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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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Free health checks in the community |
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Physical health specialists are working with ethnic communities in Islington to offer free health checks close to where people live.
The sessions include taking blood pressure and heart rate readings, and measuring weight and waist. The Population Health Nurses then go through the results with the client and explain the findings. If appropriate, with the client’s consent, they can inform a GP and help arrange appointments to follow up on any concerns.
Specialists are also able to answer health and wellbeing questions, share healthy lifestyle guidance and have a friendly chat about staying healthy in both body and mind.
The initiative is being provided by Camden and Islington NHS Foundation Trust in partnership with Healthwatch Islington's Diverse Communities Health Voice, and it provides care and support to people with mental health issues and refugee and ethnic communities.
The health checks are being trialled in central Islington, with appointments time-limited and on a first-come first-seen basis. They have, so far, been run at Hillside Clubhouse, Community Language Support Service (CLSS) which supports refugee communities from East African and Arabic speaking regions, and IMECE, which supports Kurdish, Turkish and Turkish Cypriot women and Black, Asian, Minority Ethnic And Refugee (BAMER) women affected by violence.
Key aspects of the health checks include:
- Focussing on physical and mental wellbeing
- Offering access to health services to people who may find it more difficult to access a GP because of physical or mental health barriers
- Supporting clients where language can impact on the quality of contact with the GP
- Offering the opportunity to speak to a nurse in a safe and relaxed setting they know well and trust
- Giving sensitive and expert care from Population Health Nurses, who are highly skilled and able to offer non-judgmental advice.
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Feedback from women who had health checks has been positive. One woman said: “I have been in the UK for seven months. I wish this could happen often. It’s the first time I’ve had advice. The language line is not always available with my GP”
Another told the team: “I’ve been able to talk about my issues and I feel listened to and taken seriously. The doctor does not have enough time and directs me elsewhere”
 Vanessa Bailey, Population Health Nurse, Islington Core Team, says: “There is overwhelming evidence that ethnic communities are at higher risk of mental illness and are disproportionately affected by social determinants associated with mental illness, and yet have poor engagement with services and more likely to be seen in crises which, quite frankly, can be a traumatic experience. So it follows that engaging with these populations in their trusted community spaces to initiate conversations about mental and physical health, whilst carrying out routine health checks, is really valuable work.
“Having these simple, no jargon, conversations in these settings demystifies mental health, we can shed light on the interaction between physical and mental health and encourage people to actively participate in monitoring their health.
"We have met incredible people and are learning about different cultures along the way. I really enjoy doing this!”
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Join us and give us your feedback - tell us what changes you want to our services
Our Community Mental Health Transformation Programme is working across five boroughs, Barnet, Camden, Enfield, Haringey and Islington. Staff from each will be at Hornsey Vale Community Centre, in Haringey, on 30 September, 1-4pm, to talk about the work that they are doing and listen to your thoughts on what we need to do to make services even better for you; we’ll also have some small discussion groups, and we’ll be serving refreshments. Please come and share your views over a cup of tea and piece of cake!
Work with us - join our team!
We are in the middle of a three-year transformation programme that is changing the way mental healthcare is delivered across Barnet, Camden, Enfield, Haringey and Islington. The £25 million initiative is creating hundreds of new jobs.
As well as doctors, nurses, therapists and other healthcare professionals, we want to offer jobs to people without traditional, professional qualifications, but with valuable, lived experience of mental illness. As part of our more holistic approach to mental health here will be opportunities, too, for those able to offer expertise in benefits, housing, and employment support.
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The power of personal experience |
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Tracy Kemble has used mental health services for most of her life. She was abused as a child, has been in a violent relationship and has had periods of depression – now she is using that experience to help others.
Tracy's story is truly inspiring. About 18 months ago, she was given support by The Network, a secondary care service created by Barnet Council with Barnet, Enfield and Haringey Mental Health NHS Trust (BEH). That changed her life and gave her mental and emotional stability and a new focus.
Last year, she joined BEH as a Peer Engagement Practitioner with our Barnet North Core Community Mental Health Team; she is employed by the charity Meridian Wellbeing, working in partnership with BEH, and currently supports 24 service users, with weekly appointments on the phone or face-to-face.
“I can see a difference in people after just a few sessions. Very often people have had bad experiences of the NHS and they feel angry and don’t want to get engage, but I tell them what has happened to me, and say that things are changing. It gives them hope.
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“I tell them that they can get better, because if I can do it then anybody can. It takes time and work but after a few weeks they feel the benefit.”
She introduces people to activities and services that will help them to socialise, overcoming isolation and mixing with others who have shared experiences. She encourages people to join wellbeing sessions, including some at the Meritage Centre, in Hendon, where there is a Wellbeing Café, run by Meridian Wellbeing. Tracy works as part of a multi-disciplinary team, alongside psychologists, social prescribers, community engagement workers and other specialists. They work together to achieve the best outcomes for each service user, who is consulted at every step of the recovery journey.
Tracy, who spent decades working in hotel and leisure centre, uses the new care planning tool DIALOG+ with clients and said it helps them, and her, see the progress they are making. In the DIALOG+ model, people rate how they are feeling about different aspects of their life such as relationships, employment, and the care they are receiving. (You can find out more about DIALOG+ here.)
She said: “It gives the service user a chance to say what they are feeling about lots of different things and helps to identify areas to work on. Then we go through it every couple of weeks and see where the progress is.
“I do really care, and I think people can tell that I care so that helps them to open up and makes them willing to listen to me”.
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How finding a job can help recovery
Our new model of community mental health care supports people holistically, enabling them to improve areas of their lives that they are dissatisfied with.
For some, employment is a major factor; finding and keeping a job that they enjoy and find fulfilling can be transformative, giving independence, confidence and social interaction. Many people find it helps them to have the structure and routine that regular work provides.
As the community transformation programme is rolled out across North Central London, employment specialists have started work with service users in some areas, to support them in finding and keeping paid work.
Juliette Carter is an employment specialist with Working Well Trust, an organisation founded to help people with mental health issues find paid employment, and works with people in Tottenham and Edmonton. She works as part of the core mental health team in Enfield and attends multi-disciplinary team meetings, where specialists discuss how best they can meet each service user’s needs.
People are referred to Juliette from secondary healthcare, so they may have been in hospital or had time away from work because of their illness.
She said: “We use a model called IPS – which stands for Individual Placement Support, which is not based on readiness to work, but based on their willingness to work. If people want to work and want to engage then we can work with them.
“We work by researching roles quickly and then after that, supporting their recovery. First, we find out what roles they've done previously, if they haven't done any work before, we ask what things in school they might have liked and what they like doing outside of work. We try to create a picture of the place that they would like to work.
“The work must be competitive, paid employment, we try not to place people in a role specifically set up for someone with a mental health condition, and we try to get them into something that they actually want to do. So, for example, if someone has worked as a picker and packer at a supermarket and they didn't enjoy it because it was really loud and very pressured, and it felt that made them feel triggered, or anxious, then we take that into account and try to facilitate something that's not in that environment.
“We do a vocational profile, finding out what they want and what they like doing and then work with them to write a CV, apply for jobs and prepare for interviews. The aim is to support people so that are able to do this independently, but they can ask for help at any time and we have computers here which people can use to look for jobs and fill in applications.”
Juliette and her colleagues also build up contacts with local employers and work with them to support service users as they start work.
“Many people I work with say how empowering it is to have this support. They are taking some control of their life and it is away from a clinical setting. They feel able to make decisions and choices and try new things. It is really encouraging and uplifting to see what a difference it can make.”
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Changing roles and building partnerships
In Camden, the mental health charity Mind, has been one of our key partners in transforming community mental health care and, as core teams start to take shape, new roles are forging that relationship.
Mind in Camden, along with Likewise worked with Camden and Islington NHS Foundation Trust (C&I) to set up The Resilience Network during the pandemic. This later became the Support and Connect Service, and works with people who have mental health needs, treating them holistically, taking into account social contact, welfare, physical activity, relationships, finances, housing and other factors.
New roles are being created that are a partnership between C&I and voluntary community sector (VCS) groups, including Mind. Elina Marques, is currently transitioning from her role as manager in the mental health social prescribing service, to Mind’s Senior Manager, Camden primary care core teams. She said the transformation programme will make a huge difference to communities, bringing with it a cultural change in the way mental health conditions are assessed and treated.
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She explained: “When we experience a physical symptom, for example headache, we are prescribed a medication for it, perhaps paracetamol, or something along those lines. Social prescribing encourages people to co-produce social prescriptions, which basically means working with an individual and thinking what they need to address their social needs. Those things might vary from individual to individual. There is no set toolbox that everyone needs to fit in.”
Elina says it is important to embed the new way of working across the core teams, with VCS workers alongside mental health specialists and clinicians: “This is an opportunity for change and innovation; doing things differently and more creatively. We want to change the way people think about mental health care and the resources that are available. If we do that successfully we will be able to offer much more to our residents in Camden, and the offer will be more centralised. People will be able to access all the resources they need from one place.”
The teams are still recruiting to new roles but the aim is to have eight staff from Mind across the borough, including Recovery Workers and Community Development Workers, a welfare rights expert will also work across the borough, supporting and training members of the core teams.
Elina said: “We are looking at how we can reach out to different communities, really getting an understanding of what the need is in the local areas to ensure that it's not an approach of “one size fits all”, but that the offer is targeted at different groups and hopefully meets the population needs in different areas. One really exciting element is the welfare rights post because it's something that's been missing from care models in the past but is clearly needed.”
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Published by
Barnet, Enfield and Haringey Mental Health NHS Trust, St Ann's Hospital, St Ann's Road, N15 3TH
Email: beh-tr.communications@nhs.net
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