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In the community for the community
Better mental health care for Barnet, Camden, Enfield, Haringey and Islington
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A new gardening project is helping service users nurture their mental health and wellbeing, offering psychological support alongside outdoor activity.
The Community Garden at Chase Farm Hospital, in Enfield, is being transformed with flowers and plants that are starting to flourish with the start of Spring and will improve further during the coming months. It will be a place where people at the hospital and in the wider community can enjoy being outside during the summer.
The benefits of being outdoors, and of gardening in particular, in improving mental health, has been well-documented. The community garden is a safe space for adult community mental health service users to talk about their mental health with others who have similar experiences. They can also learn new skills, including planting and the general running of the garden, while they reconnect to their hopes and values and use their time there as a way of gaining confidence socially.
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The garden project is evolving and will be part of a new integrated pathway of care within the Community Mental Health Transformation Programme, called Step and Thrive.
Lucy Gore, Enfield Community Psychologist said: “The garden provides a safe place for people to come together, connect with nature and engage in activities that enhance wellbeing. Importantly, it is a containing space where mental health needs are understood and people are supported to reconnect to identities and values beyond any diagnosis. We hope that over time, the garden will be used by service-users and staff from across Enfield as well as the wider community”
Anna Mandeville, Divisional Lead for Psychology and Psychological Therapies said: “The NHS Long Term plan sees services placed at the heart of communities. We want to be able to bring psychology ‘out of the office’ and into everyday lives. People who may not be ready for psychological therapy, or those who are waiting for it, are able to join this project, which builds a sense of community in the heart of the physical community and in the health-giving environment of nature and a garden. It's revisioning the psychology of the everyday.”
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The gardening group meets each Friday when service users work on a wide range of tasks including, planning, planting, weeding, pruning and clearing the areas. Once a month, the group invites friends and family to join them to celebrate the work that they have been doing and improvements made.
The number of people attending the sessions has been gradually growing and the team hope to increase the number of groups on offer. The vison for the garden is for it to be an inclusive space for all service-users from different services across Enfield and there are already plans to start that during the summer. It is also, importantly, a space for NHS staff to take time out during their busy days and staff are being encouraged to use the space in their therapeutic work with clients.
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Service user Steven H said: ‘I found a place where I can focus and get in touch with nature. I was amazed by the immediate benefit on my mental health. The voices and ‘seeing things’ lessened. When the voices are speaking, they are speaking about more pleasant things, which happened the first time I visited the garden. This helped me to feel more safe and attending the group has improved my confidence to speak to other people. I’ve loved it!’
Another service user said: “The gardening group helps me relax as I find life very stressful sometimes. I also really enjoy the social aspect especially with people who understand what I have been through, that really helps my well-being”.
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If anyone would like find out more about the gardening group, please email: lucy.gore@nhs.net
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Mental health specialists have now started working within GP practices; providing holistic care close to where people live, with a focus on preventing people from developing mental health conditions, and early intervention to help them recover.
These Advanced Clinical Practitioners (ACPs) and Mental Health Practitioners (MHP) play an important role in providing support, advice, knowledge and clinical time with GPs and patients in a primary care setting.
Nicole Barker, an Advanced Clinical Practitioner, is one of 18 members of staff across Barnet, Enfield and Haringey who have taken up new roles in GPs surgeries, playing an important part in our transformation of community mental health services. Here she describes how her new role works.
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“If someone gets in touch with their GP about mental health, the receptionist lets me know and I ring the client and talk to them about their concerns and what the options are, and what would be best for them.
“There are lots of different things available and people are not always aware of them. Many people are helped by using talking therapies; I may refer them to IAPT services, which is Increasing Access to Psychological Therapies, or I could put them in touch with one of our social prescribers.
“Social prescribers are specialists who have lots of information and contacts who can help sort out benefits or accommodation issues, or they may connect people to organisations that can help them meet others, which can ease loneliness or isolation.
“Sometimes we may discuss medication and then I would discuss that with the GP and see whether that’s suitable. The patient is always involved and put at the centre of their care.
“I follow up with each person I’ve been in contact with. There may be two or three follow-up calls to check that the treatment plan is working and they are recovering.
“It is an interesting and innovative new role and I am really enjoying it. It is good to be working with people in primary care, treating mental health conditions at an early stage and helping to prevent them getting worse and needing hospital treatment.”
These new posts, are funded 50% by the GPs, and the staff sit within the GP surgeries, but are managed by Barnet, Enfield and Haringey NHS Mental Health Trust. The partnership demonstrates the closer collaboration and different ways of working with our core community teams, as outlined in the NHS Long Term Plan. Click here to find out more about how this is working in Barnet, Enfield and Haringey.
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As part of our transformation of community health services across north London, peer coaches are working in multi-disciplinary teams alongside mental health clinicians, voluntary sector workers and local authority staff to provide holistic care.
Ellie has been working with Camden and Islington NHS Foundation Trust as a Health and Wellbeing Peer Coach since August 2021, and is also studying for a Masters Degree in Integrative Counselling and Coaching at the University of East London.
Here she explains what she likes about her role as a peer coach, and why it is effective:
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“It’s really nice to work as part of a multi-disciplinary team because you get lots of different people with different areas of expertise all coming together to think about the best route with a client. That also means looking at social factors. It’s a multi-pronged approach to supporting people and helping them.
"The work I do as a peer coach makes a difference because it is working really holistically with people, side by side them, and thinking with them about what is important to them and what would make a difference. We start by thinking about different areas of their life that may be dissatisfying and we have access to different community services and organisations we can connect them with to make changes.
"It is a really satisfying role, I get to meet someone on an equal level and I’m able to share some of my own experiences, if it’s relevant, and I think that humanises me and allows us to connect in an equal way, and from there we can work together to find steps forward for them.
"People I work with really appreciate hearing about my challenges and experiences, I think it makes them feel less alone and less judged and they feel that there is an acceptance from my side because I have had some experiences that are similar. It helps people accept their own challenges and not feel embarrassed by them. When there is that mutual respect, it makes it easier to think about next steps from a place of no-judgement.”
One of the Voluntary Community Sector partners working with us to change community mental health care is FLIC (Fulfilling Lives in Islington & Camden), a charity that supports people experiencing multiple disadvantage and works to improve the experience and outcomes for people accessing services. It formed the Peer Involvement Network (PIN), which encourages and supports peer workers.
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Many of Camden and Islington NHS Trust's community services are scattered across both Camden and Islington in old, expensive-to-maintain and often difficult to access buildings.
We are rolling out specialist teams working in GP practices, which are in addition to our existing community services, and we need conveniently-located buildings with more consulting rooms, where we can see service users and carers and also base our teams.
In these buildings we will provide service users and carers with flexible space they can use. We will also invite partner organisations to deliver services, thereby offering people access to more services under-one-roof in locations that are easy to reach.
Our estate transfomation programme also includes plans for a new hospital and the development of our St Pancras site. See details here.
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Dr Gina Waters, Consultant Psychiatrist, shares her experience of moving to the Trust’s new facility at Regis Road, after 20 years at St Pancras Hospital.
"In September last year, I moved to the Trust’s new community facility at Regis Road, in Kentish Town. In my case, it was not just a move to a new facility, but also to a new professional role. I had spent around 20 years working in the Huntley Centre, at St Pancras Hospital, as a consultant psychiatrist, before taking this new role as a community mental health clinician within the Camden Core Team.
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"The core Team was set up as part of our Community Mental Health Transformatton Programme to enable the Trust to deliver more holistic care near to where people live. The new facility provides a nice environment for service users from the moment they walk in. It feels welcoming and open and although there is a security door between the working and public areas, it has been designed so that it does not feel like a “them and us” environment. It is a place where people do not seem to mind waiting or being seen which is really important to beat the stigma often attached to mental health services.
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"The new facility at Regis Road makes this possible because a range of Trust staff are co-located with voluntary and community sector partners who also run services from there, for example, Likewise and Mind. It really does make it easier to have informal conversations with both C&I and partner colleagues to find solutions for an individual’s overall wellbeing.
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"I think it is incredibly important that staff feel valued, and it is difficult to achieve that in buildings that cannot possibly function to modern standards because they are so old. My inpatient colleagues on the wards at St Pancras work incredibly hard. Their job is challenging enough and they have the added burden of dealing with issues such as blocked toilets, poor ventilation and temperature control on a regular basis. |
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"Having had first-hand experience of the day-to-day challenges in older buildings, I do not take the new building for granted. We have open, modern spaces; a large kitchen area and even the smaller things like lots of charging points make a huge difference to my working day.
"There have been teething problems, for example with storage space, but overall it is a great space for staff and service user wellbeing."
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Published by
Barnet Enfield and Haringey Mental Health NHS Trust
St Ann's Hospital, St Ann's Road, London N15 3TH
Email: beh-tr.communications@nhs.net
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