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Submission - Reconnecting with Hope Conference (Mind) - Follow-up Review of Mental Health Services -

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ReconnectingwithHopeConferenceConsultationfeedback/Report DrTriciaTumeltyExecutiveDirectorMindJersey

"for too long mental health services have been jogging along, the pandemic has shown a light on the urgent need for us all to move into a sprint"

To mark World Mental health day on 8th October and as part of mental health pandemic recoveryplanweatMindJersey's held a Reconnecting with Hope conference. 160 people attended aged between 15 – 74 years and included over 60 service users as well as a wide representation from the community voluntary sector and the publicsector.

Our afternoon session involved consultation with service users and professionals around the followingquestions.

  • What are your key supports /people things that support mental health?
  • What are some of your more helpful experiences?
  • What are the key challenges and whatdoourmentalhealthservices need to do more?

Analysis of slido (digital technology aided questions and answers), and table discussion notes plus several emails reveal key strengths and challenges describingasetofmeasures, structures and processes that formthebasisofmentalhealthserviceprovisionacrossthe public and voluntary sector.

Key supports included friends followedbyprofessionals'psychoeducationalgroups, professionals, and selfcare strategies.

48 actions recommendations were refined to three key areas of serviceprovisionincluding Accessibility, Equity, effectiveness of service provided

These themes point to the need formentalhealthservicestofocus more on ways to be bothhumaneandeffectiveaswell as being accessible and effective. They also include a clearmessagethatinorderforthings to be different post pandemic there is an urgent need

for the community and voluntary sector to work more closely alongside public sector mental health services.

Accessibility of services

"Thereshouldbenowrongdoor"

Thereisaneedforaclearpathwayatthepointinwhichsomeone first asks for help Participantsattheconferencedescribeddifficultyaccessingservices at the point help is neededincreasedfrustrationand risked problems escalating.

The problem of people having to repeat their story over and overbeforegettingtheright support or going through the right door remains a concern and prevents vital opportunities for early intervention.

"We need a more joined up mental health service where there is rapid improvement and integration between statutory adult mental health services and camsandthecommunity and voluntary sectors. This would need the development of a protocol to make maximum use of sectors expertise and for both sectors to learn from each other.

While many appreciated ways in which adult mental health services are beginning to work in partnership with some of the community and voluntary sector there was ongoing concern thatservicesareofteninsilosandnotspeakingtoeachother.Greaterfocusoncommunity provision increase General Practitioner involvement and community therapy/wellbeing hubstomeetneedsofpeopleinneed who do not or cannot access current structures

"Interventions for all should be needs based not aged based"

"Opening up and talking is a hugelyimportantfirststep.Butit is just a step. and its undermined when adequate access to services is difficult or nonexistence, this is a systemic issue, not an individual one"

Many also expressed an urgent need for better communications betweenprofessionalsand service users and for service users and their carers to leave meetings feeling listened to.

Carers and the essential role they play has been identified in previous mental health improvement plans but there was evidence that carers were still often left in the dark and not signposted to appropriate support. There is an ongoing need for all professionals to become more carer aware' and work in collaboration and partnership with carers in the service user andcarer'sjourneythroughmentalhealthservices.

Equity of access to services

"it was such a rare occurrence and a privilege to use our own words to tell our own stories, at the conference. Been able to tell our own stories not just the illness story sets an opportunity for a new era and one in which the so called mentallyillareseeninanewlight"

The need to adopt a partnership approach together with people with severe and enduring mental illness is seen as a basic principle but one that is frequently forgotten. There were manysuggestionsformoretrainingforprofessionalsespeciallyaroundthedangersofburn outandlosingcompassionaswellasanabsenceofholisticapproaches to families in

distress. Participants were keen to not place blame at professional's feet but wished to campaign for better management structures that would support staff generally and increase awareness of the links between emotional distress and a person's wider social context and experiences. This includes more opportunities for professionals to gain a better understanding through more consultation and coproduction workshopsandislandled research in order to achieve changeinattitudes,inourorganisational structures and bridge the divide between public sector and community and voluntary mental health sectors.

"We are always hopeful but coproduction and participation is not widely understood by people in positions of power and staff on the ground are run off their feet. We have a long waytotravelbeforeserviceusers are viewed as assets (rather than burdens) who have skills that are vital to the delivery of more humane services "

"Everyone deserves a chance to get back on to the ladder of life but this takes time when stuck down by mental illness"

Concernswerealsoraisedaboutlackofawarenessaboutwhatis available within and betweenservicesincludingG.P.knowledge of support services availableandhavingthetime to sign post appropriately.

"Services can be there but if G.p's are not aware of them problems can escalate and people end up with a medical model of care in isolation from social context of their lives"

effectiveness of service provided

It was reported that people sometimes are signposted to a servicethatisavailablebutnot necessarily one that is most appropriate, or evidence based for what their presenting problem may be. Listening to people's stories reminded many of the need for professionals to place at the centre the centrality of a trusted relationship in which a person can safely and authentically connect with the truth of their story, their lives. Opportunities to tell and hearserviceusers'storiesofwhat'shelpedandwhathasn'tis vital if we want to continue to address inclusion, "smash stigma" and see beyond peoples labels.

" listening to people at the conference it feels like nothing much has changed over the decades but we are hopeful as we are not starting from a blank sheet. We have a lot of dedicated professionals in services who want to get things moving but who seem to be blocked by structures and processespreventingafocusonpeople and communities"

Many discussed the need for mentalhealthservicestobemorefocused around the communitytoenableaccessforthose who need it most suggestions of the need to expand dropinsupportthatcouldberesourcedsustainabilitythroughaprimarycaremodelin

partnership voluntary and public sector. This also included debate around the need for a public awareness campaign to promote better understanding of what good mental health is, and clarify the distinction between mental well being , mental ill health and mental illness. Therewasastrongfeelingthatthe value of peer support and the value of lived experience needs to become more integral to the design and delivery of improved mental health servicesacrossallagesand stages of family life.

" the pandemic has everyone talking about mental health but there is a lot of confusion about and may people are accessing tier two services when they need universal primary support

A key message from some participants was also the ongoing need toincreasepublic awareness of the distinction between mental wellbeing, mental health and mental illness andsuggestedtheneedforawhole service/community action plan for this"

Key priorities

Bridging of public adult mental health services and community voluntary sector Recognition of role of carers and roll out of Triangle of care training for professionals Recognition of the value of lived experience and increased opportunities for people to meet in central locations such as wellbeinghubstobenefitfrompeer support .

Joined up Mental health Public awareness campaign –re distinction between mental health and mental illness

Framework established to increase access for people where English is their second language Other Gaps identified /concerns raised

Lack of Monitoring and evaluation of Disordered eating provision

Lack of Monitoring and evaluation of physical outcomes for thosewithamentalillness Lack of joined up Suicide prevention co ordination