It’s all about relationships
19th April 2017
An innovative partnership project in Argyll and Bute brought carers and practitioners together to develop and test approaches to improve carer involvement in mental health services. SRN Network Manager Louise Christie tells us more.
In October 2013 a group of people got together to discuss how carers could be better involved in mental health services in the area. NHS Highland teams working with SRI 2 (SRN’s service development tool) had identified that they found engaging with carers challenging. Local organisations, ACUMEN, North Argyll Carers Centre and Dochas Carers Centre had also been raising this issue for some time. They agreed to meet and invited SRN and Carers Trust Scotland to join them. This provided the opportunity to look at ways to improve carer involvement in mental health services and, as a result, improve the experience and outcomes of people using those services.
What was achieved?
- Increased recognition amongst NHS staff of the value and benefits of involving carers
- Better links between NHS services and Carers Centres e.g. in Oban the project has led to the setting up of a carers mental health support group
- Better mutual understanding between carers and practitioners of the need to work together for their own benefit and the benefit of people using services
- A letter with a named nurse is now sent to all carers when someone is admitted to in-patient services
“The letter meant they (carers) feel they are not a nuisance. They feel they are valued and it’s okay to be involved”
Those involved in the project recognise that this is only a start and that not all parts of Argyll and Bute have yet to embrace this change. However, all were agreed that one of the main achievements of the project has been much better relationships and more joint working between the partners, carers and practitioners:
“The partnership working has been one of the biggest strengths of this project”
“We have got better working relationships as a result of this project”
Using the Triangle of Care
The project had started with a well-attended launch event in May 2014 in Kilmory Castle in Lochgilhead. From this event the partners decided that the way forward was to hold a series of workshops which brought people together. These workshops would involve using the Carers Trust Triangle of Care tool to get the discussions going and to identify priorities and opportunities for joint working. However, while this seemed simple we knew that the process itself would not necessarily be simple. Many carers felt hurt and anger about their experience of services and many practitioners were wary of involving carers in a way that felt manageable. Recognising this we decided not to bring everyone together immediately but to bring carers together in a workshop to discuss their experiences and feelings and identify what they think would have made things better. Alongside this were discussions in NHS staff teams about involving carers and using the Triangle of Care to increase understanding and identify opportunities.
“We weren’t going out there telling people what to do, we were bringing people together to find their own solutions”
A workshop approach
After the initial phase in the summer of 2014 there were four workshops in Inveraray which brought the partners, carers and NHS practitioners together over a two-year period. A lot of effort was put into ensuring that the workshops were informal but purposeful, creating the environment needed for people to respect each other’s perspectives and focus on working together towards the mutual goal of better involvement of carers in services.
The workshops themselves became not just a way to bring people together but an essential tool in the project. They provided people with an opportunity to meet and work with others that they would not normally have. Feedback included:
“I’ve got to meet and work with people I’ve never met before”
“There’s nothing else that I am aware did anything like this”
This built mutual understanding and trust and highlighted that by working together they could achieve so much more than they would trying to address this issue on their own. So while there is still much to be done these much improved working relationships provide a basis for the work to continue and develop.
“Getting everyone involved and meeting up on a regular basis has been really positive and I think that the links will continue”
This project shows what can be achieved by people working together around shared goals in a way that allows all perspectives and voices to contribute. It took a concerted effort and a long time to form the relationships but that has been one of the most significant achievements and the one which underpins the success so far and what happens next.
“The learning is that we have to work at it to form partnerships. Co-production doesn’t just happen”
The achievements of this project and how the work develops in the future are rooted in an approach which had a clear focus on improving carer involvement in mental health services but was open about how that could and should be done. By creating the environment where people can come together bringing their varied experiences, knowledge and skills those involved were able to develop and test their own solutions. We are sure that this has laid the foundations for more joint working in the future. Indeed, the organisations involved are now working with others to look at how this work can be developed in the Dunoon and Cowal area and are planning a recovery and wellbeing event for Autumn 2017.
Watch this space!
Those involved in the project wanted to share their experiences and learning so they have produced a short film (5 mins).