Mental Health Integrated Community Care ProjectIntelligence Community Framework November 2020

Index to pages in this workbookAutism, ADHD, Aspergers Click to jump to page in workbookCare planning Click to jump to page in workbookComplex emotional trauma Click to jump to page in workbookDigital & IT Click to jump to page in workbookDual diagnosis Click to jump to page in workbookHomelessness Click to jump to page in workbookIntegrated models Click to jump to page in workbookMarginalised groups Click to jump to page in workbookOlder people Click to jump to page in workbookTransitions Click to jump to page in workbookVeterans Click to jump to page in workbook

Autism, ADHD, Aspergers1

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

1 RCP Report 2014

Royal College of Psychiatry

The role of psychiatrists in the assessment treatment and management of ASD and comorbid conditions

Royal College psychiatrists

Details the role of psychiatry in accurate assessment of ASD and comorbid mental illness and the specific skills and knowledge required in management and treatment. Notes the need to have a coherent commissioned service for people with ASD.

Click here to open file in Teams Gary Billen

2 Autism Strategy section 4 and 7

Department of Health

Statutory guidance for implementation of the Autism Strategy

DoH Joint LA and NHS commissioning plans, need to address the 'gap' eg between LD and MH services. Specific groups eg Older adults and BAME. Consideration of issues in supporting individuals with complex needs

Click here to open file in Teams Gary Billen

3 NICE Guideline 6.4.8

NCCMH practice guidance for recognition assessment and treatment in ASD

NCCMH Section 6 covers principles of effective organsiation of care. Details a specialist MDT and local care pathway

Click here to open file in Teams Gary Billen

4 NICE Summary of recommendations

Autism- management and referral of adults

NICE NICE Summary of recommendations-Autism Recognition, referral, diagnosis and management of adults on the autism spectrum 142

Click here to open file in Teams Gary Billen

5 RCP Report 2020

RCP Recognition and management of autistic adults without learning disability

RCP Part of work to improve MH services for people with ASD reflecting the increasing expectation that all services should make adjustment to enable access. Details the need to treat MH disorders within mainstream services. Describes a wider network of lifelong support including health social care education and beyond

Click here to open file in Teams Gary Billen

6 Aspergers Syndrome and mental health

See link Autism referenced-mental health

Includes autism. Couldn't access full article as needs subscription

https://www.magonlinelibrary.com/doi/abs/10.12968/bjmh.2018.7.2.70

DH

2

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

7 Mental Health Services for Individuals with High Functioning Autism Spectrum Disorder

See link Employment. Mindful based therapy. Transition

This is a priority in Canada, USA and UK. Proposes interventions, saying they already exist in CMHT programmes. Supported employment gets more individuals into higher paid roles than other models. Mindfulness Based Therapy led to reductions in depression, anxiety and ruminations in individuals, but more research needed. There are a few studies on supporting parents and siblings, and they highlight the need to do this. Organisations that support people with Autism need to partner with CMHT's to help them train, mentor and build capacity for them to work with autistic people. Need to help transition to adults.

https://www.hindawi.com/journals/aurt/2014/502420/

8 College report on ASD

see link Misdiagnosed and undiagnosed ASD

Suggests that people undiagnosed with ASD may present to MH services and misdiagnosed due to the way ASD presents

click here to open the file in Teams

9 NICE Trauma informed care

NICE Have reviewed the need for CBT. Trauma informed care can be relevant. Clients need a safe and consistent setting and long term relationships - not the recovery model.

https://www.nice.org.uk/ DH

10 National Autistic Society

Resources on website

National Autistic Society

Has good information on MH on their website including what can help in different situations / diagnoses. CBT adapted for autism appears to be successful for reducing anxiety.

https://www.autism.org.uk/ DH

11 NICE - updated Aug 2018

Guidance on interventions

NICE Interventions for co-existing mental disorders. Gives clear guidance.

https://www.nice.org.uk/ DH

12 2019 - BPS Working with autism: Best Practice Guidelines for Psychologists

UK Best practice The British Psychological Society

This best practice guidance is for practitioner psychologists who work with people with autism and their families and carers. The guidance does not support any particular theoretical or therapeutic approach. Instead, it recognises that autism is a highly complex condition for which the evidence base for causation and treatment is continually developing. The guidance focuses on the role of psychologists as practitioners, as drivers of change within a system or service, and as contributors to a multidisciplinary approach. The guidance covers different contexts where psychologists may work – including with children and young people, with adults and older adults, in education, employment and in criminal justice settings. A short summary of best practice recommendations is provided at the end of each section. Useful resources and further reading are provided throughout the guidance.

Click here to open file in Teams Karen Sutton

3

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

13 Feedback on MH Provision from AS specialist teams

Specialist AS teams feedback

Karen Sutton Summary of feedback from various Specialist AS Teams (Primarily Diagnostic Teams, who provide input to Mental Health Teams)

Click here to open file in Teams Karen Sutton

14 NICE Guidance NG87 Final

NICE guidance NICE ADHD: Diagnosis and ManagementMarch 2018 (with a focus on Adults): review of services and processes, with recommendations

click here to open file in Teams Rodi Karadimova

15 MHICC Intelligence group - Adult ADHD

Group discussion notes

Group discussion notes click here to open file in Teams Rodi Karadimova

Last checked for

completeness against Teams content

18-Nov

Care Planning

4

Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

1 NHS Oxleas Foundation

trust

Oxleas(Bexley, Bromley, Greenwich, Kent)

Assessment and Care planning

NHS Oxleas Foundation

trust

The Care programme approach (CPA) is the framework to deliver care to individuals who use Oxleas mental health services. When referred to Oxleas, an assessment is made of mental health needs. This allows to understand how best to help or would be better managed by other services.A professional develops a plan of care that outlines how to work together to build on strengths and address the difficulties.

http://oxleas.nhs.uk/advice-and-guidance/mental-health-services/care-planning/

2 NHS Oxleas Foundation

trust

Oxleas(Bexley, Bromley, Greenwich, Kent)

Assessment and Care planning

NHS Oxleas Foundation

trust

Assessment and care planning patient information leaflet http://oxleas.nhs.uk/site-media/cms-downloads/Assessment__Care_Planning.pdf

3 SCIE Mental Capacity Act

Care planning SCIE Involving people in decisions about them, person centred care and support plans, involvement in the cycle of care and support planning, relationships and communication

https://www.scie.org.uk/mca/practice/care-planning/person-centred-care

4 Mental Welfare commission for

Scotland

Scotland Person centred care plans-good practice guide

Mental Welfare

commission for Scotland

Person centred care plans-new guide for mental health and learning disability services

https://www.mwcscot.org.uk/sites/default/files/2019-08/PersonCentredCarePlans_GoodPracticeGuide_August2019_0.pdf

5 Mental Health Commission

Guidance Document on

Individual Care Planning Mental Health Service

Dublin Practical Application of Individual Care Planning

Mental Health Commission

The involvement of the individual in his or her treatment and care is a significant cornerstone of the Mental Health Act, 2001. Actively working with the service user to complete his/her care plan is a logical and meaningful means of ensuring the involvement of the service user.

Guidance document.

6 Mental Health Nursing

Standards for Person Centred

planning

NHS Tayside Person Centred Care Planning

NHS Tayside The Mental Health Nursing Standards for Person Centred Care Planning provides a framework to support the development of person centred care plans and will enable a consistently high quality approach to care planning for nurses working in all mental health settings within NHS Tayside

Care planning leaflet

7 The Mental Elf Empowering, personalised and recovery care planning and coordination: When will we

Mental health experts post blogs every week day with short and snappy summaries

Care planning and co-ordination that ‘is personalised, recovery-focused and conducted collaboratively’. Administrative elements of care co-ordination reduce opportunities for recovery-focused and personalised work. There are few common understandings of recovery which may limit shared goals. Conversations about risk appeared to be neglected and assessments kept from service users.

Personalised and recovery focused care planning

5

6

Complex Emotional TraumaNo. Filename Where did the

research take place

Theme Author Summary of details Link to document Contact

1 ASCA Trauma Guidelines

Australia Complex Trauma

Kezelman & Stavropoulos

Guidelines for the treatment of complex trauma.Evolving research and clinical insights, as well as the continuing challenges of treating the multifaceted syndrome described as `complex’ trauma, mean that the original 2012 Blue Knot guidelines require updating. The following updated and expanded clinical guidelines include substantial additions to the underpinning research base in a number of areas:• the nature of complex trauma• dissociation and the related clinical challenges • phased therapy in the context of current debates• `new’ and emerging treatment approaches• issues with respect to `evidence-based’ treatment

Click here to open file in Teams Lesley Moore

2 PD Case Management Publication 2019

Mersey Care NHS Foundation Trust

Personality Disorder Case Management Service; Structured Clinical Management

Dr Simon Graham, Clinical Service Lead via email

A before-after evaluation of a Personality Disorder service in Liverpool (12 months of routine care vs 12 months after intervention started). Significant reduction in inpatient admissions and out of area placements. This also saw an increase in crisis contacts, however this was observed to decrease with time. Paper emphasises importance of the Structured Clinical Management (SCM) approach, reorganising local care pathways and working closer with CMHTs in order to reduce hospital admissions and out of area placements. A costings report reveals that a massive amounts of money has been saved thanks to the implementation of the PD case management service. No psychometrics used as outcome measures unfortunately.

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3 Email from Liverpool

Mersey Care NHS Foundation Trust

Personality Disorder Case Management Service; Structured Clinical Management

Dr Simon Graham, Clinical Service Lead via email

All referrals to Liverpool service coming from CMHTs. Service not currently using outcome measures as part of treatment pathway which they are working on implementing. There is a separate forensic service in the Merseyside area where individuals with antisocial traits can be referrred for treatment. The Liverpool service consists of 2 psychiatrists, 5 psychological therapists, 3 case managers and 10 staff in the combined PD Day + Safe service.

Click here to open file in Teams Philip Pampoulov on p.pampoulov@nhs.net

4 MHICC scoping - PD services

Nottinghamshire Mentalisation Based Treatment (MBT) Service

Mentalisation-Based Treatment (MBT); Personality Disorder service

Louisa Hagen, Team Leader after phone conversation

Nottinghamshire MBT Service serve the whole of Nottinghamshire (population of roughly 1,154,195) and offer group-based MBT (vaying between 12-52 weeks) for individuals aged 18 and over with longstanding emotional and relationship difficulties and chaotic lifestyles. They are commissioned to see 150 people through treatment each

Click here to open file in Teams Philip Pampoulov on p.pampoulov@nhs.net

7

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

year and accept referrals from primary and secondary care. However, they have recently focussed more on secondary care referrals (primarily CMHTs) as they have found referrals from primary care sources to 'lack depth' and to be 'scatter gunning' for suitable services rather than have a clearer goal about the client's treatment pathway. Service employs a Structured Clinical Management (SCM) approach with CMHTs and does accept some clients with antisocial traits, with assessment on a one by one basis. Some of their team members come from forensic backgrounds and are more comfortable with containing risk within the service. Their team are currently working towards a liaison system with CMHTs to ensure continuity and streamlining of referrals.

5 Email from Manchester Personality Disorder Service

Manchester Specialist Psychotherapy Service

Structured Clinical Management (SCM)

Dr Rebecca Hughes, Consultant Clinical Psychologist and Clinical Manager via email

This service has been providing a number of evidence-based therapies to individuals aged 18 and over with longstanding difficulties for over 10 years. Interventions include either individual or group sessions or both and each clinician is trained in delivering at least 2 modalities. Referrals are accepted from primary and secondary care, although normally with pre-referral discussions. A structured clinical management (SCM) approach developed in CMHTs, although not well established yet in Manchester. One of the service's groups (Fifteen) is led by service users and employs a Democratic Therapeutic Community (DTC) approach to allow for equal participation and group learning, running for 18 months.

Click here to open file in Teams Philip Pampoulov on p.pampoulov@nhs.net

6 MHICC scoping - PD services

Oxfordshire Complex Needs Service

Group-based interventions for adults with a Personality Disorder

Office Manager after phone conversation

Service covers both Oxfordshire and Buckinghamshire. Only group interventions offered at present with some of them being face to face with social distancing whereas others are still virtual. The service accepts referrals from both primary and secondary care, including self-referrals. The latter is anecdotally their biggest referral source but they have found that this tends to be after the client has had a discussion with a mental health professional. Large staff force of 22-24 members, most of whom are full-time. Standard triage for all referrals and put on waiting list for assessment. Interventions are graded: MBT, Emotional Skills (DBT informed) and Therapeutic Community Group. Provisions for older adults vary depending on whether they live in Buckinghamshire or Oxfordshire.

Click here to open file in Teams Philip Pampoulov on p.pampoulov@nhs.net

8

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

7 Email correspondence with North East London PD Service

IMPART Personality Disorder Service

Trauma-focussed therapies for treating adults with complex trauma and personality disorder

Dr Janet Feigenbaum, Strategic and Clinical Lead for Personality Disorder Services in NELFT via email

Offers trauma-focussed therapy which includes Prolonged Exposure for DBT, CBT for trauma and NET (Narrative Exposure Therapy) as well as other interventions (see email correspondence with service lead). Service has been around for 17 years but is not commissioned to see or treat any individuals with Antisocial Personality Disorder. IMPART are open to anyone aged 18 and over and half of their client group falls in the 18-35 age category. They serve a population of around 1,050,000 and have 300-350 people in treatment at any one point in time.

Click here to open file in Teams Philip Pampoulov on p.pampoulov@nhs.net

8 MHICC scoping - PD services

Newcastle Personality Disorder Hub

Structured Clinical Management (SCM), MBT, DBT, Trauma stabilisation

Rachel Finn, DBT Lead after video call

The service was first commissioned in 2014 (described as 'quite a journey pathwise') with funding from secondary care and SCM has been at its core. Referrals come from CMHTs (liaison person for each team) and are followed by 6-12 sessions of assessments and formulation before a suitable treatment is chosen. The reason for the long assessment period is due to clients not giving up information easily. Assessments can include aspects of psychoeducation in them. SCM is used at the service as a low-intensity intervention for emotion regulation and problem solving for around 1 hour per week on an individual basis ('our clients can't tolerate the SCM group') while it is individual and group at CMHT level. SCM focuses a lot on window of tolerance and helping clients first and foremost understand their diagnosis. Dr Stewart Mitchell (Head of the Service) has designed a special protocol for the use of SCM at the service. They are currently phasing out DBT and MBT as they feel they are not suitable for their client population due to the sheer complexity of their service users. The service used to be 'quantity over quality' led whereas now it manages smaller caseloads of higher degrees of chaotic behaviours and systems in their client group, with greater focus on complex trauma and SCM. Clinicians have found that a large proportion of the referrals were people 'labelled with BPD but far from it' due to their level of complexity and nuances in behaviour. Clients are given a choice of online vs face-to-face appointments and social distancing for groups is possible due to spacious room available at the service. Most of their clients prefer F2F as the quality of virtual treatment was "deteriorating". Main aim of the service is to provide 'scaffolding' to CMHTs and only see clients with high levels

Click here to open file in Teams Philip Pampoulov on p.pampoulov@nhs.net

9

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

of risk and complexity.9 North West

Boroughs HealthCare NHS Foundation Trust

North West Boroughs HealthCare NHS Foundation Trust

5 Boroughs Personality Disorder Hub in Warrington, St Helens and Wigan has been disbanded. Unknown how long this has been for and why as information was given from receptionist at local hospital in North West NHS Trust.

Philip Pampoulov on p.pampoulov@nhs.net

10 South London and Maudsley NHS Foundation Trust

South London and Maudsley NHS Foundation Trust

3 Boroughs Personality Disorder Service on South London is closed and transitioning to a mentalisation-based therapy service - recorded message on answer phone.

Recorded Message on Answer Phone Philip Pampoulov on p.pampoulov@nhs.net

11 Wandsworth and Nottingham

Wandsworth and Nottingham

Treatment model

They offer Ax and Tx mainly for patients with diagnosis of personality disorders or other complex long-term emotional and relationship difficulties, Age 18 plus. The main Tx model is MBT (Mentalization Based Treatment ) in an intensive outpatient therapy programme. Other treatments also available are psychodynamic psychotherapy (individual and group) and CAT. They have a Consultation Service for professionals. It’s also offered a monthly support group for friends, family and carers of people who suffer from PD or similar conditions

Click here to open file in Teams Dr Lilian Garcia-Roberts

12 Email from Cambridge Personality Disorder Service

Cambridgeshire and Peterborough NHS Foundation Trust

Group interventions; streamlining liaison with primary and secondary care referrers

Dr Amanda Barton, Consultant Clinical Psychologist

The service has been running for many years and is currently staffed by 35 people, with two clinicians manning a duty phoneline every work day. All appointments are virtual at present via MS Teams. The service heavily relies on group work, with one of them borrowing many elements from DBT. One of the groups at the service (CORE) brings together multiple teams and agencies to help support clients who are using multiple services - this is a mix of consultation, formulation and care co-ordination with secondary care teams. Their Trust does not offer anything to people with antisocial traits so their service sometimes accepts referrals for clients where antisocial traits are secondary to EUPD traits and when the risk is not high. No trauma models offered there at present, however they are working towards incorporating this in the future. Referals are accepted from different places, including primary care and the service are investing a lot of time ensuring that primary care mental health referrers are able to identiy suitable referrals. Their current discharge policy is 3 consecutive misses but this is not a blanket rule and they follow up with clients after

Click here to open file in Teams Philip Pampoulov on p.pampoulov@nhs.net

10

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

their first miss.13 MHICC scoping -

PD services List of PD services that have been contacted but not yet

received information from.Click here to open file in Teams Philip

Pampoulov on p.pampoulov@nhs.net

14 SAGE trustlink article 18 11 13

Devon Combination therapy for women survivors of childhood sexual abuse

Rachel Abraham, Sharon Lothian and Suzanne

SAGE (Sexual Abuse Groupwork Experience) is based on knowledge of the profound healing that women can offer each other. It is a therapy model originally developed in Devon, with a strong evidence base for its effectiveness in reducing feelings of isolation, stigma and self blame, and allowing women to begin working through suppressed feelings.

Through SAGE women are offered a combination of individual and group therapy, which takes place over twelve weekly sessions. The group offers up to six women a safe space where they can break the silence that usually surrounds childhood sexual abuse, and women can share with others who have themselves been abused. This combination of group work and individual work provides the safety necessary to begin to work through difficulties.

Click here to open file in Teams Di Bardwell

15 https://www.enablingtownslough.com/why-we-exist/

Slough Community support

Rex Haigh EMBRACE is a community of people who have all been through similar struggles, and a place for you to share your difficulties with others who really understand. EMBRACE believes that everyone is equal and deserves respect, so even the staff members are group members. In our community, we offer a chance for you to get support from other people, develop helpful coping strategies, and give support to others in return.

https://www.enablingtownslough.com/why-we-exist/

Di Bardwell

16 2011 Adult Treament Guidelines Summary

Dissociative Identity Disorder

International Society for the study of Trauma and Dissociation

The Guidelines for Treating Dissociative Identity Disorder in Adults: presents key findings and generally accepted principles that reflect current scientific knowledge and clinical experience specific to the diagnosis and treatment of dissociative identity disorder (DID) and similar forms of dissociative dis-order not otherwise specified (DDNOS). This summary version is intended as a useful synopsis for clinicians; further elaboration of all sections and additional sections, along with academic discussion and references, can be found in the full Guidelines. It should be understood that information in the Guidelines supplements, but does not replace, generally accepted

Click here to open file in Teams Lesley Moore

11

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

principles of psychotherapy and psychopharmacology. Treatment for DID should adhere to the basic principles of psychotherapy and psychiatric medical management, and therapists should use specialized techniques only as needed to address specific dissociative symptomatology.

17 2019: Supporting services to prevent, identify and respond to Adverse Childhood Experiences among the population of Cheshire & Merseyside

Cheshire and Merseyside

Adverse Childhood Experiences

Lisa Jones and Cath Lewis, Public Health Institute, Liverpool John Moores University

In recent years, interest has grown in the concept of Adverse Childhood Experiences (commonly shortened to ACEs).The ‘ACE concept’ incorporates a wide range of highly stressful and potentially traumatic events that children maybe exposed to whilst growing up. The report sets out recommendations on what is effective in preventing, identifying and responding to ACEs.

Click here to open file in Teams Di Bardwell

18 Services for people diagnosable with personality disorder

Position Statement

Royal College of Psychiatry

In drafting this statement the authors have explored the debate around diagnosis. Our conclusions acknowledge the argument that there is the potential for a diagnosis to cause harm, particularly if this is done in a way that lacks appropriate dialogue. However, on balance, we believe that the diagnosis has brought benefits of better describing the impact of such difficulties on people’s health and social outcomes, not least the almost two decades of life lost through physical and mental health comorbidities. Another clear benefit has been to challenge the myth of untreatability whilst supporting the development of services and interventions which are both clinically and cost effective. The diagnostic framework has also supported the development of training and education for patients, carers and staff and for some has been a simple signpost enabling access to the right services and information. The recommendations in this statement have been drafted with such an understanding in mind. Our ambition has been to address the potential for harm whilst further developing the benefits of a diagnostic framework.

Link to file on Teams - click here Di Bardwell

19 Practice Adults surviving Dr Cathy Adults -Practice guidelines for treatment of complex https://www.recoveryonpurpose.com/

12

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

guidelines for treatment of complex trauma and trauma informed care and service delivery

child abuse Kezelman and Dr Pam Stavropoulos

trauma and trauma informed care and service delivery upload/ASCA_Practice%20Guidelines%20for%20the%20Treatment%20of%20Complex%20Trauma.pdf

20 Email from Jon Maguire

Tier 4 inpatient PD services

Jon Maguire, Psychological Therapist

Please note this is only a basic flavour of the different set ops being offered out there for tier 4 inpatient PD services. Some offer a combination of psychoanalytic psychotherapy complimented by a psychosocial problem-solving approach. Some offer an adapted DBT informed approach tailored to client's individual needs / weaknesses / deficits. While Elysium in Milton Keynes offers a strictly adherent inpatient programe where as well as the actual therapy – all parts of the unit are DBT informed for patients and staff.

Click here to open file in Teams Philip Pampoulov on p.pampoulov@nhs.net

21 Email from South London and Maudsley PD service

Touchstone Centre, Beckenham

RCT about MBT treatment for people with Antisocial PD, still unpublished but potentially good outcomes

Penny Cutting, Clinical Service Lead

South London and Maudsley Trust currently redesigning PD pathway to provide clear pathway from tier 1 to tier 4. Croydon centre has a team of 11 staff, all of them trained in MBT. Most therapies are group-based (e.g. Sun Project which is an open access appraisal based coping skills group) and online via MS Teams. However, some sessions are offered face to face and there is individual therapy as well such as CAT, EMDR and support with drugs and alcohol. Clients with Antisocial PD who do not meet criteria for forensic services there can be offered support in the PD service depending on their stability level.

Click here to open file in Teams Philip Pampoulov on p.pampoulov@nhs.net

22 Trauma & Dissociation intelligence

Various UK-based trauma and dissociation services

UK-based trauma and dissociation services - SLaM and Clinic for Dissociative Studies (CDS)."

Click here to open file in Teams Jack Galbraith

23 PD Draft Strategy Dorset

Local strategy Purcell & Rushbrook

Seeks to to translate national guidance into a local strategy that aids the implementation of interventions that are effective for the people who need them.

click here to open file in Teams Di Bardwell

24 PD practitioner guide

Managing Personality Disorder in the community

Bolton, Lovell, Morgan and Wood

Meeting the challenge, making a difference: Working effectively to support people with personality disorder in the community: Intended for community practitioners and aims to bring up to date thinking about personality disorder into the daily work of thousands of staff working across health and social care services

click here to open file in Teams Di Bardwell

13

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

25 Positive Risk Taking Strategy

Positive risk Positive risk taking needs a person centred approach, where staff take a positive, recovery-oriented view of the service user and investigate what is important to keep them and others safe as they move towards better health and more independence. Positive risk taking is based on finding creative solutions rather than simply ruling out options for recovery based on fears and worries of what might go wrong.

click here to open file in Teams Di Bardwell

26 Scotland Trauma Skilled Workforce

Scotland Trauma workforce

4 skilled levels for the trauma workforce: trauma informed, trauma skilled, trauma enhanced, and trauma specialist

click here to open file in Teams Di Bardwell

27 Top 50 books Recommended books

Spring Top 50 recommended books on trauma and dissociation click here to open file in Teams Di Bardwell

28 Trauma venn diagram

Overlap of trauma

Venn diagram of the overlap between Adverse Childhood Experience (ACE), Trauma, Complex trauma, and Single incident trauma

click here to open file in Teams Di Bardwell

29 Draft Proposal for DD Treatment Pathway

Dissociative Disorders Treatment Pathway

Dissociative Disorders Treatment Pathway There are no NICE guidelines for the treatment of dissociative disorders yet so the best available treatment guidelines are those supplied by the International Society for the Study of Trauma and Dissociation (ISSTD). Dissociative Disorders should be reconceptualised as belonging to a spectrum of trauma disorders. Treatment for dissociative disorders should adhere to the basic principles of psychiatric management and psychotherapy, and should be individualised.

click here to open file in Teams Di Bardwell

30 Emotional Dysregulation Pathway referral and assessment

Emotional Dysregulation Pathway

Flow chart of Emotional Dysregulation Pathway (includes EUPD), across referral and assessment

click here to open file in Teams Di Bardwell

31 Emotional Dysregulation Pathway: treatment - support - discharge

Emotional Dysregulation Pathway

Flow chart of Emotional Dysregulation Pathway (includes EUPD), across treatment, support and discharge

click here to open file in Teams Di Bardwell

32 Icebreak Emerging Personality

16-22 year olds The Zone Presentation from The Zone summarising their mental health services

click here to open file in Teams Di Bardwell

14

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

Disorder Service33 Innovation in

Action: Review of the Effectiveness of Centrally Commissioned Community Personality Disorder Services

Various National Community Personality Disorder Pilots

Wilson & Haigh

This report presents a summary of the findings of the review of National Community Personality Disorder Pilots commissioned by the Department of Health in 2004. The aim of the commissioning of these pilots was to identify practice-based evidence regarding effective therapeutic interventions with individuals experiencing complex emotional needs. This was identified in Personality Disorder: No Longer a Diagnosis of Exclusion (2003) as an area of unmet need for a significant proportion of the national population. The report outlines the outcomes of the pilots with regards to Quality, Innovation, Productivity and Prevention. A number of key findings are identified that should inform the future development of policy and practice for this clinical population; furthermore a number of recommendations are made with regard to developing future services and the importance of maintaining those already in operation.

click here to open file in Teams Di Bardwell

34 PD - criteria outcome measures and treatments across Wessex

Southern Health NHS Foundation

Current service provision

Corbridge Current service provision click here to open file in Teams Di Bardwell

35 Brand et al 2009 review dd treatment studies

America Review examining empirical reports of treatment for Dissociative Disorders

Band et al This review examines empirical reports of treatment for Dissociative Disorders (DD), including 16 DD treatment outcome studies and 4 case studies that used standardized measures. Collectively, these reports suggest that treatment for DD is associated with decreased symptoms of dissociation, depression, post traumatic stress disorder, distress, and suicidality. Effect sizes, based on pre/post measures, are in the medium to large range across studies. Patients with dissociative disorder who integrated their dissociated self states were found to have reduced symptomatology compared with those who did not integrate. The magnitude of pre/post effect sizes for these DD studies are comparable to pre/post effect sizes in treatment studies of complex PTSD. There are significant methodological limitations in the current DD treatment outcome literature that reduce internal and external validity including regression towards the mean, limited sample sizes, and non randomized research

click here to open file in Teams Lesley Moore

15

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

designs. Implications for future research and treatment planning for patients suffering from DD are discussed.

36 DID ESTD paper UK Dissociation Richardson Introduction: Although studies of dissociation date back more than a century, it has not commonly been included in medical training in the UK. There is a large and growing body of clinical and research evidence concerning the dissociative disorders and increasing numbers of patients with these conditions are presenting for help. In many NHS Trusts, awareness is growing and funding applications for assessment and treatment are becoming more common. This information is provided for clinicians such as general practitioners, psychiatrists, psychologists and psychotherapists and for fund holders to assist in assessing patients and in deciding funding applications for assessment and/or treatment

click to open file in Teams Lesley Moore

37 Guidelines revision 2011

UK Dissociative Identity Disorder

International Society for the study of Trauma and Dissociation

Guidelines for Treating Dissociative Identity Disorder in Adults: full versionThe Guidelines for Treating Dissociative Identity Disorder in Adults presents key findings and generally accepted principles that reflect current scientific knowledge and clinical experience specific to the diagnosis and treatment of dissociative identity disorder (DID) and similar forms of dissociative dis-order not otherwise specified (DDNOS). This summary version is intended as a useful synopsis for clinicians; further elaboration of all sections and additional sections, along with academic discussion and references, can be found in the full Guidelines. It should be understood that information in the Guidelines supplements, but does not replace, generally accepted principles of psychotherapy and psychopharmacology. Treatment for DID should adhere to the basic principles of psychotherapy and psychiatric medical management, and therapists should use specialized techniques only asneeded to address specific dissociative symptomatology.

click here to open file in Teams Lesley Moore

38 International trauma Questionnaire

WHO PTSD and CPTSD Cloitre et al The attached instrument is a brief, simply-worded measure, focusing only on the core features of PTSD and CPTSD, and employs straightforward diagnostic rules. The ITQ was developed to be consistent with the organizing principles of the ICD-11, as set forth by the World Health Organization, which are to maximize clinical utility and

click here to open file in Teams Lesley Moore

16

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

ensure international applicability through a focus on the core symptoms of a given disorder. The ITQ is freely available in the public domain to all interested parties. Evaluation of the measure continues particularly as it relates to the definition of functional impairment for both PTSD and CPTSD and possibly the content of the items as they might relate to being predictive of differential treatment outcome.

39 Introduction how does trauma affect the mind and body

Wales Affect of trauma on mind and body

Cwm Taf University Health Board

The previous section, ‘What is trauma?’ described some of the terrifying events which are referred to as traumas, and which can have a lasting effect on our mental health. This section describes the effects in more detail.

click here to open file in Teams Lesley Moore

40 Understanding Trauma fact sheet

Understanding the Effects of Trauma on Health

Robert Wood Johnson Foundation

A growing body of research shows that experiencing traumatic events increases an individual’s risk of long-term physical and behavioural health issues. As health care providers and policymakers begin to understand these connections, trauma-informed approaches to care are being adopted as a crucial aspect of high-quality health care in hopes of improving patient engagement and outcomes while lowering costs.

click here to open file in Teams Lesley Moore

41 Summary of available intelligence for complex emotional trauma pathway

Intelligence A paper summarising intelligence identified click here to open file in Teams Phil Morgan

Last checked for completeness against Teams content

18-Nov

Digital and IT

17

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

1 Digital inclusion for health and social care

National document

Inclusion and accessibility

NHS Digital A document which focuses on how to make digital technology accessible to all, including marginalised groups. I think this is particularly relevant to the current situation and expanding access to interventions via digital technology such as attend anywhere or even email and links to websites for resources. There are links to projects in which access has been supported in different ways

https://digital.nhs.uk/about-nhs-digital/our-work/digital-inclusion#how-this-guide-can-help

jo.walkley@nhs.net

2 Bridging digital divide infographics

UK Digital access Centre for ageing better

Infographics of differences across groups in terms of use of digital technologies

click here to open file in Teams Kate Court

3 Herefordshire and Worcestershire digital health and care strategy

Herts and Worcs Digital investments-shared strategy

This document is a shared strategy, agreed by all partners of the HW STP and has been written so that it can be ratified by the HW STP Board. The purpose of this document is to provide guidance and a framework to the digital investments required to deliver our key priorities.if we don’t grasp the opportunity that new technologies and digital tools present, we won’t be able to achieve our vision of an empowered and independent population receiving joined up care closer to home.To make this happen, we have a set of challenges around joining up information, ensuring that an individual’s journey through complex health and social care is unified, at a time when budgets are under pressure.

click here to open file in Teams Kate Court

4 MHN Briefing - Delivering mental health services digitally

Digital services Considerations and Recommendations for the use of digital services in group sessions.

click here to open in Teams Kate Court

5 Transforming NHS Wales services though digital developments

Covid and digital technologies

A summary of the impact of Covid on the use of digital technologies in Wales, and a forward look to further work planned

click here to open file in Teams Kate Court

6 Internal Journal of Qualitative methods

Digital story telling

University of Alberta

Exploring the Process of Digital Storytelling in Mental Health Research: A Process Evaluation of Consumer and Clinician Experiences

https://journals.sagepub.com/doi/full/101177/1609406917729291

7 NIHR Applied Research Collaboration West

Bristol Touchscreen tablet

Avon and Wiltshire Mental Health Partnership

Co-designed an electronic care pathway tool with service users and staff at Avon and Wiltshire Mental Health NHS Partnership, to support joint working on care and crisis plans. Staff used the tool with service users on a touchscreen tablet.

https://arc-w.nihr.ac.uk/research/projects/evaluating-new-digital-solution-secondary-mental-health-care/

8 NIR National

USA Technology and the Future of

NIRNational

the advantages and disadvantages of expanding mental health treatment and research into a mobile world

https://www.nimh.nih.gov/health/topics/technology-and-the-future-of-mental-

18

Dual DiagnosisNo. Filename Where did the

research take place

Theme Author Summary of details Link to document Contact

1 American addiction centres, Psychiatry today, Oxford treatment centre

American addiction centres, Psychiatry today, Oxford treatment centre

Addition centre All agree with treating both conditions at the same time using a range of approaches built around the individual and their situation

https://americanaddictioncenters.org/treatment-centers/oxford

DH

2 Pan Dorset Mental Health and Substance Misuse Guidance - Aug 2019

Dorset Guidance The purpose of this guidance is to support and enable front line staff to ➢Gain professional advice, in a timely manner, when required;➢Access Services relevant to an individual’s assessed needs;➢Improve working practises between Addiction and Mental Health Services;➢Ensure regular liaison occurs between practitioners to improve an individual’s experiences of services;➢Undertake joint care planning and reviews, if required; and➢Undertake joint training sessions / away days on a regular basis.

click here to open file in Teams Tony Deavin

3 Dual Diagnosis Link Workers September 2019

Dorset Assets Dorset Healthcare

Asset list - link workers in Dorset click here to open file in Teams Tony Deavin

4 Tony's DD presentation

Dorset Current provision

Tony Deavin Current context, overview of where the CMHT fits, Role of the CMHTs - what is our offer, other community services available for treatment and support, dual diagnosis audit, relationships between MH and SM, associated risks/difficulties, planning interventions, cycle of change, skills useful for people with mild depression and anxiety.

click here to open file in Teams Tony Deavin

5 Alcohol and mental health summary pg 4 - 6

Institute of alcohol studies

Alcohol and mental health services

Institute of alcohol studies

To understand current policy and practice, we have reviewed key policy documents relating to alcohol and mental health services, carried out a survey of people working in both alcohol and mental health services in the UK, and held a seminar to bring together experts and policymakers from both fields to discuss the implications of our findings.

click here to open file in Teams Tony Deavin

6 Co-occurring mental health and alcohol drug use conditions

Co-occurring mental health and alcohol/drug use

Public Health England

It is very common for people to experience problems with their mental health and alcohol/drug use (co-occurring conditions) at the same time. Other evidence tells us that people with co-occurring conditions have a heightened risk of other health problems and early death. We also know that in spite of the shared responsibility that NHS and local authority commissioners have to provide treatment, care and support, people with co-occurring

click here to open file in Teams Tony Deavin

19

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

conditions are often excluded from services. This Public Health England (PHE) guide, developed with the support of NHS England, seeks to address this disparity. It should be used by the commissioners and providers of mental health and alcohol and drug treatment services, to inform the commissioning and provision of effective care for people with co-occurring mental health and alcohol/drug use conditions. It also has relevance for all other services that have contact with people with co-occurring conditions, including people experiencing mental health crisis.

7 DOH dual diagnosis good practice

Policy Department of Health

The guidance provides a framework within which staff can strengthen services so that they have the skills and organisation to tackle this demanding area of work. Our key message is that substance misuse is already part of mainstream mental health services and this is the right place for skills and services to be.Mental health services must also work closely with specialist substance misuse services to ensure that care is well co-ordinated. We have also highlighted some existing examples of excellent services working well now.

click here to open file in Teams Tony Deavin

Last checked for completeness against Teams content

18-Nov

20

HomelessnessNo. Filename Where did the

research take place

Theme Author Summary of details Link to document Contact

1 Housing First in England - Full Report

England Housing Homeless Link Charity

Housing first in England evaluation click here to open file in Teams

2 Housing First in England - Executive Summary

England Housing Homeless Link Charity

Research executive summary click here to open file in Teams

3 Housing First in England - Case Studies

England Housing Homeless Link Charity

Service user case studies click here to open file in Teams

4 Housing models report

University of York and Crisis

A review of the evidence base regarding the effectiveness of both ‘orthodox’ and ‘innovative’ models of supported housing for homeless people with complex support needs.

click here to open file on Teams Di Bardwell

5 Homelessness Strategy 2016-2021

England Homelessness Bournemouth Borough Council

This Homelessness Strategy presents a clear and ambitious way forward to prevent and address homelessness in Bournemouth. It confirms the priorities and aspirations for the town over the next five years

click here to open file

6 Homelessness England Review of models of homelessness

Ministry of housing community and local government

Review and assess a set of models used in the UK and internationally

click here to open file.

7 Homelessness Impact

UK Homelessness - website

Centre for Homelessness Impact

‘A society in which any experience of homelessness is rare, brief and non-recurring.’To work towards this goal and focus our efforts we have developed a framework that identifies five areas that span a whole system-level view of homelessness and its causes

https://www.homelessnessimpact.org/

8 Ending Homelessness for good

UK Strategy Centre for Homelessness Impact

Strategy https://uploads-ssl.webflow.com/59f07e67422cdf0001904c14/5cf50e1873a6235c38b7ae41_CHI_STRATEGY_REPORT_FOR_WEB.pdf

Last checked for completeness against Teams content

18-Nov

21

Integrated ModelsNo. Filename Where did the

research take place

Theme Author Summary of details Link to document Contact

1 PRISM Cambridge and Petersborough

Integrated care PRISM leaflet- the Primary care mental health service is a new service run by Cambridge and Peterborough. Provides early assessment, treatment and onward referral. More joined up approach.

click here to open file on Teams

2 LIFT Swindon Collaborative Care Model

Coventry 2015 LIFT psychology provides a primary care psychology service covering Swindon, Wiltshire, Bristol, South Gloucestershire, Bath and North Somerset.

LIFT offer a variety of services for people who are experiencing anxiety/depression or looking to improve their wellbeing.

LIFT is part of a stepped care approach to psychological care. Interventions include psycho-educational courses, self-help materials, online computer packages and individual sessions.

https://lift-swindon.awp.nhs.uk/

3 Intermountain Healthcare

USA Normalising mental health in primary care

Naylor 2016 Internationally, the Mental Health Integration programme delivered by Intermountain Healthcare in the USA provides an example of what can be achieved by re-engineering the relationship between mental health and primary care.8 A key lesson from this programme is that consistent messaging is needed from senior leaders in the health system, which normalises mental health as part of routine care in general practice.1 More widely, it is increasingly being recognised in the USA that mental health needs to be a core part of the patient-centred medical home (PCMH) model, as captured by a joint statement of professional bodies asserting that ‘PCMH would be incomplete without behavioural health care fully incorporated into its fabric’

https://journals.sagepub.com/doi/10.1177/0141076816665270

4 Primary Care Psychiatric Medicine

Nottingham Primary care People with persistent physical symptoms often suffer from years of pain and distress without effective help. For many, psychological support can be helpful and sometimes life-changing. Primary Care Psychological Medicine works under the theory that offering a psychological intervention will identify and resolve the root causes of unusually high levels of health care use and that a reduction in demand for primary and secondary care will result.

https://www.nhsconfed.org/resources/2019/09/primary-care-psychological-medicine-mhec-report

22

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

In this latest briefing by the Mental Health Economics Collaborative (hosted by Centre for Mental Health, the NHS Confederation Mental Health Network and London School of Economics Personal Social Services Research Unit), the Centre’s chief economist Nick O’Shea reports on the Primary Care Psychological Medicine service in Rushcliffe, Nottingham. The service offers psychological interventions to people who have high levels of unexplained or persistent physical symptoms of illness, which this report finds, reduces the use of GP, outpatient and emergency department services in one year by more than its own staff costs.

5 Primary Care Wellbeing Service

Bradford Primary care The PCWBS is unique in supporting GPs with their most complex and vulnerable patients who are frequent attenders at primary, secondary and emergency services, who often appear amongst the top 20 patients on the risk stratification tool, where a psychological component is confounding their help seeking behaviour or symptoms/condition. Contact with the team has been shown to reduce primary, secondary & emergency care usage amongst frequent attenders, reduce medication whilst improving quality of life. This supports GPs in delivering evidence based and evidence generated practice and reduces the demands and pressures on their time to manage unnecessary ‘crises’.

http://positivepracticemhdirectory.org/adults/primary-care-wellbeing-service-bradford/#:~:text=The%20aim%20of%20the%20evaluation%20was%20to%20assess,health%20needs%20of%20people%20with%20physical%20health%20problems.

7 Somerset Community Care

Somerset National pilot Radical approach developed from a bottom up/needs led. quarter funds into Alliance contract (Rethink) whom agreed not to deliver services but will lead the co-production element. Somerset Partnership moved to locality based teams and removed specialist psychology teams so teams all wrapped around. Open door and no discharge from services. Moved from 'diagnosis' to identifying needs and formulations of care etc. Philosophy of identifying assets and strengths. Delivering a range of therapies for 'Complex emotional trauma' under a new brand.

narrative Richard Walsh - Rethink

Somerset IAPT Somerset IAPT service _ The Improving Access to Psychological Therapies Manual

https://www.england.nhs.uk/wp-content/uploads/2020/05/iapt-manual-v4.pdf

8 Cambridgeshire and Peterborough

National pilot

23

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

STP9 Cheshire and

Merseyside STPNational pilot

10 Frimley Health and Care ICS

National pilot

11 Herefordshire and Worcestershire STP

National pilot

12 Hertfordshire and West Essex STP

National pilot

13 Humber, Coast and Vale Health and Care Partnership

National pilot

14 Lincolnshire STP National pilot 15 North East London

STPNational pilot

16 North West London STP

National pilot

17 South Yorkshire and Bassetlaw ICS

National pilot

18 Surrey Heartlands Health and Care Partnership

National pilot

19 TMH Community Mental Health Centres In Trieste

Trieste, Italy Integrated care with open access 24/7

Community Mental Health Centres across the area offering 24/7 support and treatment. Working from a holistic perspective. As consequence utlise very few inpatient beds

click here to open file in Teams Di Bardwell

20 Move from Big psychiatry to Big Community

New Zealand Wellbeing framework

Mary O'Hagan The first is having an overarching framework and drawing on Mary O’Hagan’s work https://www.wellbeingmanifesto.nz/ she talks about the Move from Big Psychiatry to Big Community – with mental health services being part of that but not being central. I wonder if we need something similar- Rachel Perkins talks about this approach but from the perspective of wellbeing and recovery. She writes, “based on such principles, O’Hagan (2018) argue that the workforce must include not only health and social care professionals but also a peer and cultural workforce and be firmly rooted within a rights framework. https://www.wellbeingmanifesto.nz/

click here to open file in Teams Di Bardwell

23 Open Dialogue UK Model of Open Dialogue is a model of mental health care which https://www.nelft.nhs.uk/dialoguefirst-

24

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

mental health care

involves a consistent family and social network approach where all treatment is carried out via a whole system/network meetings, which always include the patient

All healthcare staff involved in Open Dialogue are trained in family therapy and related psychological skills. The Open Dialogue approach, pioneered in Finland, is a different approach to much of mental health care in the UK, but it has been discussed for several years with interest by several NHS Trusts around the country.

Open Dialogue has been taken up in countries around the world, including much of the rest of Scandinavia, Germany and several States in America.

Some of the results from international non-randomised trials are striking. For example, 72 per cent of those with first episode psychosis treated via an Open Dialogue approach returned to work or study within two years, despite significantly lower rates of medication and hospitalisation compared to treatment as usual.

whatisopendialogue

24 Email SJ Hertfordshire Integrated care with open access 24/7

CPT (community perinatal team): This is a model Hertfordshire that supports new and expectant mums through the whole process with a range of interventions such a psychological therapy, OT, support from nursery nurses as well as practical advice about caring or their babies and themselves. This support is offered for up to a year and is a model that is being rolled out elsewhere. Chose this because I have vivid memories of being terrified coming home with this new creation and being expected to “bond” immediately. I freely admit it wasn’t a natural process as had a tricky first birth (you don’t have to quote that!)

click here to open file in Teams Sarah Jones, STR Worker, START

25 Email SJ Health Connections Mendips

Integrated care with open access 24/7

Health Connections Mendips: Had to choose this as seen it in action. This is a service that is available to all and helps connect people with a range of groups and services to improve overall wellbeing. They have a directory that ranges from abuse support, befriending, counselling, talking cafes etc. Patients talk to a health connector via their GP and the connector helps them reach their goals. I

click here to open file in Teams Sarah Jones, STR Worker, START

25

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

chose this because I feel strongly that building those compassionate communities is the only way forward in recovery for most people whether they believe it or not, they have to experience the power of peer support themselves.

26 Email SJ Dorset Central Locality

Integrated care with open access 24/7

A standard model of social prescribing has been developed in partnership with stakeholders, which shows the key elements that need to be in place for effective social prescribing; Link workers also support existing community groups to be accessible and sustainable, and help people to start new groups, working collaboratively with all local partners. I chose this because it one of the main key elements of our START role. Would be keen for START roles to develop and work closely alongside GPs and being trained accordingly.

click here to open file in Teams Sarah Jones, STR Worker, START

27 PG Doc Bridport, Dorset Integrated care with open access 24/7

Bridport medical centre community allotment set up by Bridport medical centre but run by the community for the community to improve mental and physical wellbeing and promote social inclusion. Works across primary and secondary services and the voluntary sector.

click here to open file in Teams Pam Goddard, STR Worker START

28 PG Doc Dorset Central Locality

Integrated care The Support, Transition and Recovery Team (START) have set up a number of talking cafes which are run by mental health champions under the guidance of START staff. The aim is to promote social inclusion, reduce mental health stigma and signpost people to relevant services / services and offer peer support.

click here to open file in Teams Pam Goddard, STR Worker START

29 PG Doc Dorset Central Locality

Integrated care Exercise on prescription – available from primary and secondary services to encourage increased fitness and improved mental health through physical movement.

click here to open file in Teams Pam Goddard, STR Worker START

30 Kings Fund.pdf Nationally Kings Fund Report

This report explores whatopportunities the emergence of these new networks creates for improving thesupport and treatment provided to people with mental health needs inprimary care.

click here to open file in Teams Marianne Gillingham

31 Cambridgeshire Integrated Care The service provides specialist mental health support for GP surgeries sothat people with mental ill health can access prompt advice and support,receive help in a community setting and experience a more joined-up

https://www.cpft.nhs.uk/Documents/Miscellaneous/PRISM%20GP%20update%20Feb%202017.pdf

Marianne Gillingham

26

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

approach to their care.

The Primary Care Mental Health Service provides early assessment,treatment and/or onward referral in the community. It supports people tofocus on their goals and access local community resources.The service promotes a person-centred approach to physical and mentalhealth, and supports people to step down from specialist mental healthservices. Patients’ social care needs are also be considered as part of thisintegrated approach.

33 Frimley Health and Care. Htm

Frimley Integrated mental health model

The new service, known locally as GPimhs (General Practice Integrated Mental Health Service), is designed to improve access to a wide range of specialist support. Extended appointments with mental health experts from the NHS, social care and specialist third sector organisations, plus access to therapies, physical health checks and pharmacists, are just some of the wider expertise patients will be able to access at their local GP practice and in the community under new ways of working. Patients will be able to explore the situation affecting their wellbeing – whether that is an ongoing mental or physical health problem, loneliness, debt, or other issues. They can then be guided to appropriate resources that may help, including talking therapies, benefits advice, or an introduction to a local community group.

https://nhsdorsetccg.sharepoint.com/sites/MHICCIntelligenceGroup/Shared%20Documents/General/Integrated%20models/Frimley%20Health%20and%20Care.htm

34 British Columbia integrated models lit review

British Colombia Integrated models of primary care and mental health & substance use care in the community

Ministry of Health

The work to develop this guiding document was overseen through a tripartite partnership between the Ministry of Health‘s Mental Health and Substance Use Branch, the Ministry of Children and Family Development’s Child and Youth Mental Health Branch, and Fraser Health. The objectives of the project were to: · Review the academic and grey literature to identify the best and most promising models of integrated primary and mental health and substance use community care across the lifespan.

click here to open file in Teams Di Bardwell

27

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

· Develop a report including a menu of program models for various populations that health authorities can explore and implement as appropriate, across the continuum of needs. · Assess the quality of evidence and make recommendations regarding areas for further research and/or evaluation.

35 Evolving Care New York The integration of primary care and behavioural health care.

Chris Collins, Denise Levis Hewson, Richard Munger, and Torlen Wade

This report assesses models of integration in their applicability to primary care settings and, in particular, to the “medical home.” Many of the challenges and barriers to integration stem from differing clinical cultures, a fragmented delivery system, and varying reimbursement mechanisms. This report also provides an orientation to the field and, hopefully, a compelling case for integrated or collaborative care. It provides a concise summary of the various models and concepts and describes, in further detail, eight models that represent qualitatively different ways of integrating and coordinating care across a continuum—from minimal collaboration to partial integration to full integration. Each model is defined and includes examples and successes, any evidence-based research, and potential implementation and financial considerations. The report culminates with specific recommendations on how to support the successful development of integrated care.A resource section at the end of the report provides a list of websites, toolkits, and other references regarding models of integration.

click here to open file in Teams Di Bardwell

36 Filling the chasm: Reimagining primary mental health care

Birmingham The role of primary care in mental health

Dr Karen Newbigging, Dr Graham Durcan, Dr Rebecca Ince and Andy Bell

This briefing paper seeks to identify promising initiatives that could provide the basis for a framework or set of standards for primary mental health care to support commissioning and provision. It is a collaborative effort between GPs with an established track record in this area, in partnership with the Health Services Management Centre and Centre for Mental Health, who each bring expertise in mental health systems and service development. To create this report we have held meetings, undertaken a rapid appraisal of the literature informed by the review undertaken by the Healthy London Partnership (NHS Clinical Commissioners, 2017b), sought examples of good practice through a call on the Centre’s

https://www.centreformentalhealth.org.uk/sites/default/files/2018-12/CentreforMH_Filling_the_chasm_0.pdf

Di Bardwell

28

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

website and followed these up with telephone interviews or visits to eight local areas. We have also interviewed GPs who are leading developments in this area in their practices. The aim of these interviews has been to identify emerging positive practice, the challenges to developing capacity in primary mental health care, and how these may be overcome.

37 Mental health in Primary Care: illusion or inclusion

Integrated mental health care within primary care

World Health Organisation

Integrated mental health care within primary care has the potential to enhance access to mental health services that are provided in a way that is coordinated around people’s needs, respects their preferences, and is safe, effective, timely, affordable, and of acceptable quality.

https://www.who.int/docs/default-source/primary-health-care-conference/mental-health.pdf?sfvrsn=8c4621d2_2

Di Bardwell

38 The Interface Between Primary and Specialist Mental Health Care – Why does it have to be so hard to get it right?

Manchester Interface between primary and specialist care

Linda Gask What principles do we need to think about?Think ‘population’ not ‘services’: Think ‘people’ not ‘referrals’Think ‘primary care’ not just ‘mental health teams’Think ‘continuity’ not ‘boundaries ‘Think ‘helping’ not ‘assessing’Think ‘evidence’ not ‘word of mouth’Think ‘leadership’ not just ‘development’

https://www.relias.co.uk/blog/the-interface-between-primary-and-specialist-mental-health-care

Di Bardwell

39 Models of collaboration between primary care and mental health & substance use services

Rapid Review

Ontario integration of services and improved access to high-quality and consistent care

CAMH Ontario has identified several priorities for its health care system, among them are greater integration of services and improved access to high quality and consistent care. ‐But access to care is inconsistent. In Canada, an estimated one in five persons are affected by mental illness or substance use problems. By 2041, it is projected that this number will increase by 1.3 times, to 8.9 million. This represents a significant burden on the healthcare system.

A number of approaches have been suggested to decrease rates of mental illness and substance misuse. One such approach is collaboration between mental health and substance use and primary care providers, which can take many forms. The overarching goal of this holistic approach is to strengthen relationships among health care providers to ensure patients receive continuous and complete care.

This rapid review looks at models of collaborative care between primary care and mental health and substance use

https://www.eenet.ca/fr/resource/models-collaboration-between-primary-care-and-mental-health-substance-use-services

Di Bardwell

29

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

40 Wellbeing Manifesto for Aotearoa New ZealandA submission to the Government Inquiry into Mental Health and Addiction

New Zealand community based services

Mary O’Hagan for PeerZone and Action Station

We must restart the journey to Big Community and resist pressure to pour more resources into the current obsolete model. Big Community needs to replace Big Psychiatry at the hub of the system and position psychiatry as one of its many spokes, so that everyone with mental distress and addiction has open access to a comprehensive range of responses."We call on the Inquiry into Mental Health and Addiction to recommend that all people with mental distress or addiction have open access to a full menu of services, so that no-one who seeks help is turned away and everyone is offered more than medication."

https://www.wellbeingmanifesto.nz/ Di Bardwell

41 Everyone's Business: Mental Health in Dorset

Dorset Collation of community learning re mental health

Dorset based workshops sought to find out: “How can we create communities that accept people as they are. How do we learncollectively to support ourselves, our colleagues, our neighbours, our communities? What can we do individually andcollectively to create these conditions and harness the power within communities?”Report is in two parts - first with the process, second with the results

click here to open file in Teams Di Bardwell

Part 2 of above report click here to open file in Teams 42 Healthmatters:

Community-centred approaches to health and wellbeing

UK Community based services

PHE 1. Why work with communities? Why communities matter for health2. Building on evidence and assets: What are community health assets?All communities have health assets that can contribute to positive health and wellbeing.3. Being connected matters: Research shows that lacking social connections is bad for our mental and physical health4. The family approach: The family of community-centred approaches: Strengthening communities, Volunteer and peer roles, Collaborations and partnerships, Access to community resources.5. Call to Action: PHE recommends a community-centred recommends a community-centred

click here to open file in Teams Di Bardwell

43 ImROC Developing PCNs and

Nottinghamshire Community based services

ImROC The ‘Live Well’ Model Interim Report: An integrated approach to support, enable and empower people who are lonely, inactive and/or have long term conditions(s) to

click here to open file in Teams Di Bardwell

30

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

Community Approaches: Case Study

live well in their communities.This paper describes the development of ‘Lets Live Well in Rushcliffe’ (henceforth referred to as the Live Well model). Although only 9 months into its development, this service brings together a number of differentevidence based approaches to provide an integrated place-based model to empower, enable and engage local people to live well in their communities. Early evaluation results indicate that the project is attractinghigher numbers of referrals than other similar reported projects (with over 650 referrals in its first 6 months of operation) and those engaging with the service are comparable with other reported social prescribing projects (in terms of socio-demographic characteristics and baseline levels of community engagement). The outcomes of the project (impact on service use – and related cost implications, changes in loneliness scores, social engagement and activities, changes in levels of activation, self-management and wellbeing) will be available in a separate evaluation report in April 2019.

44 Webinar-Somerset MH Transformation Update PPP SEPT 2020 FINAL v2.ppt

Somerset Mental health transformation update

No wrong doorBreak down barriers between primary and secondary careEarly access to assessments and interventions within primary careImproved Eating Disorder and Personality Disorder pathwaysReduce thresholds and cliff edges (smooth transitions)Established partnership with VCS offering a wide scope of support

click here to open file in Teams Sam Dench

45 Barnet PCMH Response Document

Barnet MDT teams within GP practices

Camden and Islington NHS Foundation Trust

Outline of Barnet model proposal 'More mental health patients should be cared for within primary care. ' C&I is proposing to establish a multi-disciplinary team(MDT)within the GP practices of the Barnet South Locality. This team would consist of a psychiatrist, psychologist and nurse who would work alongside existing primary care staff and in conjunction with other providers to improve the overall effectiveness of the healthcare system. The model proposed is constrained by the available budget set out in the tender process. We are proposing to maximise the effectiveness of the service by supporting the local team with administrative support and

click here to open file in Teams Di Bardwell

31

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

neuro-development services from our teams in Camden. These services are located at major transport hubs at Camden Town and Kings Cross and easily accessible from the Barnet South Locality by public transport.

46 BSN IPCMH Pilot presentation

Barnet Integrated primary care mental health network

Barnet south network Integrated primary care mental health network pilot. Characteristics of service users and approaches supported by the MDT, split by 'Common mental health problems', 'Non psychotic, chsotic and challenging disorders', 'Recurrent ongoing psychosis'.

click here to open file in Teams Di Bardwell

47 JCPMH community guide

Specialist mental health services

Joint Commissioning Panel for Mental Health - Guidance for commissioners of community specialist mental health services. What would a good community specialist mental health service look like?

click here to open file in Teams Di Bardwell

48 PCMH Case Examples 2014

Case studies Camden and Islington NHS Foundation Trust

Case studies provided by Camden and Islington as a basis for the Barnet response

click here to open file in Teams Di Bardwell

49 PCMH discussion paper 2014

Camden and Islington NHS Foundation Trust

Further information to the Barnet response document click here to open file in Teams Di Bardwell

50 Power Threat Meaning model

Alternative to traditional models

The British Psychological Society

The Power Threat Meaning Framework was developed, over the course of five years, to serve as an alternative to more traditional models based on psychiatric diagnosis.The approach of the Framework is summarised in four questions that can apply to individuals, families or social groups:What has happened to you? (How is power operating in your life?)How did it affect you? (What kind of threats does this pose?)What sense did you make of it? (What is the meaning of these situations and experiences to you?)What did you have to do to survive? (What kinds of threat response are you using?)

https://www.bps.org.uk/power-threat-meaning-framework/introduction-ptmf

Di Bardwell

51 Scientific literature review

Primary care models

Healthy London Partnership

Informing the development of models of primary care in mental health Scientific literature review September 2017

click here to open file in Teams Di Bardwell

52 53 54

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No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

Last checked for completeness against Teams content

19-Nov

Marginalised Groups

33

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

1 Reverse Commissioning Powerpoint 2

BME Dr Vivienne Lyfar-Cissé MBA

Reverse Commissioning is an effective process to engage BME communities to ensure their health needs are addressed by the NHS

click here to open file in Teams Rick Dyer

2 International mental health collaborating network

Values and principles

International mental health collaborating network

There are a number of NHS providers who have signed up to this network. There multicultural approach provides a good deal of learning and it would be worth exploring further. Individual Service UsersCitizenshipRecoveryWhole Person, Whole Life and WellbeingCultural Diversity and ValuesRespect and DignityIndividualisation, Identity and Personal Responsibility

Community Mental Health ServicesPerson CentrednessAccessibilityComprehensivenessEffectivenessEquityEvidence based practice and valuesFamily involvementEfficient use of resourcesRelationshipsAdvocacy

https://imhcn.org/charter/the-imhcn-values-and-principles/

Sarah Rose

3 Bournemouth University

Marginalisation and societal integration

Bournemouth university

The Seldom Heard Voices: marginalisation and societal integration Research Centre brings together a range of academics of different disciplines from across Social Sciences and Social Work as well as colleagues from health disciplines such as Mental Health Nursing. The Centre includes early career researchers keen to be mentored as well as established researchers

https://www.bournemouth.ac.uk/research/centres-institutes/centre-seldom-heard-voices

4 Supporting Mental Health for All

London London Assembly

Health Committee

This report brings together the cross-cutting issues identified that the Mayor’s Thrive LDN programme should address to ensure that all Londoners receive the help they need

https://www.london.gov.uk/sites/default/files/mentalhealthfinal.pdf

5 Good practice in mental health care for socially marginalised groups in Europe

Europe Good practice in mental health care for socially marginalised groups in Europe

Stephen Priebe et al

Good practice in mental health care for socially marginalised groups in Europe: a qualitative study of expert views in 14 countriesOutreach model

https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-12-248

34

Older PeopleNo. Filename Where did the

research take place

Theme Author Summary of details Link to document Contact

1 Email SJ UK Older persons substance misuse

Sarah Jones, STR Worker, START

Substance misuse in older people talks about a Government model in the care of older people who need to be screened and assessed for alcohol and substance misuse. There is a model of care that provides guidance for local organisations to provide specialist treatment such as inpatient detox and residential programmes. Chose this because I feel it is a hidden problem and the nature of that age group who are less likely to admit they have a problem and is probably more common than we think.

click here to open file in Teams Rachel Smith

2 Email SJ Leicester Partnership NHS

Biosocialpsychological model

Sarah Jones, STR Worker, START

Leicester Partnership NHS: Embedding a bio-psycho social model of care in older people with dementia. This report/model talks about an inpatient service that aims to change the culture of care to reduce falls and improve wellbeing. Their emphasis is on teaching staff to communicate effectively with specific interventions that improve wellbeing and health thus providing a much more positive experience. I chose this because I could have done with this when working on a dementia unit and always felt it could have been a better experience for staff and clients. I also feel that our work with clients with early onset dementia/memory loss can be challenging but with the right support/connections can lead to more fulfilling lives and keep clients better for longer.

click here to open file in Teams Rachel Smith

3 PG Doc Beaminster, Dorset

Biosocialpsychological model

Pam Goddard, STR Worker, START

Yarn Barton centre in Beaminster – A community organisation that works across services and offer support to people of all ages including older people such as I.T. face to face support to enable people to develop skills in I.T – email, social media, online shopping and banking etc.

click here to open file in Teams Rachel Smith

4 PG Doc Dorset Biosocialpsychological model

Pam Goddard, STR Worker, START

Age UK – Multiagency working. In Dorset they run better balance classes that are designed to improve confidence, increase stability, improve mobility and balance, strengthen muscles, improve posture, most importantly help prevent falls and lessen the impact a fall can have on the body.

click here to open file in Teams Rachel Smith

5 Ageless Service Evidence resources

Impact of ageless services for older people- evidence and reports summary

click here to open file in Teams Rachel Small

6 Final Age Importance of The mental health of older people facts and fiction. Why it click here to open file in Teams Rachel Small

35

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

Equality Presentation October 2019

mental health in older people

is important and that it is vital that all services are responsive to the needs of older people with mental health needs.

7 Key Facts and Myths about OPMH - NHSE

Older people under represented group in mental health facts

NHS England Understanding the scale of need-initial statistics and dispelling myths

click here to open file in Teams Melissa Mitchell

8 Older-Peoples-Mental-Health-Competency-Framework-INTERIMV1.2.pdf

Competency framework

NHS HEE Partnership between HEE and NHS England and Improvement Older Peoples Mental health. Details the skills, knowledge and abilities required.

click here to open file in Teams Melissa Mitchell

9 Royal College Report (CR211)-Older Peoples Services November 2018

Older peoples services

Royal college Suffering in silence:age inequality in older people's mental health care

click here to open file in Teams Sam Dench

10 Share Idea.docx Ideas from professionals on access to older peoples services

Older peoples sub group DHC

Ideas about what professionals/inputs should be in a single point of access/triage type service (the type that may sit between/bridge the gap between primary and secondary care services) to ensure that that it meets a “gold standard” of care for the needs/assessment for Older People

click here to open file in Teams Tracey Fuller

11 Surrey_Health_mental_health_OP_Integration_Nov_19.pdf

Surrey Whole person whole place whole model approach

Surrey Health Partnership

Older peoples integrated mental health model of care click here to open file in Teams Melissa Mitchell

12 A halt to ageless mental health services

Old age psychiatry services

The Royal College of Psychiatrists (RCPsych)

Summary of research. “The trend for ageless services will disadvantage further are growing, but already disadvantaged, section of society. We believe that old age psychiatry services should be preserved and enhanced, and not left to whither on the vine.”

click here to open file in Teams Kate Court

13 JCPMH older people mental health commissioners guide

Commissioning for mental health and learning disabilities

The Joint Commissioning Panel for Mental Health (JCP-MH) (www.jcpmh.info) brings together leading organisations and individuals with an interest in commissioning for mental health and learning disabilities. This guide has been developed by a group of older people’s mental health professionals, people with mental health problems, and carers. The content is primarily

click here to open file in Teams Kate Court

36

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

evidence and literature-based, but ideas deemed to be best practice by expert consensus have also been included. By the end of this guide, readers should be more familiar with the concept of effective older people’s mental health services

Last checked for completeness against Teams content

19-Nov

37

TransitionsNo. Filename Where did the

research take place

Theme Author Summary of details Link to document Contact

1 Email SJ Hertfordshire ASD Sarah Jones, START STR Worker

Hertfordshire has a transition team that sits within the council’s health and community services (formerly adult care services) department and starts to work with young people with autism from the age of 16 years.. One of the practice issues currently for Hertfordshire is the criteria they have in place for service users diagnosed as having an autistic spectrum disorder (ASD). Chose this because we often work with clients diagnosed with Asperger’s who do not fit the criteria for learning disability services. Hertfordshire are trying to address the gap for people without a learning disability.

click here to open file in Teams Sarah Jones

2 Email SJ USA Offenders Sarah Jones, START STR Worker

TPC (Transition from prison to community) is a model in the USA rolled out across six American states. The model strives to reduce victimisation and reoffending by working and planning collaboratively with MDTs prior to release with clear definitive goal planning that will include access to community resources. I chose this as feel there is a place potentially for START to connect with people and MDTs prior to release or at least be involved with the planning process in prison.

click here to open file in Teams Sarah Jones

3 MH Service Delivery for 16-25 year olds

UK and Australia Gaps MG Birmingham researchers have worked with colleagues at the University of Melbourne to research mental health policy and service delivery models for 16-25 year olds in the UK and Australia. This research helped define the difference between a ‘transition issue’ and a ‘service gap’; helped to identify what makes transition challenging from a service perspective; and clarified young peoples’ understandings about significant transitions into, within, and between services and how access and engagement are negotiated. The team have used this understanding to inform policy development in order to improve service provision for young people.

click here to open file in Teams Marianne Gillingham

4 Forward Thinking Birmingham

UK Service MG Forward Thinking Birmingham'-offer a 16-25 aged service through one Organisation.

https://www.forwardthinkingbirmingham.org.uk/about-us/partners

Marianne Gillingham

5 Transitions Good Practice Principles

South West Service South West Mental Health Clinical Network

Services should:Be co-producedAge appropriateOffer need and complexity based careYouth friendly and non-stigmatising environment

click here to open file in Teams Di Bardwell

38

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

Offer early identification and interventionOffer early access, flexibility and choiceCollaborate in partnership and integrated workingDeliver effective management of transitions.

6 Young People's Perspectives

Views from young people

Views from young people on transitioning between services

click here to open file in Teams Di Bardwell

7 Transforming transitions in MH Services

0-25 year old service

NHS Confederation

This is NHS Confederation statement, published in Sept 2019, which gives the rationale behind the NHS long term plan commitment to provide a 0-25 years old service; ie to avoid the cliff edge around current transition cut offs, different commissioning streams which stop at the age of 18 and different models of working with families.

https://www.nhsconfed.org/blog/2019/09/transforming-transition-in-mental-health-services

Marianne Gillingham

8 Healthcare Safety Investigations Report

Safety Healthcare Safety Investigation Branch

This is a Healthcare Safety Investigation Branch report published following the death of young person soon after transition to Adult Mental Health Services. They have made some safety recommendations. Through the long term plan NHSE England should meet the needs of those young people , who don’t fulfil criteria for current AMH services, also assess the young person’s readiness for transition, requires that services move from age based to needs based criteria for transition.

https://www.hsib.org.uk/investigations-cases/transition-from-child-and-adolescent-mental-health-services-to-adult-mental-health-services/

Marianne Gillingham

9 MH Service transitions for young people

MDT 16-25 year old services integration

Social Care Institute for Excellence

This is an older document(2011) but some of the recommendations are still aspirational – multidisciplinary 16-25 years old services, to integrate voluntary sector, non-health sector, universal services, GPs, joint working during a period of transition between CAMHS and AMH, also identifies gaps in provision

https://www.scie.org.uk/publications/guides/guide44/keymessages.asp

Marianne Gillingham

10 College report on AMH/OPMH transitions 2010

Improving care RCPsych Improving care and better mental health policy https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/college-reports/college-report-.pdf?sfvrsn=71e17654_2

Marianne Gillingham

11 DHC Transitions guidance

Current procedures

DHC Current procedures for transitioning young people to different MH Services. Detailed description of process but transition criteria is age rather than need.

on Doris Marianne Gillingham

Last checked for completeness

19-Nov

39

No. Filename Where did the research take

place

Theme Author Summary of details Link to document Contact

against Teams content

40

VeteransNo. Filename Where did the

research take place

Theme Author Summary of details Link to document

Contact

1 Models of good service for veterans Summary of research

Nice guidelines: engaging with veterans Nice guidelines: training and developing the workforce The Resiliency Model of Role Performance for Service Members, Veterans, and their Families: A Focus on Social Connections and Individual Assets The Role of Military Social Support in Understanding the Relationship Between PTSD, Physical Health, and Healthcare Utilization in Women Veterans Effectiveness of Supported Employment for Veterans With Spinal Cord Injuries: Results From a Randomized Multisite Study

click here to open file in Teams

Di Bardwell

2 Veterans Mental Health Support info trawl Summary of research

A collation of Trusts providing High Intensity Service and links to partnership organisations

click here to open file in Teams

Jack Galbraith

3 HIS Final Leaflet Service leaflet

Leaflet summarising the Veterans Mental Health High Intensity Service (HIS) Midlands - A specialist service for veterans and their families who require an intensive period of mental health care

click here to open file in Teams

Jack Galbraith

Last checked for completeness against Teams content

18-Nov

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