MHFA - crisis intervention

In addition to the umbrella intervention provided by ALGEE (Assess Risk, Listen non-judgementally, Give reassurance, Encourage referral to other agencies, Encourage self-help strategies), MHFA has strong and clear guidelines for crisis intervention. From MHFA:

 Crisis First Aid for someone experiencing an acute psychotic episode

• Do not get involved physically
• Call the police and explain what is happening, unless the person has a mental health crisis card with clear steps describing how you can help.
• Try to create a calm, non-threatening atmosphere.
• Be reassuring, calm and concerned.
• Do not try to reason with someone who is experiencing acute psychosis.
• Express empathy for the person’s emotional distress.
• Comply with reasonable requests.

Pat Deegan on youtube

Bridge Building for Social Inclusion

Bridge building for social inclusion is the mainstream approach designed as a care pathway based on clients' own aspirations, goals and choices.  A one-day training which incorporate bridge building approaches and assessment tools is now running throughout south London and Surrey.

Commissioned by Merton & Sutton Primary Care Trust the training 'Planning for Good Mental Health & Social Inclusion'  is being delivered by trainer and course author John Vanek. Attendees include health visitors, GPs, occupational therapists, members, social workers and day centre workers. Library managers and staff have joined the training cohort, making for diverse and lively learning. The training benefits from the facilitator's experience in both bridge building and Mental Health First Aid (MHFA).
Current attendees on the 'Planning for Good Mental Health & Social Inclusion' course cover a broad range of professional disciplines from across NHS and commissioning services. These have included health visitors, Social Workers, a service commissioner, a GP, specialised physiotherapist, a dietician, day service workers and many others.  Recently, library staff and managers have joined the training cohort.

The course is designed to be of benefit for anyone who is a service provider, not specifically within the caring or health professions.  The social inclusion assessment strategies include the 'web' and the 'recovery star'.  Trainees also get the chance to do assessments on each other and many have commented that the assessment tools are highly appropriate for their own work domains.

Typical groups who benefit from the trainings include:

Employers who wish to know more about common mental health conditions

Business owners who wish to address problems of lost productivity due to undiagnosed or diagnosed staff mental health problems

Anyone who wishes to know more about current mental health legislation and their legal rights and requirements.

Community-based workers who wish to learn about developments in social inclusion over the last fifty years.

HR practitioners who wish to gain simple assessment skills and tools for helping clients or employees make a successful return to mainstream life after illness or setback.

Health & Safety personnel keen to know more about what's out there for people who may be experiencing mild or more severe mental health challenges.

Cascade effect of mainstream

As a social inclusion bridge builder I work with clients with severe and enduring mental health diagnoses. They are referred or they self-refer with the desire to access mainstream life domains. 

Clients aspire to a variety of mainstream choices. It might be volunteering or befriending, it may be arts activities, it might be employment or running your own business. Client aspirations may include sports, faith, education, training or a selection from any or all of these.

Enabling individuals with a 'severe and enduring' background is not always a straightforward process although it certainly can be sometimes. A client can be introduced to a mainstream outlet and it can work for him or her almost immediately. Other clients may be unready for mainstream for a variety of reasons. They may suffer a relapse before accessing the mainstream environment. They may visualise mainstream as another form of day service or statutory support system, which it isn't.

Equally, clients can sometimes express a wish to access mainstream out of a misplaced fear that not accessing it might in some way affect their payments and benefits. It can be a long process before the value and rewards of mainstream are understood.

What is true is that clients who successfully access or re-access mainstream in turn become examples of mainstream's effectiveness. Signposting to mainstream as part of the mental health recovery pathway is undoubtedly effective, even if it does not work for everyone straight away.

Mainstream also helps to sustain recovery in the individual and even better, it can propagate more success and recovery out of its own resources. An example of this would be the musician who successfully links up with a mainstream recording studio. After months of regular rehearsal the musician is invited by the studio manager to contribute to a recording session. I witness this kind of beautiful outcome and its benefits for the client in my work as an arts bridge builder. 

Another example - again from music bridge building - is the guitarist client who uses a studio regularly and invites a friend to join him during the session. The friend may well be another mental health service user who has never successfully engaged with mainstream despite the best efforts of the bridge building service. Where services have been unsuccessful a friendship and peer network can do the job far more effectively. 

Mainstream reaches the places other services cannot reach and in the process it is able to create a cascade effect - a continuing path of development, recovery and individual growth.

She Could Save a Man song by John Vanek

She Could Save a Man by John Vanek

Life Domains

Bridge building for Social Inclusion is a way to enable people to connect or re-connect with mainstream life.

Bridge building to mainstream is widely practiced as part of the care pathway for people in recovery from severe and enduring mental health conditions.

Bridge building is based on key 'social domains' or life domains.  Each domain represents an area that may be important or relevant to a person's development.

Life domains include:
Healthy Living
Arts & Culture
Education & Training
Faith & Cultural Communities
Volunteering & Befriending
Employment

Bridge builders work with clients to help them identify key areas they may wish to access in one or more life domains.

DDA: Disability & the Law

The Disability Discrimination Act (DDA 2005) makes it "unlawful for a service provider to discriminate against a disabled person by refusing to provide any service which it provides to members of the public.” 

'Service provider' refers to public and commercial sectors alike. A service provider may be a retail outlet, an NHS service, an employment bureau, a police station, a dating agency....the list is endless.

The implications for mainstream are highly significant. Clients referred from backgrounds of mental ill-health to mainstream life will encounter a new range of service providers. It is a social inclusion bridge builder's role to ensure that clients accessing mainstream are introduced to any service providers the client may have identified as key. Once a client is engaging with the services or products of that provider, he or she will be a beneficiary of the policies, procedures, insurance and legal obligations of that provider. The service user becomes equal with all the other consumers who are accessing mainstream as a matter of course. Consumers' rights are considerable.


Another result of the mainstream process is that it puts the responsibility for provision onto the mainstream provider. A client accessing a mainstream service such as a recording studio, for example, is a beneficiary of all that the studio provides. Provides not merely in terms of the studio service and products, but also in terms of the studio's policies, procedures, insurance and legal obligations. Equality with every other consumer creates an equal opportunities situation for the person now accessing mainstream.

Mainstream is not required to provide 'special settings' and nor should it. Mainstream should not stigmatize because of its awareness or unawareness of mental health issues. It should not stigmatize because stigma is not part of any reasonable access to a mainstream product or service.