Bradford improves community mental health care with a SMI-LE approach
The COVID-19 pandemic has seen millions of lives undergo a period of immeasurable strain, exacerbating mental health difficulties for many people. According to the World Health Organisation (WHO), anxiety and depression increased globally by 25 per cent in the first year of the pandemic alone and WHO says the pandemic is ‘nowhere near over’ With a 30 per cent increase in COVID cases over the last month.
Like all mental health services during the pandemic, Bradford District Care NHS Foundation Trust has seen a growing demand for its adult community mental health (CMHT) services, with often long waits, on average six weeks to be allocated a care co-ordinator.
The Trust, working with MIND Bradford, the local authority and other voluntary and community organisations across the district have developed a six-week intensive support programme for individuals to tackle the issue.
Originally set up as a six-month project to better meet growing demand for Bradford’s adult community mental health services, the scheme focuses on the issues that are triggering mental health challenges to ensure a more holistic approach to mental wellbeing. This has meant people receive person-centred support earlier, which is having a positive impact on their mental wellbeing. It has also created more capacity for community mental health teams to help address backlogs.
Individuals are referred to the Trust’s SMI-LE (serious mental health illness – local engagement) service) through the CMHT care coordinators and allocations process and offered support for mental health triggers such as employment, bereavement and benefit support. According to WHO, one of the major explanations for the increase in stress, anxiety and depression caused by the pandemic include grief after bereavement, constraints on people’s ability to work, financial worries and social isolation. The SMI-LE approach to tackling these issues includes peer support, signposting, social prescribing, short-term help with housing issues, as well as identifying wider needs for supporting people with employment, bereavement and benefits assistance. Time-limited support is provided using a holistic assessment of need, identifying goals that people would like to work on, in line with the skills and expertise of the provider.
Cases have included an individual with housing issues, which has impacted negatively on their mental health and a person with acute anxiety exacerbated by the impact of COVID and social isolation, which has requiring gradual exposure to the outside world because they are unable to leave the house. Another case includes an individual whose first language isn’t English, who needed urgent dental support after losing two front teeth, who rarely leaves home on their own, and has low self-awareness of their mental health needs.
Kelly Barker, General Manager, Mental Health and Learning Disability Services for the Trust explained: “We knew collectively that people coming into mental health services often had holistic needs, which weren’t just about accessing specialist mental health support. We considered what we could do, as a system, to enable people to have access to other types of support such as housing, finance, making connections and minimising isolation. We knew that working together with our voluntary sector partners and the local authority we could co-ordinate an offer that could reach out to people while they waited for services.
“The new approach provides ‘scaffolding’ to support individuals and families to build autonomy and skills into their lives. The feedback we’ve had from people that have accessed the service has been overwhelmingly positive. This has led to people been seen earlier and if psychiatric support is needed this support has focused on the persons clinical needs, as the holistic needs, such as housing or social isolation, have been addressed.”
Partnership working lies at the heart of the success of this pilot scheme, which has been extended for a further 12 months, following the positive impact on people’s mental health. Improving outcomes and mental health support for local people, supporting them to get the right care, at the right time, with the right professional with this joined up, holistic approach to mental health.