Fascinating insight into the work of Peer Debrief volunteers

Written by Martin Delgado, Peer Debrief Volunteer:

Peer debrief

“C&I has taken a bold and innovative approach to improving standards of care for service users by recruiting volunteers to interview patients who have been physically restrained.

The Trust is one of the first in the country to launch the Peer Debrief initiative after the National Institute for Health and Care Excellence (NICE) published new guidelines recommending that individuals who are external from the Trust be brought in to talk to patients after restraint incidents on a ward.  Some volunteers and Trust staff involved in the initiative are pictured above.

The scheme, which is being rolled out across wards at St Pancras and Highgate Mental Health Centre, has so far proved successful and was singled out for praise in the latest Care Quality Commission report, published in March 2018. There has been significant interest in the model from other mental health trusts, who have asked C&I about setting up their own Peer Debrief schemes.

Several of the C&I volunteers are former patients with ‘lived experience’ of mental health issues, though there are plans to expand the team by recruiting more widely among carers and in the voluntary sector.

Kevin Cann, C&I’s Prevention and Management of Violence and Aggression Lead, said: “The Trust’s strategy to reduce restrictive practice is not just about reducing the number of prone restraints. It’s about improving the standard of all restrictive practices so they become safer and less disturbing for service users.”

“Due to the Peer Debrief staff being external to the Trust, patients are more open with them about why the incident happened and how it can be prevented in the future.  This is information we would otherwise not have been able to obtain.”

The interview questions aim to aid consistency; are intended to establish what may have led a patient to behave violently or aggressively; whether the subsequent restraint was carried out in a way which minimised physical and psychological harm to the service user; and how restraint can be prevented in the future.

Interviewees are also offered advice on how to access advocacy if they feel they were subdued in a manner which failed to meet the high standards expected of C&I staff.

Senior managers, however, emphasise that there is no intention to ‘blame’ staff involved in restraint incidents. Individuals are never named in the reports filed by volunteers. The aim is to encourage reporting of restraints and, over time, to reduce their number, leading, it is hoped, to less aggression on wards and beneficial results for all clinical staff and patients across the entire C&I estate.

The data is showing a clear emphasis on the importance of communicating effectively with patients to prevent frustration and anger building up. Recurring themes are beginning to form, with a clear emphasis on improved communication between staff and patients on what is happening and why.

Kevin Cann commented: “The key to reducing violence is early intervention and planning. The nursing teams are always pushed for time but taking preventative measures such as behavioural support planning with the patient to avoid restraint saves a lot of time further down the line.

“After each interview, the volunteers give one copy of their report to the patient and another to the ward manager. Findings are also inputted into a database so that issues which occur repeatedly in debriefs can be spotted and action taken to address concerns.

“Patients have often commented that when staff debrief them after a restraint, there can sometimes be a feeling of ‘punishment’ that shuts down dialogue. That’s why Peer Debrief is so important. It gets across the message that we are curious about how and why it happened and we want to stop it happening again.”

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Conference on violence and agression

VoiceAbility secured some free tickets to a conference called “Violence and aggression: short-term management of violent and physically threatening behaviour among adults, children and young people with a mental health problem” which happened yesterday.

Violence and agression

Here is Dean (volunteer Peer Mentor)’s account of the day:

“I attended a conference today around violence on secure wards and how best to manage these incidents. we heard from a wide variety of speakers who shared their experiences and how they feel they are best addressed. there was also a solicitor who spoke on the legal aspects of patient restraint which was very interesting and gave some food for thought.

I feel I have benefited greatly from this experience. I learned a lot about different ways they debrief the staff and patients after an incident and they gave lots of examples of deescalating a situation that could turn violent.

There were speakers from Rampton and Ashworth hospitals and there were lots of different people to network with. If this conference is run in the future, I would recommend anyone that does peer support or have any contact in the mental health profession should attend.”

Regards Dean @ VoiceAbility

VoiceAbility CEO Jonathan Senker: On TV

JS speaking

In July 2013, Advocacy service providers appeared before the House of Lords Committee charged with investigating the Mental Capacity Act 2005. Jonathan Senker (Chief Executive Officer of VoiceAbility) was among those who spoke about their experiences of representing vulnerable people.

Service users have expressed an interest recently, you can find the full video here:

https://videoplayback.parliamentlive.tv/Player/Index/0075169a-b2b3-4166-af52-e65f74c71aec?audioOnly=False&autoStart=False&statsEnabled=False

Guardian: “Four million people in England are long-term users of antidepressants”

Data obtained by the Guardian shows that one in six people in England were prescribed antidepressants in 2017

prescriptions

More than four million people in England are long-term users of antidepressants, new figures obtained by the Guardian show.

You can read the full article on the Guardian website here: https://www.theguardian.com/society/2018/aug/10/four-million-people-in-england-are-long-term-users-of-antidepressants

BBC Minds Matter programmes

“One in four of us will experience some kind of mental health problem over the course of a year – so most of us will either have experienced it ourselves or know at least one person affected by it.”

BBC 1 in 4

The BBC has launched a campaign called #1in4 to try and break through the stigma associated with mental illness and making it easier to talk about your mental health.

You can find out more information and see the programmes on the BBC website here: https://www.bbc.co.uk/programmes/p04t6bc1

CBUG & Peer mentoring at St. Mungos Mental Health festival!

VoiceAbility supported CBUG volunteers Romano, Davide and Mark and Peer Mentors Maria and Jahanara to run two stalls at the St. Mungo’s Mental Health festival on Thursday 5th July.

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Above: Mark (CBUG), Ani (VoiceAbility Peer Mentor Coordinator) and Jahanara (VoiceAbility admin volunteer).

The festival was great fun for everyone involved with activities like spray painting & graffiti workshop, drum playing, dancing and hand henna design. There was also a delicious grill, salads and drinks. Our volunteers made the most of this opportunity to promote the Peer Mentoring Project and CBUG with flyers, banners and forms.

All in all it was a great sunny day! 4 people showed an interest in becoming peer mentors, 5 people enquired about CBUG and a couple of people were also interested in Camden Frontline and the Sunday Project (substance misuse groups).

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Above: drumming at the festival.

We had interesting conversations with many attendees who showed interest in VoiceAbility projects. We also did some networking with the stalls of other organisations who promote mental health awareness.

There was Yoga, music performance by the charity Key Changes, stand-up comedy, massage and flower arranging!