Open statement - Mental Health, learning disabilites and autism.pdf (123 KB)

This open statement is being issued from Joined Up Care Derbyshire (JUCD) which is a collaboration of health, social care, voluntary and community groups, private care organisations and partners who are working together across Derby and Derbyshire. We are united by a will to improve the lives of people (children and adults) with mental health needs and conditions, people who are living with neurodiversity, learning disabilities and/or are autistic as well as their carers and families.

We are sharing this information to explain what we are trying to do to transform our services and to ask for your help in working with us to make sure that these are the right changes to make a positive difference to people's lives.

The Covid -19 pandemic has tested us all in many ways; and especially for those of us who have lost loved ones, our lives will never get back to the way they were. The changes to our daily routines, ways of working and how we support each other have been profound. This has brought with it challenges both emotional, physical, financial and social; but also opportunities of thinking differently about what is important to us and how we want to live our lives.

Even before the pandemic, we had started to look at the way people are supported as we know across all ages local people are experiencing challenges associated with mental health and wellbeing. We know that these needs have not gone away during the pandemic, in fact for many people they have increased. This is why we believe this work is so important. We know that there are health inequalities which are leading to differing outcomes experienced by some people because of barriers created by a traditional ways of working.

Our health and social care system, Joined Up Care Derbyshire, has the following five priorities: • Prevent physical and mental ill health and help people to make better lifestyle choices • Make sure services are tailored and targeted to people and their communities • Make it easy for people to get the right care, when they need it, in the right place for them • Health, and social care need to work seamlessly • Make organisations as efficient as possible

In line with these high-level priorities, as we try to come out of the pandemic, we want to work harder to provide support that is more:

• inclusive

• compassionate

• helpful

To achieve this, we know that we need to do more work on listening to and understanding what is important to individuals, families, carers, communities and service providers; but we don’t want it to stop there.

We would like to:

•  enable and encourage people who have lived experience to work with us to design, assess and improve our services
• provide employment and volunteering opportunities for people who are finding it difficult to get a job
• provide easily accessible information, advice and support for those who are currently experiencing challenges
• work closely with people who don't often seek support to see what we can all do to make things easier for them
• make sure that decision making is transparent - that all partners have an equal voice in influencing how we use resources to deliver services to ensure we meet the needs of our communities.

This will represent different ways of working and may require the re-forging of established working relationships, alongside the development of new ones. We think this will take time to flourish, and there will be lots of challenges on the way, but we hope that you are all keen to come on this journey with us to help improve the lives of people in Derby & Derbyshire.

 

To help us focus on initial priorities we have broken down our work into the following priority areas:

• Community Mental Health Service Transformation - Living Well – working with communities to review and shape services that support people with lived experience of mental health difficulties to manage their health and social care needs and improve their wellbeing. We want our NHS and Local Authority services to work in partnership with the VCSE sector and to link more effectively with local communities. We want to help to bridge that gap and help people to access the support they need when they need it. We want there to be 'no wrong door' to people getting support. We want services to work together in an integrated and coordinated way appreciating the unique set of skills and experience they each bring.
  
  
• Urgent Care and Support – for the time when things are getting difficult; and people need urgent access to support to keep them safe and healthy. We know that lots of people don't know how to access the support they need when things are overwhelming; and we also know that sometimes the support accessed isn’t the most suitable. We want to improve this by making it easier to get right help at the right time and the right place. We also want to get a better understanding of the things we can do to help prevent people getting to this stage of crisis.
  
  
• Autism Support –. We know that there is some good examples of care and support being provided within communities for people with autism and their families. However, we also know that workforce is stretched and that relationships and pathways can be strengthened. We want to support local community sector providers to develop a new community of practice who can work closely together to share ideas, good practice and identify local solutions.
  
  
• Clubs and Groups for young people – We want to make it easy for people to find out what clubs and groups are running in their local areas. We are working to gather this information and will share the links we receive on our local offer websites.
  
  
• 24/7 access to urgent care and support for children, young people, parents and carers – we know that the current crisis support offer for our children and young people is fragmented with a different response in different parts of Derbyshire. We want to reform our offer for children and young people who need extra help by developing a consistent crisis response for all our children and young people seeing them as individuals first whatever their mental health, eating disorder, learning disability, autism or complex behaviour needs.
  
  
• Young adults (18-25 years) we know that currently young people experience a 'cliff edge' in the care and support available when they reach 18 years of age. Becoming a young adult can be a stressful and difficult time and we are acutely aware that this can be even tougher for our more vulnerable young adults; for example those who may have mental health issues, are leaving care, have learning disabilities or autism.
  We want to better support the transition of young people on their journey into adulthood, providing more opportunities and a helping hand to establish themselves in the adult world.
  
  
• Engagement with under-represented groups and people whose voices are seldom heard within our services in order to improve people's health. We know that for some people we need to do much more to make this a reality. We want to better understand how our services need to be shaped, for services to work and be acceptable for people from different backgrounds, to ensure the services we offer are truly co-produced with the people who need to use them.

We want to create a collaborative provider structure where partners across sectors can work together to explore the best means of providing support to achieve inclusive and effective delivery.

To do this, we want to understand who is interested in providing certain services/ support functions and how a system-wide delivery response could be structured. We anticipate that the range of services that we will focus on collectively will grow over time; however, the areas we would like to focus on initially are:

1. Community Mental Health Service Transformation (Living Well) resourcing: making sure that the right number and type of roles are in place to deliver what we need to, including considering what is already in place in local communities. This will involve a strong focus on a varied and multi-skilled workforce including peer support roles, and – as further collaborative work takes place – may include additional specialist roles such as family support and physical health. Where these roles are already in place the focus will be on strengthening awareness and routes of access.

 If you are interested in working with us to define and deliver these roles, or shape how providers could work together to create a collaborative approach then please email ddccg.cypprogram@nhs.net quoting 'Living Well' in the title

2. Crisis Alternatives: the delivery of Crisis Café's and/ or Safe Havens within Derbyshire and Derby City (please see here for further information regarding this kind of provision)

 If you are interested in working with us to shape this provision, delivering it, or potentially taking a lead role in creating a consistent approach across JUCD then then please email ddccg.cypprogram@nhs.net quoting 'Crisis Alternatives' in the title

3. Autism Support:

If you are interested in working with us around any of the following areas, please email ddccg.cypprogram@nhs.net quoting 'Autism' in the title

• Inovations to and new services as part of the post-diagnostic pathway
• Insights into how we can better support young adults who are autistic and who are/were in receipt of NHS care whilst they were a child.
• Suicide prevention and awareness.
• Ideas that could feed into the design of drop in 'community hubs' which can support people who are autistic
• Tailored support for young people and families.
• Alternatively, we are interested in any further gaps that in provision that VCSE partners have identified and want to help address.

4. 24/7 access to crisis support for children, young people, parents and carers: We are expanding our crisis services. Alongside this we are seeking access to a range of individualised local community support to 'wrap around' the child or young person (CYP) when they need it most. If you are interested in working with us around any of the following areas, please email ddccg.cypprogram@nhs.net quoting 'CYP Crisis' in the title

• A range of individualised local community support to 'wrap around' the child or young person (CYP) when they are most at risk. ie. Intensive (up to 24/7) 1 to 1 engagement and supervision provided flexibly in the CYPs home, community, education setting, paediatric unit - to support CYP and their parents / carers alongside the crisis liaison and intensive home treatment team.
• Ongoing personalised care – opportunities for CYP to engage in supported purposeful occupation which has the potential to become a longer term 'hobby' e.g. Sports, drama therapy, art therapy, equine therapy etc.
• Training in CYP crisis support, trauma informed care etc

5. Young adults (18-25 years): We are working to improve our response to young adults, and in particular how we support those who need ongoing support from adult mental health services. Young adults with lived experience are part of developing our plans which includes creating peer support / youth workers to assist those aged 18-25. This work links closely to both the Community Mental Health Service Transformation (Living Well) and the 24/7 CYP crisis response If you are interested in working with us to define and deliver peer support / youth worker roles, then please email ddccg.cypprogram@nhs.net quoting 'Young Adults' in the title.

6. Engagement with under-represented groups and people whose voices are seldom heard within our services.

If you can help us broaden our perspective and understanding by being the link into groups who don’t usually engage with services, please email ddccg.cypprogram@nhs.net quoting 'engage' in the title.

 

We hope that this will be the start of ongoing conversations.