What is community mental health transformation?
Community mental health services have played a crucial yet under recognised role in the delivery of mental health care, providing vital support to people experiencing mental health problems closer to their homes and communities since the establishment of generic community mental health teams (CMHTs) for adults 30 years ago. However, the model of care needs fundamental transformation and modernisation.
Through the adoption of the new Community Mental Health Framework (CMHF), people with mental health problems will be empowered to:
- Access mental health care where and when they need it and be able to move through the system easily, so that people who need intensive input receive it in the appropriate place, rather than face being discharged with no ongoing support
- Manage their condition or move towards individualised recovery on their own terms, surrounded by their families, carers and social networks and supported in their local community
- Contribute to and be participants in the communities that sustain them, to whatever extent is comfortable to them.
This Framework places community mental health services in the centre of the community, as the central pillar of mental health care, allowing all other services in the mental health care system to function more effectively.
A key aspect of effective mental health care is ensuring that all communities can maximise the support they provide to people who need it and therefore address local population needs.
The CMHF sets out six principles that underpin good quality mental health care. These are:
- Promote mental and physical health and prevent ill health.
- Provide evidence based psychological and/or pharmacological approaches that maximise benefits and minimise the likelihood of inflicting harm and use a collaborative approach that builds on strengths and offers choices, underpinned by a single care plan accessible to all involved in the person's care.
- Improve a person's quality of life, including supporting people to contribute to and participate in their communities as fully as possible, connect with meaningful activities and create or fulfil hopes and aspirations in line with their individual wishes.
- Move away from restrictive practices to a flexible system that proactively responds to ongoing care needs.
- Work more collaboratively across different organisations to address health and social inequalities.
- Build a model of care based on individual need, particularly for people with multiple needs and the highest levels of complexity who experience marginalisation.
To achieve this, mental health services will have processes that offer good quality assessment of needs and interventions which are shown to work and be accessible at the location most appropriate to people's needs. Care should be stepped up when needed and stepped down, in a flexible way without the need for cumbersome referrals and repeated assessments.
Finally, development of effective links with community assets to support and enable people to become more embedded within their community and to use these structures to support their mental health.
In the CMHF there will be no wrong door approach to accessing care. People with the full range of mental health concerns will be able to access support, care and treatment in a timely way and from wherever they seek it, whether from their GP, from a community service, through online self referral or other digital means. People with the highest levels of need and complexity will have a co-ordinated and assertive response in the community.
The transformation of mental health services will provide community teams that are responsive to the needs of service users and their carers, be proactive and ensure all teams work in a joined up way free from stigma and oppressive practice. First appointments will be used to ask about what people have been experiencing and how these things have been affecting them; this might include using Patient Reported Outcome Measures. This will help us to fully understand needs and how we might be able to help. This also involves building new partnerships with GPs, voluntary organisations and other existing services.
If you have any questions relating to the Community Mental Health Transformation Programme, please contact the team on: cmh
View the changes to mental health care services provided in the community leaflet.
Community mental health services recognise and appreciate the valuable contribution that people with lived experience (either directly or as a carer) can bring to the organisation. We’ve been increasing our workforce to represent this and plans are in place to increase our knowledge and experience.
Mersey Care is setting an ambition for the health care system to build positive, trusted and enduring relationships with the individuals and communities we represent to improve services, support and outcomes for people.
Community mental health services have committed to developing and implementing a Lived Experience Charter, aiming to improve the recruitment and retention of a larger, more diverse, inclusive and representative workforce.
The charter will focus on policy, organisational culture and positive practices to:
- Support open and inclusive recruitment of people with lived experience
- Raise awareness within our organisation of the benefits of employing people with lived experience, barriers faced and how to overcome them
- Provide people with lived experience the support they need from the start of their employment journey
- Develop clear progression pathways for people with lived experience
- Develop a workplace environment and culture that is free from discriminatory practices, unconscious bias or prejudice
- Share good practice and ensure co-production of our services with people with lived experience.
As part of the CMHF, community teams will work more closely with voluntary, community, faith and social enterprise (VCFSE) organisations. VCFSE organisations work with specific groups of people and can support in ways that community teams cannot. It may involve assisting with leaving the home, supporting to attend a local social group, or having a regular chat on the phone.
By building locally based networks of support for people, we’re able to provide care in the best possible way, at the most appropriate stages of a service user’s journey. This work helps to support and build confidence in the patient on their pathway towards recovery.
Our local community mental health teams are working with the following VCFSE organisations.
Age Concern: Liverpool, Sefton and Kirkby
Through Combat Isolation, Age Concern intend to launch a bespoke suite of services. Age Concern will deliver one to one community based social interventions, supporting individuals, building personalised community support programmes designed to supplement existing care plans and delivering activity programmes/volunteer befriending services.
Age Concern Liverpool and Sefton
Mind Connect: Kirkby and South Liverpool
Mind Connect work in partnership with Mersey Care community mental health teams to support patients with their mental health and wellbeing. They accept referrals from Speke (Moss House) and Kirkby (Northwood House).
Mind Connect offers accessible wellbeing sessions from facilitators on managing emotions, relationships, trauma, stress and anxiety - to help improve overall health and wellbeing. Dependent on the person’s needs, they can offer specialised group work and bespoke one to one sessions to help improve specific mental health needs. They also offer wraparound support from the team, offering consistent one to one sessions and work closely with other health teams to ensure people are fully supported.
Mersey Care (mindconnect.org.uk)
Imagine Independence: Liverpool and Sefton
This service aims to enhance the quality of care being provided by the community mental health team. Eligible people include those with severe mental illness who have a history of lengthy admissions to psychiatric hospitals and remain socially isolated from their communities. This group of people will be supported to live better, more meaningful lives in the community, with the provision of social based interventions. These interventions are aimed at people who will be considered for the community rehabilitation pathway as per NHSE transformation requirements.
Sean’s Place: Sefton
Sean’s Place provides an easy entry point for people with mental health needs who are ready to be stepped down into primary care by providing learning based opportunities to help manage their mental health, reduce isolation and loneliness, develop their skills and live independently in the community.
It provides evidence based education, tailored mental health support, training and experience and signposting to professional services and other third sector support.
Mens Mental Health Support Sefton | Liverpool - Sean's Place
Sefton Council for Voluntary Service (CVS): Sefton
Sefton CVS assist and support VCSFE organisations as well as providing a holistic approach to care to complement existing health services within Sefton. CVS offers a high intensity intervention and signposting service which prevents people identified as ‘frequent flyers’ from attending hospital through provision of proactive and targeted social interventions in the community.
Interventions are provided by trained support workers in collaboration with the patient’s clinical care team. Staff are highly trained to support service users to improve their independence and develop coping strategies to prevent further crises.
Sefton CVS will expand this service to provide meaningful interventions to people being supported by adult community mental health teams who have been identified as high users of urgent support systems.
CVS have created a dedicated pathway for community mental health teams to refer people (who are not subject to Care Programme Approach) directly to the service to provide proactive and preventative social interventions.
Sefton CVS | Supporting Local Communities
Warrington, Halton, Knowsley and St Helens
In Warrington, Halton, Knowsley and St Helens, the transformation team opted for an approach of working closely with Voluntary and Community Action (VCA) teams. Together they identified the benefits of locally based care co-ordinators. These are employed by VCA and connect patients being discharged from Mersey Care inpatient and community services to local organisations in the VCFSE sector that can support the patient step down process.