Iola Davies and Paul Hudson Crisis Care concordat Mental HealthFeb 2014 The Mental Health Crisis Care Concordat is a national agreement between services and agencies involved in the care and support of people in crisis It sets out how organisations will work together better to make sure ID: 581617
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Slide1
Working with Crisis in Personality Disorders
Iola Davies and Paul HudsonSlide2
Crisis Care concordat :Mental Health;Feb 2014
The
Mental Health Crisis Care Concordat
is a national agreement between services and agencies involved in the care and support of people in crisis. It sets out how organisations will work together better to make sure that people get the help they need when they are having a mental health crisis.
http://www.crisiscareconcordat.org.ukSlide3
4 main foci
Access to support before crisis point
– making sure people with mental health problems can get help 24 hours a day and that when they ask for help, they are taken seriously.
Urgent and emergency access to crisis care
– making sure that a mental health crisis is treated with the same urgency as a physical health emergency.
Quality of treatment and care when in crisis
– making sure that people are treated with dignity and respect, in a therapeutic environment.
Recovery and staying well
– preventing future crises by making sure people are referred to appropriate services.Slide4
Declarations, action plans and action!
96 collaborative action plans covering 152 local authority areas across England (Jim Symington 2015)
National Police Chiefs’ Council – Police custody used 4,537 times in 2014/15, down from 6,667 times in previous year. Under 18s, a 37% reduction from 256 to 161.
Bristol street triage from SeptemberSlide5
What is a crisis ?
Self defining
Personality disorder extremes?
Variable from one person to another and within one person?
Self harm/suicide?
Depth?
Frequency?
Length?Slide6
What might be helpful before a crisis? Focus 1
Better understanding of why a person might go into crisis
Difficulties with emotional expression, schema triggers,anniversaries,sleep difficulties?
Proactive rather than reactive services
Prevention
Effective person centred crisis plans drawn up in collaboration with the service user when they are
not
in crisisSlide7
During crisis; foci 2 and 3
Adequate and efficient use of resources
Collaborative working between services
Skilled workers and effective communication
e.g
Meeting the Challenge p.41
Consistent team working within and across services and sectors (shared plan?)
Your role in the journey?
Staff self awareness; stigma, understanding,reflection and supportSlide8
BOUNDARY SEESAW MODEL (Hamilton 2010)
Package developed by Laura Hamilton, Registered Forensic Psychologist, Peaks Unit, Rampton Hospital
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Abusing Dominating Controlling Caring
Caring Indulging Enmeshed Abusing
CONTROLLER
Fixed Limits
NEGOTIATOR
Fixed and Flexible limits
PACIFIER
Flexible Limits
Under-involved & too controlling
Over-involved & too placating
Involved enough to nurture & empower
Hamilton, L (2010). Boundary Seesaw Model: Good fences make for good neighbours. In Tennant, A. & Howells, K. (Eds.),
Using Time, Not Doing Time: Practitioner Perspectives on Personality Disorder & Risk
(p181-194). Chichester: Wiley-Blackwell.
Punishing Controller
Exploitative CarerSlide9
Empowerment
Effective collaborative, accessible plan?
Real choice for service users?
Specific individual and group needs?
‘Mental health crisis review- experiences of minorities’ (case studies and key themes)
Bristol women’s crisis house: Link House
20 plus year campaign led by service users
Max 4 week stay, person centred, recovery and holistic approach
10 beds opened Jan 2010,part of whole system
Tender process- service users key part in all stages of the process