Q Exchange

Bridging the gap with Peer Support: Secure Services and Beyond

Establishing a peer network for individuals currently within or recently discharged from secure services. This will include creation of two peer support groups/cafés within Langdon hospital and the community.

Read comments 12

Idea
2018

Meet the team: #DPTThePowerofPeers

Also:

Sophie Bate
Joanna Duke
Kirsty Lane
Alice Vanstone
Fleur Lee
Service User 1
Service User 2

Langdon Hospital is a Secure Mental Health Hospital providing 111 male inpatient beds. Supporting men from the South West area of England who, as a consequence of their mental health needs, have had contact with the legal system and require a safe and secure environment that enables them to receive a wide range of treatments, therapies and care to assist in their recovery. People staying with us may have medium secure, low secure or open accommodation. The video below created by service users, demonstrates the journey through Langdon Hospital .

Transitions between wards and into the community can be extremely challenging and distressing for some people. This was summarised recently by one of our service users when describing why he thought this proposal was important:

“the hospital is like your family, you’re in here for so long and then all of a sudden you are discharged and it just gives you the feeling that the support will be carried on through into the community, its just not nice being around a group of people that you have known for so long and then you don’t see them again- without this, it’s going to be like taking a step back rather than forward.”

We are aiming to co-produce a peer network both at Langdon Hospital and in the local community. For those individuals currently at Langdon Hospital this will provide a pathway into the community and most importantly instill hope. Service users have identified the crucial need of having a peer support group; “likeminded individuals that can provide a different kind of support, your peers are key. They give you a different kind of hope”

This will be a weekly session were individuals with lived experience may offer social, emotional or practical help and support to each other. There is a key focus on strengths with a consensus of everyone working towards their own wellbeing and recovery. Peer support groups have evidenced improvements in mental health symptoms – reducing the risk of readmission, larger social support networks , enhanced self-esteem and social functioning.

The Forensic male client group are exceptionally vulnerable and in order to prevent high levels of psychiatric morbidity and further re-offending; structured pathways from hospital to community are required to enable seamless transitions whilst supporting service users sustained recovery (Davies et al, 2007). To significantly aid this it has been recognised a peer support group is vital. A peer support group will bridge the gap from hospital to community. Service Users are susceptible to institutionalisation, with the familiarity of ward routines, security and staffing; the long awaited discharge can be somewhat daunting and can exacerbate relapse.

We asked current service users that are close to discharge at Langdon Hospital ‘why would you like a peer support group in the community?’

“….familiar faces, support network, able to keep in contact with friends you have met in hospital. When I’m discharged I feel I won’ t have anyone to turn to that know me, I would also be worried for my mum and the lack of support network for my family – as once I am discharged the support will be gone. If there was somewhere in the community the support network would carry on, it would be helpful, a familiar face. When you leave hospital it feels like they just dump you, a CPN (community psychiatric nurse) is not enough ….I will have to start all over again and will be easier for my mum to talk to someone she knows and that knows me”

“…To catch up with people that have been in similar positions as me, it will be somewhere to meet; a safe place. People would want some help with information on banks, benefits, information leaflets, it would provide reassurance and assure information is confidential. If I was struggling it would be a good place to come, talk about my problems with people I already know and trust. It would really help with being discharged and would definitely prevent relapse, because if the staff have worked with me previously they understand how I deal with my problems and will know how to help me.”

“It would be great, more positive and strong, somewhere to meet up and have a chinwag, with people I already know”

Aims and Objectives:

To provide a co-produced and co-designed peer support recovery service provision, to bridge the gap from inpatient to community.
To provide a cost-effective solution to support individuals that have come into contact with secure mental health services reach their full potential in leading fulfilling and meaningful life out in the community.
To improve independence/functional ability and quality of life during and following inpatient admission.
To provide a safe environment that offers respect and opportunities for its members; a key focus being recovery, alongside social inclusion, meaningful participation and interpersonal skill development.
To promote the principles of recovery in every aspect of the peer support group.
To provide social support for high-risk hospital users with organised and informal recreational and social activities where individuals and staff can assist each other in solving daily living problems.
To support individuals with developing resources and self-help management strategies they can use in their recovery.
The group will be organised as a support system, not as a service or treatment program- with the key ethos being inclusion and peer support.
Through a co-produced approach members participate in consensus-based decision making regarding the group. Individuals are members not ‘patients’ or ‘clients’.
A recommendation can be made by the service users multidisciplinary team and can be identified as part of their care pathway, however individuals have the choice to participate in the peer support group.
To ensure the peer support recovery group is utilised as a timely opportunity during service users stay at Langdon Hospital.
To reduce length of stay through a focus on preventing relapse, supporting discharge, and reducing risk of readmissionand reoffending.

Benefits for the Q community:

This proposal is easily translated to other sectors of the health community with measurable outcomes, evidenced base approach and cost benefits. We will provide regular updates to the Q community through a group blog. We will provide updates for Q events. Q members will be welcome to attend and observe the group. Service users who are part of the project will be encouraged to become Q members. This project will link with other projects taking place across the region and nationally which we will link with through the South of England mental health collaborative, the Quality Network for forensic mental health and New Care Models for Secure Services in the South West and ImROC (Implementing Recovery Through Organisational Change).

How you can contribute

We will benefit from ideas and guidance from other Q members who have similar projects and ideas from the wider community.
Other Q members to share experiences of peer support networks that we can learn from.
Supporting our idea

Comments

Helen Hanks 15 Jun 2018

Hi Sam and Helen,

I wholeheartedly support this proposal - having worked within the secure services with you both I completely agree with the aims and objectives behind this. A conversation I had with a service user several years really stuck with me and completely resonates with why this is so important - I asked him how he was feeling about leaving hospital. He replied "I have no idea what it is like out there anymore, I don't know what I am going to enjoy doing or how to find out". So this peer support network is vitally important to support these vulnerable adults as they make the very challenging step back into the community.

More than happy to be involved and support in any way that I can. Good luck.

Helen
Claire Madsen 31 May 2018

Hi,

This looks like such an exciting proposal. We have some experience of delivering peer mentor training in prison around substance misuse and recovery and are starting to see some exciting results. Would be happy to share learning with you?

Good luck in progressing!

Matthew Areskog (Twitter @Matthew_A83 )
1. Samantha Churchward 15 Jun 2018
  
  Thank you for your support Claire, Yes please this would a great help, we have completed some training around mentoring and setting up a peer support group. However, it would be excellent to gain further insight and information from your experiences.
  Look forward to hearing from you
  Best Wishes
  Sam
Tina Campbell 21 May 2018

Hi Helen and Sam
Agree that this looks great I think this is a valuable and much needed project ;the learning and structure of which should be easy to share with other services across the Trust and beyond. I know that our patient partners, staff and carers are very motivated to get this project going and with the level of support and expertise through the Q community we can really go from good to great. Looking forward to hearing more about it and being involved if I can. Best of luck!
1. Samantha Churchward 15 Jun 2018
  
  Hi Tina,
  Thanks so much Tina, we are all very excited about this project. Please add yourself as a supporter. We will keep you updated with our progress and developments.
  Many Thanks
  Sam
Dimitrios Tsiakiris 21 May 2018

Hi Helen and Sam,

I fully support your idea, as I believe that it will have significant positive impact on patients well-being. There is no argument against the importance of Peer Support and the potential benefits from it. I would like, though, to make a comment about your proposal. It seems that the community Peer Support group would be able to support people that they are discharged to an address in Devon. Have you thought about the ones that may decide to live elsewhere? What I am thinking is that the initial stage would be to set up a Devon Peer Support network. I am wondering of whether you intend then to start creating a SW-wide or even a UK-wide network or it is within your plans to utilize social media and relevant resources.

In general, I believe that this is an excellent idea!
1. Samantha Churchward 15 Jun 2018
  
  Hi Dimitrios,
  Thank you so much for your support and thoughts. The majority of our service users are discharged to Devon and Cornwall, we have considered the geographical barriers to attending our group. In an attempt to overcome this we have allocated funds to purchase technology that could support virtual attendance and engagement. We also have a carer’s Facebook page which supports peer support and communication.
  At Langdon hospital we are part of the new care model which includes all south west regional secure care which we hope will facilitate networking within the region. However, we would be very open to creating and building on relationships UK wide, are you aware of any services within the UK involving peer support?
  Look forward to your feedback
  Best Wishes
  Sam
Jonathan Broad 20 May 2018

Hi Helen

Sounds like a great idea and would happily support if I can, one thought, as we know the SW community can be very small and I wonder if there would be value in pairing with another unit to support each other in a peer support methodology which could lead to spread a bit easier in the future.

The principle is strong and so I happily have supported the idea.
1. Samantha Churchward 15 Jun 2018
  
  Hi Jonathon
  Thank you for your support, absolutely great idea we would welcome the opportunity to work alongside another unit. Are you aware of any services that would be keen to be involved or have similar projects?
  Currently we are in communication with Recovery Devon, Devon Recovery Learning Community, East London Foundation Trust, Sussex Partnership Trust, Mersey Care Foundation Trust and IMROC (implementing recovery through organisation change).
  Look forward to hearing from you
  Best Wishes
  Sam
Helen Smith 20 May 2018

hi Karen

thanks for your comments. Part of this projects development was done within a collaborative event with patients and their families in secure services. We have been thinking about peers making up the support group, it would be interesting to have a think about a families support group, with some cross over if people wanted to consider this?

kind regards

helen
Karen Machin 18 May 2018

Sounds like a really interesting project - and I'm hoping you've linked in with other projects around peer support in secure care so that we can all share learning? It's interesting that in the quote the person refers to support for his mum. Have you thought about how to involve carers and whether this would provide peer support for families too?
1. Samantha Churchward 15 Jun 2018
  
  Hi Karen,
  
  Thank you for your support and feedback, we have connections with other secure services within the south west and elsewhere in the UK. However, would welcome further suggestion or signposting to any projects or services you are aware of?
  Our Recovery College (the Discovery Centre) has relationships with Recovery Devon and other agencies who have supported us to provide a course about setting up a peer support group and mentoring courses. We also have relationships with recovery colleges throughout the UK that we regularly share our work with. In regards to carers involvement, we host regular drop in sessions and focus groups to ensure we are co-producing this project with carers and service users. We also have a carers Facebook page that we utilise to gain consultation about developments around peer support. Following a series of introductory workshops we are now planning to set up a carer’s working party that will develop the peer support project. Our carers feel very passionate about peer support and we plan to build in opportunities for carers to attend the group.
  
  Best Wishes
  Sam