Primary Care Mental Health and Wellbeing VOLUME 1, ISSUE 1: JANUARY 2013

Foreword and Introduction from Dr Ian Walton those of you who have not read the NHS Confederation report about us, published on their website only last month, it is available at: http://www.nhsconfed.org/ Publications/reports/Pages/ CaseStudyReportOnSandwell.aspx Image: Dr Ian Walton Dear Colleagues, I am delighted to be asked to introduce our first newsletter. With all your help it will evolve and develop with our services and make a similar amazing impact. This really is an exciting time for us, for

It is highly complimentary and confirms that we are the leading model for collaboration, integration and early intervention in mental health and wellbeing and this is backed up by the tremendous results you are all achieving. Thanks for all the hard work. We are a priority service for the new Sandwell and West Birmingham

Clinical Commissioning Group and I am delighted that Lisa Hill will continue to integrate and support the services in her new role as the Senior Commissioning Lead for Mental Health.

Gupta the Commissioning Manager for pulling all the contributions together into such a good newsletter and thank you to all those who have contributed.

Best Wishes, Our success has reached the attention of the Kings Ian Walton, Fund who are a highly influ- Mental Health and IAPT ential independent health Lead think-tank and another Primary Care Mental Health Event will take place on Thursday 17th January 11am - 1pm at WBA Football Club, The Hawthorns to showcase services that are available in Sandwell. Thanks must go to Daniel Stanyard, our newest recruit at the Hub and to Rita

Message from Lisa Hill Well what a whirlwind three economy. months it has been. We are currently reviewing My role has now changed all of mental health at the alongside my moment and I‟m delighted responsibility so I am now a to show the amazing senior commissioning man- results we have in primary ager at Sandwell and West care at a time when cuts Birmingham CCG with a and the economic crisis lead on mental health, older are affecting everything people and learning disabili- we do. We are privileged ties as well as primary care, in Sandwell to have such a the homeless and domestic great and motivated team violence. It is a massive and the write up from the period of change and this NHS Confederation which newsletter is an opportunity I will send you all a copy to keep you up to date with reflects that. change and also latest developments across the I look forward to building

on what we are doing and Now go and give somekeep on supporting the one a hug - you‟ll both people of Sandwell at a feel the benefit… time of great need. Our next event is 17th January Lisa Hill 2013, 11:00am - 1:00 pm and will be for external sites from Wales, Devon, Midhurst and Oxleas Trust to come and share what we and they are doing alongside the Kings Fund. For those of you I did not see before Christmas, I hope you had a great one and rest so we can have yet another great year in 2013.

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Report from Rita Gupta Hi, it has been an amazing 5 years in developing primary care mental health and wellbeing services in Sandwell and we are still going from strength to strength! Part of my role is data management and measuring patient outcomes for all services that we commission. From April „11 - March „12 over 1700 clients entered our services (a third of which are male). As we have no age criteria, our clients range from as young as 9 right through to 80+. We have set up one referral number for access to any of our self help and self help group work, and one to one therapies

which include IAPT and the Primary Care Counselling Service. All our staff/therapists are trained on CORE Net which is an IT based outcome measurement system, and use measures such as CORE10, PHQ9, GAD7, and WEMWBS to record pre and post measures to capture improvement for each client. Figures from CORE 10 (a clinical measure) have shown there has been a real improvement from all services offered, especially from Health Improvement Programmes; Positive Mental Training CDs; Psychotherapy; and Esteem Team. The WEMWBS (Warwick-Edinburgh Mental

Wellbeing Scale) also showed vast improvement results in the wellbeing of clients especially from our Chin Up programme for young persons, Flourish self care programme, and Listening & Guidance Chaplains for Wellbeing. Our Sandwell IAPT (Improving Access to Psychological Therapies) Service has also been achieving quarterly targets of 57.4% of people who complete treatment and who are moving to recovery. Rita Gupta Sandwell & West Birmingham CCG Commissioning Manager Rita.gupta@sandwellandwestbhamc cg.nhs.uk

Dr Walton collects SWB CCG’s first award Vice Chair of the Black Country Local Commissioning Group, Dr Ian Walton, has been named Clinical Leader of the Year 2012 at a prestigious awards ceremony held in Birmingham. Ian was one of three nominees for the title at this year‟s National Association of Primary Care Commissioning (NAPC) Visions Awards, presented by Practical Commissioning Magazine. The awards recognise the hard work of clinical commissioners, and what they have achieved through service redesign. Clinical Leader of the Year differs from the other awards in that there is no self-nomination – winners are chosen by the Practical Commissioning editorial team from the inspirational leaders featured in the magazine. Ian‟s work with the Primary Care Mental Health and Wellbeing Service was highlighted in October 2011.

“While I appreciate the fact I’ve been rewarded as the clinical leader of this service, it is the hard work and support of the whole team – commissioners, support staff and frontline workers – that has enabled us to win this award, and we should all celebrate our success together” - Dr Ian Walton.

Photographed with the award, from left to right, are some of the members of the PCMH Clinical Steering Group: Dr B Choudhary, Dr Shail Agarwal, Rita Gupta, Dr Ian Walton, Lisa Hill, Dr Suman Chawla, Dr Pauline Naughton, Dr N Haque, Rachel Peacock, and Dr Sinha.

Brief Psychological Interventions In order to further develop wellbeing services in Sandwell, a team of therapists who specialise in PTSD, Trauma, emotional distress and guidance as well as anxiety and depression have been recruited. The idea is to build a pool of

people with different characters and a range of skills so that the service can adapt itself more easily to clients. A common criticism of healthcare generally is the way in which the person trying to get help is made to conform to the health system and while that approach can have its

advantages, there are many people who do not respond well to it. By having a varied team, we stand a better chance of finding the right therapist for the right client at the right time. For a nurse or a GP, this doesn't change the referral system. This is ideal for those clients who cannot normally access services due to work. 2

Confidence and Wellbeing Team The Confidence and Wellbeing Team at Health for Living deliver a variety of self help and guided self help programmes and workshops. The range of programmes aims to support individuals to look after their own health and wellbeing.

Team also go into organisations and workplaces to promote self help techniques and deliver one off workshops.

Programmes are delivered at a range of accessible locations throughout Sandwell, at different days and times, so there will be something suitable for most people.

One patient who took part in the PMT CDs had not had a good nights sleep for over 2 years. On his last review, he brought his wife and she reported how she had to physically shake him to wake up as he had such a good nights sleep. He now encourages his wife and daughter to listen to the programmes.

As well as programmes in the community, the

For further information on our range of initiatives please contact the Wellbeing Hub.

“The program is easy to use, I have gone from having panic attacks every night to none at all, I am much more happier in myself and positive”. A young student was referred by her GP and was escorted to her appointment by her parents, suffering with severe depression, she did not have the confidence to attend on her own. She did not want medication and wanted to try the relaxation CDs instead. After 4 weeks, she had taken her driving test, started university and her stress levels had drastically reduced.

Cognitive Behavioural Therapy Service (Talking Therapies - IAPT) Provided by Psychological Wellbeing Practitioners and High Intensity Therapists offering Cognitive Behavioural Interventions for mild to moderate anxiety and depression; combination of face to face, text, email, telephone and guided computerised CBT. Low Intensity Psychological Wellbeing Practitioners It has been a successful year for Sandwell Mind‟s Talking Therapies Low Intensity Service having achieved an amazing 54% client recovery rate, which is above the national average for the service. In the ten-month period up to the end of October 2012 the service had received a total of 1,702 referrals. At the start of the year the majority of these referrals came directly from GPs but encouragingly in recent months more people have self-referred to the service.

The service currently has 10 qualified Psychological Wellbeing Practitioners-three of which have recently qualified- as well as three new trainees from Birmingham University along with one high intensity trainee, all under the guidance of IAPT Manager Sue Vincent. The service has also recently moved into purpose-built offices, specifically designed to support their requirements. High Intensity Therapists The service has now been established for over a year and have had very positive feedback so far

with people commenting on the positive impact the therapy has had in different areas of their lives including home, family life work and physical health. They aim to work with people to resolve their difficulties quickly and recognise that getting help early is a key factor in enabling people to manage their psychological problems, maintain their lifestyle, improve their wellbeing and hold on to their job. In addition to this they also offer a Punjabi language service and specialism's in single episode trauma including Eye Movement Reprocessing and Desensitisation (EMDR), mindfulness and compassion based approaches.

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Esteem Team: Complex Needs & Maternal Mental Health The team has been operational for one year; Gateway and Link workers are used to assess and signpost clients with complex needs and underlying mental health issues. Within this first year the Esteem Team have engaged and built links with a vast variety of agencies and community groups across the borough, and have made a positive difference to a lot of people‟s lives. Since the service was set up in August 2011 they have received over 500 referrals. The team have recently undertaken an exercise to gain some feedback from clients who have now been discharged from the service. Some of the comments follow: “The ladies were very helpful, pleasant and patient. Love them” - Esteem client. “Dr Walton referred me to yourselves. I am now very happy to be „where‟ I am. If this is down to any specific therapies or just the fact that several people, took an interest in me, believed in me, I do not know. I am just grateful for the effect „whatever‟ has had on me, giving me a much more contented life. Thank you all!” MMH client.

Since the service was set up in August 2011 the team has received over 250 referrals. The team have forged strong links with Health Visitors, Sure Start Centres, Children's and Families Teams and GP surgeries. This has resulted in women being referred to the service and receiving early support.

Sandwell Celebrates Happiness 2012 Following the success of last years International Happiness Day celebrations, our Primary Care Mental Health and Wellbeing team and partners did it again this July. Through collaboration and partnership with Sandwell Libraries, community groups, Sandwell MIND, My Time Active Healthy Walks, Esteem Team, Unique People, SUN and Regis Medical Centre over 20 different events took place across Sandwell between Saturday 7th to 14th July. The main „Happiness‟ event of the week took place at Tipton Library which was attended by over 300 people. It was a day full of laughter, stories, arts and crafts, music,

This year our „Free Hugs‟ team was invited to spread some happiness at the Regis Medical Centre, where we gave out 80 hugs in just two hours! A further 560 hugs were given out during the Tipton Library event. By popular demand we have also published a second edition of the „Sandwell‟s Book of Happiness‟. Over 40 members of the public contributed their own stories, poems and art work to this years book. If you would like a free copy of the book please contact us on the number at the end of this article. Sasha Gelpi, Sandwell PCT‟s Mental Health Promotion Officer says “it has been exciting to continue this work across Sandwell as more and more individuals and organisations wish to be a part of spreading happiness. The amount of positive feedback we continue to receive from the public has been inspirational, especially the positive impact people have told us they get when receiving a „free hug‟ and reading the „Sandwell‟s Book of Happiness‟. It just shows that it is often the smallest things that can make a big difference.” If you would like to be a part of future happiness and wellbeing events, or would like to order your free copy of the „Sandwell‟s Book of Happiness‟ please ring 0303 033 9903, Image: Free Hugs’ team at the Big Happiness Event at Tipton Library

Maternal Mental Health The Maternal Mental Health Team undertake various works regarding the referrals they receive. The MMH Team support clients who may have underlying mental health issues during pre/ postnatal within primary care.

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Make Friends With a Book Groups The two Oldbury and Smethwick based weekly reading groups with a twist continue to be well attended and regularly attract new members. During the first two quarters of this year the groups have already had just over 400 attendances.

“I was glad to read the play first as it may have been more difficult to follow otherwise. I loved the special effects, the quality, the visual drama. The acting was wonderful. So many of us were there - it was a special day - one of many I hope. I will remember this forever. Yes I definitely will want to see Shakespeare again! Thank you very much for opening new worlds and horizons which are accessible for all to reach.”

Earlier in the year the groups were excited to begin the challenge of reading Shakespeare‟s Tempest. In order to celebrate this achievement „Make Friends‟ facilitator Gina Neale was able to organise a trip to Stratford Upon Avon for the groups to see the live performance of the Tempest at Shakespeare‟s Theatre. The trip was attended by 31 people who thoroughly enjoyed this experience.

‘Arts On’ Community Arts Group „Arts On‟ group is a community arts group that meets 10am – 4pm every Thursday at The Public, West Bromwich. The group was re-launched in April 2012 with a new facilitator and has gone from strength to strength. Weekly attendance now averages at about 18 individuals and the group continues to attract new participants via referrals from professionals as well as self -referrals. Over the period of six months the group attracted 425 attendances.

Image: Some of the “Make Friends With a Book” gang on their trip to see the Tempest at Stratford-upon-Avon

Group members have exhibited their work at “Outside In”, Compton Verney and “All Over the Place”, at the Custard Factory in Birmingham. The group is also proud to be currently holding an exhibition of their work at The Public, West Bromwich.

there is no charge for visiting. We would encourage everyone to go and see the exhibition and marvel at the quality of the work produced by the group.

The display is held on the ground floor of The Public and Image: „Arts On‟ exhibition at The Public

The group facilitator Teresa encourages the participants to practice and try out a whole range of techniques ranging from watercolour, collage, acrylic, crafts and textiles amongst others, helping each person to discover their own creative outlet. The group has been gaining a lot of confidence and we want to congratulate them and celebrate their achievements.

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Wellbeing Hub The Wellbeing Hub has been operational since April 2011 receiving and processing referrals for Primary Care Mental Health and Wellbeing services. The Wellbeing Hub team has steadily grown since it was first opened. The team consists of four members Louise Perkins, Meena Patel, Indy Kaur, and Daniel Stanyard. You can contact the team by calling 0303 033 9903 or by email: [email protected] All services mentioned in this newsletter as well as a whole range of others can be accessed through the Wellbeing Hub. These cover group work, self help programmes and materials, and individual talking and listening services. Services are available for anyone living in

Sandwell or registered with a Sandwell doctor. You can obtain a referral form by calling the number below or requesting a referral form on the e-mail address provided. Referrals are accepted from GPs, Health Professionals, Organisations, as well as self referrals. Referrals are made by completing a Primary Care Mental Health and Wellbeing referral form and forwarded to the Wellbeing Hub using one of the following methods: E-mail: [email protected] Fax:

0121 531 4711

Post:

Wellbeing Hub, C/o Spires Health Centre, Victoria Street, Wednesbury WS10 7EH

Tel No: 0303 033 9903

Sandwell Therapists trained to use EFT EFT is useful for a variety of conditions including emotional stress, trauma and insomnia. The technique is closely related to acupuncture, but does not use needles. The patient taps on acupuncture points on the body (mainly on the head and hands), while focusing on a specific traumatic memory, in order to alleviate an emotional problem such as stress or anxiety. “I was amazed at how simple EFT was but at the same time

very effective. Just one session helped me to overcome my inner fears and anxieties to confront my issue positively. Highly recommended.” Over 150 patients have been treated with treated with EFT in Sandwell, and a recent service evaluation showed that EFT produced both clinically and statistically significant results for a wide range of emotional issues.

Flourish: Self Care Programme for those recovering from Mental Illness The Flourish programme has been designed and is delivered by members of the Service User Network (SUN) who have had first hand experience of the mental health system in Sandwell. The programme is spread out over a number of weeks in small bite size chunks. It is a group programme delivered from GP surgeries that are aimed to help people cope with their issues and help them on their recovery journey. The updated programme will be launching in December 2012. Service User Network (SUN) The next Service User Forum is planned for 15th January 2013 with a range of discussions presented by speakers from the newly formed Clinical Commissioning Groups as well as an update from Welfare Rights about Mental Health related benefits. There will be an opportunity to discuss Service User Network‟s role in obtaining service user‟s views of mental health services in Sandwell. If you‟re interested in attending the forum please contact Lana as per below details. We are looking for current and ex service users to come on board with SUN for opportunities to be a part of our membership, steering group and mailing list. Please contact us on 0121 525 8790 or email [email protected] if you know somebody who could benefit from being part of the group.

Welfare Rights Lee Kempson is a Welfare Rights Officer supports the IAPT project. The specific role Lee has is to assist patients engaged with IAPT to fully maximise their benefits and to help reduce the stress and anxiety they may face when dealing with the Department of Work

and Pension. So far in the first half of the financial year Lee has managed to assist 172 people to get £197,347 in benefits.

entitled to and if you are on the correct ones. They assist with debt issues and other financial advice. Home visits can be provided.

The service itself offers advice about all benefits. You can find out which benefits you are

The service will also support and advise whether you are entitled to claim additional benefits. 6