least two suicides prevented within its first few weeks and several more officers given the help they need to overcome their problems.

“IT IS ABOUT BRINGING TOGETHER ALL THE HELP AVAILABLE AND ENSURING THE OFFICERS WHO NEED IT HAVE THE CORRECT LEVEL OF SUPPORT.“

“Policing is incredibly stressful,” said Terri. “When officers are experiencing high levels of distress, my job is to pick them back up and make sure they get access to high quality mental healthcare at the point when it is needed the most. “Wherever necessary, I will refer them urgently to one of our inpatient units or our crisis teams, where they can receive longer term help. “The people we see are considered to be very high risk, but by being there and listening, we can show them they are not on their own.

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“The officers are always incredibly grateful for the help we provide, and appreciate the fact we can quickly refer them to the right place to receive the specialist support they need. “The partnership is the first of its kind in the country, so Norfolk really is leading the way on this important work. Other forces are now looking to roll out similar schemes which, if they save even one life, will be well worth it.” A strong partnership already exists between the police and NSFT.

––– SPOTLIGHT ON CRIMINAL JUSTICE AND LIAISON SERVICES –––

Mental health nurses work in police control rooms to provide expert advice quickly in any situations where mental health is a factor, in turn making sure people get the right support when they present to the police in crisis. The new initiative builds on the success of that project, taking the support provided to the next level. “The concept is simple but extremely effective,” said Paul Ridgway, Chairman of Norfolk Police Federation. “It is about bringing together all the help that is available and ensuring the officers who need it have the correct level of support. “Many of our reps have been contacted by members in mental health crisis at all hours of the day and night. They turn to their reps because they either cannot get hold of their line managers, or the officers do not feel confident that the line manager will be able to keep their situation confidential from the force. “We are delighted that NSFT are now working with us to carry out mental health assessments for those officers who are the gravest concern. Terri uses her expertise to offer guidance on what actions reps should be taking, including completion of their own reference notes in addition to the ongoing welfare of individual officers. “She then meets with officers identified as potentially high risk, with their agreement, to determine if our level of concern is justified or not. This process has been extremely successful so far and we have already prevented officers from taking their lives through this intervention. “It also provides welcome relief and support for reps who had previously been trying to manage these issues alone.”

“THE PARTNERSHIP IS THE FIRST OF ITS KIND IN THE COUNTRY SO NORFOLK REALLY IS LEADING THE WAY ON THIS IMPORTANT WORK.”

Since the launch of the project, Norfolk Police Federation has presented the initiative at Westminster and spoken to local MPs about the scheme. It has also attracted interest from the Shadow Minister for Policing, Her Majesty’s Inspectorate of Constabularies, the National Professional Firearms Officers Association, the OPCC and the College of Policing.

In the future, the Federation hopes to work with NSFT, Norfolk and Suffolk Constabulary and a variety of other partners to create a more wide-ranging support programme to help officers and staff who are suffering from mental ill health. This could include talking therapies, such as cognitive behavioural therapy, counselling and neuro-linguistic programming, as well as signposting people to other sources of support. “This is the start of a programme that will continue to grow and as more branches, constabularies and partners come on board,” added Paul. “It can only lead to a better opportunity for officers to feel truly supported. “If one officer is saved through this programme, it will all have been worth it.”

Insight | Autumn/Winter 2016 27

Improved eating disorders services helping more people than ever People in Norfolk and Suffolk are now seeing the benefit of expanded and enhanced services. 28 Norfolk and Suffolk NHS FT (NSFT)

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––– SPOTLIGHT ON EATING DISORDERS –––

new Suffolk-wide eating disorders service has been launched and young people are now receiving the highest quality help from the enhanced service.

Dr Rosalind Tandy, a GP in Bury St Edmunds and Mental Health Lead for NHS West Suffolk CCG, said: “Eating disorders are severe mental illnesses with serious psychological, physical and social consequences.

The Children and Young People’s Community Eating Disorder Service (CEDS) offers a gold standard of dedicated care to people aged up to 18 with anorexia, bulimia and binge eating disorder.

“A significant number of people with anorexia nervosa die as a result of the condition and the lives of many young people are badly impaired due to long-term health conditions which result from having an eating disorder, such as brittle bones, poor circulation, infertility and kidney damage.

Funded by NHS England and the Suffolk clinical commissioning groups (CCGs), it builds on the existing services already in place in line with new national guidance. As well as making provision consistent across the county, it aims to reach more people at an earlier stage of the illness, and reduce hospital admissions. CEDS provides a range of best practice interventions and will be tailored to each individual’s needs. This includes help changing behaviour, medication, nutritional advice, psychological help, meal support, family therapy and education. The service also responds to the broader needs of families and carers by supporting them with techniques to help manage eating disorders and information about additional support services or expert advice. Our Trust has also contracted Beat, the eating disorders charity, to provide training and education to help our staff and NHS colleagues recognise the symptoms so that people can get help at the earliest opportunity. Beat is also delivering awareness training and workshops in schools for staff and pupils to increase understanding about eating disorders, the risk factors and where to go for help. It is also providing online peer

support groups for under 18s who are struggling with an eating disorder or with difficulties with food. Alison Armstrong, NSFT’s Director of Operations (Suffolk) said: “This is providing a real gold standard of care for this vulnerable group, ensuring they receive the right support at the right time. “A key aim is identifying people and families affected earlier so that they can access help in the community or their own home. We are also working closely with colleagues in the acute hospitals to ensure that patients who are admitted with an eating disorder are given the right support to allow them to return home quickly.” Additional staff have been recruited to deliver the enhanced service, including a consultant, family therapist, specialist nurses and two assistant practitioners, who work with children, young people and their families in their own home to support them at mealtimes. It aims to see routine referrals within four weeks, urgent cases in one week and emergencies within 24 hours.

“This service is so important as it gives young people access to an intensive level of support and care which will give them the best possible chance of recovery, help them regain a healthy weight and maintain a positive relationship with food.”

“THIS NEW-LOOK SERVICE IS PROVIDING A REAL GOLD STANDARD OF CARE FOR THIS VULNERABLE GROUP.”

Louise Dunne, Interim Head of Services at Beat, said: “We are delighted to have been commissioned by NSFT to contribute to the exciting new Children and Young People’s Community Eating Disorder Service. “Our work will support the Trust’s aims of early recognition, early intervention and improving access by raising awareness, improving knowledge and education, and engaging with young people throughout Suffolk, enabling them to get the right help at the earliest opportunity.”

Insight | Autumn/Winter 2016 29

––– SPOTLIGHT ON EATING DISORDERS –––

Eating disorders services see 25% rise in demand A rise in demand for eating disorders services locally is leading to expanded and improves services right across Norfolk and Waveney, as well as a new service in Suffolk.

ndy Goff, Improvement and Development manager for Children, Families and Young People’s services, Norfolk and Waveney, explained that local demands fully reflect the trends seen throughout the UK. “By the end of 2015, our service had seen a 25% year-on-year increase in the number of referrals, and an increase in the complexity of cases we are seeing, meaning more support, often for a longer period of time, is required. “In central Norfolk alone we saw 100 new referrals of complex, severe eating disorders in 14 -15 years olds in 2015/16. “To meet this unprecedented rise in the number of young people, in particular, being referred, and to respond to the previously unmet need for eating disorders services locally, our services across Norfolk and Waveney have been expanding. And of course we have seen a new look service being rolled out in Suffolk too.

patients, and therefore we see an increase in the number of referrals.” Dr Kiran Chitale, Consultant Child and Adolescent Psychiatrist for NSFT, explained there were many factors leading to an increase in referrals, including increased awareness of eating disorders and the support offered. “However, these young people also feedback to our services that they feel huge social pressures to have the perfect body,” she said. “This places vulnerable teenagers under significant pressure and drives them to dangerous food restricting behaviours.

“With commissioner’s investment we have increased our staffing levels in Norfolk and Waveney over the past year and we aim, within the next 12 months, to more than double our capacity.

“We have to find better ways to support young people to gain a healthy balance between exercise, food and nutrition, so that they can enjoy a healthy lifestyle and improved self-esteem.”

“As our services have expanded so we are able to see more and more

When at full staffing capacity the aim of the expanded and

30 Norfolk and Suffolk NHS FT (NSFT)

redesigned services will be to meet the new national standards, and see treatment after referral start within: • Seven days for urgent cases • 28 days for routine cases Andy explained: “This doesn’t mean the person is not receiving any support before their full therapeutic treatment begins. “They will be going through our triage process and full assessment, receiving GP support, including undergoing full physical health checks. They may also be receiving support from other mental health services, support staff based in schools, or have support from a charitable organisation such as Eating Matters or Beat. “Locally, we are seeing a definite move towards more investment and increased access to our services. There is still a way to go, but we are all moving in the right direction.”

––– SPOTLIGHT ON EATING DISORDERS –––

“You can find yourself again and get on with enjoying your life” A Suffolk dancer has pledged to raise awareness of conditions such as anorexia and bulimia after secretly suffering with an eating disorder which threatened both her mental and physical health.

After returning home to Bury St Edmunds and writing her mum a letter explaining what was happening, Julia was prescribed antidepressants by her GP and referred to NSFT’s specialist mental health team for cognitive behavioural therapy. However, her recovery only began in earnest after she was voluntarily admitted to Wedgwood House, our Trust’s inpatient unit in Bury St Edmunds, following a breakdown.

ulia Drake became ill in 2012 while studying at a performing arts college in Leeds.

“I wasn’t the shape I thought I should be,” she explained. “I began counting calories and over-exercising and started really struggling in lessons. “I knew that my thoughts weren’t healthy and I needed help, but at the same time I didn’t think I was skinny enough to be ill. It was a strange position to be in. “I eventually decided to tell my mum after I fainted at college. I weighed myself and my BMI showed I was officially underweight. At that point, my brain finally accepted I was ill – it was like my body had caught up with my mind.”

“My case worker and I decided admission was what I needed – it was somewhere I wouldn’t be able to hurt myself,” explained Julia, now 22. “But although I went there voluntarily, I wanted to leave after just one night. Suddenly all of my choices were taken from me and everything was totally out of my control. “That was the thing that helped me turn the corner and made me finally decide to start recovering properly – I ended up spending three days there and didn’t want to be in that position again.” With the support of her NSFT case worker, family and friends, Julia slowly got better and was on her way to recovery by her 20th birthday. Keen to do her bit to help others, she has now become an ambassador with the eating disorders charity Beat, which sees her work with the media, give talks

to GCSE students and help train GPs to improve the care they provide. “When I first got ill, a lot of people around me didn’t understand and could be quite judgmental,” said Julia, who is now studying for a history degree at Anglia Ruskin University. “Even though eating disorders are common among dancers, we weren’t educated about the dangers, which I now find quite shocking. “I wanted to help spread awareness and improve care for people with conditions such as anorexia and bulimia, which is why I started working with Beat and sharing my story. “For me, I realised that as long as I kept giving in to the eating disorder and following its voice, I would never lead my own life. When I was ill, I was ruled by the eating disorder and there were so many restrictions on me. Part of my recovery was to find what I wanted from life and focus on that rather than letting the eating disorder’s voice drown everything else out. “Recovery was hard, but well worth it. I know that I’ll have to live with the eating disorder for the rest of my life, but that doesn’t mean I have to suffer. Hopefully I can show others that you can find yourself again and get on with enjoying your life.” Insight | Autumn/Winter 2016 31

“You are not alone and it is not forever – there is life after an eating disorder” A Suffolk runner who overcame bulimia to complete 10 marathons in just six months has urged other people suffering with an eating disorder to speak to someone and ask for help, saying “you are not alone”.

om Fairbrother spent two years fighting a secret battle against the illness after developing it in January 2013 when a fellow runner made a comment about his weight.

But everything changed in December 2014 when his dentist delivered a stark wake-up call, warning Tom he would lose his front teeth within the next six months if he didn’t taken action to tackle his illness.

Over the following months he lost a quarter of his body weight and became a virtual recluse, making excuses not to socialise with family and friends and instead binging on junk food before inducing vomiting. Although permanently exhausted, Tom continued to exercise regularly and even ran two marathons, inadvertently putting his long-term health at risk.

“I look back now and think how lucky I have been,” said Tom, who grew up in Woodbridge, in Suffolk. “I was lucky that I didn’t suffer organ failure or any other permanent damage, lucky I didn’t seriously injure myself when I was running with no fuel in the tank, and lucky that I got toothache and my dentist confronted me.

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“Up until that point, I hid my weight loss with my running and my reclusiveness behind my dedication to training, but I knew I wouldn’t be able to hide being 26 years-old with no front teeth. That was when I realised I had to stop – it gave me the motivation I needed.” Over the next few months, Tom slowly began to increase the amount he ate, concentrating initially on keeping down healthy foods such as fruit and vegetables as he built up his strength. Several months later, he finally felt able to speak to his friends and family about his illness, whilst also setting himself the

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daunting challenge of running 10 marathons in just 150 days to raise awareness of eating disorders in men and essential funds for charity. “Stereotypically, eating disorders are seen as something which only affect body-conscious teenage girls, not fit, healthy men in their 20s,” said Tom. “Because of this, I didn’t initially tell anyone or ask for help – I was embarrassed about what they would say. “But I had no need to worry. As soon as I opened up, everyone was incredible and really supportive, which makes me wish I’d said something earlier. I was instantly inundated with positive messages from people I haven’t seen or spoken to in years and contacted by complete strangers on social media who have been affected, directly or indirectly, by an eating disorder themselves.” The 28-year-old started his ‘Tom Runs Ten’ challenge with the Flitch Way marathon on New Year’s Eve 2015 before completing – among others – the London, Manchester

and Edinburgh marathons and finishing with Man V Horse, in Llanwrtyd, Wales. He claimed first place in four of the marathons, completing eight in less than three hours. At the same time, he raised around £2,300 for eating disorders charity Beat – money which he hopes will help others who find themselves struggling in the future. “I saw the challenge as the perfect way to celebrate my new-found physical and mental strength while doing something that I love. I also hoped that continuing my recovery in the public domain would show other sufferers that eating disorders can be beaten, and may inspire them to seek professional help or confide in a friend or relative,” explained Tom. “Eating disorders claim more lives than any other mental illness, with one in five of the most seriously affected dying prematurely from the physical consequences or from suicide. And just like any other illness, they are very difficult to beat alone.

“I was frail, weak and had no energy. I would wake up exhausted, force myself to go for a run, eat nothing all day then binge in the evening before doing it all again the next day. Even now I don’t know how I managed to survive like that for two years. “With hindsight, I wish I had spoken to someone about what I was going through, and would urge anyone else who is suffering to do just that – if you can’t talk to friends or family, speak to an independent third party, like Beat or a health professional. They won’t judge you and are qualified to give you good advice. “You are not alone and it is not forever – there is life after an eating disorder. And although there are some horror stories, there are plenty more positives about people who have come out the other side and recovered – I for one am stronger, fitter, faster and much happier and more confident than I was before. “Always remember that an eating disorder is an illness just like any other. It’s really important to get the right treatment and taking those first steps towards recovery.” To read Tom’s blog, visit tomrunsten.com. You can sponsor him until December 2016 at justgiving.com/TomRunsTen

Eating disorders affect 725,000 people in the UK, 15 to 20% of which are men and boys. However, the illnesses are treatable, and the sooner someone gets the support they need, the more likely they are to make a full recovery.

Insight | Autumn/Winter 2016 33

Specialist eating disorder service shortlisted for top regional award A specialist service which ensures children and young people get the help they need to overcome eating disorders has been shortlisted for a regional award.

ur Central Norfolk Child and Adolescent Eating Disorders Service (CENCAEDS) has been named as a finalist in the team outstanding clinical achievement category in the East of England Leadership Recognition Awards. The shortlisting comes in recognition of the work which has taken place over the past few years to develop CEN-CAEDS from a small service run by two part-time members of staff into

a top-performer which has been accredited by eating disorders charity Beat. The team now cares for more than around 140 young people at any one time, and concentrates on providing the right interventions at an early stage to give the individual a greater chance of making a good recovery and prevent a hospital admission, wherever possible. A range of treatments are available, including psychoeducation, motivational enhancement therapy,

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cognitive behavioural therapy, medical management and individual therapy, along with group sessions, family work, and carer support. Now 10-strong, the team is made up of a consultant, associate specialist, clinical nurse specialist, clinical team manager, nurses, assistant practitioners, a systemic therapist, a cognitive behavioural therapist. The service also hosts trainee doctors and nurses, while work is currently taking place to recruit a dietitian to further improve the care which patients receive.

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Dr Kiran Chitale, Consultant Child and Adolescent Psychiatrist, said: “We are absolutely delighted that the service has been shortlisted for this award. It’s a testament to the hard work and dedication of the team, who are managing increasing numbers of patients with more severe problems every year.

“OUR YOUNG PEOPLE HAVE PLAYED A MAJOR ROLE IN HELPING US TO SHAPE THE SERVICE SO THAT IT RESPONDS WELL TO THEIR NEEDS.”

“We work with our patients and their families to put together individual treatment plans tailored to meet their needs, which could include individual and group therapies to help them manage their feelings, as well as health and nutritional restoration within a holistic care model. “Young ambassadors and carer ambassadors have an input into the way the service is delivered and developed, and will often come with us to talk to local GPs to raise awareness of the symptoms of eating disorders and the importance of early intervention. “We feel very privileged to work with them and are really grateful for helping us to make the service what it is today.” The winners will be announced during a ceremony at the Imperial War Museum in Duxford in November

EXPANDED SERVICE NOW OFFERING EXTRA HELP FOR WEST NORFOLK PATIENTS More young patients in West Norfolk are now able to get specially-tailored help with eating disorders after our Trust expanded the service it provides. New staff have been recruited to the eating disorders service based at Thurlow House, in King’s Lynn, which means it is now able to offer bespoke care to even more young people suffering with illnesses such as anorexia and bulimia. The expansion means the team can reach more people at an earlier stage of the illness before their problems become too great, as well as focusing on preventative work in schools and colleges. It has been made possible with transformation funding awarded to the region by NHS England. Debbie Murrell, Clinical Team Leader, said: “We are delighted that we have been able to expand the service we provide, as it means we will be able to help even more young people and their families. “When we receive a referral, we carry out a full assessment before putting together a tailored care plan which will meet their individual needs. We have designed the service to be as flexible as possible, and can offer support in people’s own homes, schools or colleges, or at our clinic. Debbie works alongside Mental Health Practitioner Elliot Robinson and a family therapist to deliver the service, while Specialist Nurse Karolyn MacRae was also due to join the team at the end of November. Together, they offer a wide variety of help, including nutritional therapy, psychological therapy, family therapy and help with the social aspects linked with the illness.

“IT’S VITAL TO REACH PEOPLE AS EARLY AS POSSIBLE, AS IT MEANS THEY CAN GET BETTER SO MUCH SOONER. TO HELP US DO THIS, WE ARE ALSO CARRYING OUT A LOT OF WORK TO RAISE AWARENESS OF THE CARE WE PROVIDE, AS WELL AS THE WARNING SIGNS PEOPLE SHOULD BE LOOKING OUT FOR.”

They also work closely with GPs and other NSFT specialists, while also providing meal support in people’s homes, colleges or schools. The team have introduced a support group for parents and carers to help boost their confidence and give them coping mechanisms, and are also finalising plans for a parent and teacher workshop. The service offers support to people up to the age of 18 who live in west Norfolk. It takes referrals from GPs and other health professionals, such as school nurses, while parents who have concerns about their child can call the team on 01553 736011

Insight | Autumn/Winter 2016 35

More dedicated care being provided to more people Our new-look specialist eating disorder service is now helping twice as many people than before after extending the care it provides.

he Community Eating Disorder Service (CEDS) now supports people of all ages in the in the Great Yarmouth and Waveney area. This means people referred in their teens can receive consistent care from a dedicated team without the need to transfer elsewhere when they reach 18. In addition, the service has also expanded to care for people with moderate difficulties, whereas previously it could only take referrals for the most seriously ill patients.

Over the last few months, new staff have also been recruited to the team using money awarded by NHS England. As well as allowing CEDS to reach more patients, it has also allowed them to extend their opening hours into the evening and over weekends. “We are very excited about our new service, which we believe is already making a real difference to patients and their families,” said Psychiatrist Louise Brabbins. “We know from listening to our patients and their families, as well as looking at research, that transition and change can be an

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excruciating process for young people with an eating disorder. That is why we have an all age service, where there is no transition to go through at the age of 18.” The CEDS team is made up of Clinical Team Leader Fiona Lain, a specialist dietitian, assistant practitioner, a psychological therapist, occupational therapists, specialist nurses, and psychiatrists. All are experienced in treating and supporting patients and families, and offer a wide variety of help such as talking therapies and meal support in homes, colleges and schools.

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“Eating disorders are complex psychological conditions with potentially very serious physical complications,” added Louise. “The team understands this all too well and so works closely together, and with colleagues in the wider NHS, to help manage and reduce the risks as much as possible. We also try and make sure our patients can recover at home, as long as it is safe for them to do so.

“WE HAVE HAD SOME AMAZING RESULTS SO FAR AND ALTHOUGH THE NEW-LOOK SERVICE IS STILL IN ITS INFANCY, IT IS ALREADY MAKING A HUGE DIFFERENCE TO OUR PATIENTS AND THEIR FAMILIES.”

“People with an eating disorder can often find themselves really socially isolated, having lost their friends, work or college placements, and may be terrified to face the world again. Our team will work motivationally with them to help them make changes physically, psychologically and socially.” The team is now rolling out training to improve understanding of eating disorders among healthcare professionals and others who are involved in young people’s lives, such as teachers. Louise explained: “This is a crucial part of our work to help with early detection and treatment for those young people and comes in addition to the education and training we already offer in primary care, secondary care and to university students.

“We also facilitate a group which empowers carers and parents to support the person with the eating disorder through an incredibly difficult time. “We are passionate about delivering good quality, evidence-based, compassionate treatment, and will soon begin offering multi-family therapy with our psychological therapies colleagues. This will help families who feel swamped by how the eating disorder has affected them to move on and make positive changes in their lives.” Service user Birdie (not her real name), has suffered with anorexia for more than 20 years. She has been receiving support from the team for some time, and has described them as an “invaluable” part of her ongoing recovery. “To have the support and encouragement of the team who know this illness inside-out is crucial, and something that I’m extremely grateful for,” she said. “At the onset of my illness, I genuinely believed that I could make it on my own. How wrong I was! A major regret is that the level of expertise I draw upon now was not available when I was a lot younger, and the stark reality is that I missed out on what could have been the best years of my life. “Nevertheless, in spite of all the adversity I’ve faced in the interim, I’m still here and doing my best. It would be a harder task if I didn’t have the team backing me every step of the way. I certainly couldn’t do it without them. “I would reassure other sufferers that with the eating disorders team behind them, they are not alone.”

IN ADAM’S WORDS: “I FEEL MYSELF AGAIN AND NO LONGER FEAR FOOD” “My name is Adam. Last year we discovered that I had anorexia, which made me feel sad, worried all the time and easily stressed out. I had a lack of energy and didn’t want to socialise and go out with my friends. “I felt very anxious about food because I was very worried about the way I looked and I didn’t want to be overweight. “I was also very uptight about burning off the calories which I took in. Every day I would try to eat as little as possible and would also burn off as much as possible. “When I first started getting help I really struggled. The minute I heard about eating more food and burning less off I was instantly scared. The first few weeks were extremely hard, but over time we started introducing more and more foods that I love. “Now I feel very well and I am feeling myself again. I no longer have any fear of food or calories, and I don’t think about what I am eating. I eat when I’m hungry, and I drink when I’m thirsty, and this is all because of the help which I was given and the effort which I put in.” *Names have been changed to protect the family’s identity. Continues on next page >>

Insight | Autumn/Winter 2016 37

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IN JANE’S* WORDS:“HE’S BEEN A SUPERSTAR – WE’RE INCREDIBLY PROUD OF THE WAY HE HAS TACKLED HIS ILLNESS” << Continues from previous page “Adam* was almost 12 when we noticed a problem. He had been a straightforward, easy going, upbeat child until then. It started when he began cutting out unhealthy foods (the whole family is vegetarian and we eat fairly healthily anyway), then started to drastically reduce the quantity and range of food he would eat. He was always a slightlybuilt child and the weight dropped off him rapidly. “He became very tired, his mood changed drastically and he became obsessed with food and exercise. Alarm bells rang, I phoned the GP surgery and told them I thought Adam was anorexic. The practice nurse saw him that evening and immediately referred him to the Child and Adolescent Mental Health Service (CAMHS). “When the diagnosis was confirmed, a specialist nurse gently told Adam about his condition and how dangerous it was. He seemed to understand but was initially reluctant to make any changes. “He was very conscious of the effect of his illness and I think this was ultimately the factor that caused him to decide to fight it. With his nurse’s guidance, we wrote down all of Adam’s demons and he began to defeat them one by one. He was given a target daily calorie intake, which slowly increased over the weeks. We saw the nurse weekly and although progress was very slow, our son gradually began to put on weight.

“Adam used music to help change his moods and gradually became more social again. He had a special song that he would play if he was feeling wobbly. He showed amazing strength of character and became determined to ‘kick its sorry ass into the middle of next week’ and this was paramount in his recovery. We talked a lot, the two of us and as a family. Sometimes it was very emotional, but ultimately kept us all on track. My husband and I worked as a team, shopping for groceries, preparing different meals and introducing previously taboo foods one by one. “By now we had the tools to progress Adam’s recovery ourselves, but still kept in touch with CAMHS by phone and appointments. Adam is now well on the road to recovery and looks and feels much better, is sociable and enjoys eating out and meeting new people.

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“He has been a complete superstar and I’m incredibly proud of the way he has tackled this illness, and feel we have all come out stronger.

“ADAM IS NOW WELL ON THE ROAD TO RECOVERY AND LOOKS AND FEELS MUCH BETTER, IS SOCIAL AND ENJOYS EATING OUT AND MEETING NEW PEOPLE.”

“We will never forget it though and I am very alert to the slightest change in Adam’s mood. We still see our nurse, just to check everything is okay. “She is still there for support and we really appreciate it; she has been so kind and understanding.”

Celebrating three successful years A ground-breaking project which has helped thousands of service users to focus on life beyond mental illness and become experts in their own recovery is celebrating a milestone after reaching 3,000 people. Continues on next page >> Insight | Autumn/Winter 2016 39

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<< Continues from previous page

SFT’s Recovery College offers service users, carers and staff the chance to take part in courses and workshops which will help develop their skills, understand mental health, identify personal goals and open up new opportunities. More than 3,000 people have come through the doors within the first three years, with courses continuing to grow in popularity with every term. A key element of the success hinges on the involvement of people with lived experience of mental ill health. All of the college courses are jointly produced by NSFT mental health practitioners and people with lived experience of mental ill health, while around 20 peer tutors help to deliver the sessions. The Recovery College is open to current secondary mental health services users, and those who have been discharged from mental health services within the past 12 months, as well as NSFT staff, carers and partners. It now offers 28 different courses and is working on developing 12 more. Each course has been created by people with lived experience of mental health working with a professional. This has resulted in excellent feedback with 90% of people who have been on courses saying they would recommend it to others. Sarah Mitchell, Recovery College Manager, said: “The aim of the college is to give service users support, hope, control and the opportunity to go onto a meaningful life, despite their diagnosis.

“Everything at the college is based around understanding and living well with mental health issues. “It provides a friendly and positive environment in which students learn from one another as well as from the tutors. Its strength based approach frequently leaves students feeling empowered and uplifted.” Since its launch, the college has welcomed 2,621 service users, carers and staff, who have taken part in 598 workshops held as part of 233 courses. Each year, capacity has increased and, for the autumn 2016 term, we’ve had space for 1,640 participants.

“THE AIM OF THE RECOVERY COLLEGE IS TO GIVE SERVICE USERS SUPPORT, HOPE, CONTROL AND THE OPPORTUNITY TO GO ONTO A MEANINGFUL LIFE, DESPITE THEIR DIAGNOSIS.”

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Both the Recovery College and the peer support worker programme have since become key elements of the NSFT’s recovery programme, which aims to help those who’ve experienced mental illness to achieve personal goals while using their knowledge and expertise to inspire and educate others. “I have been very humbled and heartened by the passion and commitment our staff, service users and carers have brought to this whole programme,” added Sarah. “The key thing about the Recovery College and Peer Support Workers is that they focus on helping people to understand their illness so that they can make choices about managing their symptoms, in turn offering them hope for recovering a meaningful life. That is crucially important and one of the things which makes this project so successful.” For more information about the Recovery College and its latest courses, visit nsft.uk/recoverycollege

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“I WAS HOOKED – THIS WAS WHAT I HAD COME INTO NURSING TO DO” Sarah Mitchell, NSFT’s Recovery College Manager tells Insight in her own words what it has meant to her and how it brought her career in mental health back to life offering her a job she ‘absolutely loves’. I started my career in mental health nursing as a teenager in 1983, motivated by ideals in a world where the word ‘yuppie’ had only just found its way into our vocabularies. For nearly three decades, I happily worked away on the wards and within the community. I enjoyed it, but if I’m honest with myself, the later years didn’t bring quite the same levels of job satisfaction as when I first started out. “Then, around three years ago, a conference about the ImROC (Implementing Recovery through Organisational Change) programme sparked my interest. I signed up and chose the workshop option for something called the ‘Recovery College’. “I remember being amazed, inspired and actually blown away by the speakers. I was hooked and realised that this is what I had come into nursing to do. Right there and then, I decided I had to get involved. “When our Trust launched its Recovery College later that year, I went to the very first workshop and immediately registered my interest in becoming a recovery champion. I soon found myself becoming more and more involved, and eventually began working for the college permanently. “I’ve never been a confident public speaker, but this didn’t deter me. Although I can get anxious, I don’t shy away from a challenge and, with the right motivation, can put myself light years out of my comfort zone. Teaching in the Recovery College has helped me do just that. “I’ve gone from almost being one of those people who counts down the shifts until their retirement to someone who enjoys each and every day and is upbeat and enthused. I absolutely love my job.

“Every aspect of each course and workshops has been written by someone with lived experience of mental ill health, alongside someone with professional experience. This co-production makes such a big difference – it leads to an understanding and viewpoint which just isn’t possible by reading a book or sitting in a traditional classroom. The positive feedback we have received so far backs this up. “From a personal point of view, I’ve also been using recovery philosophy in my own life. I decided to practice what I preach and get out and do more things which are interesting to me. It’s made a huge difference – I’m connecting more with friends and have reignited my love of music and dancing and joined a local community band which is loads of fun.

“The thing which is so different from my experience of nursing is the constant focus on the positive and what’s going right in a person’s life. Recovery College courses and workshops don’t aim to ‘fix’ things for the attendees, but rather help them to identify and grow their existing strengths alongside learning skills to manage difficulties.

“I have so much gratitude for being involved in this project and am delighted with the difference it has made to the quality of my own personal and professional life. I’ve been fortunate to have been given the opportunity and work with mentors who could see my strengths and help me fan a tiny spark into a whopping great bonfire. It’s true to say I definitely feel I live recovery philosophy.

“The other hugely enlightening and rewarding difference for me has been in the co-production partnerships I have developed and learned an incredible amount from.

“The Recovery College has shown me you can teach an ‘old dog’ new tricks. I hope that my story inspires others to get involved and begin their own recovery journey.” Insight | Autumn/Winter 2016 41

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New lead outlines plans for helping more people recover Our new Head of Recovery, Participation and Partnership has spoken of his ambition to build on the success of our Recovery College so that even more people can benefit from its innovative approach.

arcus Hayward took on his new role in the summer (2016) after getting a “buzz” from seeing the work of the Recovery College first-hand in his previous job as a locality manager. He is now leading the Trust’s ImROC (Implementing Recovery through Organisational Change) programme, which includes developing the Recovery College and NSFT’s wider recovery strategy. In addition, he is also responsible for making sure the voices of service users and carers are heard, and they are involved in the way services are developed. “When I attended the Recovery College launch in 2013, I felt the way it was co-presented by staff and service users in partnership was the way forward,” said Marcus. “I bought into the concept from that moment, and was keen to get more directly involved which is why I applied for this post. I felt that it would give me the opportunity to get closer to what brought me into the NHS in the first place, which is about making a positive difference and helping to overcome the stigma that still surrounds mental illness.

courses can be extremely powerful and mutually beneficial. I see it as a real example of contemporary best practice in mental healthcare.” Marcus is now working to co-produce the NSFT Recovery Strategy, to further embed the Recovery College model and create outcome measures.

“Recovery is about helping people to find or rediscover a meaningful life, with or without the ongoing presence of mental illness. Just about everyone needs to find a sense of meaning in life, and that’s as true for staff delivering services as it is for those who use those services. “Some of the courses we offer are very creative and are as much about developing life skills and ways to express yourself as they are about understanding and managing symptoms of mental illness. “Recovery provides a new rationale for mental health services. The college shows that service users and staff can work together to co-produce courses very successfully, and that those

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This will provide evidence of the success of each course by asking service users if it helped increase their sense of hope for the future, control over their own life and choices and opportunities beyond their illness. The strategy will also encourage more service users and carers to have their say and contribute to service developments. And it also aims to recruit more people with lived experience of mental health difficulties to become peer support workers and peer tutors, so that they can offer vital support to others experiencing similar difficulties. Marcus added: “I really value the perspective of service users and carers – it can be very powerful to listen to their stories, and as more of our staff are exposed to these stories, the more it will help build a culture of collaboration in the delivery of mental healthcare.”

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“It’s a wonderful place and has given me a new purpose in life” A service user who has spent around 40 years receiving help for mental health difficulties has spoken of the huge difference our Trust’s Recovery College has made to her life, wellbeing and confidence levels.

illian Thompson, who lives in Bury St Edmunds, started attending her local branch of the college, at Blomfield House, in Looms Lane, after suffering a breakdown in 2013. A former teacher, she was so enthusiastic about the courses that she was soon asked to become a peer tutor in April 2014. Gillian now co-facilitates a variety of different courses each term, including Introduction to Recovery and Wellness, and has also helped to produce two courses looking at spirituality. Her confidence has grown and she has made new friends as a result, in turn contributing to her own recovery. “I’ve been in services for a long time after initially developing post-partum psychosis after giving birth to my son 40 years ago,” said Gillian, who was also diagnosed with bipolar in the early 2000s. “Part of my past life was one-to-one teaching and I have always loved studying, so I really liked the idea when I heard about the Recovery College – it seemed right up my street. “I decided I wasn’t going to be a victim anymore and would lose the

‘I can’t do this’ mentality. I was really enthusiastic when I went to my first course in January 2014 and I haven’t looked back since.”

different people and I am constantly learning myself, and to get good feedback from others doing the courses is really nice.

For Gillian, the college provided a safe environment where everyone – including staff – could share their stories of recovery, should they wish to. This proved hugely inspirational, and helped her to realise she was not alone.

“Being involved in designing the courses is not without its stresses, but that in itself is good as it reflects real life and helps to build your own qualities. It is also quite empowering to see your idea put forward and developed – it shows that what you have got to say has some kind of merit, which in turn helps build confidence.”

“I WAS REALLY ENTHUSIASTIC WHEN I WENT TO MY FIRST COURSE IN JANUARY 2014 AND I HAVEN’T LOOKED BACK SINCE.”

“The Recovery College shows that everybody goes through tough times. That was a big thing for me – I felt that no one else had got what I’ve got, but listening to others, hearing what they had been through and sharing their experiences showed me I was wrong. That realisation was very powerful,” she explained. “I was terrified but also chuffed when I was asked to become a peer tutor. I now teach several courses and really enjoy it. I love meeting

Gillian is now encouraging others who feel they may benefit to think about signing up for a course. “The college has had a real impact on my life,” she explained. “The years since I’ve been involved have been the best with regards to the way I feel, which shows there is something out there which can help. “The college encourages you to take responsibility and shows you need to help yourself, not view yourself as a victim who someone else should fix. It provides you with the tools and techniques to move forward with your life, and has given me things I haven’t got from more traditional treatments. “It’s a wonderful place to be and to learn, and has given me a new purpose in life.”

Insight | Autumn/Winter 2016 43

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“I found its message very positive” Attending Recovery College had such an impact on Occupational Therapist (OT) Nina Mason that she has now helped create a specially-adapted version of one of its courses for patients receiving care on our wards.

ina, who works for our Trust at Northgate Hospital, in Gt Yarmouth, attended a six-week Wellness Planning course and praised both the principles she was taught and the fact that staff and service users learned together. Nina found the course so useful that she has now worked alongside colleagues Sarah Kennard and Amanda Gibley to condense its content so that it can be used on our acute mental health wards to encourage people to start thinking about recovery at an early stage.

“I found the course really valuable as it gave me a much greater understanding of the Recovery College, which I can now pass onto the service users when I make referrals,” said Nina. “I really liked the way it focused on empowerment and placed the onus on the individual taking responsibility for their own recovery. I found its message very positive. “Attending the course changed the way I work as it reinforced the importance of delivering patientcentered care, which has seen me make changes to care plans to ensure they are truly co-produced with our patients.

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“Working alongside the service users at the Recovery College was also a useful reminder that the boundaries between staff and the people we care for are arbitrary. “We have now condensed the course into three stand-alone lessons and have added them to our existing programme of OT activities on the ward and started delivering them in the autumn. “We hope that the sessions will give continuity to our patients, who can start learning about the principles of recovery during their admission and build on that work by attending the college following their discharge.”

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National recognition for innovative programme An innovative programme which gives people with lived experience of mental ill health the chance to inspire others on their journey to recovery has been given a national award after making a real difference to people in Norfolk and Suffolk.

SFT’s Peer Support Worker (PSW) training programme has been highly commended in the good practice awards run by the Care Coordination Association (CCA).

“Our PSWs complement the care our clinical teams provide, and offer vital emotional support and empathy as well as the ability to have different conversations. “They are recruited as a direct result of their own lived experience, which they then use to inspire and role model others. All talk about their recovery in a very positive way and are happy to explain to others what they have learnt on that journey.

It has received the recognition in the ‘promoting service user involvement in delivering effective care processes’ category. The PSW programme gives those with lived experience of mental ill health the opportunity to work alongside clinical staff to offer emotional and practical support to help others find a way forward in their recovery and rebuild their lives in a meaningful way. PSWs can offer understanding, acceptance and empathy based on shared experience and – most importantly – can be a role model and demonstrate that recovery is possible. NSFT has received the CCA award for the training programme it offers PSWs, which is spread across 13 weeks and includes a mixture of classroom-based training and clinical placements. A total of 72 students have received the training so far, with around 30 PSWs employed in community and ward-based posts and others within our Trust’s Wellbeing services.

“ALL OF THE FEEDBACK WE HAVE RECEIVED ABOUT OUR PEER SUPPORT WORKERS HAS BEEN INCREDIBLY POSITIVE.”

Justine Brown, Peer Support Coordinator with NSFT, said: “We were delighted to receive this national recognition. The programme is making a real difference not just to the peer support workers but also the service users they are working with.

“All of the feedback we have received about our PSWs has been incredibly positive, with service users appreciating the opportunity to talk to someone who knows exactly how they are feeling. "The role also brings benefits to the PSWs themselves, and is an important part of their ongoing recovery, while helping them use their experience in a positive way.” For more information or for details about Peer Support working, email justine.brown@nsft.nhs.uk or visit nsft.uk/peersupport

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WINN ER

A prestigious prize for inspirational Haley Gosling A Peer Support Worker has spoken of the satisfaction she gets from using her personal experience of mental ill health to inspire and motivate others after she was awarded a prestigious prize in recognition of her commitment and dedication.

Haley Gosling, who works on Thurne Ward, at Hellesdon Hospital, near Norwich, was presented with the ‘Emerging Talent’ accolade during our Trust’s Putting People First Awards 2016 for the impact she has had on service users. Winning was especially poignant for Haley, who became one of our first ward-based Peer Support Workers (PSW) in April 2015 – the role she describes as her “dream job”. “When I was 17 I suffered with personality disorder and spent

18 months under section in a psychiatric unit,” said Haley. “After that I lived in community care homes, so have had a lot of involvement with services as an inpatient. Even though I used services a long time ago, there are still some staff around who I remember, which speaks volumes of their passion and dedication, which I have them to thank for. “My own experiences have shown me just how daunting it can be to be admitted, especially if you are in a

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time of crisis or it’s your first time as an inpatient. That is why I wanted to work on the wards – I felt it was an area where I could make the most of my experience and knowledge and would be of most use. “I think our patients find it quite comforting to be able to sit with someone who has been through a similar situation. We can all appreciate traumatic times, but to be able to say I’ve been on a ward myself can really bring comfort and builds an instant bridge.

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“My own experiences also give me that knowledge of the small things that can have a really big impact on patient care, such as introducing yourself and being considerate of how a ward environment can be difficult to manage. In a clinical environment, little touches can make a big difference, and I feel blessed that I am able to put them in place for patients and help other staff be more aware of these too.” Thurne Ward is a 15-bedded assessment unit, where short stay patients are assessed for any mental health difficulties they are struggling to manage before they are referred elsewhere for continuing care or discharged home with support. Haley carries out a variety of duties, including one-to-one work with patients and engaging with their families. Her role focuses on recovery and giving hope and support to patients, while helping them identify their own strengths and maintain their wellbeing. She has also played an important role in brightening the ward by working with patients to display artwork and make the environment more homely. “I try and gather as much patient feedback as I can so that we can further improve the care we provide,” added Haley, 42, who joined NSFT after spending nearly 10 years working in physical healthcare. “It’s essential for patients to have their voice and feel heard and respected. “One of the things people said we should do was to brighten up the ward, so I got the patients involved in creating a recovery tree and other artwork, such as blackboards to display the day’s menus. It has made the ward look friendlier and the environment is now a nicer place for people to be in. “Another thing I try and do is break down the worries and fears associated with employing a former

service user – it’s quite a big step for some trusts, so it’s great to think that I was specifically employed because I’d had those experiences. I hope they are learning from me as much as I am learning from them! “I’ve had so much positive feedback since joining the team, and lots of thank you letters and cards from patients and their families. Many referred to the hope I represented for them and helping to make their stay on the ward a little easier. My colleagues have also been really supportive, which has really helped as I’ve started this new phase of my life. “Winning a staff award when I was once an inpatient myself was an amazing personal and professional achievement for me and represents hope and opportunity for everyone. “I have grown so much as part of the team and my colleagues have guided me in different ways with their experiences and ways of working. “I feel privileged to have the opportunity to work alongside such fantastic staff and provide vital support to patients.” Haley was nominated for the award by Staff Nurse Owen Spalding, who praised her commitment to involving patients and listening to their feedback to improve services.

“HALEY’S EXPERIENCE OF MENTAL HEALTH DIFFICULTIES… HAS HELPED MANY FEEL VALUED ON THEIR RECOVERY JOURNEY.”

He said: “Haley’s proactive and positive approach is paramount in developing a link between patients and staff. “Her experience of mental health difficulties, and the empathetic way in which she has presents this to patients, has helped many feel valued on their recovery journey, while a great deal of feedback we receive specifically mentions Haley’s input as an integral part of their care. “She constantly strives to go above and beyond at work and regularly engages in one-to-ones with patients who feel comfortable speaking to her because of her experience of mental health problems. "It can also help offer them another perspective on their care and treatment, as well as helping them understand there is less of a barrier between staff and patient, making them more willing to engage with other members of staff in the future. “We are lucky to have her.” Insight | Autumn/Winter 2016 47

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Trust project receives top research award A Clinical Psychologist has beaten stiff competition to pick up a regional research prize for a special project which explores the role of Peer Support Workers and their integration within clinical teams.

octor Jo Smith was awarded the prize for the best presentation at a Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) East of England event in Cambridge.

“I hope that we will be able to use the findings of this research to make changes, which will further improve the training PSWs receive while ensuring their integration into their team is as smooth as possible,” added Jo.

It came as a result of her work looking at the way Peer Support Workers (PSWs) at NSFT are prepared for their roles supporting service users and integrate into clinical teams.

“MY GOAL WAS TO FIND WAYS OF MAKING SURE THE PSWS CAN INTEGRATE INTO THE ORGANISATION FULLY.”

PSWs are people with lived experience of mental ill health who work alongside clinical staff to offer emotional and practical support to help others find a way forward in their recovery. “PSWs play an important role in helping to deliver recovery-focused care while also inspiring and motivating service users,” said Dr Smith. “I wanted to see what more we, as a Trust, could do to help them settle into their new roles by finding out about the challenges they face when they are placed in teams which are traditionally made up of people who are experts by training. “My goal was to find ways of making sure the PSWs can integrate into the organisation fully and that NSFT does

what it can to help them overcome challenges so that they can not only do their best for other service users but also enhance recovery-orientated practice in teams.” Dr Smith’s project was funded by CLAHRC, and saw her interview nine PSWs as well as clinical staff during the course of the research. She is now conducting further analysis of her findings and hopes to present the project nationally once that work is complete.

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“I was absolutely delighted when I was awarded the prize, and also surprised, since the standards were high, and the projects so interesting. I was very pleased, too, to see a mental health project valued in this way.” Dr Smith gave the presentation with the help of NSFT PSW Brigitte Platt Her research was carried out under the supervision of CLAHRC supervisors Professor Fiona Poland at UEA and Dr Marcus Redley from the University of Cambridge.

Answering the tough questions NSFT understands that people need to know the answers to their questions and the issues that concern them. To ensure the Trust fully answers peopleâ&#x20AC;&#x2122;s concerns, Insight will cover some of the recent stories hitting the headlines, and the directors will take up the challenge. Continues on next page >>

Insight | Autumn/Winter 2016 49

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We’re out of special measures as CQC publishes an ‘improved’ report Our Trust was given an improved rating following the Care Quality Commission’s (CQC) re-inspection earlier this year, and has come out of special measures as a result. We asked Chief Executive Michael Scott to explain more about where we performed well while highlighting those areas where improvements can still be made.

<< Continues from previous page Over the past month or so, you will probably have seen the fantastic reports in the local press about our Trust being removed from special measures. On the NSFT Board we are delighted at this news, which comes after the Care Quality Commission (CQC) published its inspection report into our services, which found our overall rating had positively moved to ‘requires improvement’.

ASK MICHAEL If you would like to ask Michael a question directly you can do so via: emailmichael@nsft.nhs.uk and he will get back to you as soon as possible. You can also keep up-to-date with our news and views via the Trust’s news pages at nsft.uk/news, follow us on Twitter @NSFTtweets, or on Facebook at facebook.com/NSFTrust

“The report was published in the autumn and highlighted improvements in patient satisfaction, leadership and staff morale as areas for celebration. This is a real testament to all of the hard work and commitment of our staff, and reassuring for our patients. To have made this positive shift in just over a year-and-a-half is a real achievement and we are incredibly proud of the progress we have made together. “The CQC commented that our Trust had made ‘…significant progress…’ since our last inspection, that ‘…staff morale has significantly improved…’ and staff appeared ‘…happy in their roles and proud of the service they worked in…’

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“And CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, also said we should be ‘...proud of our achievement so far…’ “Once again, we achieved an overall ‘good’ rating in the CQC’s ‘caring’ domain, with the report describing our staff as ‘…kind, caring and compassionate, treating patients with respect and wanting to provide high quality care…’

“THE CQC COMMENTED THAT OUR TRUST HAD MADE ‘…SIGNIFICANT PROGRESS…’ SINCE OUR LAST INSPECTION."

“Feedback was also good from our service users and carers, with inspectors reporting that ‘… patient satisfaction (with services) had improved...’ and ‘…the majority of people we met were positive about their care, treatment and the service they had received…’ They went on to say: ‘...most felt involved in their care planning…’

“But there will be no complacency on our part. Our overall rating makes it clear that we still ‘require improvement’, which places us alongside the majority of other NHS mental health trusts in England, where 64% rated by the CQC as of July 31 2016 ‘require improvement’. * “We fully understand that there is still a way to go and we welcome any support to help us continue on our upward path.

“WE REMAIN 100% COMMITTED TO DELIVERING THE VERY BEST CARE AND SUPPORT THAT WE CAN.”

“The inspectors raised some concerns about quality and safety, and we responded immediately, drawing up clear actions to rectify any issues and make improvements straight away. Many of these have now been completed, or are well underway. “In all of this we need to be balanced and ensure that as well as celebrating what we’re doing well for our service users, we must continue to improve wherever we can. We’ll be continuing to receive support from NHS

CQC RATINGS

COMMENTS FROM THE CQC:

Our Trust’s overall ratings were: • NSFT overall Requires improvement (from inadequate) • Are services caring? Good (from good) • Are services well led? Requires improvement (from inadequate) • Are services effective? Requires improvement (from requires improvement) • Are services responsive? Requires improvement (from requires improvement) • Are services safe? Inadequate (from inadequate)

Improvement as we improve further and move towards a ‘good’ overall rating, while never losing focus on the needs of local people. “We all remain 100% committed to delivering the very best care and support that we can and safety remains our paramount concern and focus.”

“…staff morale has significantly improved…” with staff appearing “…happy in their roles and proud of the service they worked in…” “…most staff told us that the Trust encouraged openness…” and that “…the majority of staff were aware of the Trust’s values and shared them…” “…patient satisfaction (with services) had improved...” “…the majority of people we met were positive about their care, treatment and the service they had received…” “...most (patients and service users) felt involved in their care planning…” “…(the Trust’s leadership team had) revitalised energy…with a spirit of stronger leadership…”

Continues on next page >>

* CQC’s State of Healthcare and Adult Social Care in England 2015/16 report, published 13/10/16 Insight | Autumn/Winter 2016 51

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<< Continues from previous page

SINCE THE LAST INSPECTION IN 2014... Our Trust has doubled the number of ‘goods’ in its overall ratings. We received no ‘inadequate’ overall ratings in service areas. Four service areas – the equivalent of a third of those inspected – achieved ‘good’ overall ratings. This represents an increase of 82% from 2014. Our ratings improved in 14 service areas. Forensic Services made the huge leap to a ‘good’ overall rating from ‘inadequate’. NRP and the Long Stay / Rehabilitation Service in Suffolk were both inspected for the first time and both achieved a ‘good’ overall rating.

AREAS FOR IMPROVEMENT Michael Scott continues: “I’m really pleased to report that our Trust has already taken action to address the areas which the CQC identified needed further improvement. Much of this work has been completed, or is well underway. But there is still more to be done. “Ten out of 19 of these fell within the ‘safe’ domain, with the CQC saying it had concerns about unsafe environments, insufficient staffing levels, inadequate arrangements for medication management and seclusion and restraint practices. Bed numbers and early discharge were also raised. “The inspectors highlighted the need for an '...immediate review into clinical information handling and systems so that risk can be identified in order to protect patients’ safety…' and said we needed to put better systems in place to monitor quality and performance. Care Plans and Risk Assessments were also raised as an issue, with inspectors commenting

‘Inadequate’ ratings dropped from 11 to five, which is the equivalent of a 55% decrease. The Norfolk Recovery Partnership (NRP), which provides substance misuse services, and our Child and Adolescent Mental Health Inpatient Services achieved a full run of ‘good’ ratings in all of the CQC domains.

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these needed to be regularly updated and developed with service users, while Mental Health Act guidelines must be fully complied with. “The safety and quality of our services is our number one priority. We need to continue to listen to our service users, carers and staff and engage with you all to continue to improve and raise the bar on quality.”

“WE NEED TO CONTINUE TO LISTEN TO OUR SERVICE USERS, CARERS AND STAFF AND ENGAGE WITH YOU ALL TO CONTINUE TO IMPROVE AND RAISE THE BAR ON QUALITY.”

To read the full report, visit tinyurl.com/cqc-improved

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look brighter to in g e b s e c n a Fin Although NSFT is continuing to face financial pressure, our forecast deficit this year stands at £4.8m, compared with £8.9m during 2015/16. We asked Director of Finance Julie Cave how the Trust has made this improvement and for the latest on our ongoing drive for fairer funding for mental health services.

“Like all public sector organisations, we are continuing to face financial challenges – but things are starting to look a little brighter. “Going into the winter, we remain on course to achieve our planned deficit of £4.8m for 2016/17 – which is a significant improvement on last year. Although there is still work to be done, I believe it is possible that our Trust could return to a positive financial position soon.

“WE STILL HAVE A LOT OF HARD WORK AHEAD, BOTH THIS YEAR AND NEXT, BUT THERE IS GREAT POTENTIAL TO DO THINGS DIFFERENTLY AND CONTINUE REDUCING WASTE.”

in our staff and services, while good recruitment has seen spend on agency staff reduce. “We are also looking at our estates, and will consider selling any buildings which are no longer used so that we can reinvest the money into our services. “We still have a lot of hard work ahead, both this year and next, but there is great potential to do things differently and continue reducing waste. One real positive, and something I’ve been really impressed with in my time so far with our Trust, are the ideas that our staff are coming up with to help us do just that.

“Our work to lobby for fairer funding is also continuing at every opportunity, and we make sure it is raised in our discussions with MPs and commissioners and at any national event we attend. “As such, we were really pleased that the national ‘Five Year Forward View for Mental Health’ gave such a clear steer to everyone that mental health is a priority. “As a result, we expect to receive additional funding to improve care across a range of mental health areas, including children's and young peoples' services, community, acute and crisis care, secure services and suicide prevention. “Some of this money will be made available nationally, while some has been included within the allocation we receive from commissioners. “Rest assured that every single penny will be spent developing the care which our service users receive so that we can make a difference to the lives of as many people as possible.”

“This improvement is the result of several key factors. We have negotiated with our commissioners and secured an additional £3.3m in funding to support the investment we have made

Insight | Autumn/Winter 2016 53

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Working in partnership to reduce police detentions

The care which people with mental health difficulties receive after being arrested has hit the headlines in recent months. We asked Debbie White, Director of Operations for Norfolk and Waveney, for an update on the steps our Trust has taken to make sure this vulnerable group receives help in a healthcare facility rather than being put behind bars.

“If someone has mental health difficulties and is facing crisis point, the last thing they want or need is to be put behind bars. Instead, they should be offered the safety and security of a healthcare facility, where trained mental health staff can provide a full assessment of their needs as well as onward referral, wherever appropriate. “Over the past few years, our Trust has been working closely with police colleagues to improve the services we provide to this vulnerable group and make sure they are looked after in the right place. Through a range of initiatives, we estimate around 150 detentions under the mental health act have been avoided in Norfolk alone over the past year. “Figures released by the police also show a vast improvement, with the number of people kept in cells following detention reducing by 75% in Norfolk and 94% in Suffolk. “For some time, our Trust has provided five section 136 suites across both counties, which offer a safe environment where mental health

patients who have been detained can be taken for assessment. "Over the past 18 months, we have been carrying out improvements to these facilities and there is now more to come, so that we can make sure they are up-to-date and meet the latest standards around privacy and dignity. You can read more about this on page 63.

“THROUGH A RANGE OF INITIATIVES, WE ESTIMATE AROUND 150 DETENTIONS UNDER THE MENTAL HEALTH ACT HAVE BEEN AVOIDED OVER THE PAST YEAR.”

“In addition, our mental health nurses work within police control rooms, to try and help avoid the need for a 136 detention in the first place. Our staff can assist the police to signpost people on appropriate places of safety and avoid a detention, wherever possible.

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“In Suffolk, our staff work with officers in the mental health triage car, seven-days-a-week, and will attend incidents when people appear to be experiencing mental health difficulties. The mental health staff make an initial assessment and will consult any health records to make sure the person’s mental health needs are taken into account so they can receive the most appropriate care. “All of these innovative projects have contributed to a significant reduction in the number of people detained under section 136 and have been held up nationally as an example of best practice. Many other counties are now rolling out similar models following our positive results in Norfolk and Suffolk. “We will continue to look for ways to build on the success of these initiatives to ensure that everyone who comes to the attention of the police receive a timely assessment of their mental health needs and are directed to appropriate services at the earliest opportunity.” For more information about the initiatives our Trust has introduced in partnership with the police to improve mental health care for people who have been detained see pages 22 - 24

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morale Improving staff

Improving morale among our staff is a priority for our Trust. We asked Leigh Howlett, Director of Strategy and Resources, to explain more about the work which has taken place and the positive impact it has had so far.

“Over the past 18 months, huge changes have taken place across our organisation to make sure all of our staff are fully engaged and involved in the way we work. We want people to feel valued and appreciated, because they are. Our Trust values, developed in partnership with staff, service users and carers, have been absolutely fundamental to this, and we are delighted with the difference they are helping to make. “Our values provide a common framework which clearly show the standards we expect our workforce to embrace every single day. Within seven months of their launch, 2,500 of our staff had completed training on how to live them in their day-today work, while they have also been embedded in our recruitment and appraisal processes. “So far, evidence shows they are making a real difference by giving staff an increased sense of pride in the organisation and the confidence to challenge poor behaviour by anyone in our Trust. This was also recognised by the CQC during their return visit in July 2016, when inspectors told us they had seen a huge change in staff morale.

“We are really proud of our values, and are now looking to ensure what we all do every day demonstrate them. To do this, we are holding a second round of ‘In Your Shoes’ listening events to see if there is anything more we could do to embed them further. See page 67.

“WE ARE REALLY PROUD OF OUR VALUES, AND ARE NOW LOOKING TO MAKE SURE WHAT WE ALL DO EVERY DAY DEMONSTRATE THEM.”

“Elsewhere, we have published a new five-year Workforce and Organisational Development Strategy which shows how we will recruit and retain the best staff while looking after, and training, those who already work for us. We want everyone we employ to reach their full potential, and this strategy sets out how we help them become the best they possibly can be. You can read more about this on page 66.

“Protecting our staff’s wellbeing is a key element of all of this work and something else we have been focusing on. We have sent booklets out giving advice, encouraging staff to engage with us and explaining more about what is happening to safeguard wellbeing across the Trust, and have also been inviting colleagues to bid for funding to drive their own projects. “So far, we’ve helped gardens to bloom, given staffrooms a makeover and made it easier for staff to get on their bikes, and are receiving more applications all the time. We are proud that we now have over 100 health and wellbeing champions across the Trust, and will not stop until we have one in every team. “Finally, we are introducing a new Leadership Academy, which will give managers at all levels the chance to develop their own skills and ensure strong leadership across the Trust, both now and in the future. Offering such opportunities for further development will also have a positive impact on our retention rates, as it will help attract the best new staff into the Trust while also investing in those who are already working hard for us every single day.” To find out more about how the values are impacting our staff and service users and to take part in the next ‘In Your Shoes’ listening events, turn to pages 67 and 68

Insight | Autumn/Winter 2016 55

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Reducing the use of re straint Our Trust is always looking for ways to promote a positive environment on our wards and reduce the use of restrictive practices. We asked Dr Jane Sayer, Director of Nursing, Quality and Patient Safety, about the work which is taking place to diffuse potentially difficult situations before they arise, and the improvements we have seen a result.

“Restraint can be distressing not just for those involved, but for other service users, carers and staff. That is why minimising its use has become a priority for our Trust, and why we have set ourselves a fouryear target to reduce use of all restraint by 25% by 2018. “Although we avoid any form of restraint where we can, there will always be times when we need to use it to keep our patients and others safe. "This could be in a huge variety of situations, such as restraining someone who has difficulty in maintaining self-control in order to prevent harm to others, or stopping a service user with highly complex needs from self-harming or attempting to take their own life.

“ALTHOUGH WE AVOID ANY FORM OF RESTRAINT WHERE WE CAN, THERE WILL BE TIMES WHEN WE NEED TO USE IT TO KEEP OUR PATIENTS AND OTHERS SAFE.”

“However, it is also important to understand that the term ‘restraint’ covers any physical contact – so our statistics also include incidents at the other end of the spectrum. This could be when staff gently guide an elderly patient to another room, for example, or touch someone on the arm when helping them to eat or wash. “Full restraint of a patient, such as prone restraint, is only ever used as an absolute last resort where all other interventions have been exhausted. All of these incidents are reviewed monthly by our patient safety group and quarterly by our Board to see if anything could have been done differently and lessons could be learnt. “Our training team also work closely with wards to review such incidents and look for learning opportunities to prevent these situations happening again. “Over the past few years, we have introduced a variety of actions to help reduce incidents of restraint

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and seclusion, where patients are placed in supervised isolation away from others. "This includes putting more staff on our wards to help diffuse potentially difficult situations before they arise and introducing the Safewards initiative (see page 65) in some of our inpatient units to promote positive relationships and good communication.

“FULL RESTRAINT OF A PATIENT, SUCH AS PRONE RESTRAINT, IS ONLY EVER USED AS AN ABSOLUTE LAST RESORT WHERE ALL OTHER INTERVENTIONS HAVE BEEN EXHAUSTED.”

“Staff now receive support managing complex cases from prevention and management of aggression link workers, while we have also invested in improving the environment in which people receive care, all of which is having a positive impact. “We will continue to monitor any incidents which do occur closely over the coming months so that we can react quickly to any increases and see if there is anything further we could do to better manage aggressive behaviour.”

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people g n u o y r fo s e ic v r Improving se NHS England announced that Suffolk would receive an additional £1.6m in funding each year to improve services for children and young people. We asked Alison Armstrong, Director of Operations for Suffolk, to tell us more about how that money is being spent.

“This additional funding has been great news for children and young people from across Suffolk, and has already started to make a real difference to the care they are receiving. "It has also given us the chance to work more closely with our health and social care partners, so that we can further improve services and make sure young people receive the help they need quickly and easily, before their mental health problems become too great. “The money is being used to drive the county’s Children and Young People’s Emotional Wellbeing Plan, which is made up of a range of different initiatives designed to improve care. “One of the most significant improvements so far has been the development of our new-look Children and Young People’s Community Eating Disorder Service (CEDS). Launched in autumn 2016, it offers a much improved standard of care to people aged up to 18 with anorexia, bulimia and binge eating disorder, and offers a wide range of interventions tailored to each individual’s needs. “Elsewhere, we are working with our commissioners, GP colleagues

and Suffolk Community Healthcare to develop a new pathway for attention deficit hyperactivity disorder (ADHD). Due to be finalised in autumn 2016, it will make sure the care families are offered is joined-up and well-coordinated. “Our aim is to work together to give young people with behavioural difficulties the right support to allow them to stay in school and live healthy and productive lives, rather than becoming marginalised by their condition. “Young people are also now able to get easy access to help for a variety of common mental health problems, such as depression, anxiety and stress, thanks to our new Wellbeing Suffolk service, which has been expanded to care for people of all ages. “As part of the new service, primary mental health workers will go into schools and colleges, focusing on prevention and early intervention. "In addition, 4YP (part of Suffolk Young People’s Health Project), which is one of our partner organisations, will be extending their remit by taking their knowledge and experience out into the community and offering counselling and support groups closer to where young people live.

“WE BELIEVE THAT ALL OF THESE INITIATIVES WILL PLAY A KEY ROLE IN PROTECTING THE MENTAL HEALTH AND WELLBEING OF OUR YOUNG PEOPLE”

“We believe that all of these initiatives will play a key role in protecting the mental health and wellbeing of our young people both now and in the future – but this is just the start. "During the coming five years, the NHS and social care organisations in Suffolk and North East Essex will be working together on a government initiative to create a Sustainable Transformation Plan for the area. “We are really pleased that a large part of this plan will concentrate on mental health, in turn giving us a fantastic opportunity to build further on the work we are currently doing so that we can improve services even more in the future.” For more information about the new Suffolk eating disorders service go to page 28 and find Wellbeing Suffolk on page 10 And read more about our Trust's services for children, families and young people on page 76

Insight | Autumn/Winter 2016 57

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What’s behind the figures on unexpected deaths? We recently appointed independent experts Verita to look in detail at unexpected deaths among service users to see if there was anything we could do differently to reduce the number. We asked Dr Bohdan Solomka, NSFT's Medical Director, to update us on whether our Trust is seeing an increase in numbers and why.

One single avoidable death is one too many, which is why we commissioned the independent Verita investigation last spring. We wanted to understand whether there were any issues which we could address which would further improve the safety of our services and if any or how many of these deaths were ‘avoidable’. “But it is important to note that ‘unexpected deaths’ does not mean

suicide. Nor does it mean that mental health care or support was necessarily lacking, or that a death could have been avoided. “The term ‘unexpected death’ is used to describe those where the cause could not be anticipated. Following an inquest, the deaths can subsequently be found to be the result of natural causes, suicide, an accident unrelated to the person’s mental health condition, or be given an open or inconclusive verdict at inquest.

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“For example, we are seeing more older people in our services; they may die suddenly and it is subsequently discovered that they died from natural causes, such as a physical, age-related condition. That would be reported initially as an ‘unexpected death’ but might not be a death which could have been avoided. “However, we still fully investigate each death to assure ourselves it couldn’t have been avoided, and to learn if more could be done.

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“Having said all of that, there is evidence of an increasing trend in the number of unexpected deaths of NSFT service users over the past four years, and this was a factor in our Trust’s Board commissioning the Verita review. “It is also correct that we did see an increase in the number of unexpected deaths at NSFT in May 2016; these numbers started to decrease again from the summer onwards. “Within that peak of 21 unexpected deaths in May, it looks likely that eight were drug or alcohol-related accidental deaths and at least six appear to be from natural causes. The Coroner’s verdict still needs to determine the cause of death in all. “Our Trust has also recently held a review looking specifically at suicide rates among our service users and former service users. This has shown that the suicide rate among our patients has remained relatively stable, with no specific increase or decrease, since 2012, even with fluctuations in numbers of unexpected deaths. “So, unexpected death numbers have risen locally and elsewhere, but there are a number of changes which may have influenced this measure. “During the same four years there has been a significant increase in the demand for our services, with the number of individual service users seen per year increasing by around 22,000. “Both the rise in demand for mental health services, and in the number of unexpected deaths has been seen not only locally but nationally, particularly in the area of drug-related deaths.

"THIS HAS SHOWN THAT THE SUICIDE RATE AMONG OUR PATIENTS HAS REMAINED RELATIVELY STABLE, WITH NO SPECIFIC INCREASE OR DECREASE, SINCE 2012."

“Our NHS trust is unusual in that we provide substance misuse support services (Norfolk and Waveney) in many other areas this is often provided by third sector providers. “Unexpected deaths in this cohort represent about 25% of all of NSFT's unexpected deaths. This not unusual in a group with high risk lifestyles and physical co-morbidity issues such as heart and liver failure and lung disease. “We also need to consider that a significant number of people who die unexpectedly will be active to other statutory agencies such as

social services, GPs and other health agencies, perhaps even the police, and together we are responsible for raising safeguarding concerns or issues of welfare. “In a recent Norfolk County Council Public Health report we saw that the number of suicides in the county is increasing, but only a third (30%) of these cases will have ever had contact with mental health services. 90% will, however, have been in contact with their GP in the time leading up to their death. “It is also important to note that most of these agencies do not publicly present their unexpected deaths, which can leave people with the impression that the issue is relevant only to a mental health trust, rather than a system-wide and community issue in which we need to work together. Continues on next page >>

Total unexpected deaths reported with suicide/undertermined intent verdict

Unexpected deaths

“It is also a national requirement to record unexpected deaths up to six months after the service user has been discharged, therefore some of these patients may no longer be in the care of our Trust at the time of their death.

10 9 8 7 6 5 4 3 2 1 0

Total suicide/undertermined intent Mean

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<< Continues from previous page “But what can our Trust do to ensure we’re doing all we can to help prevent suicides or unexpected deaths? “In commissioning the Verita report, our Board wanted to know that we are acting correctly in trying to prevent unexpected deaths and that we take efficient action where there is a need for improvement or a lesson to be learned. “We received Verita’s key findings in spring 2016, which recommended we should tighten up our processes in several areas, such as: • Improving internal investigation processes • Ensuring lessons are consistently learned and embedded across its services • Improving support and engagement with bereaved families • Better evidencing of Board discussion on unexpected deaths

“We are already acting on these findings. We are far from complacent – there would be no point in commissioning the investigation if we then turn a blind eye to where it indicates we need to do better. “We are reassured by Verita’s findings, which reflect that we are a Trust which is a high reporter of unexpected deaths and serious incidents, and one which reports early. It is recognised that organisations with high levels of reporting are generally safer organisations. It is where there is a culture of hiding, blame or deflection that things go very wrong.

“WE ARE FAR FROM COMPLACENT – THERE WOULD BE NO POINT IN COMMISSIONING THE INVESTIGATION IF WE THEN TURN A BLIND EYE TO WHERE IT INDICATES WE NEED TO DO BETTER.”

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“The stand out point for our Trust is that we need to work even more closely with bereaved families, offering a consistent level of support and engagement. Our Board has given their commitment that we are making this a priority. “We are also offering greater support and training to our staff on how to best document and investigate unexpected deaths and are recruiting additional investigation managers to support this. “And early in 2017 we will publish our Trust’s Suicide Prevention Strategy. In this we will be clear about the priorities we will focus on to help avoid any death by suicide of people in our care. “We take the death of any of our service users incredibly seriously, and will review each case in detail to see if there are any further lessons we can learn. We will continue to maintain this focus in the future so we can make sure the right support is available when people need it the most.”

Men’s mental health is top of the quality agenda “I want to change the perception of men’s mental health and the stigma of cultural expectations which impacts on the ability of men to seek help.” Continues on next page >> Insight | Autumn/Winter 2016 61

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GRANT WILL IMPROVE HELP FOR BOYS AND MEN

<< Continues from previous page

ur Trust’s new Men’s Wellbeing Nursing Lead started his innovative new role in the autumn to promote a better understanding of issues facing men and to encourage them to seek support and treatment.

NSFT was recently awarded a £118,000 grant by the Burdett Trust for Nursing to further develop the care it provides to men and boys.

Gabriel Abotsie wants to improve the accessibility of services on offer to males of all ages in Norfolk and Waveney, and it is hoped that reaching boys and men at an early stage will also help to reduce suicide rates among a group which statistics show is more likely to consider taking their own lives. Gabriel said: “We know from the evidence available that there are differences in the way men and women deal with mental health issues, and that women are more likely to seek treatment. One of the areas we need to address is the stigma of cultural expectations and how it can impact on the ability of men to seek help. “Right from the development of a child, expectations of boys is different. How many times do we hear people being told to ‘man up’? We need to see a cultural change, and we need to change the way in which we provide services.” Gabriel will be working with Wellbeing Norfolk and Waveney and NSFT’s other specialist mental health services to provide training and to offer an insight into how male psychologies work. This, he says, can go a long way in impacting the way service providers work with men during therapy. Gabriel said the role would also see work taking place with such groups as MIND, Rethink, Men’s Shed, MensCraft, the Walnut Tree Project, which works with veterans, and sports organisations. The project will also involve collaborations with Norfolk Public Health.

The Burdett Trust makes charitable grants which support the contribution nurses make to healthcare. Some of the funding from this grant will be spent further improving access to services so people find it easier to ask for help with their mental health.

He also intends to establish links with GP surgeries and offer training sessions on male mental health issues. “We know that men are more likely to go to GPs with physical health issues such as headaches, back pain, neck pain, a racing heart, tightening of the chest – all of which can be symptoms of some mental health conditions. So we hope the work we do will mean GPs are better able to recognise early signs of mental health issues in their male patients and allow for early intervention. “If we are able to increase access of men to mental health care and then fully engage them and maintain their engagement throughout their therapy, they can gain so much from it.” The two-year role has been funded through a grant to NSFT from the Burdett Trust for Nursing. Turn to page 129 to read about how our Trust is supporting this year’s Movember campaign, which focuses on men’s mental health

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And some will help fund our new dedicated male wellbeing nurse to deliver specialist training to staff. Dr Roger Kingerlee, Senior Clinical Psychologist with NSFT, said: “These funds are a major step forward as they will enable us to work with men and boys in new and progressive ways. “We know from both research and day-to-day clinical experience that males of all ages often find it difficult to ask for psychological help. However, once they do, they can very often quickly learn new skills and increase their emotional repertoire to enable them to begin to recover from the issues they were facing. And these are issues which all of us are likely to encounter in one way or another at some time; none of us are immune to stress. “With the specialist training for our clinicians and other health professionals, innovative use of social media to make services more male-friendly, and events aimed at normalising help-seeking for men we really believe we can increase the access to the help and expertise available.“

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Building better support for people in crisis People facing a mental health crisis will receive help and support in more calming and comfortable surroundings when a project to upgrade and refurbish three special ‘places of safety’ is complete.

he ‘section 136’ suites at the Fermoy Unit, in King’s Lynn and Northgate Hospital, in Great Yarmouth will be refurbished and updated at a cost of about £12,000 each, while a £220,000 project to rebuild and extend the unit at Hellesdon, in Norwich, will also take place. The suites are a safe place where police officers can take vulnerable people who are facing a mental health crisis, or have been sectioned under the Mental Health Act. Following an assessment, they will be given tailored help and support from mental health professionals working for our Trust. Debbie White, Director of Operations in Norfolk for NSFT said: “This funding will allow us to improve our existing crisis care facilities at Northgate and the Fermoy Unit and create safe, calming and engaging environments for people when they are their most vulnerable. “The project will also see the suite at Hellesdon expanded to cater for more patients, in turn reducing the need for them to be transferred elsewhere. A ‘place of calm’ will also be created, where people can receive practical and emotional support in comfortable surroundings.

“THE PROJECT WILL ALSO SEE THE SUITE AT HELLESDON EXPANDED TO CATER FOR MORE PATIENTS, IN TURN REDUCING THE NEED FOR THEM TO BE TRANSFERRED ELSEWHERE.”

“This project will play a major role in helping to improve the experience which patients have when using these suites while also providing greater privacy and dignity and reducing the stigma associated with a detention under the Mental Health Act. Improved facilities will also make it easier for our staff to monitor this vulnerable group and take appropriate action to deescalate often damaging episodes of crisis before they require detention, hospitalisation or specialist referral.” The project has been made possible after the Department of Health, Home Office and NHS England awarded our Trust and partners from the NHS, charitable and social housing sectors in Norfolk a one-off sum of £394,700. The remaining money will potentially be spent creating a community “hub” in Norwich, which could provide a

further place of safety for those facing crisis. Commissioners will now work to explore the idea further. Clive Rennie, from the Norfolk integrated mental health commissioning team, said: “This idea is still very much in its infancy but has worked in other areas of the country and is a longer term ambition. We now need to look in detail at how it could be taken forward in a way that is sustainable.” Read more about how our Trust has helped reduce numbers of people in custody on page 54

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SUFFOLK STAFF CROWNED “TEAM OF THE YEAR” FOR DEDICATION TO HIGH QUALITY SERVICES Staff at a low secure mental health unit who work closely together to make sure patients receive the highest standards of care have been named as NSFT’s team of the year in recognition of their dedication.

WINN ER

The Foxhall House team, which is based at St Clement’s Hospital, in Ipswich, was presented with the prize during our Trust’s Putting People First Awards 2016. The award was specifically designed to celebrate closely connected, supportive groups of staff who communicate well and respect each other. Foxhall House is a low secure ward which cares for men with a history of crime or violence who also have mental health issues, such as bipolar disorder, aggression, psychosis or severe depression. The accolade comes after staff turned around the fortunes of the

unit to help it become one of NSFT’s best-performing while making sure patients and carers are involved in every aspect of care. Consultant Psychiatrist Dr Sohail Abrar, who nominated the team, said the unit had received some excellent feedback after driving through a range of improvements. This included making sure service users are included in risk assessments and kept fully involved in discussions and organising regular meetings with carers and patients so that they can feed back their views for further improving care.

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Dr Abrar added: “When I walk in the front door, I don’t feel I’ve come to work – it’s more of a fun place. The staff members trust in each other’s abilities and want to do their best for the welfare of patients. They take pride in what they do. Another thing I really like is everybody is approachable, everybody is responsible and everybody is willing to work. “Foxhall House is one of the best wards I have worked in, where everybody is so helpful and welcoming that it feels like home and work becomes more of a passion rather than a job.”

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How Safewards is making a difference to service users A national initiative which looks at ways to better diffuse harmful events in wards is having a positive effect in our Trust’s inpatient units.

he Safewards project is helping to create a more positive environment while promoting improved relationships between service users and staff. Dr Jane Sayer, Director of Nursing, Quality and Patient Safety, explained: “Safewards is based on years of research and it looks to provide staff with new ways of working to avoid or diffuse things such as aggression, substance use, absconding, medication refusal and self-harm among service users. “It encourages staff to work alongside patients therapeutically, breaking down barriers and developing strong relationships so that situations don’t become inflamed in the first place. “In this way the initiative can help us further reduce the need to use prone restraint and restrictive practices on our wards, such as seclusion, for example. “It has been running across some of our wards for over a year now, and is making a real difference to both patients and staff by improving the environment in which care is delivered.” She went on to explain how Safewards uses staff engagement and cultural and behavioural change to make the ward environment

a safer, more peaceful place by reducing conflict and containment. It places an emphasis on staff to work in partnership with service users, which in turn means patients are better placed to understand what is going on and more likely to want to accept treatment. This is achieved through improved communication, setting clear mutual boundaries and expectations, encouraging collaboration, sharing positive messages of support and advice and providing reassurance. “Evidence shows that the model also benefits staff, leading to improved wellbeing and increased confidence to avert or deal with difficult, upsetting or potentially unsafe situations while at work.

“IT HAS BEEN RUNNING ACROSS SOME OF OUR WARDS, AND IS MAKING A REAL DIFFERENCE TO BOTH PATIENTS AND STAFF BY IMPROVING THE ENVIRONMENT IN WHICH CARE IS DELIVERED.”

“We are continuing to monitor the progress on our Safewards closely, while our Patient Safety Group review any incidents where restrictive interventions have occurred to see if any lessons can be learned,” said Jane.

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Becoming a champion for positive mental health Four key documents have been published which explain how our Trust will fulfil its mission to become a champion for positive mental health while further improving the services we provide.

hree of the documents – Our Strategy, NSFT’s Clinical Strategy and the Workforce and Organisational Development Strategy – span the next five years. The fourth, our Quality Account, shows the progress we have made during the past year, as well as our priorities for the next 12 months. It includes a wealth of performance information, as well as patient experience feedback and data about complaints and serious incidents. Our Clinical Strategy will inform the development of clinical services in our Trust, and has been developed by clinicians and senior operational managers and co-produced with service users, carers and commissioners. It will raise the quality of our services while creating clinical pathways which effectively and consistently meet the individual needs of our service users, regardless of where they live. Our Workforce and Organisational Development Strategy shows how we will develop our staff to be the best they can be within a supportive but accountable leadership culture.

It focuses on creating an engaged, skilled and responsive workforce, where every member of staff collaborates to make our Trust a great place to work and receive care.

• Improving quality and achieving financial sustainability • Working as one Trust • Focusing on prevention, early intervention and promoting recovery

Our Strategy, featured in the last issue of Insight, explains how we will become a champion for positive mental health by providing safe, effective, trusted services together with our partners. It includes three core goals:

It describes how we will develop our services while underlining our commitment to quality, safety and improved outcomes for the people we serve.

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The full documents are available at nsft.uk/our-priorities

Help us understand life “in your shoes” Our Trust is inviting people to help us improve the experience service users have when accessing our care by telling us what life is like in their shoes.

t the start of 2017 we will ask service users, families and carers, as well as staff and Trust members, to give us their feedback and opinions on the care we provide.

These are designed to ensure that service users and carers from across Norfolk and Suffolk have the best possible experience when accessing our mental healthcare. This next phase will test whether those values are being fully embedded in the care and support we offer and what else we may need to do to improve further.

The sessions, called ‘In Your Shoes’, will be the second wave held as part of our Putting People First programme which launched in 2015. The programme aims to listen to our service users, carers and staff and work together to: • Develop a shared understanding of the experience we want to provide for our service users and staff • Develop shared expectations of the behaviours we want to see, hear and do more and less of in the future in order to deliver these experiences we aspire to • Identify improvement priorities which will improve service user and staff experience in the future

• Embed the standards which service users and staff co-develop in everything we manage, measure and do As a result of engagement with more than 1,300 service users, carers and staff, our Trust launched a new set of values and behaviours in October 2015.

The In Your Shoes listening sessions will take place from February 2017 onwards. For further details, please email inyourshoes@nsft.nhs.uk Alternatively, you can find out more about Putting People First on our website at nsft.uk/putting-people-first You can read more about our Trust’s values at nsft.uk/values

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BRINGING OUR TRUST’S VALUES TO LIFE Dedicated staff and service users from across our Trust are working hard to bring our new values to life so that they can make a real difference to the care we provide and the experience of our patients and carers. Since their launch our values and behaviours have been embraced by service users, carers and staff, who are finding innovative ways to reinforce them during their everyday work. In the Norvic Clinic, our secure inpatient unit in Thorpe St Andrew, near Norwich, Security Lead Elaine Potter worked with Acting Deputy Matron Lucia Hanning to create an interactive values tree. Skillfully painted by Lucia on a previously blank wall, the individual Trust values are included as branches. Service users and staff are invited to add leaves with a ‘You said, We did’ message to show the changes which have been made as a result of feedback. Elaine said: “I thought it was a really nice idea to show that we were listening to our service users and we’re also encouraging people to add things we have not yet been able to do so that we can revisit them in the future. “We felt it was important to include the values to help further reinforce them and underline to everybody the way in which we work. “We’re really grateful to Lucia, who was kind enough to paint the tree design, which has really brightened up the clinical corridors and made a big difference. The tree has already started to bloom with new leaves and more and more are being added all the time.”

The values were put together with the help of service users, carers and staff, and include pledges to involve people and share information and knowledge, be professional and effective and be proactive by looking for solutions when faced with problems. They also outline the importance of open, twoway communication and valuing everyone’s unique experience, skills and contributions. Ginnie Benedettini, one of our Trust's Norfolk Service User Governors, was among those to take part in the project and share her views of accessing services and the ways in which care could be improved.

“THE FINAL VALUES AND BEHAVIOURS REALLY RESONATE WITH ME AND ENCOMPASSED EVERYTHING I WANTED TO SAY. ”

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She said: “The final values and behaviours really resonate with me and encompassed everything I wanted to say. They felt like my personal story and the story of lots of other people who use the Trust’s services, as well as its staff. “The basic human things we can all do, such as showing empathy, are critical when delivering mental health services, and can have a big impact and make a really positive difference to people. The development of these values feels like this has become a priority for the Trust – it showed we had been listened to in great depth, and that action was being taken as a result. “There are already good signs emerging of the values in action. It’s good to see that they are being embedded as they will provide a constant reminder of the behaviours everyone should share while emphasising the importance of treating every service user as an individual.”

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AWARD FOR FULFILLING “GAME-CHANGING” TASK Paul Johnson, our Trust’s Organisational Development Lead, was instrumental in helping develop NSFT’s values, cheerfully listening to the views of almost 1,300 staff, service users and carers to fulfil the “game-changing” task.

WINN ER Paul, supported by Liz Keay and other colleagues from NSFT, consulted with a huge variety of people, skillfully leading discussions and helping scores of staff to think more about the impact they have on everyone accessing mental health care. He also made sure the views of service users and carers were taken into account so that the values reflected everyone’s opinions. In recognition of his hard work, Paul was presented with Unsung Hero Award (Non-Clinical), which celebrates those who go above and beyond to deliver excellent support to their colleagues, during our Trust’s Putting People First Awards 2016.

“PAUL HAS CONSISTENTLY UPHELD THE VALUES THAT WERE CHOSEN – POSITIVELY, RESPECTFULLY AND TOGETHER.”

“When people think about Paul, they often smile unconsciously,” said Acting Consultant Psychiatrist Karen O’Sullivan, who submitted his nomination. “Many people see a very laid-back but consummate professional who often sports a big smile himself… he quietly commands respect and is able to see the best in others.

“Paul has consistently upheld the values that were eventually chosen – positively, respectfully and together. “This has been a game-changing project… and Paul has risen to the challenge magnificently. It is his warmth, humour and passion which has made the project so well received, and he has demonstrated day after day that he is an unsung hero. Everyone has, and will, benefit from this, and it has brought staff closer together with service users and carers.”

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Patients treated with dignity in clean surroundings, results show A rigorous patient-led assessment has shown our Trust is ensuring service users are treated with privacy and dignity and receive high quality food in clean, well-maintained buildings.

he results of the 2016 Patient-Led Assessment of the Care Environment (PLACE) showed NSFT scored better than the national average in all eight key areas, and ranked among the country’s top 10 mental health trusts for food and dementia friendliness. Inspectors visited nine sites across Norfolk and Suffolk. Although their findings showed a year-on-year improvement for food scores, other areas saw a slight decline on last year’s performance. Julie Cave, Director of Finance, said: “Ensuring that our service users and patients can enjoy clean, well-kept, dementia-friendly buildings and good quality food is a priority for NSFT. “Maintaining people’s privacy, dignity and wellbeing at a time when they can be extremely vulnerable is also important in helping towards better outcomes for our patients. These are also areas which have a big impact on the experience which people have when accessing our services, which is why these assessments are so important. “Although these results show we have out-performed the national average in all areas, there are always areas where we could do better.

OUR TRUST SCORED HIGHER THAN THE NATIONAL AVERAGE IN EVERY AREA National average

Trust score

Cleanliness

98.06%

98.75%

Food

88.24%

96.57%

Organisational food

87.01%

93.91%

Ward food

88.96%

98.54%

Privacy, dignity and wellbeing

84.16%

89.92%

Condition appearance & maintenance 93.37%

97.33%

Dementia

75.28%

94.38%

Disability

78.84%

92.29%

“We will now concentrate on any areas where further improvements can be made with the aim of delivering better results in next year’s assessment.” Every NHS organisation completes PLACE annually, with patients, service users, Healthwatch members, staff and the public all forming part of the inspection team. They look in detail at the quality, taste and aroma of the food which is available, levels of cleanliness and the general maintenance of the buildings in which services are provided. The assessors also consider the steps each organisation takes to ensure the privacy, dignity and wellbeing

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of its patients, as well as the work which has been done to meet the needs of patients with dementia, such as using dementia-friendly colour schemes. A new category has been added this year, which looks at how well premises meet the requirements of people with disabilities.

“ENSURING THAT OUR PATIENTS CAN ENJOY CLEAN, WELL-KEPT, DEMENTIAFRIENDLY BUILDINGS AND GOOD QUALITY FOOD IS A PRIORITY FOR NSFT.”

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New-look garden helps Ipswich patients enjoy the great outdoors Older patients receiving care at a specialist unit in Ipswich are now able to make the most of the great outdoors when the sun is shining following a mini-garden makeover.

arge planters which were once left derelict and unkempt have been filled with colourful plants and aromatic herbs, in turn bringing the courtyard at The Willows, which is part of the Woodland’s Unit based at Ipswich Hospital, to life. New seating and areas for planting small vegetables have also been added so that service users can enjoy growing their own. The project was made possible by the Woodbridge branch of Wyevale, which donated the plants, compost and gardening gloves to NSFT Staff Nurse Lesley Bradshaw.

Some of our service users helped with the planting throughout the summer, with more patients than ever using the new-look garden to enjoy time away from the ward. “We are really pleased with the makeover, which has added some colour, texture and aroma to what was once a rather bland and unloved courtyard,” said Lesley. “We asked our patients if they would like to get involved in planting and they really enjoyed it and found it quite therapeutic – one lady in particular who loves gardening at home was in her element.

“We are very grateful to Wyevale for their generosity, without which this project would not have been possible. "More people are now using the space and enjoying sitting outside to get some fresh air, which shows that they really appreciate the work we’ve done.” Brian Luke, Charity Champion with Wyevale, said: “It is a pleasure to help and I hope that we are able to support the unit again in the future and that many people get to enjoy the new space.”

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REINVESTING IN OUR ESTATES Our Trust has pledged to reinvest the profits from the sale of two former units in Norwich into further improving our existing buildings on behalf of service users.

£300,000 IMPROVEMENT PROJECT TAKES SHAPE A £330,000 improvement project designed to give people accessing mental healthcare in Ipswich a brighter welcome in more spacious surroundings has been taking place.

Meadowlands, a former inpatient unit close to St Andrew’s Business Park, and Highlands, a smaller unit on Yarmouth Road, have been successfully marketed to a local development company.

“INSTEAD, WE CAN REINVEST THESE RESOURCES INTO MAINTAINING OR UPGRADING BUILDINGS WHERE WE CAN PROVIDE A SAFE AND SUITABLE ENVIRONMENT FOR OUR SERVICE USERS.”

Both buildings had stood empty for some time after they became unsuitable to house services. Mark Kittle, Head of Strategic Estates and Maintenance Services, said: “The sale of Meadowlands is part of our ongoing strategy to review our estate to ensure we do not use important NHS resources to maintain empty properties which are no longer fit for purpose. “Instead, we can reinvest these resources into maintaining or upgrading buildings where we can provide a safe and suitable environment for our service users.”

The work will see a new reception added at Mariner House, in Handford Road, and the main entrance to the building improved. As well as significantly increasing the space available to service users, families and staff, the project is bringing together two waiting rooms which were previously split by steps, in turn making access easier for visitors. The improvements are an example of the work our Trust is doing to enhance the buildings from which we deliver services, with the aim of boosting the experience people have when accessing care. Helen Whight, Community Services Manager for East Suffolk, said: “The previous reception and waiting areas were on two levels, which could be challenging for people with mobility problems, while also making it more difficult for staff to observe our service users and ensure they are safe and

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comfortable while waiting for their appointment. “Over the years, we have also increased the services we offer from the buildings, which means our original waiting rooms simply weren’t large enough to cope with demand any more. “The improvement project will allow us to offer a much nicer environment for service users and staff, along with comfortable seating and lots of space. This will make a really big difference, especially to our service users, who will hopefully find the new layout much calmer and easier to navigate.” The project has been carefully planned to minimise disruption to the services delivered from the site, which include Wellbeing Suffolk, the Access and Assessment Service, Ipswich Integrated Delivery Team (community mental health) and the Community Memory Assessment Service.

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Innovative resources help new Trust staff to ‘Listen’ Extra emphasis is being placed on improving the care available to people reaching crisis point after our Trust began using special resources designed by service users and clinicians during staff inductions.

he ‘Listen’ project saw people with first-hand experience of NSFT’s services work alongside clinical staff from east Suffolk to develop a set of tools to help in a crisis. They include posters and badges to act as a reminder for anyone working with someone in a high state of distress, and carry the acronym:

Listen and look Involve and inform Share understanding Time and availability Empathise, encourage and evaluate Next steps in treatment

Sharon Picken, Service User and Carer Involvement Lead with our Trust, said: “This important project has seen our service users work with staff to develop these useful tools, which highlight how they would like to be treated.

“We are now incorporating the acronym in everything we do, and are giving out the cards to both clinical and non-clinical staff during inductions to act as an important reminder about how to treat everyone who is accessing our services.”

“It comes as part of our ongoing drive to involve local people in the way mental health services are designed and place them at the heart of the care they receive.

The poster can be downloaded from our website by visiting nsft.uk/listen

Feel free to cut out and keep your own LISTEN card

Small credit card-sized reminders carrying the acronym are now being handed out to all staff during inductions, and have also been shared with partner organisations. In addition, LISTEN will also be used by national body Skills for Health within its new Mental Health Core Skills Training Framework, which sets out the expected learning outcomes and minimum standards for the delivery of mental health services.

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State-of-the-art ‘Sim Man’ takes training to the next level Clinicians at our Trust are now getting hands-on practical experience of treating physical as well as psychological conditions following the introduction of a life-like patient simulator.

he full-size “Sim Man” was purchased with a generous £27,000 donation from Health Education East of England. He is now being used in the simulation suite at Hellesdon Hospital in Norwich to recreate a wide range of different scenarios so that staff can improve their communication skills, confidence and team-working, as well as the way they respond to a deteriorating patient. The mannequin is controlled remotely using a computer software system, and can cough, breath and hold a conversation with doctors and nurses to explain how he is feeling. Fully interactive, he can

develop a huge range of physical conditions to test clinicians’ knowledge and decision-making skills in a safe environment.

“HE WILL MAKE REAL DIFFERENCE TO OUR STAFF BY GIVING THEM THE CHANCE TO DEVELOP THEIR TEAM WORKING AND COMMUNICATION SKILLS.”

Training sessions held using the Sim Man sessions are focusing on the concept of ‘diagnostic

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overshadowing’, which prompts clinicians to think about whether someone’s physical symptoms are being caused by their mental health problem. Doctors and nurses at NSFT are able to use him to practice their basic observation skills, take measurements such as pulse and blood pressure or hone techniques such as cannulisation. While this is taking place, the Sim Man can be programmed to become agitated or non-complaint, in turn making the training more realistic. The mannequin can also be used to simulate specific emergency situations, such as a patient’s airway becoming blocked, a drugs

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HIGH STANDARDS RECOGNISED WITH PRIZED ACCREDITATION A specialist team who make sure people who are admitted to hospital for physical treatment also receive the right care to safeguard their mental health has been awarded a prized national accreditation in recognition of the safe, high quality services it provides. The West Suffolk Psychiatric Liaison Team has been awarded the Psychiatric Liaison Accreditation Network (PLAN) accreditation by the Royal College of Psychiatrists.

overdose or suffering a bleed on the brain following a fall. Jane Sayer, Director of Nursing with NSFT, said: “We are very grateful to Health Education East of England for funding this fantastic patient simulator. He is making a real difference to our staff by giving them the chance to develop their team working and communication skills. “The Sim Man gives them the chance to take and respond to physical observations and test their decision-making if the patient’s condition suddenly deteriorates. People with mental health problems can be agitated or non-compliant, or may be taking medication for other conditions which affects their behaviour, so being able to recreate those scenarios in a safe environment will be incredibly valuable for our staff. “We are delighted to be able to roll out the opportunity for training to colleagues across the Trust and making good use of this state-ofthe-art equipment to help us further improve safety and quality at NSFT.”

The accreditation came just two years after the team was launched. Made up of 12 clinical staff and admin support, they assess and risk manage patients with a potential mental health need who are also receiving treatment for a physical issue at West Suffolk Hospital. The team takes referrals from both the emergency department and the inpatient wards and, where appropriate, also provides onward referrals to other NSFT services.

“THE ACCREDITATION SHOWS THAT OUR PATIENTS ARE RECEIVING SAFE, HIGH QUALITY AND RESPONSIVE SERVICES.”

To achieve the accreditation, they submitted a wide range of written evidence documenting the patient pathways which are in place to make sure service users receive the right care to meet their needs. The way the team deals with patients in crisis as well as signposting and onward referrals was also documented.

Independent assessors then spent a day at the hospital to see the work carried out by the team first hand, and also interviewed staff, service users, family carers and staff from across West Suffolk Hospital. Neil Brandon, Clinical Team Leader, said: “We are delighted that we have been awarded this highly valued accreditation just two years after the service launched. It is a testament to the dedication of our team and the strong working relationship we have with colleagues at West Suffolk Hospital and comes following a lot of hard work. “The accreditation shows that our patients are receiving safe, high quality and responsive services, as well as the appropriate onward referral to meet their needs. It also underlines our staff’s commitment to continually improving the care we provide. “Achieving the accreditation will open up new opportunities for the service, such as the chance to share good practice with a network of peers, and also assures our commissioners and stakeholders about the quality of service we provide. “We will continue to look for ways to further improve the service we provide after receiving this accreditation for the benefit of our patients and their carers.” The accreditation lasts for three years.

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First patients welcomed to ÂŁ1m young people's unit An improved inpatient unit which is providing specialist care for young people with acute mental health needs has opened thanks to a ÂŁ1m investment from our Trust.

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he 12-bedded Dragonfly Unit has been created at Carlton Court, near Lowestoft, and welcomed its first patients in September following a nine-month building project. It was developed as a centre of excellence so that our Trust can provide more specialist care closer to home, in turn reducing the number of 12 to 18-year-olds who need to travel out of the area for treatment.

Kitchen space gives patients and visiting carers the chance to learn how to cook their own food, while a separate dining room is also available.

The new unit replaces our previous inpatient facility at Airey Close, and is the only young person’s general admission ward in Norfolk and Suffolk. It offers services to both boys and girls with conditions such as depression, anxiety, psychosis and eating disorders, who cannot be supported in the community.

“The investment will make a huge difference to both boys and girls in Norfolk and Suffolk with complex mental health needs. Currently seven beds are open at the unit, and NSFT is negotiating funding to open the five additional beds in the near future.

As well as the 12 individual en-suite bedrooms, the unit has three school rooms and a fully equipped therapy suite, which includes a two-way mirror for family therapy and gym to boost young people’s recovery.

Rob Mack, Children, Families and Young People’s services manager for Great Yarmouth and Waveney, said: “We are really pleased that our patients are now benefitting from these improved facilities, which offer the very best standards of safety, privacy and dignity.

“We have worked with our young people and their families throughout the project, from the planning stages through to the design, as we wanted to make sure the building would meet their needs and provide a comfortable, welcoming environment. We would like to thank them for their invaluable input which has helped us to create a fantastic facility which will continue to benefit young patients for years to come.”

"This will mean that more young people than ever will be able to access the specialist help and support they need closer to home, without the need to travel outside the local area, which can be stressful for both the patient and their family. Insight | Autumn/Winter 2016 77

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FUN-PACKED FETE RAISES VITAL FUNDS Young patients receiving care at our Trust’s newest unit are benefiting from extra home comforts thanks to a fun-packed fundraiser.

OPEN AFTERNOON WELCOMES THE SUNSHINE Young service users and their families enjoyed an open afternoon of activities at the Child Treatment Centre, in Walker Close, Ipswich.

One of the highlights of the day was the announcement of the new name for the centre – The Sunshine Child and Family Centre – decided by the young people themselves. Kathryn Searle, Deputy Service Manager for Children, Families and Young People’s services in East Suffolk, said: “On a busy day, we can see between 60 and 75 families accessing services to benefit the mental health and emotional wellbeing of young people under 18. Our Children, Families and Young People’s services organised a special fete at Airey Close, in Lothingland, just weeks before moving to our new £1m Dragonfly unit at Carlton Court, in Lowestoft.

“The new centre is fantastic, but we wanted to raise some funds to buy some little home comforts. It was a great day for the young people, who really took ownership of the event.”

The event featured a cake sale, wet sponge throwing and a tombola with prizes donated by local businesses, and was supported by past and present service users and their families. All of the money raised has been used to pay for equipment at the Dragonfly Unit, including a planned sensory room. Occupational Therapist Lucy Allen, who organised the event, said: 78 Norfolk and Suffolk NHS FT (NSFT)

“The aim of the open day was for families and young people to come and meet the team, including our consultant and find out exactly how we can help.” The children got the chance to take part in art activities while a relaxation room was opened to promote the benefits of a calmer environment. There was also information about caring for a young person and feedback sessions. Kathryn said: “It is a place for change and a place for families and children, so we were looking for it to have its own identity which reflects the character of what we do and the young people themselves.”

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Extra help for children in crisis A new out-of-hours crisis service designed to give children and young people 24/7 access to specialist mental health support will launch in 2017 thanks to a £456,000 investment from our Trust.

he service, which will operate across Norfolk and Waveney, will see staff carry out out-of-hours assessments at acute general hospitals. The aim is to provide children and young people who are facing a mental health crisis outside of normal working hours with the right help and support, in turn preventing an admission to a mental health inpatient unit. It expands on the successful service which is already in place to provide care during the working day. The new service has been made possible after NHS England awarded Norfolk and Waveney an additional £1.9m each year to further develop services for children and young people. Our Trust has worked with Norfolk County Council and the area’s five clinical commissioning groups to plan how the money will be spent to benefit the greatest number of people.

“WE HAVE LISTENED TO OUR YOUNG PEOPLE AND WORKED WITH OUR PARTNERS TO DEVELOP THE SERVICE, WHICH WILL MAKE SURE THIS GROUP GET THE HELP AND SUPPORT THEY NEED TO PREVENT AN ADMISSION INTO AN INPATIENT UNIT.”

The 24/7 crisis service just one of a range of improvements which have been developed as a result. Over the next few months, other new and innovative services will be available to children and young people, including a single point of contact which will help young people and their families to get help more quickly. Andy Goff, Improvement and Development Manager with NSFT said: “We are delighted that this money has allowed us to expand our children and young person’s service to provide 24/7 crisis support across Norfolk and Waveney.

“We have listened to our young people and worked with our partners to develop the service, which will make sure this group get the help and support they need to prevent an admission into an inpatient unit. “We will also be rolling out a training programme to first responders, colleagues working in general hospitals and others who respond in a crisis to make sure they have the necessary skills to provide the right support when these vulnerable people need it the most.”

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“INSPIRATIONAL LEADER” ACCOLADE FOR YOUNG PEOPLE’S CHAMPION A mental health expert who has played a key role in developing our youth services into some of the country’s best has been honoured for her work, winning our Trust’s Inspirational Leader Award 2016. Dr Sarah Maxwell, a Consultant Child and Adolescent Psychiatrist with our Children, Families and Young People’s services in Great Yarmouth and Waveney, received the accolade at our Putting People First Awards 2016. She was nominated by her colleagues for the major contribution she has made to develop our 0 to 25 young people’s service, which was the first of its kind in the country and was introduced to prevent patients from having to make the difficult transition to adult services when they reach 18.

“THE IMPORTANCE OF GENUINE AND POSITIVE CLINICAL LEADERSHIP IN THE NHS IS FUNDAMENTAL. SARAH DELIVERS THIS – IN ANY AND EVERY WAY SHE IS A TRULY INSPIRATIONAL LEADER.”

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Yarmouth – all while also caring for her patients and offering extensive support to colleagues. “Sarah has been instrumental in leading the innovative development in child, family and young people’s services both within the community and inpatient settings,” said Nicky Shaw, Deputy Service Manager, who nominated Dr Maxwell.

In addition, she was instrumental in setting up the adolescent inpatient services which ensure young people with conditions such as depression or psychosis receive therapeutic care, and their families and carers are supported.

“She is also fantastic to watch with patients and their families – she really engages the young people very quickly so they feel comfortable to talk to her and discuss issues, while the families also feel supported and that they are getting the help they need with their child.

Dr Maxwell also helped establish a community crisis and support team for under-18s, which works over the weekends to help avoid unnecessary admissions to the local James Paget Hospital, in Gorleston, near Great

“Sarah is assertive and personable, and has an ability to deliver effective change that enhances the national reputation of NSFT. This is all achieved in a humble and gracious manner that exemplifies

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Dr Maxwell’s characteristics as an inspirational leader. “Sarah is a genuinely nice person who has time for people, staff, families and young people. She is always approachable and doesn’t mind if you just need to talk. “Her commitment to her profession and support for other medical colleagues is outstanding. She has successfully and consistently recognised the importance of her role and used her skills, ability, experience and personality to greatly enhance the services she is in. “The importance of genuine and positive clinical leadership in the NHS is fundamental. Sarah delivers this – in any and every way she is a truly inspirational leader.” To learn more about Sarah you can watch her nomination video on our Putting People First Awards 2016 website at nsft.uk/awards

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Partnership services shortlisted for prestigious national award Two innovative services which find creative ways to help some of Norfolk’s most vulnerable families overcome complex relationship and mental health difficulties have been shortlisted for a prestigious national award.

he Compass Outreach Service and the Norfolk Parent Infant Mental Health Service (PIMHS) have been jointly shortlisted for a national Health Service Journal Award in the “improved partnerships between health and local government” category. They will find out if they have won at a ceremony in London this autumn. Both services also saw success at our Trust's Putting People First Awards 2016. Compass Outreach, which is run by our Trust in partnership with the Benjamin Foundation and Norfolk County Council, works with ‘looked after’ children and those at risk of being taken into care, whereas PIMHS offers targeted mental health support for parents and specialist attachment focused therapy. Both initiatives proved such a success during their pilot phases that they have been fully funded by Norfolk County Council since April. Nicki Bramford, Deputy Service Manager for NSFT’s Children, Families and Young People’s services, and operational lead for Compass and PIMHS, said: “We are absolutely delighted to have been shortlisted for this high-profile national award in recognition of the success of the teams.

“WE ARE FOCUSING ON SUPPORTING VULNERABLE FAMILIES SO THAT CHILDREN CAN GROW UP WITH THE LOVE AND CARE THEY NEED.”

“The two services have gone above and beyond the call of duty, displaying a care and devotion that has been recognised by the families and services alike. They place the child and family at the centre of all of their work, and look at their needs in a holistic and inclusive way. “The teams tackle everything with enthusiasm and passion and are incredibly committed to building relationships to support and change the way we work with babies, children, families, carers and services in Norfolk and Waveney."

Roger Smith, Chairman of Norfolk County Council’s Children’s Services Committee said: “I am delighted that these two projects which are aimed at – and succeeding in – keeping families together are being recognised. “We know that children do far better if they spend their childhoods with their own or extended families, and I am delighted that we are focusing on supporting vulnerable families so that children can grow up with the love and care they need.” Kirsty Pitcher, Director of Operations (Early Help) from the Benjamin Foundation said: “As a voluntary sector organisation, we are proud to be involved in this partnership with each of us bringing different strengths to the project. By working together, we are strengthening the support available leading to improved outcomes for children, young people and families.” Insight | Autumn/Winter 2016 81

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INNOVATIVE SERVICE HELPS VULNERABLE FAMILIES STAY TOGETHER The parents of more than 50 babies who were at risk of being taken into care have been given targeted mental health support and specialist therapy to encourage bonding thanks to an innovative service which aims to ensure families can remain together. The Norfolk Parent Infant Mental Health Service (PIMHS) sees a team of therapists, psychiatrists, social workers, family support workers and health professionals – including heath visitors and midwives – provide parents with a specially tailored package of support focussed on improving their relationship with their baby. Based in children’s centres in Norwich, King’s Lynn and Great Yarmouth, the team works intensively with families where a specific safeguarding concern has been raised.

The aim is to reduce the number of children going through court proceedings and ultimately being taken into care. A joint venture between NSFT and Norfolk County Council, PIMHS works specifically with parents who have mental health difficulties where there is a significant attachment concern. It has proved such a success that it was presented with a top prize for 'innovation' during NSFT’s Putting People First Awards 2016.

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Project leads Dr Catherine Thomas, Dr Danny Taggart and Dr Richard Pratt were all recognised following a nomination from Verity Smith, NSFT Assistant Psychologist. She said: “They are outstanding in their work because of their continued enthusiasm to share their expertise and disseminate the learning achieved during the project.” PIMHS worked with 55 families within 15 months of its launch, with babies remaining with their parents in 75% of cases where therapeutic interventions were offered.

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“THEY ARE OUTSTANDING IN THEIR WORK BECAUSE OF THEIR CONTINUED ENTHUSIASM TO SHARE THEIR EXPERTISE AND DISSEMINATE THE LEARNING ACHIEVED DURING THE PROJECT.”

Calculations showed that if it helped just 15 children to remain at home it would have paid for itself, as the average annual cost of placing a child in care is very high. “This innovative service aims to provide therapeutic help and joined up services for parents who have high emotional and mental health needs and may be struggling to bond with their babies,” said Dr Pratt, Clinical Psychologist at NSFT. “In many cases, parents have experienced domestic violence and have often had other children removed from their care, so can be wary of services such as ours. We work hard to overcome that anxiety and build trust by bringing people together therapeutically and offering them specialist help. “A strong attachment between a parent and their baby is vital as it helps the baby to feel safe and able to explore the world as they develop. Our aim is to support the parent, improve attachment and have a positive impact on the family’s emotional experiences during a crucial stage of the baby’s development, in turn helping them remain together.” Families who may benefit from the initiative are identified as early as possible, and can be offered support from pregnancy until their child is two years old.

Interventions vary according to the needs of the family, and focus on raising awareness and beginning to address the attachment needs of both of parent and infant. “Feedback we have received so far has been positive, with some families telling us they are finding the sessions helpful in a way they have not experienced before,” added Dr Pratt. “This is partially because of the flexibility of the service and the outreach nature of the work – rather than expecting parents to come to a clinic, we are taking help directly to them.

"OUR AIM IS TO SUPPORT THE PARENT, IMPROVE ATTACHMENT AND HAVE A POSITIVE IMPACT ON THE FAMILY’S EMOTIONAL EXPERIENCES DURING A CRUCIAL STAGE OF THE BABY’S DEVELOPMENT, IN TURN HELPING THEM REMAIN TOGETHER.”

“Given the complex and enduring challenges that some of the parents experience, there may be some babies who – despite our efforts – will be removed. We hope that in such cases, we will be able to contribute to a better understanding of the issues that need to be addressed in the future to reduce the likelihood of this happening again. “As well as making the service more convenient for parents, bringing health and social care staff together is also helping

us improve communication between organisations and work in collaboration more effectively. This can only be a good thing as ultimately the more services are connected up, the more likely they are going to be successful and helpful for families.” Turn to page 8 to read more expert advice from Dr Thomas on postnatal depression

FILMS OFFER VITAL GUIDANCE FOR PARENTS Six short films which bring together a wealth of advice to help new parents are now available online. They include interviews with health professionals and parents and are designed to provide mums and dads with an insight into life with a new baby as well as the steps they can take to safeguard their own and their child’s mental and emotional wellbeing. They cover a range of topics including parental wellbeing, what is PIMHS (parent and infant mental health services), teenage pregnancy, early childhood development, becoming parents and attachment between parents and their children. The films examine the importance of the relationship between a parent and their child and the impact which it can have on mental wellbeing later in life. To watch the films or read the blogs, visit whatsthedealwith.co.uk

Insight | Autumn/Winter 2016 83

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COMMITTED SHOKY PICKS UP PRIZE A staff member who has played a key role in supporting clinicians in the Compass Outreach Team to deliver essential help to vulnerable families has been presented with an Emerging Talent award in recognition of her achievements.

VITAL SERVICE CELEBRATES FIRST YEAR SUCCESS A vital service which is finding creative ways to help some of Norfolk’s most vulnerable families overcome complex relationship and behavioural difficulties is celebrating success after supporting more than 170 children within just one year.

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Shoky was praised for her organisational skills and eye for detail, which have seen her successfully put an administration system in place to help the project meet high demands for regular reporting while playing a key role in helping the team find a new base.

“SHOKY HAS… A ‘CAN DO’ ATTITUDE WHERE PROBLEMS EXIST ONLY TO BE SOLVED.”

Andrew Goff, Improvement and Development Manager with NSFT, said: “Shoky has energy, a willingness to take on new responsibilities and develop new skills and an approach which is based on a ‘can do’ attitude where problems exist only to be solved. “Her level of commitment to promoting the new service is without question, as is her refreshingly innovative thinking.”

The Compass Outreach Service works with ‘looked after’ children and those on the edge of care. A partnership between NSFT, the Benjamin Foundation and Norfolk County Council, it aims to improve the way different agencies work together so that children with complex needs and the highest vulnerabilities do not fall between gaps in provision. The team offer therapeutic, flexible support within the community or people’s own homes, and aim to address underlying issues and reunite families where a child has been taken into care. In its first year, the outreach service supported four children who were

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in placements outside Norfolk to return to the county. A further 18 children and young people were able to return to their families following intensive support from the multi-disciplinary team. As a result of this success and in recognition of its collaborative approach to working with children, young people and families, the service was highly commended in the ‘Partnership’ category during the Trust’s Putting People First Awards 2016. The service was set up with £1.2m in Government money and has proved such a success that Norfolk County Council has agreed to continue funding it in the future.

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“SUPPORT HAS HELPED ME ASTRONOMICALLY” A mum who struggled to cope with her son’s violent behaviour and unpredictable moods has expressed her gratitude for the specialist support she is receiving which has helped her family find new ways to communicate while improving their relationships. Sally*, who lives in Norwich, was referred to the Compass Outreach Service after her son James’ behaviour became increasingly difficult. Affected by changes at home, the 10-year-old became “extremely violent and uncontainable”, leaving his family struggling to manage. “James* had always had some difficulties, but a change in our home situation set us both off on an unsure path,” said Sally. “He was extremely violent and uncontainable and I found it very difficult to know how to manage. “Friends and family were asking what they could do to help, and I just didn’t know the answer.” The family had worked with social workers, outreach support teams and a family support worker, but only started to see positive changes after they were referred to Compass. The multi-agency service works with families, providing joint health, social care and education assessments and tailored support to address their own individual needs. “We couldn’t go on the way we were as James needed some form of mental health support,” said Sally. “We were trying to put in place some help with behavioural management, but that wasn’t going to work unless the underlying issues were also addressed. “The support the team provides is helping me massively – gigantically – astronomically! They are really flexible and responsive, and the service meets the needs of the

family as a whole, as well as those of individual family members. “I have a much greater understanding of family culture and can now look at the bigger picture. I’ve gained the confidence to make my own decisions and support my son the way he needs to be supported. “I’m also learning to be more open and honest and the team have helped me develop a dialogue with James which I didn’t have before, which is really positive.” As well as talking openly and honestly, the family have also embraced more innovative ways to work with the Compass team, such as while building dens in the garden or during day trips to local tourist attractions. Sally added: “Going to different places with members of the Compass team has been a really good opportunity for learning and putting into practice some of the things I’ve learnt. “It’s really helped my confidence and helped me feel that I can cope with whatever my son throws at me.

“I’VE GAINED THE CONFIDENCE TO MAKE MY OWN DECISIONS AND SUPPORT MY SON THE WAY HE NEEDS TO BE SUPPORTED.”

“One of our massive things is trust and being constant. The team have helped me work out where my inconsistencies are and why and how that affects my son. It really has been a turning point. “We are now looking at different approaches to take with my son to see which will suit him and help him get to a place where he is comfortable to talk about things. “But I already know that because I am better prepared to talk about difficult situations or feelings, then he is better off as well.” *Please note – names have been changed to protect the family’s identity

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Promoting positive mental health in Suffolk’s schools A new film highlighting the experiences of young people who are dealing with mental ill health is being shown in schools across Suffolk to help break down stigma and raise awareness of the help which is available.

ind Your Language was scripted and developed by aspiring filmmakers from Samuel Ward Academy, in Haverhill, and members of our Trust’s Youth Council. Placing young people centre stage, the film is designed to prompt discussion on the often taboo subject of mental health in the classroom, including finding the right language to discuss the issue and advice on how to seek support. The film is structured in six short sections - presented almost exclusively by young people, illustrated by personal stories – focusing on key areas such as the differing perceptions of emotional wellbeing and identifying where to go for help. It invites young people, teachers, parents and others to take up the subject as a talking point and to make simple pledges to tackle the stigma surrounding the subject. NSFT'S Young Person’s Participation Lead said: “This fantastic project has given members of our Youth Council the chance to use their own experiences of mental ill health to bring about positive change and benefit others. Tackling the stigma around mental health while raising awareness of the help which is available within schools is one of our

priorities, and we were delighted to be invited to take part in creating this valuable resource. “We hope that Mind Your Language makes a real difference to the emotional health and wellbeing of pupils from across Suffolk while also showing those who need extra support where they can go for help.”

“THE STUDENTS WERE SO ENTHUSIASTIC ABOUT THIS PROJECT AND ABOUT STOPPING STIGMA AGAINST MENTAL HEALTH.”

Alana Blackwell, 18, was one of the Youth Council members involved in the film. She said: “I found it really amazing that the students were so enthusiastic about this project and about stopping stigma against mental health. I loved working with the

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students and seeing a difference being made within school. It’s positive that things are changing for the good and it’s been great to be a part of it.” Councillor Tony Goldson, Suffolk County Council’s Cabinet Member for Health, said: “Finding the language to express how they are feeling while overcoming the perceived stigma around mental health, are just two of the challenges facing young people today. That’s why this film takes a positive approach to empower young people to identify what support is available and to feel confident when discussing the subject. “We want this to be a resource for Suffolk schools to explore the language and stigma around the subject as a starting point for discussions both inside and away from the classroom.” You can watch the film or make a pledge to support others by visiting tinyurl.com/hs-myl

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Improvement ideas showcased at Westminster Young people with first-hand experience of mental ill health have explained their ideas for improving services and making them more accessible after being invited to Westminster.

round 12 members of our Trust’s Youth Council met Luciana Berger MP, Shadow Minister for Mental Health. During the visit, they talked about the importance of providing as much treatment as possible for young people with mental health issues at home rather than in hospital settings, and also described their ideas for raising awareness within schools. This included making sure at least one staff member is trained in mental health, providing peer mentoring, including emotional checklists in pupils’ homework diaries and displaying more information so that young people know where to go if they need support. The group also talked about the best practice they picked up from around the world while at the International Association for Youth Mental Health (IAYMH) 2015 conference in Canada where they gave a presentation on mental ill health from a young person’s perspective. Meg Teviotdale, 22, from Norwich, received care from NSFT several years ago after suffering with anxiety and was among the delegation: “Our priorities for discussion were the costs of hospital admissions and how that money could be better spent treating

people at home. We also focused on education, as it plays such a large part in young people’s lives. “Peer mentoring would also be beneficial, as sometimes people feel more comfortable confiding in someone their own age. “In addition, more posters and leaflets would also have an impact. There are lots around about subjects such as eating five-a-day, but not many about mental health. We want people to realise that mental health is just as important as physical health. “Ms Berger seemed to really like our ideas and we hope she will be able to take some of them forward for the benefit of young people across the country.”

“WE WANT PEOPLE TO REALISE THAT MENTAL HEALTH IS JUST AS IMPORTANT AS PHYSICAL HEALTH.”

Luciana Berger said: “It was a pleasure to meet with young people from NSFT’s Youth Council during their visit to Parliament. “There is a wealth of knowledge and experience among members of the council, so it is fantastic that they are offering so many ideas to make a difference to their local services. I was particularly interested to listen to the group’s vision for how young people’s mental health services could be transformed.” Insight | Autumn/Winter 2016 87

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“I CANNOT THANK HER ENOUGH” A young service user has described how a member of our staff helped her rebuild her life after crippling anxiety left her housebound, suicidal and caught in the grip of self-harm and an eating disorder. Leah Cranswick said she “couldn’t thank” Assistant Practitioner Emma Wigley enough for the help, support and outstanding care she has provided to help her on the road to recovery. Emma, who works in Children, Families and Young People’s services in Norwich, was recognised for her work, when she received a Public Choice award in the children, families and young people's category of our Putting People First Awards 2016.

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It came following Leah’s heartfelt nomination, which said Emma had “helped her rebuild her life” by gradually increasing her confidence so that she could start doing new things and successfully apply for a college place and work placement.

“EMMA IS A CREDIT TO THE SERVICE. I ADMIRE EVERYTHING SHE DOES AND I REALLY BELIEVE SHE IS AMAZING AT HER JOB.”

Leah said: “I couldn’t leave my house and spent my days sitting at home wallowing in sadness and anxiety. It was at its worse when I started sixth form. “I couldn’t go into lessons, I was skipping most days, crying in the toilets… I’d walk out of classrooms and not get my homework done on time.... I wouldn’t be able to get through a lesson without having a panic attack and didn’t have any friends… It got to April and I took an overdose.

“Then my referral to Emma went through… I gelled with her – she listened to everything I said, she helped me leave my house, walk to the shops and even buy things on my own.

“Emma is a credit to the service. I admire everything she does and I really believe she is amazing at her job. She treats me like a normal person; she’s always up for my jokes and works with me in the way that I work best.

“She made me feel valued and I slowly began to trust her with a little persuasion and a lot of humour on Emma’s behalf, which made me feel at ease instantly. She helped me apply to college and when I finally got my letter that I had been accepted, she instantly thought ahead about how she could help.

“She listens to my feedback, has come to know my likes and dislikes and I feel as though she’s a genuinely good person and someone who really enjoys their job. To think that if I hadn’t have met Emma I could still be stuck in that place is terrifying, but I’m so thankful that she’s helped me as much as she has and continues to work with me.

“She has helped me become independent again. It’s the little things like that which make you feel valued, and she takes a real interest and has offered so much support to help me rebuild a new life for myself.

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“Thanks to Emma, I’ve made progress with my anxiety and I am no longer stuck in a hole of worry. I really appreciate everything she’s done for me. I cannot thank her enough.”

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AWARD-WINNING ART PROJECT OFFICIALLY UNVEILED A mural depicting some of Lowestoft’s most recognisable landmarks which has been designed and painted by young people facing issues with mental ill health has been officially unveiled. The beach scene has been created at Boston Lodge, Lowestoft, by young people who have received services from NSFT. It comes as a result a yearlong therapeutic partnership between our Trust, Mind and the Ormiston Families charity, which manages the community centre.

WINNER

The project has seen a group of 14 to 25-year-olds work together to brainstorm ideas and research the town’s history before creating the design – which includes landmark’s such as Lowestoft’s lighthouse and wind turbine. They then met up each week to paint the mural using materials kindly donated by Dulux. The project was driven by Occupational Therapists Claire Moran and Catherine Kilbey, who work with our young people's services and were keen to find an innovative way to promote teamwork while making a difference to the community. The mural was part of a wider initiative to redevelop the centre, which proved such a success that it was presented with the 'Partnership Working' accolade at our Trust’s Putting People First Awards 2016. “We are absolutely delighted that this innovative project has made such a difference to the young people,” said Claire. “Not only has their confidence increased, but they have also acquired new social and practical skills, and feel a real sense of accomplishment. The level of commitment shown by the group has been outstanding.

“BEING A PART OF THE PROJECT HAS GIVEN US A SENSE OF PRIDE AND ACHIEVEMENT. I HAVE FOUND IT EXTREMELY REWARDING.”

“From an occupational therapy perspective, this is a meaningful activity for the young people, and one which has made a positive difference to the community centre and the individuals involved. The response from people using Boston Lodge has been really positive and everyone loves the mural. It’s really nice for the young people to feel they have contributed to that. “When we all first met, a lot of the young people were struggling with confidence and engaging with social activities. It’s been fantastic to see that

change as the project has progressed and their confidence has grown; a couple of members have now left the service which is great news.” One service user said: “Being a part of the project has given us a sense of pride and achievement. I have found it extremely rewarding – it has helped me to grow in confidence and feel like a part of something. I have something to look forward to every week. My social skills have progressed and I feel much more comfortable in groups.” Sharon Tejada-Jimenez, service manager at Boston Lodge for Ormiston Families, said: “It has been so rewarding to see the positive progress of each and every person involved in the project.” Some of the team have also blogged about the project. To find out more, visit tinyurl.com/bostonlodge Insight | Autumn/Winter 2016 89

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Turning the spotlight on mental health in schools An innovative partnership which is improving the mental health support available to pupils in Norfolk schools has been showcased as best practice at a national policy event.

ob Mack, Children, Families and Young People’s Service Manager with NSFT, gave a joint presentation with Dr Simon Fox, Principal of Flegg High School, at the ‘Children and Young People’s Mental Health: Creating a Comprehensive Approach’ conference, which took place in London.

of support to students for their emotional and mental health and wellbeing. However, this has been a step change for us, as it has allowed us to take a strategic approach to in-school provision which we’ve never had time to explore before. “We also believe the co-production of this service through our partnership with NSFT means the long term impact is likely to be far more sustainable and far-reaching than if we’d tried to go it alone.”

They described a pilot project which has taken place over the past year and has seen a family therapist from NSFT, supported by a clinical psychologist, seconded to the school to help shape its strategic approach towards providing mental health support.

“SEVERAL OTHER SCHOOLS FROM ACROSS NORFOLK AND SUFFOLK HAVE ALREADY CONTACTED US WITH AN INTEREST IN DOING SOMETHING SIMILAR."

As well as strengthening partnership working between the two organisations, the pilot has also allowed NSFT to offer direct support to some of Flegg’s 820 pupils, as well as training and guidance for staff. “The project has been really well received by the pupils, their families and the teaching staff, and there have been some really lovely examples where we have had a major impact,” said Rob. “Our focus has been on providing specialist training and supervision for staff so that they can support their pupils’ emotional wellbeing, in turn helping them enjoy a better quality of life.

“Several other schools from across Norfolk and Suffolk have already contacted us with an interest in doing something similar, while we’ve received invitations from across the country to go and talk about the project as a result of our presentation at the conference.” Dr Fox added: “As a school, we have always provided a good level

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The conference took place a year after the release of the Children and Young People’s Mental Health Taskforce’s ‘Future in Mind’ report, and examined the challenges ahead in delivering effective mental health services. To read a blog written by Dr Fox about the project at Flegg High, visit tinyurl.com/ ioh-mhprovision

Special events celebrate recovery Hundreds of service users, carers, volunteers and people touched by the effects of substance misuse have joined forces at two inspirational events designed to celebrate recovery. Continues on next page >>

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<< Continues from previous page wo Recovery Conferences have taken place over the past few months, giving people affected by drug and alcohol issues the chance to find out more about local support, as well as a series of taster sessions.

aged just 29, give an inspirational speech explaining the impact which the loss had on his family. Henry now visits addiction services and prisons to raise awareness of the dangers of alcohol misuse, and is donating all proceeds to addiction charities from his latest single “Lost Days”, which is dedicated to Tom.

“BOTH CONFERENCES WENT REALLY WELL, WITH PAST AND PRESENT SERVICE USERS, CARERS, VOLUNTEERS AND PARTNERS ALL CONTRIBUTING BY CELEBRATING RECOVERY.”

This and the Norwich-based event in the autumn, which saw MP Norman Lamb give a key note speech, were organised by the Norfolk Recovery Partnership (NRP), which is a partnership of NSFT, The Matthew Project and the Rehabilitation for Addicted Prisoners Trust.

The Swaffham event saw singer songwriter Henry Mayberry, who lost his brother Tom to alcohol addiction

Chris Strivens, NRP’s Deputy Service Manager, said: “Both conferences went really well, with past and present service users, carers, volunteers and partners all contributing by celebrating

recovery, sharing inspirational stories and finding out more about local services. “Some of our partner organisations, such as Alcoholics Anonymous and Narcotics Anonymous, held open meetings which were really useful as they gave people the chance to find out more about what to expect when joining the fellowships and dismissing any misconceptions they may have. “We were very fortunate that Henry was able to join us at the Swaffham event and explain the way he had turned the sad loss of his brother into a positive thing by raising the message of recovery and funds for addiction services. His story was really well-received, with lots of people finding it both emotional and inspirational at the same time.”

WHERE TO GET HELP Norfolk: Anyone who would like help with alcohol or drug problems should contact Norfolk Recovery Partnership on 0300 7900 227, visit the website at: nsft.uk/nrp or follow the service on Twitter @NRPartnership Suffolk: Turning Point - in partnership with Suffolk Family Carers, Iceni and Air Sports provides an integrated Drug and Alcohol Service with hubs in Ipswich, Bury St Edmunds and Lowestoft. For more information about Turning Point, call 0300 123 0872 or visit turning-point.co.uk

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WINN ER

FAMILY’S PRAISE FOR “REMARKABLE” OWEN A former alcoholic and his family have praised the “remarkable care and understanding” they received from a member of staff which they credit as helping to save the vulnerable man’s life. John (not his real name) described the support he received from Criminal Justice Recovery Worker Owen Mutton as “totally pivotal” in helping him rebuild his life and reunite with his wife and daughter. That is why he nominated Owen for a Public Choice category of our Trust's Putting People First Awards 2016, an award which he won. John’s issues with alcohol escalated after he was made redundant in 2008. At his lowest point, he drank up to 20 cans of cider or beer a day, on one occasion also finishing a bottle of spirits. He became violent and verbally abusive, and was eventually sent

to prison for seven months, two weeks before Christmas when his daughter was just a teenager.

“I HAVE NOT GOT THE WORDS IN ME TO SAY HOW THANKFUL I AM TO THIS MAN FOR BRINGING MY FAMILY BACK TOGETHER.”

“It got to the point where I didn’t want to go home. I hated the man I was married to and felt guilty because my daughter was miserable,” said his wife.

“We were not important anymore – John’s reason to get up in the morning was to have a drink and once he’d opened that first can it would snowball.” As he was not allowed to see his family following his release from prison, John moved to Norfolk where his mental health continued to deteriorate, eventually leaving him contemplating suicide. Then he met the man he credits with saving his life. “I was highly vulnerable and isolated and was at one of the lowest points in my life,” he explained. “I thought I had lost everything – my family, my home and my self-worth, and genuinely Continues on next page >>

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<< Continues from previous page believed that there was no point to my life. I considered suicide. “That’s when I went to the Norfolk Recovery Partnership (NRP) and met my case worker Owen. He was remarkably caring and understanding. His level of support was remarkable. He put it into my mind that there is always hope. “Nothing has ever been too much trouble for Owen, and I have to say that if it was not for my good fortune of having him as my case worker, I don’t think that I would be here today. This is why I nominated Owen for an NSFT Public Choice Award.

“IF IT WAS NOT FOR MY GOOD FORTUNE OF HAVING HIM AS MY CASE WORKER, I DON’T THINK THAT I WOULD BE HERE TODAY.”

“Owen is such an asset to NRP and someone I will never forget for the rest of my life. Due to his support, I am now back with my family full-time and will be eternally grateful. I’m a better husband and certainly a better father. He has given us the opportunity to rebuild our family. “He is such a kind and considerate person and always goes the extra mile to help in any way. I believe I owe him my life.” “I have not got the words to say how thankful I am to this man for bringing my family back together,” said John’s daughter. “To have my dad back is the most amazing feeling and I don’t think anyone can understand how it feels to be able to say that I have my family.”

“INSPIRING” KARON NAMED AS UNSUNG HERO A “warm and inspiring” Substance Misuse Nurse who has dedicated nearly two decades to helping people overcome problems with drugs and alcohol was also recognised with a special “unsung hero” award. Karon O’Flanagan was awarded the accolade for her clinical work after she made a major contribution to the service’s relapse prevention work and helped support one particular service user through recovery and into a new role as a Peer Support Worker with the Trust. She was nominated by Denise Grimes, Service Operations Manager with Norfolk Recovery Partnership. “Karon has been employed by the service since 1999 and throughout that time has demonstrated a high level of professionalism, care, commitment and knowledge to her service users, colleagues, managers and other stakeholders.”said Denise

“SHE GIVES HOPE WHERE THERE IS VERY LITTLE AND HER PRIDE IN SERVICE USERS WHO ACHIEVE THEIR GOALS IS EVIDENT.”

“She has worked tirelessly to ensure people with very complex issues get the support that they need. She is an inspiring member of the NRP team and is warm and welcoming to all new members of staff and freely offers advice and support to anyone who has difficulties.

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WINNER

“Karon is an established, knowledgeable, extremely competent practitioner whom I have the greatest of respect for. She truly lives the values that should underpin every health and social care professional of being positive, non-judgmental and respectful of everyone she comes across. “She gives hope where there is very little and her pride in service users who achieve their goals is evident.” For more information about NRP, visit nsft.uk/nrp To read more about Owen, Karon and all the other staff awards winners, visit nsft.uk/awards

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“I wasn’t bothered if I lived or died” Trapped in the grip of an addiction which cost him his partner, job and almost his life, former postal worker Shaun would have been happy to fall asleep and never wake up again...

fter spending more than a decade abusing substances, he found himself stuck in a destructive cycle of drinking all day and smoking crack, while also taking a methadone script and injecting heroin.

“I tried to get clean a few times and ended up on a methadone script, which stopped me from getting withdrawal symptoms but didn’t give me that instant hit. I ended up turning to alcohol instead, again thinking I could control it.

It was only after reaching rock bottom that Shaun, whose name has been changed to protect his identity, realised the time was right to make a change, and contacted the Norfolk Recovery Partnership (NRP) to ask for help.

“It was only several years later that I realised it didn’t really matter what the substance was – I wasn’t able to control it in any way, shape or form.”

Now, after chalking up more than two years drugs-free, he has rebuilt his life, is helping others through voluntary work and is just about to start a new job.

“FOR SOME REASON I THOUGHT I’D BE ABLE TO CONTROL THE WAY I USED IT, BUT BEFORE I KNEW IT, IT WAS CONTROLLING ME AND I WAS DEPENDENT.”

“I used to use recreational drugs and ended up progressing to heroin from there,” said Shaun, who lives in Norwich. “For some reason I thought I’d be able to control the way I used it, but before I knew it, it was controlling me and I was dependent.

Shaun became so unreliable as a result of his drinking that he eventually lost his job. Things also came to a head in his personal life when his girlfriend left him – with Shaun turning to substances to fill the gap. “I would drink all day, use methadone, smoke crack and inject heroin on a regular basis,” said the 47-year-old. “I spent nearly six weeks in hospital with cirrhosis of the liver and overdosed several times, waking up hours after injecting with the needle still stuck in my arm. “Another time I needed the opiate antidote naloxone after overdosing. It was a massive shock, both physically and mentally, as I went from being in a pleasant, hazy bubble to being surrounded by ambulance people who saved my life. “Now it scares me to think about what happened, but at the time I wasn’t that bothered if I lived or died.”

Shaun approached NRP, and spent the next six months in a treatment centre detoxing from methadone and alcohol. He explained: “I was just going crazy. My life was repeating itself day after day and I just couldn’t stand it anymore. At that time I would have been quite happy if I went to sleep and didn’t wake up.

“NRP GOT ME INTO REHAB AND STOOD BY ME WHILE I WAS BEING QUITE DISHONEST AND UNRELIABLE, AND I’M NOT SURE I’D BE ALIVE TODAY WITHOUT THEM.”

“I was so used to being under the influence that it was a shock not to have drugs inside me when I started detoxing. In those first few weeks I just wanted to leave the treatment centre, but something inside me told me to stick at it.” When he returned to Norwich after his treatment, NRP helped Shaun move to a new flat to get him away from the environment where he had been using and later asked him to become a volunteer. Continues on next page >> Insight | Autumn/Winter 2016 95

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<< Continues from previous page He now runs recovery and after-care groups, as well as regularly speaking to medical students at the University of East Anglia about the reality of addiction. He also recently began a new job as a support worker in a hostel for homeless people.

NEW BID TO REDUCE OPIATE DEATHS IN NORFOLK People in Norfolk who use opiates are now getting better access to a potentially life-saving antidote thanks to a new initiative designed to reduce the number of people dying from overdoses.

“I really enjoy the work and using my experience to help other people, and am really grateful for all the help that I’ve received,” added Shaun. “NRP got me into rehab and stood by me while I was being quite dishonest and unreliable, and I’m not sure I’d be alive today without them.

“THE KEY THING ABOUT GETTING CLEAN IS THAT YOU NEED TO WANT TO DO IT FOR YOURSELF.”

“Spending six weeks in hospital, losing my job and losing my partner wasn’t enough to get me off the drugs – I carried on in my addiction after all of those things had happened. The key thing about getting clean is that you need to want to do it for yourself – you have to reach your own rock bottom before you make the change. “Part of me thought that once I put drugs down, life would be miserable and dull, but the last two-and-a-half years have shown me that exactly the opposite is the case.” For more information about NRP and the support it offers, visit nsft.uk/nrp

Norfolk Recovery Partnership (NRP) is giving service users, their families and hostel staff take-home kits of the naloxone antidote, which is used when people have taken heroin and other opiate overdoses. By providing people with the drug, along with training in how to administer it, NRP hope to reduce the number of people who die prematurely as a result of an overdose.

“ALMOST 1,000 PEOPLE DIE PREMATURELY IN THE UK BECAUSE OF OPIATE OVERDOSE EACH YEAR.”

The move comes after legislation about the way the drug is supplied was changed last year. It can now be

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issued by without a prescription by drug treatment services such as NRP. Chris Strivens Deputy Service Manager of NRP, said: “Statistics show that people who use opiates illicitly are 10 times more likely to die than their peers, while almost 1,000 people die prematurely in the UK because of opiate overdose each year. “Many of these deaths are witnessed by other people, and could therefore be avoided if the right medication was available to help. We hope that by supplying these kits to service users, their families and other key people, we will be able to make sure anyone who has overdosed gets the antidote they need as quickly as possible, in turn saving lives.” For more information and videos about the kits, visit NRP’s website at nsft.uk/nrp

Governors help to put dementia in perspective NSFT Governors have given carers, service users and health and social care professionals an informative insight into dementia during a special event which took place in the autumn. Continues on next page >>

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<< Continues from previous page

he half-day conference, called ‘Dementia in Perspective’, took place at the Jerwood Dance House, in Ipswich, in November, and was organised following the success of a similar event in Norwich earlier in the year. It brought together a raft of information about research and possible future treatments, local services and the support which carers need. The conference was opened by our Chair Gary Page, alongside Suffolk Public Governor Andrew Good. Councillor Roger Fern, Mayor of Ipswich, also gave an address before Prof Eneida Mioshi from the University of East Anglia gave an insight into the latest research, treatments and the growth of the condition. Derek Wilding, a Dementia Support Worker for the Alzheimer’s Society,

spoke on behalf of two people living with dementia. He was followed by Louise Marks, Dementia and Older Carers Policy and Development Officer from Carers Trust, who explained more about the needs of carers and what could be done to support them.

“Dementia is a condition which touches many people’s lives,” said Andrew, who helped organise the event. “But its complexities can mean it is not always clear what help is available or what innovative research is being done every day.

Ways in which the community and advocacy can benefit people with dementia was also examined, before NSFT Consultant Psychiatrist Judy Rubinsztein and Consultant Clinical Psychologist Ruth Mills gave an overview of current services in the county and planned developments for the future.

“We organised this event for anyone with an interest in dementia. It gave them the chance to hear from expert speakers as well as the opportunity to ask questions on a variety of different aspects of living and caring for people with dementia."

“IT IS NOT ALWAYS CLEAR WHAT HELP IS AVAILABLE OR WHAT INNOVATIVE RESEARCH IS BEING DONE EVERY DAY.”

NSFT’s Council of Governors will be hosting its next event in the spring in Norfolk. For more information, email governors@nsft.nhs.uk or visit nsft.uk/governors

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For more information about dementia and some of the services available go to pages 102-107.

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Samaritan urges others to give some of their time A retired Chief Executive who has dedicated the past 21 years to volunteering with the Samaritans has spoken of the satisfaction he gets from helping people.

ndrew Good, who is a Public Governor with our Trust, hopes his experience will encourage others with a few hours to spare to think about volunteering.

In addition to his work with the Samaritans, Andrew took on a second voluntary role - as an NSFT Governor - three years ago, where he reflects the views of our Members, helps decide the Trust’s future direction and holds its Non-Executive Directors to account.

Andrew spends around four hoursa-week working with the Samaritans in the charity’s Colchester office, where he answers calls, talks through people’s problems and, where appropriate, signposts them to further sources of help. Answering emails and texts are also part of his duties, and give people a choice in how they make contact.

“IT’S REALLY IMPORTANT TO HAVE EMPATHY, AS IS THE ABILITY TO RELATE TO OTHERS AND LISTEN TO THEM WITHOUT BEING JUDGMENTAL.”

Alongside his fellow volunteers, he also plays a key role in keeping the charity afloat by helping to raise around £40,000 each year to pay for the running costs of his branch. Andrew, who lives in Suffolk, said: “We receive calls for all sorts of

He explained: “The main reason I decided to stand as a Governor was as a result of the calls I take as a Samaritan. More than half face mental health challenges, whether through having an illness themselves or by caring for someone else, and a lot of these people are very vulnerable and have no one else to talk to. reasons. People may have had a bad day at work, recently lost a pet or had an argument with someone they love, while others may be very anxious or depressed. In other cases, they may be actively thinking about suicide or in the process of taking their own life. “All of our volunteers are local people from all walks of life with a few hours to spare. It’s really important to have empathy, as is the ability to relate to others and listen to them without being judgmental. “I would thoroughly recommend it and obviously get something from it otherwise I wouldn’t have done it for so long.”

“Working with both organisations allows me to inform myself about mental health while also feeding back learning from the Samaritans to the Trust with the aim of driving through improvements. “Lots of my fellow Governors are also volunteers, and use the knowledge and experience they gain from those roles to help inform their work with the Trust, which I think is really vital.” A wide variety of volunteering roles are also available at NSFT. Find out more on pages 117-119

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Suffolk mum shares her experiences to help other parents A Suffolk mother has shared her experiences of caring for her daughter to help other parents whose children may be facing a mental health crisis.

The website has been funded with a £565,000 grant from the Department for Education and has been developed by a consortium of experts.

The website includes more than 35 bite-sized e-learning topics, all of which have been co-authored by parents with lived experience of mental ill health, working alongside mental health professionals.

“Left untreated, these disorders have the power to impact on a child’s education and their ability to interact with others which can have a knock-on effect on employability and their lives as adults. That’s why giving families the knowledge and information to support early effective intervention is essential.

nne Humphrys, an NSFT Carer Governor, has co-authored four sections of a new website, MindEd for Families, which aims to give families the skills to identify and support a child with a mental health condition. She was invited to contribute after working with YoungMinds, a charity committed to improving mental health for young people.

“I AM DELIGHTED TO BE INVOLVED IN SUCH A USEFUL ONLINE RESOURCE.”

Anne is one of several parents from across the country who has contributed to its content. She has worked on sections covering ‘children’s social care referral’, ‘finding helpful information’ and ‘speaking up for your child’. She has also co-authored pages looking at ‘setting up a support group’ after co-founding PACT (Parents and Carers Together) to support others in East Anglia.

Dr Raphael Kelvin, Child Psychiatrist and Clinical Lead for the MindEd programme, said: “We know that up to three children in every classroom have a diagnosable mental health disorder and half of all lifetime cases of mental illness begin by age 14.

“I am delighted to be involved in such a useful online resource,” said Anne. “I have felt the frustration of being faced with dozens of results when trying to find urgent online advice at 2am to help my daughter, when all I wanted was one comprehensive website with all the information I needed. “The MindEd for Families website has been designed specifically to meet parents and carers’ needs. By using our personal experiences, this new website is able to give other mums and dads the information they need swiftly and in easy-tounderstand language. It not only makes understanding services easier but also gives parents advice about what practical steps they can take to help their child.”

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“We would not have been able to develop MindEd for Families without the support of parents and carers themselves. Learning from their experiences and the battles they faced enabled us to identify the key stages of a family’s journey, pin point the information that would be of most use to them and display it in a user friendly format that is most appropriate for parents and families.” Visit the website at minded.org.uk/families For more information about PACT, visit tinyurl.com/pctogether

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CAST YOUR VOTE AND HELP US TO ELECT NEW NSFT GOVERNORS Members of our Trust are being urged to make their voices heard by casting their votes and helping us to elect seven new governors to drive through further improvements on behalf of service users. The Trust will open the polls on 7 December to fill seven empty seats – three public seats in Norfolk and three in Suffolk, and one service user seat in Norfolk. The seats have become available after existing Governors came to the end of their terms. The successful candidates will be announced at the end of December and take up their posts on 1 February. They will represent the views of local people and help shape our Trust’s future. They will be responsible for holding NSFT’s nonexecutive directors to account, while acting as a key link between the Trust and the communities it serves. The Governors meet six times-a-year in public and hold two special themed events annually.

They also attend sub-groups and committees, as well as visiting services and speaking to staff. Robert Nesbitt, Company Secretary, said: “Our Governors play a vital role at NSFT by representing the views of local people, arranging important engagement events and helping appoint our Trust Chair. “Elected Governors come from all walks of life and share an interest in mental wellbeing and a desire to see NSFT develop and thrive. We would encourage all of our Members to cast their vote in these latest elections and have their say on who will become their representatives for the next three years.” A full list of candidates is available on our website at nsft.uk/governors

The election runs until 29 December, with results published on our website the following day. The successful candidates will join the Trust’s Council of Governors, which includes 23 elected seats across its six constituencies, and will hold a three-year tenure

BECOME A MEMBER OF OUR TRUST The membership of our Trust is drawn from people living in the communities served by us – its service users, their carers, staff and interested members of the public. Our Members bring commitment and enthusiasm for improving mental wellbeing in their local communities. If you would like to become a Member of our Trust there are various ways to do this. Visit nsft.nhs.uk/member and: • Complete our online membership form • Download, print and complete our printable membership form and send by freepost (details on form) • Complete our emailable form, save and email it as an attachment to membership@nsft.nhs.uk • Call our Membership Office on 01603 421468

Insight | Autumn/Winter 2016 101

You can live well with dementia A clinical psychologist responsible for delivering expert care to dementia patients has reminded people from across Norfolk and Suffolk that it is possible to live happily with the condition and enjoy a good life. 102 Norfolk and Suffolk NHS FT (NSFT)

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octor Rebecca Poz, who is a member of NSFT’s Integrated Delivery Team, based in Bury St Edmunds, said that a diagnosis was not something to be feared – but that the community has a role to play in making patients’ lives easier. The call comes after Dr Poz completed a series of sessions to raise awareness of dementia and the difficulties it can cause to patients and their carers with schools and organisations across west Suffolk. This included a pioneering initiative with 10 and 11-year-old pupils at Great Barton Primary School, where resources provided by the Alzheimer’s Society were used to explain how the illness interrupts messages to the brain, making everyday tasks more difficult.

The session was such a success that Dr Poz, a Clinical Psychologist and Clinical Neuropsychologist, has since rolled it out to other schools and is hoping that teachers will begin building it into lessons so that education about the illness can begin at an early age.

“I BELIEVE THAT ONE OF THE KEYS TO CREATING A TRULY DEMENTIA-FRIENDLY SOCIETY LIES IN EDUCATION.”

“I believe that one of the keys to creating a truly dementia-friendly society lies in education,” said Dr Poz. “The children were fabulous and much more engaged with the work than I had anticipated. “We watched some video clips and carried out practical tasks to help them think about the sort of problems people with dementia may face, such as putting on their clothes in

the wrong order or not recognising someone walking into their house. The material wasn’t scary or dry and was something I’d like to see included in the curriculum – the children were very empathetic, understood it and really took the messages on board.”

“WE CAN ALL PLAY A ROLE IN HELPING PEOPLE CARRY ON LIVING THEIR LIVES THE WAY THEY HAVE ALWAYS DONE, WITH ACCESS TO THE THINGS THEY LOVE AND THE CARE AND UNDERSTANDING THEY NEED.”

As well as completing the school sessions, Dr Poz has also visited the Theatre Royal, in Bury, to train staff so that they can help support people with dementia as they enjoy visits to the theatre. “This outreach work links very closely with the Alzheimer’s Society’s Dementia Friends initiative,” she added. “The aim is to make the community as easy as possible for those with dementia to access by helping the public understand the difficulties they face so that they can support them in a better way. This could be by doing something as simple as offering help or reassurance to someone who is confused or disoriented. “As well as our outreach work, we understand that good practice needs to start ‘at home’. So we have been improving G Block in Bury in line with Kings Fund guidelines to make it more dementia friendly. All of our reception and administration staff in Bury, Haverhill and Sudbury have also undergone dementia awareness training.”

TYPES OF DEMENTIA Alzheimer’s disease is caused when a loss of brain cells leads to the brain shrinking, affecting complex processes such as the way it stores and retrieves memories. Vascular dementia is caused when the blood flow to the brain is interrupted and cells begin to die. There are several different causes of frontotemporal dementia, which all involve a build-up of abnormal proteins in the brain which clump together and become toxic, eventually killing brain cells and causing the brain to shrink. Lewy body dementia is caused when small lumps of protein, called Lewy bodies, develop inside brain cells, causing damage.

FACT FILE • Around 800,000 people in the UK have dementia. One in three people over 65 will develop it, while two-thirds of people with dementia are women. • By 2021, it is estimated that the number of people with dementia in the UK will have increased to around 1 million. • People should see their GP if they are experiencing any of the signs of dementia, such as memory loss, problems with language and thinking speed.

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<< Continues from previous page Dementia is a common condition which is associated with an ongoing decline of the brain and causes memory loss, problems with language, mental agility, thinking speed and understanding. People are more likely to develop it as they get older, while excessive drinking, smoking, lack of regular exercise and suffering a head injury later in life can also increase the risk.

"I ENJOY SPENDING TIME WITH EACH INDIVIDUAL AND TRYING TO MAKE A POSITIVE IMPACT IN IMPROVING HOW THEY EXPERIENCE DAY TO DAY LIFE."

There are several different types of dementia. The most common is Alzheimer’s disease, followed by vascular, fronto-temperal and Lewy body dementia. The condition cannot be cured, although medication may slow its progression. “Someone who is referred with memory problems will typically be seen by a dementia specialist nurse or a medic, who will carry out an assessment so that they can make a diagnosis,” added Dr Poz. “If the results are equivocal, the patient will come and see me for further neuropsychological assessment so that we can get to the bottom of what is going on. “I also co-run a young onset clinic for people who develop dementia aged under 65 and work with a team of medics, nurses, an occupational therapist and support workers to support people with all stages of dementia, from mild

to severe. As well as individual support, we offer these patients the chance to take part in groupbased cognitive stimulation therapy, which includes re-orientation, discussions and evoking old memories through activities. “In addition, we provide a compassion-focused therapy group for people who have just received a diagnosis and their partners. Over six weeks, we look at the impact their diagnosis could have on their identity and relationships, as well as concerns about driving and making future plans. We also focus on the factors we know are important to help people stay well, such as

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maintaining good social networks, eating a healthy diet and not drinking too much. “Even though I work with people who are distressed and have a lifelimiting diagnosis, I enjoy spending time with each individual and trying to make a positive impact in improving how they experience day to day life. “Listening carefully and working out what effect their diagnosis is going to have on their overall sense of self and wellbeing can still be a really positive experience and gives us the chance to promote the idea that people can live well – and happily – with the condition.”

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“We always do what we can to help others” A generous couple who took part in a dementia research trial with the aim of helping future generations have encouraged others to consider signing up for studies so a cure can be found more quickly.

upported by her husband Phil, Sue Page, who lives near Bury St Edmunds, took part in the National Institute for Health Research’s Minocycline in Alzheimer’s Disease study (MADE) after she was diagnosed with the illness.

“I HOPE THAT ONE DAY, DOCTORS WILL BE ABLE TO STOP THE ILLNESS AT AN EARLY STAGE IF IT'S CAUGHT EARLY, BUT THAT WILL ONLY HAPPEN WITH RESEARCH.”

The trial, which runs until next autumn, is investigating whether Minocycline, an antibiotic which has been shown to slow down progression of some animal forms of Alzheimer’s Disease, could also benefit humans. Patients with very early Alzheimer’s who chose to take part were given either a dose of Minocycline or a placebo, with their progress monitored closely to measure any potential impact.

“From the very beginning, Louise was professional, polite and understanding,” said Phil, who is 72 and has been married to Sue for 51 years. “She explained everything, regardless of the time it took, and nothing was too much trouble.

“AT THE TIME I DIDN’T FEEL ANY DIFFERENT AND DIDN’T THINK I HAD A PROBLEM.”

“I was diagnosed around 18 months ago,” said Sue, who is 71. “At the time I didn’t feel any different and didn’t think I had a problem – you hear so much about people forgetting things and I just thought I was in the same category as them.

“But when my children and grandchildren said they had noticed a difference in me, I asked for a referral to the memory clinic and was given my diagnosis. “I was happy to take part in the trial if it was going to help someone else, but had to stop taking the tablets after three months as I was suffering with side effects. I’m glad I did it though, and would take part again in the future if the trial didn’t involve taking pills. “I hope that one day, doctors will be able to stop the illness at an early stage if its caught early, but that will only happen with research.” Both before and during the trial, the couple were supported by NSFT Research Nurse Louise McCarthy, who continued to visit them after Sue had decided to stop taking the pills.

“We were more than happy to take part in the trial. We know we can’t cure Sue, but if we could find something that in five or 10 years’ time will help our children or our grandchildren, then it has to be worth it. “We always do what we can to help other people, and would encourage anyone else in the same situation to think about signing up for a trial as well.” Read more about Louise McCarthy and her role as a research nurse with NSFT on page 116

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Dementia patients set to benefit from new focus on research A mental health professor has spoken of his excitement at bringing together expertise from NSFT and a leading university to develop cutting-edge research which will bring real benefits for patients with dementia.

rof Michael Hornberger joined the Trust last November as Research Programme Director for Dementia and Complexity in Later Life, and also works as Chair of Applied Dementia Research at University of East Anglia (UEA). Since moving to Norfolk from Cambridge, he has concentrated on facilitating research among staff at all levels, while also overseeing the creation of a new research clinic at Hammerton Court along with Prof Eneida Mioshi, as part of the Trust's specialist dementia unit at the Julian Hospital, in Norwich. Prof Hornberger has also played a key role in creating a special mobile phone game to collect data which could be used to predict who may develop dementia in the future.

“I LOVE THE SCIENTIFIC ASPECTS OF MY JOB, BUT ALSO REALLY ENJOY CONTACT WITH PATIENTS AND THEIR FAMILIES – WHICH IS WHY ESTABLISHING THE RESEARCH CLINIC WAS SO IMPORTANT TO ME.”

to see when crises are about to happen so that we can potentially find ways to avoid those crises altogether in the future.” Dementia disrupts the formation of new memories, often leaving those affected isolated and disorientated. According to a recent report, the illness will affect 135 million people worldwide by 2050 – which is why research is so vital.

“For me, dementia is an exciting area to be involved in,” said Prof Hornberger. “I’ve had a long-term interest in the brain and its functions, as well as the way it effects people when things go wrong. My own grandmother also had dementia, so the two link together for me.

Prof Hornberger is now hoping that more people from across both Norfolk and Suffolk will volunteer to take part in research projects and help improve care and treatment for future patients.

“I love the scientific aspects of my job, but also really enjoy contact with patients and their families – which is why establishing the research clinic was so important to me.

“One of the attractions of coming here was that it gives people a fantastic chance to get involved in research,” he added. “In the past, people assumed that patients and families carried enough of a burden, and you shouldn’t bother them with research requests, but we have seen that the opposite is very often the case.

“Very often patients with dementia are seen regularly following their diagnosis, but can then disappear into the community after their medication has been arranged. One of our first research projects is to follow people over time – we want

“Patients and families really get empowered by taking part in research as they feel they are doing something about the condition. They know it’s unlikely it will help them, but are spurred on by the thought it may help others in the future.

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“The mobile phone game is a great example of that and shows how my previous work with patients is now being put to good use.” Called Sea Hero Quest, the game has been co-created with Dr Hugo Spiers from University College London. It looks at the way people without dementia navigate through different scenes, gathering huge amounts of information. Following analysis, it is hoped this data could be used to predict who may be presymptomatic, eventually improving diagnosis and potentially the way their condition is managed. “For many people living with dementia, one of the first effects they experience is a reduction in spatial orientation, as they lose the ability to navigate their way through even well-known places and environments,” explained Prof Hornberger. “This project has given us an unprecedented chance to study how many thousands of people from different countries and cultures navigate space. This will help shed light on how we use our brain to navigate and aid future work on diagnostics and drug treatment programmes.

“We have been overwhelmed with its success, as the game was downloaded one million times in the first month alone. We hope to start working through the data by the end of this year and be using our findings to impact patients within two to three years.”

project and find funding for it so that we can work together to improve care for patients still further in the future.”

As well as working with more patients, Prof Hornberger is hoping that increasing number of staff from NSFT will also get involved with research now that the clinic has been established. “There is enormous financial pressure on the NHS at the moment and budgets are stretched. That makes research even more important as it allows you to find the evidence base of what is really effective for patients so that you can show you are getting best value,” he added. “This is why staff involvement is so critical. They see patients with dementia every day, so are ideally placed to feed into research. “They might have fantastic ideas of how to help patients but very often don’t know how to go about researching those ideas more thoroughly. My role is to give information and advice about how they would approach the

Anyone who would like to volunteer to help future dementia research can join a national database, found at tinyurl.com/dr-nihr, and will be contacted when a suitable study becomes available.

In your words... “We consider ourselves extremely fortunate to have received amazing professional treatment for my mother’s dementia. The kindness and consideration for the whole family has helped us to understand and better manage this very cruel disease.” Carer “The three months (…) was in your care was undoubtedly the happiest she has been in a long time. We as a family noticed a remarkable improvement, not only in her health but in her outlook… She enjoyed her cake making, her outings for fish and chips and ice cream, a boat ride and having her nails done. This meant a lot to her and to us. We just had to look at her face, she was smiling; something she hadn’t done for a long time. When we left we were confident she was being cared for as she deserved to be, with dignity.” Family of service user, Carlton Court, Lowestoft

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Inspirational art project extended following firstyear success An innovative project which uses art and rare museum artefacts to inspire people with mental health problems is looking to continue after helping more than 60 people in its first year.

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reative Heritage in Mind sees small groups work with artist Juliet Lockhart to research collections at four Suffolk museums and make their own creative response to the material. The project is led by the Association for Suffolk Museums, working in partnership with our Trust, and has been funded by the Heritage Lottery Fund. The initiative has been so well received during its first year that it has now attracted a £5,000 Working Together Award from Suffolk County Council and the Suffolk Foundation to help its future work. Maggie Batchelar, Art Therapist with our Trust, said: “The project has gone incredibly well, and we have received some fantastic feedback from those who have taken part. Participants have reported lots of positive, recovery-focused outcomes from their involvement, and feel less isolated and more engaged with their community and local museums.

“THIS BOOST IN SELF CONFIDENCE HAS HELPED ME WITH MY RECOVERY.”

“Those taking part have told us the project is sustaining their mental wellbeing, inspiring creativity and increasing confidence, which were some of the key outcomes we hoped for when we developed the project. “Many of the participants hadn’t done any art since they left school, but from involvement in the courses have rediscovered their creative

potential. Most have been inspired to continue some art practice outside of the courses and many continue to visit the museums. “All of the artwork which has been produced is really quite stunning, and was displayed at two very wellattended exhibitions in Ipswich and Bury St Edmunds in the autumn. A booklet was produced for each of the three courses, containing photographs of artworks and participant’s testimony. These were given to everyone who took part as a celebration and record of achievement.” Organisers are also hoping to establish a studio opportunity at the four museums – Ipswich Museum; Gainsborough’s House, in Sudbury; Moyse’s Hall, in Bury St Edmunds; and the Museum of East Anglian Life, in Stowmarket – so that those who have been on the courses can continue meeting occasionally and making artwork.

“IT IS SO VALUABLE TO HAVE A SUPPORTIVE SPACE TO BE CREATIVE IN, AND TO FEEL PART OF SOMETHING.”

“Learning has been especially important to me as it has improved my self confidence in my abilities to concentrate and learn, and this boost in self confidence has helped me with my recovery,” said Amanda, who took part in the course. “The course really helps because I struggle to get motivated on my own, so the regular sessions are really important to me. It is so valuable to have a supportive space to be creative in, and to feel part of something.” A short film has now been made to showcase the project, which is available at tinyurl.com/ch-inmind

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ARTISTIC RECOVERY COLLEGE COURSE LAUNCHES People attending our Recovery College will be given the chance to explore how art and learning in museums can promote wellbeing and contribute to recovery at a new workshop launching this autumn. The one-day Arts, Museums and Wellbeing workshop has been introduced following the success of the Creative Heritage in Mind project. It will invite participants to discover more about the history of their local community through a short tour of the museum collection. They will then take part in some creative exercises which aim to demonstrate how historical artefacts can resonate with individual stories and strengthen a sense of connection and belonging to the community. The workshop will take place in museums in Ipswich and Bury St Edmunds and has been co-designed by NSFT Art Therapist Maggie Batchelar, artist Juliet Lockhart, museum curators and project participants. It will be co-delivered by a participant from the Creative Heritage in Mind project, who will show some of the artwork they made on the course and speak about their experience.

“WORKING WITH MUSEUM OBJECTS IN AN IMAGINATIVE WAY CAN HELP US TO TELL OUR STORY, CONTRIBUTE TO OUR RECOVERY JOURNEY AND HELP US FEEL MORE CONNECTED TO OUR LOCAL COMMUNITY."

“We are delighted that we are now able to offer this Recovery College taster session which explores the link between art, museums and our own narratives,” said Maggie. “It will give people the chance to find out more about their local museum and the rich sources of inspiration in their collections. Participants will be invited to explore how the objects and their stories can resonate with our experiences,

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creating opportunity for expression of personal narratives. “Working with museum objects in an imaginative way can help us to tell our story, contribute to our recovery journey and help us feel more connected to our local community.” For more information on other courses available at NSFT’s Recovery College go to page 39 or visit nsft.uk/recoverycollege

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OUR OWN ‘TED TALKS’ ON MENTAL HEALTH ISSUES LAUNCHES ITS YOUTUBE CHANNEL A new YouTube channel which gives people from across Norfolk and Suffolk the chance to watch experts discuss a wide range of mental health topics has been launched. Called ‘Mental Health Perspectives’, the channel offers an online library of more than 50 videos filmed at carers’ conferences and workshops organised by NSFT Senior Mental Health Practitioner Howard Tidman. The channel gives everyone the chance to hear the invaluable information provided by the guest speakers at the events, which includes talks on dementia, medication, carers and caring and psychosis. “Perspectives was born from my passion for supporting carers and follows on from the successful forums we have held across Norfolk and Suffolk,” said Howard. “We wanted to share the information given by our excellent speakers with as many people as possible, and decided a good way to do that was to launch this new channel. “Speakers include mental health professionals such as psychiatrists, psychologists, and pharmacists, but also experts by experience, such as carers and people living with mental illness themselves. As the name suggests, our aim is to provide a variety of different insights and perspectives into mental illness.” The channel was launched at a national Triangle of Care conference in April 2016, during which Howard and colleagues Sharon Picken and Philippa Everett showcased the work taking

place at NSFT to ‘care for carers’. This includes running the special forums, offering Recovery College courses and embedding the Triangle of Care programme, which aims to ensure carers are fully supported and involved in decisions about care. Howard added: “Carers play an incredibly important role, offering vital help and support to their loved one which helps take the some of the pressure off health and social services. That is why it is imperative that we put support structures in place to help them to continue successfully fulfilling their caring role. “We have held around 20 carer’s forums across Norfolk and Suffolk so far, reaching nearly 1,500 people. We make sure we cover a range of different subjects, and have welcomed speakers on everything from dementia to legal highs and dual diagnosis. “The events we’ve held have been extremely well received by everyone who has attended and we’re

delighted that we’ve now been given the chance to showcase them in more detail to colleagues from across the country at the conference.” Feedback from those attending the carers’ forums has been overwhelmingly positive, with: • 89% rating them as useful • 90% agreeing they had helped give them more confidence in their caring role and • 81% saying it had increased their awareness of the services which are available In addition, NSFT has also been awarded a gold star from the Carer’s Trust for successfully achieving the first stage of the Triangle of Care, which underlines its commitment to involving carers in all aspects of their loved one’s treatment and recovery. You can access the new channel by going to nsft.uk/mhperspectives

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Dedicated group ‘take steps’ to raise awareness Adults with learning disabilities and autism have raised awareness of the conditions and the things people could do to help make their lives easier during a special sponsored walk.

further events to raise awareness and understanding. Current plans include visiting schools and taking part in events at local cafes, as well as purchasing special picture cards to help make communicating easier.

They also raised nearly £200 in sponsorship for completing the walk, which they will spend organising

NSFT’s Professional Lead for Learning Disabilities and Autism, Sue Bridges, who led the group, said: “We were really pleased that this dedicated group came up with this fantastic

he group of service users walked just over six miles from South Pier, in Lowestoft, to Kessingland, taking regular stops along the way to chat to the public about the impact which learning disabilities and autism can have on their lives.

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idea to raise awareness of learning disabilities and autism and went onto to complete the walk. It was a great achievement and gave them a real sense of pride. “We hope that they helped the people we met along the way to better understand the challenges which people with learning disabilities and autism face while also showing them how best to offer support.”

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SPECIAL FORUMS OFFER ‘CARE FOR CARERS’

CARERS’ LEADS SHOWCASE HELP People who look after someone with a mental health problem from across Suffolk have been finding out more about the help which is available during a series of events organised by the county’s carers’ leads.

People who care for someone with a mental health problem have been given practical advice on the support and benefits available to them at three special forums in Norwich.

The first Carer’s Forum took place at the Great Hospital, during national Carers’ Week and was designed to celebrate the contribution which carers make while highlighting the challenges they face. A range of top speakers attended, covering subjects such as capacity and confidentiality when someone is detained under the Mental Health Act and ways to support older carers. A second forum took place at the King’s Centre and was themed around ‘keeping us both safe’ and focused on safeguarding, suicide, anger management and self-harm, while a third, at the City Academy in October, looked at psychosis and personality disorders. Different NSFT services and voluntary groups held stalls giving more information about their work and how to access support at all of the events, while carers were able to enjoy free holistic therapies and ask any questions.

In addition, staff have taken information directly to carers living in rural towns and villages across Great Yarmouth and Waveney during a 10-stop bus tour. Organised in partnership with several other local organisations, the tour was aimed at promoting wellbeing while giving carers easy access to valuable advice and support. NSFT’s Howard Tidman organised the events. He explained said: “People in more rural areas can find it difficult to visit our forums, so the tour was a good way of taking invaluable help and support directly to them instead. “We were really pleased with how the events went. They were all wellattended and everyone who came along told us they found them both interesting and informative.” Further forums will be organised over the coming months. For more information, visit nsft.uk/carersforums or follow us on Facebook or Twitter

A host of different activities took place during Carers’ Week 2016, including a tea party at Carlton Court, in Carlton Colville, near Lowestoft, and drop-in sessions at libraries where people could pick up information or ask for advice. Catherine Phillips, NSFT’s Carers’ Lead for the Waveney area, also met with Suffolk Family Carers to discuss the best way to identify young carers so that the can receive help and support. Carers’ leads were introduced by NSFT and Suffolk County Council in late 2015, and are responsible for promoting awareness of the support available to people in caring roles. They work alongside NSFT staff in Suffolk and Waveney to make sure carers’ needs are fully considered, while raising awareness that carers are entitled to an assessment at any time. Julia Wunderlich, Professional Advisor for Mental Health, said: “We would encourage anyone who is caring for someone supported by NSFT to talk to a carers’ lead and ask for an assessment. Early advice, support and intervention can often help to prevent crises from arising and our carers’ leads have a wealth of knowledge about resources which could help.”

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Quality is top of the agenda for Matrons Matrons in our Trust are taking part in a unique programme to assist them in providing the best quality of care for our patients.

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he Matrons’ Development Programme has been tailor-made for NSFT and is aimed at helping Matrons do the job they love even better and giving them the tools to deal with the demands of the role. Dawn Collins, Deputy Director of Nursing and Professional Practice, said: “Matrons make a huge impact on the way we deliver care to people and the roles are fundamental to the way our Trust operates and the provision of high-quality care. “The programme aims to equip the Matrons to deal with the leadership challenges they face now and in the future. “It’s about their understanding the demands of the role, their teams, understanding how the organisation works and how they fit into it.

“MATRONS MAKE A HUGE IMPACT ON THE WAY WE DELIVER CARE TO PEOPLE AND THE ROLES ARE FUNDAMENTAL TO THE WAY OUR TRUST OPERATES.”

“Ultimately, this leads to their delivering the best possible quality of care and our aim is that the year-long programme helps us to make a real difference to service users and the care that they receive.” Ches Hankins is a Matron based at NSFT’s inpatient Fermoy Unit, in King’s Lynn. She joined the programme after taking up her role as Matron last year.

“There is a real focus on improving leadership within our Trust and this programme is a significant part of that, helping us to build leadership skills which we can effectively use within our roles. “At a time when there are a lot of financial pressures, my role is to always bring the focus back to the quality of care we are providing, and to ensure our targets to improve and maintain quality are focused. “An example might be ensuring that a care plan is in place and that it is meaningful and collaborative, and the safest it can possibly be. “The programme has been a real challenge, but working closely with other people in the same role has been a fantastic opportunity to share information, ways of working and best practice.”

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Helping the next generation A specialist research nurse with our Trust has spoken at the satisfaction she gains from working at the cutting-edge to help develop new treatments which could benefit people with dementia in future years.

ouise McCarthy became a research nurse five years ago. Her interest was piqued when she stood in for a colleague during a study looking at whether computerised cognitive remediation training, or “brain training”, would reduce the negative effects of schizophrenia. Since then, she has fully embraced the role, and now runs studies for universities and pharmaceutical companies while developing ideas of her own. She also plays a key role in recruiting patients, and will work closely with them and their family or carer throughout the study to monitor their condition and answer any questions they may have. “My job is really interesting and I thoroughly enjoy it,” said Louise, who has recently been promoted to Research and Development Lead for Suffolk for Dementia and Later Life Studies, and works from Wedgwood House, in Bury St Edmunds. “It’s incredibly satisfying to think that the project you are working on could end up helping thousands of people in the future. But seeing something through from the development stages to everyday use does take a lot of time – you don’t do this job to get immediate results and need to have a lot of patience. “Research is hugely important and has made a massive difference to

“Often I act as a link between the patients and the university or pharmaceutical company which is carrying out the study,” added Louise. “I’ll visit them regularly and carry out outcome tests and monitor their blood, for example, and answer any questions they may have.

cancer services. As a society, we need to replicate that success with dementia, and I hope the projects we contribute to at NSFT will help.” Louise started her career as a mental health nurse based unit at Wedgwood House. Although she is still employed by NSFT, her current role has been funded by the National Institute for Health Research. She now carries out a wide range of different studies, from intensive clinical trials which involve a lot of patient contact to projects which look purely at data. She also contributes to observational studies into how services are performing, such as a recent initiative which examined how certain dementias are diagnosed and managed. Over the coming months, she also hopes to develop more in-house studies which explore ideas thought up by NSFT’s own clinicians.

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“The thing that has surprised me is how willing people are to get involved. I always assumed that people would say they had enough on their plates coping with a diagnosis, but they see trials as a hopeful thing. They realise it may not make a difference to them, but could for the next generation, and that sort of altruism really is something to be admired.”

Anyone who would like to volunteer to help future dementia research can join a national database, found at tinyurl.com/dr-nihr, and will be contacted when a suitable study becomes available.

You can read more about some of the research work going on in dementia in the Spotlight on Dementia section on pages 102-107

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Mental Health ACT Hospital Managers recruitment At NSFT we are looking for people to join our team of independent volunteers who ensure that the rights of detained patients in our services are protected.

he volunteers work together on the Mental Health Act Hospital Managers’ Committee. This is responsible for ensuring that patients are correctly sectioned under the rules of the Mental Health Act (MHA) and can hear appeals against any MHA detention. The role of Mental Health Act Hospital Manager is suitable for those with a keen interest in mental health as explained by Rob Bennett, Vice Chair of the Committee. Volunteers come from a wide range of backgrounds – the present team of Hospital Managers includes a music teacher, a fruit farmer and a retired physiotherapist Rob came from a background in finance but had a long-standing interest in issues surrounding mental health and took up his role with the committee two years ago.

“I have a strong interest in mental health and believe it doesn’t get treated with the importance it deserves. “Although we are independent of the Trust, the organisation ensures we are fully trained to be able to reach the right decision for the patient and the wider community.” A committee hearing panel has the power to discharge any detained patients (except those under certain sections of the Act), to discharge

any Community Treatment Orders, and can also order a review at any time about whether or not a patient should be discharged. The role involves sitting on 10 to 12 panels a year, and undergoing training and development days. A fee is paid for attendance at hearings and travelling expenses can be claimed. Rob explained that the role was challenging but also extremely rewarding: “You must be able assimilate medical reports and be able to listen carefully and ask questions in a constructive way.

“You also need to be able to put the patient at ease – we try and make the hearings as relaxed as possible without losing some of the necessary formality. It is the mechanism for objectivity and fairness and deciding what is the best course of action for patients – the medical staff cannot decide in isolation. “One of the most enjoyable aspects of the role for me is having the chance to learn so much as you go along.” For more information about becoming a MHA Manager, email susan.o’hagan@nsft.nhs.uk or helen.dewson@nsft.nhs.uk Insight | Autumn/Winter 2016 117

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Trust pledges to recruit an army of volunteers NSFT’s new Voluntary Services Manager is appealing for anyone interested in helping to further improve services for patients and staff to get in touch as she prepares to recruit an army of volunteers.

ve Edwards, who joined the Trust earlier this year, hopes to attract scores of new volunteers over the coming months to fulfil a wide variety of different roles in clinics, wards and offices and support NSFT’s 4,000 staff to deliver even better services. She hopes that people from all walks of life with a few hours to spare will consider applying, with roles available in both Norfolk and Suffolk. Posts will be advertised on our Trust’s website, and could include offering companionship at mealtimes, becoming a dementia buddy, playing games with patients and encouraging service users to complete surveys to help drive through improvements. “I love working with volunteers, have an interest in mental health and also have experience of working in the NHS, so the role at NSFT was the perfect job for me,” said Eve, who joined the Trust from an eating disorders charity. “My first job has been to update and refresh our service so that we can offer new, exciting and diverse opportunities to grow our network of much-valued volunteers. "We will soon be ramping up our efforts to attract new volunteers to

She said: “It has been a privilege to have met many people with their own individual challenges to face and try and overcome. Later it is a joy to see many of them eventually leave, equipped to continue their lives independently away from the support of the staff who have helped them. the Trust and are keen to hear from anyone who would like to help out in the future.” Around 50 volunteers currently work with NSFT, meeting and greeting service users and carers as they arrive at clinics, helping with occupational therapy sessions and visiting patients with their ‘pets as therapy’ dogs. They are encouraged to make use of their own skills and interests, with one keen photographer currently running teaching sessions and a complementary therapist offering Indian head massage. Among them is Pauline Elliott, who has volunteered with NSFT for nearly seven years, meeting and greeting service users at Lowestoft’s Recovery College, at Kirkley Cliff.

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“No two days are ever alike, but that makes my volunteering experience interesting, worthwhile and enjoyable.” Eve added: “Volunteering is tremendously rewarding, and can really make a difference to people’s lives. We always try and put each individual’s skills to good use and will have roles available to suit every interest – there really will be something for everyone. “You don’t need any previous experience. All we ask is that you are empathetic and keen to meet new people and learn new skills and we’ll do our best to accommodate you.” For more information about volunteering with our Trust, visit nsft.uk/ volunteer or contact Eve on 01603 421348 or by email volunteer@nsft.nhs.uk

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Volunteering helps me settle a score with dementia A dedicated volunteer who takes music onto our Trust’s dementia wards to help trigger positive memories for patients has spoken of the satisfaction she gets from igniting a spark in others and helping them communicate.

eather Edwards visits the Julian Hospital, in Norwich, several times each month and plays the keyboard for inpatients. Her music sometimes prompts singing or dancing, while also encouraging people to communicate by starting conversations about their memories. Heather began volunteering with our Trust around seven years ago to make good use of her long-standing interest in the link between music and dementia. She also has personal reasons for giving up her time to help, as her late father sadly developed dementia following a stroke. “I am very angry about dementia and feel I am settling a score with it,” said Heather, who also plays in acute hospitals, care homes and sheltered housing schemes. “Any little thing I can do which is useful can only be a good thing. “When I go onto the wards, the staff often have a very good idea about who may want to engage with the music so that I can direct the session appropriately. I watch the patients and see if there is anything which rings a bell or is appealing, and will then try to tap into that.

It comes following her own experiences with her father, who began speaking again after she started reading a book he had written about his childhood to him.

“People sometimes start singing or dancing, or will come and talk about the music. I try and engage as many different people as I can and find a spark wherever I can. “For me, it is a privilege to work with the staff on the ward who do a wonderful job. They are resourceful and creative, and I am lucky to be able to learn from them and contribute. They are amazing and deserve every recognition.” In addition to her work with NSFT, Heather has developed an initiative called Music Mirrors, which gives people the chance to record their life story in their own words, with sounds and music embedded to spark memories later.

“The Music Mirror is an electronic dossier of people’s own words and sounds, which helps them to communicate when they can no longer speak for themselves,” added Heather. “I’ve seen it make a real difference and encourage people who haven’t spoken for a long time to start engaging again – it helps overcome the threshold of communication. “Sound and music are not affected by dementia as they are processed by a different part of the brain, which is why sounds can have such a positive impact on people with the illness. “I would encourage people of any age to think about putting together their own Music Mirror. Not only is it great for mental health, but is something you could share with family and friends and will form part of your legacy.” For more information about Music Mirrors, visit musicmirrors.co.uk

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NESTA’S EXPERTISE IS RECOGNISED WITH CLINICAL AWARD A Consultant Clinical Psychologist who played an instrumental role in shaping our new-look Wellbeing services has received an award in recognition of the difference she has made to service users.

WINNER

Nesta Reeve was presented with the Clinical Achievement Award during our Putting People First Awards 2016. It comes after she ensured a high level of clinical expertise as the service developed while also encouraging innovation, such as using webinars and Skype.

“NESTA ABSOLUTELY EMBODIES OUR TRUST VALUES AND BEHAVIOURS AND HAS A STEELY DETERMINATION TO DO THE RIGHT THING."

A strong leader, Nesta is always on hand to provide expert advice and support while also maintaining her own caseload. She was nominated for the award by Ian Young, NSFT’s Associate Director of Specialist Services, who said: “I don’t know anyone more passionate about delivering the right sort of service than Nesta. When you add to that passion her immense clinical knowledge and experience, you get a very powerful result. “Nesta is at the forefront of contemporary thinking when it

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comes to how mental health services should be delivered now and into the future. "For many years she has been consistently lobbying for this style of service and I am delighted it is now so closely associated with her. “Nesta absolutely embodies our Trust values and behaviours and has a steely determination to do the right thing. "You can’t ignore the fact that she works incredibly hard… (because) she believes the service is so important.”

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MORE DOCTORS WELCOMED INTO OUR TRUST

NEW APPOINTMENT TO PROTECT CONFIDENTIALITY

Our Trust has appointed 18 new doctors to help further improve the services we deliver while reducing our spending on temporary staff. In addition to the new doctors, our Trust has also recruited an additional 550 clinical staff in past 18 months, helping to reduce the amount we spend on agency workers. NSFT Medical Director Dr Bohdan Solomka said: “We are delighted that we have been able to welcome so many new colleagues to NSFT over the past few months. “They bring with them a wealth of experience and expertise which will be of great benefit to our service users, and we look forward to working closely with them over the coming months and years. The group have all been recruited within the past 18 months and include consultants, specialty doctors and specialty registrars. They will work in a variety of settings across both Norfolk and Suffolk, including inpatient units at Wedgwood House, in Bury St Edmunds and Northgate Hospital, in Great Yarmouth, as well as the Norvic Clinic and Hellesdon Hospital, both in Norwich. The new recruits will be based in the Trust’s Children’s, Families and Young People’s Services, Gender Clinic, Psychiatric Liaison, Integrated Delivery Teams and the Psychiatric Intensive Care Unit. They have all been appointed on permanent or fixed-term contracts to help increase the mix of skills available at NSFT.

“Like many other NHS trusts across the country, we have struggled to recruit to posts due to a shortage of qualified staff coming through the system. This has meant we have had to rely on temporary staff to help us continue to deliver safe, effective services for people in Norfolk and Suffolk. “Reducing our agency spend continues to be a key priority for the Trust and we have a clear recruitment strategy in place which has seen us invest £2.6m in recruiting more staff for inpatient areas and £950,000 in additional community staff. “This latest raft of new recruits shows that strategy is beginning to bear fruit and we look forward to welcoming more new faces in the near future.”

Dr Vivien Peeler has been appointed as Caldicott Guardian for our Trust, responsible for the protection of patient and service user information. Dr Peeler is a Deputy Medical Director in NSFT. Every NHS organisation is required to appoint a Caldicott Guardian, who is responsible for protecting patient confidentiality while enabling information sharing, where appropriate. The Caldicott Guardian can also advise staff within an NHS trust and are responsible for policies concerning confidentiality.

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A day in the life of a forensic psychiatrist In this issue, we take a look at a day in the life of one of our consultant psychiatrists, Dr Mark Earthrowl, who gives us an insight into working in secure forensic services.

octor Mark Earthrowl joined NSFT in 2015 as a Consultant Forensic Psychiatrist within female secure services. He divides his working week between the low secure Whitlingham Ward and the Forensic Community Team, which are both based at Hellesdon Hospital, near Norwich. The Trust’s secure services and Forensic Community Team cares for offenders with mental disorders, many of who have had restrictions placed on them by the Ministry of Justice. Arriving at work at around 8am, his day is filled with a mixture of ward rounds, patient assessments and

supervision, while he also takes part in meetings, including case reviews and discharge planning. “I have been a forensic psychiatrist for the past 15 years and chose to specialise for a combination of reasons,” said Mark. “I really enjoy the interface between psychiatry and the law, and being called to give advice on complex mental disorders or other factors relevant to offending behaviour. “Working in secure services also generally means I work with patients over a longer period of time, which gives me the chance to really get to know them and their families well.

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“Our patients often have a very complex range of needs. “Most have one or more significant disorders or mental health illnesses, often combined with personality disorders, as well as issues with substance or alcohol misuse. Many have a history of trauma or abuse, and can exhibit very challenging behaviour which is a risk to both themselves and others.” Whitlingham Ward can care for up to 12 patients at any one time, all of which have been assessed as requiring low secure care because of the risk they present to others. Patients are usually admitted for several months, and can receive

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talking therapies, group sessions, medication and other treatments, while also taking part in a variety of recovery and vocational activities. During their admission, patients also receive support to maintain their links with the community and social networks. The team fulfils a variety of roles, including supporting discharge, monitoring medication, helping with personal budgets, supporting vocational activity and community integration and providing supervision and risk management. Its overall aim is to help patients transfer smoothly to NSFT’s adult recovery teams. “The secure wards are not that different from any other ward, but do have specific environmental features because of the patients we work with,” added Mark. “We also closely monitor the things our patients are allowed to bring onto the ward. “The majority of our patients will have committed a serious offence, such as arson. Additionally, female patients

have increased rates of self-harm, so we need to monitor any risks and develop an in-depth knowledge of their histories and triggers.

to secure services. This sees him travelling the country to wherever the patient has been remanded so that he can assess which unit would best suit both their needs, and the level of risk they pose to others.

“I REALLY ENJOY THE INTERFACE BETWEEN PSYCHIATRY AND THE LAW, AND BEING CALLED TO GIVE ADVICE ON COMPLEX MENTAL DISORDERS.”

“The patients I visit are usually in another hospital or prison, and can be anywhere in the country,” said Mark. “I take a multi-disciplinary team with me, including nurses, trainees and – where appropriate – a psychologist so that we can carry out a comprehensive assessment before making a recommendation.

“Despite that, the risk to staff who work in forensic services is lower than in other acute areas of psychiatry, as we have a very experienced and supportive team, physical and procedural security measures in place and a higher ratio of staff to patients.” In addition to his roles at Hellesdon, Mark is also responsible for assessing female patients from Norfolk, Suffolk, Cambridge and Peterborough who are referred

“THE PATIENTS I VISIT ARE USUALLY IN ANOTHER HOSPITAL OR PRISON, AND CAN BE ANYWHERE IN THE COUNTRY.”

“Often our patients do not have insight into their condition or need for treatment. They may not feel they are unwell or need to be in hospital, which can present a serious challenge to developing a therapeutic relationship. As a result, they can be abusive and threatening, as they may perceive that the team is working against them and don’t always accept that we are trying to help. “Unlike many other branches of medicine, our staff receive less positive feedback from patients. Because of this, there is a need for a degree of resilience and to get your sense of job satisfaction by celebrating the small gains and maintaining an awareness of the longer term rewards, which happen when you see the patient recover and be able to leave hospital.”

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Return to the NHS and have a rewarding career in mental health Former nurses and healthcare staff across Norfolk and Suffolk are being encouraged to resume or start up a new career in mental health as part of the Trust’s ongoing recruitment campaign.

ur Trust has announced its commitment to those who return to the NHS by working with NSFT and is offering appropriate candidates £1,000 towards their expenses and courses at the University of Suffolk or University of East Anglia. Dawn Collins, Deputy Director of Nursing and Professional Practice with NSFT, said: “We have a national shortage of nurses across the NHS and in mental health we can only recruit nurses who have trained in the UK, which gives us an even smaller pool of experienced staff. “This is why we are doing everything we can to help those who want to return but are hindered due to expenses for childcare, travel and books during their retraining.”

and might consider a career in mental health as a rewarding one for them.

The Nursing and Midwifery Council (NMC) recently wrote to 1,161 former NHS nurses in Norfolk and 825 in Suffolk who have left its register to encourage them to return.

“The Return to Practice programme is essentially a period of updating skills and knowledge to enable a former nurse to work again and become re-registered.

Dawn said it was an important time to consider returning to nursing or other areas of expert practice: “For our Trust, it is the chance to employ experienced people who may have retired, had a career break or left to start a family. They may previously have worked in mental health or even in other parts of the health service

It’s a combination of classroom and placement-based learning, and a minimum of 75 hours of clinical practice taking place over approximately three months.” If you would like to build up your confidence before commencing a Return to Practice programme, there are lots of

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ways in which you can volunteer at NSFT, and you can commit to as much or as little time as you like each week. For more information about volunteering with our Trust visit nsft.uk/volunteer or turn to pages 117-119 If you would like to discuss the possibilities of returning to your NHS career with NSFT you can email dawn.m.collins@nsft.nhs.uk for further information or you can read more by visiting tinyurl.com/hee-nursing

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“… Return to Practice students can have more life experience, and are ideally placed to help …” Conrad Debney qualified as a nurse in 1994 before severe mental health problems led to his retirement from the profession in 2011.

e spoke about how he worked to return to the job he loved: “I had lost my job, my registration and even my marriage, and I reached a point where I believed I could never be a nurse again due to the hidden effort it took me just to present myself as 'normal'.”

part of which includes one day-aweek with the Recovery College where he continues to be a Peer Tutor.

However, in 2012 a colleague tracked Conrad down and encouraged him to get involved in NSFT’s Recovery College. Three years later he was a Peer Tutor and beginning to think a return to practice may be possible.

“My ex-wife Julie Debney, who also works for NSFT, and for whom all of this was just as difficult, has also been incredibly supportive and giving, allowing me to share our story in order to help others.

But it was during a particularly difficult time, helping to care for his mother-in-law who had terminal cancer, and her beloved dog Lillie who had diabetes, that Conrad was persuaded he could still care and support people. He began researching the Return to Practice course at the UEA, although without a degree, or a diploma, was unsure whether he was even eligible.

“I was also pleasantly surprised to find that old colleagues welcomed me back. They encouraged me so much while I was away from nursing and I am lucky enough to be working with them again.

very supportive, and felt that my own experience of mental health issues was a positive aspect to my application,” Conrad explained. Encouraged, he applied and was accepted on a Return to Practice course in September 2015. “I discovered a new-found confidence with which to question current practice, but in a much more positive, compassionate and Recovery-focused way than I did before.

“My other concern was that now my autism and mental health problems had been properly diagnosed, I needed to be sure the Trust would both accept and support me.

“My university cohort were also invaluable in supporting me and I took inspiration from some of them who had been away from nursing much longer than me, but were still determined to return, despite juggling major issues and changes in their lives,” he added.

“I found that the Deputy Director of Nursing, Dawn Collins, was

After passing the course, Conrad began working as a Dementia Trainer,

“I am glad I have returned to nursing practice, and to have discovered colleagues who also want to see our service continue to change in creative, bold, and transparent ways, which break down the divisions between staff, service users and carers. “However, there is still work to be done in helping our Trust live up to its new values, and I feel that Return to Practice students who perhaps inevitably have more life experience, are ideally placed to help facilitate this. “I am determined to try to use my experiences as a service user, my previous nursing career, and my knowledge of Recovery to try and help facilitate this.”

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I wanted to give something back to the NHS that had helped me so much with my recovery…

WORK FOR US People looking for a rewarding career in the NHS and within mental health can keep in touch and find out more about the opportunities available and what it’s like to work for NSFT after a new microsite and Twitter feed were launched.

Tanya Tomkins took part in a recent Return to Practice programme with NSFT after having to take a career break.

fter being taken ill with a serious medical condition, Tanya eventually had to leave nursing. But after receiving a diagnosis, and treatment, her health slowly improved and, during her recovery, Tanya worked in a care home which gave her the inspiration to start the Return to Practice course.

and then, with the right emotional support and treatment, become a much happier person is such a massive reward that you forget about all the challenging stuff.”

Tanya said: “Nursing was always a vocation for me and something I had always wanted to do. I worked with adults with learning disabilities and mental health issues for around five years at the Trust’s specialist Airey Close unit, in Lothingland, near Lowestoft.

“The interview was a relaxing experience and, although I was very nervous, both interviewers were kind and assisted in dissolving the nerves. I was extremely worried, but finally got my dream and was accepted on to the course,” she said.

“After my illness I wanted to give something back to the NHS that had helped me so much with my recovery. “Mental health is a very difficult area in which to attract and keep staff. And it can be extremely challenging at times, but holding on in there makes it so rewarding. “To have a service user display challenging behaviour and distress

She explained that her application to go on the programme involved two essay-type personal statements, form filling, then an interview with a maths and English test.

Keen to work with people with dementia, Tanya was offered a placement at NSFT’s unit for older people’s mental health in Carlton Colville, in Suffolk. “The Return to Practice programme has made me feel every emotion, but with hard work and support from colleagues, lecturers and family, it is achievable, even at the age of 52.”

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The new approach to recruitment has seen an exciting range of career choices across Norfolk and Suffolk advertised to a wider range of people via the @NSFTjobs Twitter account and the microsite, which was launched in the spring. Available at nsft.uk/work-for-us the site includes: • Links to NSFT’s latest vacancies and full NHS jobs listings • Videos on working for the NHS and the variety of jobs on offer • A link to our @NSFTjobs Twitter feed • Details of upcoming recruitment fairs and events • Highlights of our innovative Nursing Academy • Information on apprenticeships, work experience and temporary positions In the future there will be detailed career profiles, additional video content and a more detailed recruitment calendar.

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PRAISE FOR OUR TRUST’S NURSE TRAINING Our Trust has been commended by Health Education East of England (HEEoE) for the high quality training and development we provide so that our nurses and allied health professionals (AHPs) can deliver the best possible care to service users and carers. HEEoE visited Hellesdon Hospital, in Norwich, earlier this year to carry out an annual quality and performance review, which looks in detail at the education systems in place to make sure staff receive the training, development and support they need. The team rated the Trust as ‘Green’ against all eight criteria, which included the clinical learning environment, the support offered to students, engagement with education providers and the plans in place for further improvement. They also singled out several key areas for specific praise, such as localised teaching sessions, particularly within the dementia unit, and the investment in “growing your own” talent.

An action plan is now being drawn up to address any areas where HEEoE said improvements could be made. Trudii Isherwood, Trust Education Lead, said: “We are delighted with the report we received from HEEoE.

“WE WILL CONTINUE TO LOOK FOR WAYS WE CAN FURTHER IMPROVE SO THAT WE CAN BUILD ON THESE FANTASTIC FOUNDATIONS IN THE FUTURE.”

“Our whole education team, and particularly our admin assistants, have worked incredibly hard over the past few years to put the right systems in place to deliver these excellent results, and our thanks go to them. “We pride ourselves on the training we provide to our students. They tell us they are happy to work at the Trust and have the right support in place to help them thrive, which is great news for our service users and carers “We will continue to look for ways we can further improve so that we can build on these fantastic foundations in the future.”

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NSFT NED HONOURED BY THE QUEEN The dedication which one of our Trust’s non-executive directors has shown to serving his community has been recognised after he received a CBE in the Queen’s 90th birthday honours. Bishop Tim Stevens, who joined NSFT last December, received his CBE for services to the Church of England and the community in Leicestershire, where he spent 16 years before retiring to Suffolk in 2015. On receiving the honour he said: “It is a special privilege to receive this award in Her Majesty’s 90th year, and I shall hope to live up to the confidence shown in me in my work with NSFT in the future.” Bishop Tim was ordained in 1976 and started his ministry in east London before becoming team rector at Canvey Island and serving

as the Bishop of Chelmsford’s urban officer, then returning to the capital as Archdeacon of West Ham. He was Bishop of Dunwich from 1995 until 1999, when he was appointed Bishop of Leicester. He also spent six years chairing the Bishops’ Bench in the House of Lords, where he contributed to national debates by speaking on the behalf of 26 bishops.

“IT IS A SPECIAL PRIVILEGE TO RECEIVE THIS AWARD IN HER MAJESTY’S 90TH YEAR.”

GRADUATION DAY FOR THE NEWLY QUALIFIEDS A new round of graduates from NSFT’s academy for newly qualified staff have 'passed out' at the Trust’s AGM in October. A total of 22 staff made up the latest group of newly-qualified nurses and therapists who have received further training and support during their transition from university to work. The Newly Qualified Academy, launched by NSFT in 2014, was set up to respond to concerns, both locally and nationally, over the large number of nurses in particular who leave their professions within two years of qualifying. Trudii Isherwood, Training Manager at our Trust’s Education and Development Department, said:

“By participating in the academy, we know that our staff feel more valued, engaged and confident to develop their personal and professional needs in their transitional year as newlyqualified staff.

“THEY ARE ABLE TO WORK TOGETHER AND SUPPORT EACH OTHER AS THEIR LEARNING ON THE JOB CONTINUES.”

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“And the key to the success of the academy has been that they are able to work together and support each other as their learning on the job continues.” Following review and feedback from the first cohort of newly qualified nurses, the academy’s programme has been redesigned to a ‘step-on, step-off’ rolling system allowing newly qualified health professionals to join at any time, providing enrolment is in the first year of their registration. More information is available at nsft.uk/NQAcademy

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Staff grow a mo for mental health awareness Mo’ staff from across our Trust went the extra mile this November by sculpting fine moustaches to raise awareness of safeguarding men’s mental health

s hundreds of teams across the country signed up for this year’s Movember campaign, our Trust launched it's One Trust Grew a Mo team. Team members got off to a flying start raising thousands of pounds for the campaign which sees men go from clean-shaven to hirsute after refraining from shaving their moustache during November. The annual fundraiser is organised

by the Movember Foundation, which encourages teams to ask for sponsorship in return for their hair-raising efforts. All of the money raised is plunged into initiatives to protect men’s health, with the foundation setting itself the target of reducing the number of men dying prematurely by 25% by 2030. The challenge resonated with our Trust’s staff more than ever before as the focus for Movember 2016 was placed on improving mental

health and reducing suicide. Its aim has been to encourage men to look after their mental health before they reach crisis point, and ask for help should they need it. As a result, it is hoped that suicide rates among men – which are three times higher than among women – will reduce. You can still sponsor our Trust team at nsft.uk/movember

NSFT MOTIVATION: A WORD FROM SOME OF OUR MO BROS

Michael Scott

Tim Bishop

Gabriel Abotsie

Andy Goff

“The Movember challenge resonates even more with us this year because of the focus on improving men’s mental health and reducing suicide. We hope we can help encourage men to look after their mental health before they reach crisis point, and ask for help should they need it….”

“Forty years ago or more at my school a boy hanged himself in desperation, which we all missed.

“Too many men are ‘toughing it out’, keeping their feelings to themselves and struggling in silence.

"I’ve always wondered if any of us could have been his lifeline.

"The Movember Foundation is aiming to reduce the rate of male suicide by 25% by 2030, and I want to help them get there. Help me stop men dying too young...”

“The Movember Foundation is the only global charity focused solely on men’s health, so this Movember I’m getting on board.

"The Movember Foundation is aiming to reduce the rate of male suicide. Here we go…”

"I’m raising funds to tackle some of the biggest health issues faced by men: prostate cancer, testicular cancer, and poor mental health..."

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No soggy bottoms at Sandringham as staff got a rise out of Bake Off! As Great British Bake Off fever swept the nation a team of budding bakers on Hammerton Court’s Sandringham Ward, in Norwich, rose to their own team-building challenge.

irthday cake, celebration cake and often ‘just because it’s Wednesday cake’, staff on Sandringham Ward rarely pass up the chance to try something sweet on their tea breaks. So it was only right that everyone’s favourite cookery show provided the inspiration for Charge Nurse Kate Stelling’s team-building initiative. And the icing on the cake was a visit by one of Norfolk’s top chefs Richard Hughes who made a

special appearance at a tea party to mark the end of the challenge in November, offering his critique of the wonderful bakes produced by the staff. The challenge kicked off on the ward - which is part of NSFT’s specialist dementia unit, based at the Julian Hospital, in Norwich - with each participating staff member selecting the name of a Great British Bake Off contestant, and as their unlucky baker left the TV show, they were required

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to make something based on the theme of that week’s programme. The would-be bakers were only too keen to show off their talents and those who lacked experience more than made up for it in enthusiasm. Colleagues eagerly followed the trials and tribulations of the Sandringham team as they earned their crust through challenges involving biscuits, pastry, batter, bread, cake and desserts, battling to take home the elusive Golden Wooden Spoon.

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Each week the team looked forward to the chance to sample such delights as Sam Conway’s ‘Almond and Coconut Bakewell’, Sarah Houston’s ‘A-maizing Loaf’, Janusz Lesnianski’s ‘Tangy Lemon Drizzle Cake’, Karen Beard and Catherine Rose’s biscuits, Nicky Gordon’s Clafoutis and Debbie Chowns’ lemon meringue pie.

“IT’S BEEN FANTASTIC FUN AND WE HAVE ENJOYED EATING ALL THE CAKE AND BAKES WHICH THE TEAM HAS MADE OVER THE WEEKS.”

Kate said: “It’s been fantastic fun and we have enjoyed eating all the cake and bakes which the team has made over the weeks. Everyone has really got behind it and it has been a great team-building exercise." And the winners of this year’s Great Sandringham Bake Off were Sandy Loftus and Josie Andrews with a special prize for Susan Bissmire for making her own puff pastry from scratch.

“EVERYONE HAS REALLY GOT BEHIND IT AND IT HAS BEEN A GREAT TEAM-BUILDING EXERCISE.”

On winning the Golden Wooden Spoon Sandy said: “It has been a great competition and everyone has made beautiful cakes over the weeks. I hadn’t baked for years but maybe this is the chance to start again.”

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Claire Murdoch visit

Good work showcased during national Directorâ&#x20AC;&#x2122;s visit The NHSâ&#x20AC;&#x2122;s National Mental Health Director has visited our Trust to find out more about some of our most innovative services while seeing first-hand the improvements which have been made. 132 Norfolk and Suffolk NHS FT (NSFT)

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laire Murdoch met Chief Executive Michael Scott at Hellesdon Hospital in Norwich in the autumn, before listening to presentations about our Wellbeing and Compass services and visiting the women’s low secure unit, Whitlingham Ward, to meet staff.

“SHE WAS IMPRESSED BY THE GOOD PRACTICE SHE SAW DURING HER VISIT, AND WAS PARTICULARLY KEEN TO CONGRATULATE STAFF ON THE IMPROVEMENTS WHICH HAVE TAKEN PLACE.”

She divides her time between the national role and her existing job of Chief Executive of Central and North West London NHS Foundation Trust, which provides both mental health and community services. “Claire’s visit was a great success which will help to put NSFT on the map and attract national recognition for some of the good work which is taking place at our Trust,” said Michael. “We hope that it will also open the door for us to get more involved in some of the exciting new initiatives which are happening nationally and could directly benefit our service users.

to help vulnerable families overcome complex relationship and behavioural difficulties.

“CLAIRE WAS VERY CLEAR THAT MENTAL HEALTHCARE NEEDS MORE FUNDING, AND TOOK AWAY THE RESEARCH WE HAVE DONE TO SHARE WITH COLLEAGUES NATIONALLY.”

She also heard more about the range of improvements which were introduced ahead of the CQC’s re-inspection earlier this year.

“She was impressed by the good practice she saw during her visit, and was particularly keen to congratulate staff on the improvements which have taken place and thank them for their hard work, which resulted in coming out of special measures so quickly.

“She was also interested in the work taking place at the Whitlingham Ward to introduce a new model of care which blends low and medium secure services together, as well as hearing how the ward became one of our most improved after it was rated by the CQC as ‘Good’.

Ms Murdoch, who has been a registered mental health nurse for 34 years, was appointed as NHS National Mental Health Director in June 2016.

“Claire’s visit gave us the chance to showcase some of our most innovative services, including our new-look Wellbeing services and Compass, which finds creative ways

"In addition, Claire was very clear that mental healthcare needs more funding, and took away the research we have done to share with colleagues nationally.”

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In your words... “Over the last 10 years thanks to caring staff I have moved forward under difficult circumstances. Their care and understanding made me see reasons to go on living, because I know help is on hand if needed.” Service user “I found the staff at Walker Close wonderful. If you are prepared to work with them, employ their strategies and take the advice and support, there is a light at the end.” Service user “I don’t feel judged at all and that spurs me on and I feel optimistic about the future. I think the service is brilliant.” Service user, Central Norfolk Early Intervention Team “Within 10 minutes of your presentation things started to make sense to me. Our son’s actions and his perspective on the world… Afterwards he said he was relieved he could talk to someone.” Carer “A really heartfelt thank you from my wife and me for all that you have done. You are the first health care professional in my life who has truly understood how I work. We will always be grateful to you.” Service user, Autism Diagnostic Service, Stowmarket “I have nothing but praise for the mental health workers. The team have been brilliant supporting both my husband and me. I don’t dare to think where we might be without them.”

TRUST CONTINUES SUPPORT FOR WAVES SERVICE Our Trust is to continue funding a support group offering life skills for people with a personality disorder following the success of a recent pilot. Called Waves, the programme is run by Norwich and Central Mind and follows a model used very successfully by Suffolk Mind.

daily functionality and empowering people to achieve positive change.

It is aimed at people in the Norwich area who have a borderline personality disorder and offers therapeutic support to help them build confidence and successfully deal with the challenges of everyday life.

“We place a lot of onus on responsibility and encouraging people to express how they feel honestly and transparently in a safe, confidential and nonjudgmental environment.”

Day-long sessions take place each week, and include a life skills programme to help individuals to build relationships, take responsibility for their actions and successfully manage their emotions. Those taking part are also being given the chance to join in with activities such as arts and crafts, health walks, Thai chi and beauty treatments.

“Afternoons are dedicated to creative sessions and fun activities.

Borderline personality disorder causes problems with mood and how people interact with others. Treatment can include various types of psychotherapy, as well as therapeutic support offered by services such as Waves. Debbie White, Director of Operations, Norfolk and Waveney, said: “We are delighted to continue our work with Norwich and Central Mind to deliver this innovative new service.

“THE PROGRAMME HAS ALREADY MADE A REAL DIFFERENCE TO THOSE WHO HAVE TAKEN PART BY GIVING THEM THE SKILLS THEY NEED TO MANAGE THE CHALLENGES OF EVERYDAY LIFE.”

“The programme has already made a real difference to those who have taken part by giving them the skills they need to manage the challenges of everyday life and deal effectively with their emotions.

Waves Manager Anna Infanti said: “Waves is a support group which covers a range of life skills topics, all of which are focused on improving

More details are available at norwichmind.org.uk

Service user, Psychiatric Liaison Team, Ipswich Hospital 134 Norfolk and Suffolk NHS FT (NSFT)

“We hope that the service will continue play an important part in helping people’s recovery so that they then feel able to move on with their life.”

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SPECIAL EVENT SHOWS ‘IT'S OKAY TO TALK’ Musicians, dancers, face painters and even farm animals descended on Great Yarmouth to mark World Mental Health Day while encouraging people to talk about mental illness. The theme for the event in the autumn, set by the World Federation for Mental Health, was psychological first aid and the support people can provide to those in distress. Our Trust joined forces with other local health organisations and charities, including Mind, Alzheimer’s Society and Samaritans, to raise awareness of mental health issues and reduce some of the discrimination often associated with mental health conditions. Karen Slatcher, a Mental Health Practitioner with Wellbeing Norfolk and Waveney, who helped organise the event, said: “By holding an event like this, we are able to reach out

to people who wouldn’t normally access mental health services. “We want to say to people that mental health conditions are out there and it is ok to talk about it. You can get through it and there are services which can help.”

“BY HOLDING AN EVENT LIKE THIS, WE ARE ABLE TO REACH OUT TO PEOPLE WHO WOULDN’T NORMALLY ACCESS MENTAL HEALTH SERVICES.”

The free event has become a popular attraction in recent years and stalls offered advice about mental health services in the area. The highlight of the day was a performance by Bollywood Sparkles dance group, who brought some colour and bhangra beats to the town. Visitors were also treated to theatre productions from the Wellbeing Drama Group and a chance to meet some of the animals from Clinks Care Farm, in Toft Monks, near Beccles, which offers opportunities for people with mental health issues to help on the farm and aid their recovery.

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SURVEY REVEALS NEARLY 90% OF MENTAL HEALTH SUFFERERS FACE STIGMA Nearly nine out of every 10 people with mental health problems have experienced stigma or discrimination, according to the results of a major survey published earlier this year. The survey of more than 7,000 people, carried out by the Time to Change campaign, revealed that 64% said they felt isolated, 61% felt worthless and 60% said they felt ashamed as a result of the stigma and discrimination they had faced. A total of 68% said they felt judged. However, the results also revealed that more than half of those who responded – 57% – found it easier to talk about mental health problems than in previous years. The survey was carried out by Mind and Rethink Mental Illness, who run the Time to Change campaign. The biggest of its kind, it found that 60% felt better once they had started talking about their mental health problems, saying they felt relieved and like a weight had been lifted.

STAFF RAISE THEIR GAME TO COLLECT VITAL CHARITY FUNDS Staff from our Trust raised £550 for patients affected by dementia and learning disabilities thanks to a charity football match. A team from the Julian Hospital, in Norwich, took to the pitch in Yelverton, just outside Norwich, against staff from Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH).

“THE MOST IMPORTANT RESULT FOR US IS THAT WE RAISED SUCH A FANTASTIC SUM, WHICH WILL MAKE A REAL DIFFERENCE TO OUR PATIENTS.”

Money raised during the day will be used to fund ward activities at NSFT’s Hammerton Court, which provides care for patients with dementia who have complex needs which cannot be met within the community.

Of the 88.2% of people who said they had experienced stigma or discrimination, 37.6% said it happened less than every month, but more than once a year. It was most common in friendships (63.7%), followed by family life (56.6%) and then in the workplace (56.01%). Sue Baker, Director of Time to Change, said: “We have got to continue to make progress, show that mental health isn’t something to be ashamed of, and tackle the causes of stigma and discrimination.” 136 Norfolk and Suffolk NHS FT (NSFT)

The other half of the funds will support activities on the wards for patients with learning disabilities at the NNUH. Andrew Russell, Activities Coordinator at Hammerton Court, said: “We all enjoyed the game and the most important result for us is that we raised such a fantastic sum, which will make a real difference to our patients and those at the NNUH. "Everyone had a great time on the day – including the staff and service users who came along to support us – even though we ended up losing 8-5 to NNUH. “Our team had never trained or played together before. We’re planning another charity game against Norfolk Police, but this time will make sure we fit in a few training sessions first.” For more information about NSFT’s charitable fund or to donate, visit nsft.uk/charitablefunds

Generous young people give gifts to our patients Gifts worth hundreds of pounds were handed over to NSFT patients, thanks to the fundraising work of a group of teenagers from Ipswich

he 16 and 17-year-olds raised £500 as part of the National Citizen Service (NCS) initiative by arranging a fete and selling homemade T-shirts.

“THE CARE PACKAGES ARE A BRILLIANT IDEA AND WILL MAKE A REAL DIFFERENCE TO THOSE ON THE WARD.”

The money was used to buy board games, art supplies, DVDs, beauty products and adult colouring books for patients at the Woodlands Unit, at Ipswich Hospital, to give them something fun to do in the evenings.

Molly Steward, Group Leader with NCS, said: “We were really pleased to raise so much for this worthwhile cause and hope that the patients at Woodlands enjoyed the gifts.

The students also paid for popcorn for patients to enjoy while watching their DVDs, and there was enough money left over for a pizza night.

“Several of the group have experienced mental health problems, so unanimously voted to support NSFT. They have shown

fantastic drive and determination throughout the project and we are very proud of them all.” Tara Brown, Modern Matron at Woodlands, said: “We are really grateful that the group chose to do something special for the people who are receiving care at Woodlands. The care packages are a brilliant idea and will make a real difference to those on the ward.” For more information about National Citizen Service, go to ncsyes.co.uk

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––– DIARY DATES –––

Diary Dates We have a busy schedule of events taking place across Norfolk and Suffolk in the coming months which will give you the opportunity to improve your wellbeing, keep informed about Trust developments and provide you with the opportunity to get more involved by attending service user and carer forums and membership events.

SERVICE USER AND CARER FORUMS DIARY HIGHLIGHT: These monthly forums keep NSFT service users and carers informed about local issues and provide the opportunity to comment on service developments and get involved.

GT YARMOUTH AND WAVENEY Eastern Wellbeing Service User Forum Alternating between third Tuesday of each month, 4 - 5.45pm and the third Thursday, 5.45 - 7.30pm Oaktree Centre, Northgate Hospital, Great Yarmouth, NR30 1BU Waveney Learning Disability Service User and Carer Forum Second Tuesday of each month, 3 - 5pm Boston Lodge, Boston Road, Lowestoft, NR32 1UG NORTH NORFOLK North Service User and Carer Forum Second Wednesday of each month, 1 - 3pm Jubilee Rooms, Aylsham, NR11 6JG

NORWICH City South Service User and Carer Forum First Wednesday of each month, 3 - 5pm Open, 20 Bank Plain, Norwich, NR2 4SF ImROC/Recovery Forum First Wednesday of each month, 12.30 - 2.30pm Open, 20 Bank Plain, Norwich NR2 4SF For those interested in how mental health services will support people with their recovery in the future Dementia Focus Group Third Tuesday of each month, 10am - 12pm Julian Hospital, Norwich, NR2 3TD Secure Services Forum First Thursday of each month, 5 - 7pm The Norvic Clinic, Norwich, NR7 0HT

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WEST NORFOLK West Wellbeing First Tuesday of each month, 5.30 - 7pm Wellbeing Norfolk & Waveney, Fermoy Unit, King's Lynn, PE30 4ET SUFFOLK Suffolk Learning Disability Service User and Carer Forum Third Thursday of each month 2 - 3.30pm Red Gables, Resource Centre, Ipswich Road, Stowmarket IP14 1BE CARERS GROUPS For those caring for people with mental health problems: All welcome, Monday, 7 - 9pm Yarmouth Acute Services Centre All welcome, Wednesday, 7 - 9pm Board Room, Hellesdon Hospital, Norwich All welcome, Tuesday, 7 - 9pm Waveney Acute Services Centre For more information and contact details for the above groups, visit nsft.uk/Suandcarer

––– DIARY DATES –––

BOARD OF DIRECTORS

OTHER EVENTS

9.30am - 12.30pm

Suffolk VASP The Suffolk VASP (Voluntary and Statutory Partnership) for mental health is an open forum for anyone with an interest in mental health. It is formed of several local VASPs across Suffolk. To find out more about this organisation and their events email: vasp@bsevc.co.uk or visit their website at suffolkvasp.co.uk

November 24, 2016 February 23, 2017 April 27, 2017 Elisabeth Room, Endeavour House, 8 Russell Road, Ipswich, IP1 2BX January 26, 2017 March 30, 2017 May 25, 2017 King’s Centre, King Street, Norwich, NR1 1PH

COUNCIL OF GOVERNORS 1 - 4.30pm January 5, 2017 King’s Centre, King Street, Norwich, NR1 1PH April 6, 2017 Elisabeth Room, Endeavour House, 8 Russell Road, Ipswich, IP1 2BX

NSFT MEMBERSHIP EVENTS

Suffolk User Forum (SUF) SUF gathers, records and collates the experiences of mental health service users in Suffolk and make recommendations or commendations to providers and commissioners. They also aim to inform service users of developments in mental health care. To find out more about SUF visit suffolkuserforum.co.uk

Mind Mind provides advice and support to anyone experiencing a mental health problem. They campaign to improve services, raise awareness and promote understanding. Your local Mind also provides services which include supported housing, helplines, drop-in centres, employment and training schemes, counselling and befriending. For more information and to access your local Mind for information on upcoming events, go to mind.org.uk Relate Relate services include relationship counselling for individuals and couples, family counselling, children and young people’s counselling and sex therapy. For more information about regular workshops and meetings, go to relate.org.uk/norfolk-suffolk

For information about Membership events or to find out more about becoming a Member, contact Peter Haylett, NSFT Membership Officer, on 01603 421468 or email membership@nsft.nhs.uk

WELLBEING SUFFOLK AND WELLBEING NORFOLK AND WAVENEY Offering a range of support to improve your wellbeing and help you cope with stress, anxiety and depression, with free taster and mindfulness courses across the counties. For more details and to keep yourself informed on all the news, visit wellbeingnands.co.uk

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Norfolk and Suffolk NHS Foundation Trust values and celebrates the diversity of all the communities we serve. We are fully committed to ensuring that all people have equality of opportunity to access our service, irrespective of their age, gender, ethnicity, race, disability, religion or belief, sexual orientation, marital or civil partnership or social & economic status.

Trust Headquarters, Hellesdon Hospital, Drayton High Road, Norwich, NR6 5BE Tel: 01603 421421 Web: www.nsft.nhs.uk â&#x20AC;&#x2DC;Like usâ&#x20AC;&#x2122; at: facebook.com/NSFTrust Follow us: @NSFTtweets

PATIENT ADVICE AND LIAISON SERVICE NSFT PALS provide confidential advice, information and support, helping you to answer any questions you have about our services or about any mental health matters. Email: PALS@nsft.nhs.uk PALS Freephone: 0800 279 7257 Produced by Norfolk and Suffolk NHS Foundation Trust, November 2016.

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