At the Faculty of Old Age Psychiatry Conference in Nottingham last week, 2 sustainability scholars set up a stand on sustainability in mental healthcare.
We presented a poster looking at the concept of sustainability in mental healthcare and introducing what the 4 scholars are doing.
We also presented posters on some of Dr Daniel Maughan’s work on reducing the financial and carbon costs of depot prescribing, and a trust sustainability survey, highlighting the variations in sustainable practice.
There was interest in the Occasional Paper 97 - Sustainability in Psychiatry, and delegates were able to look through copies. In addition delegates were able to sign up to Psych Susnet.
We also highlighted the 4 principles of sustainable healthcare and the position statement on sustainability in mental healthcare which can be seen here: http://networks.sustainablehealthcare.org.uk/networks/psych-susnet/position-statement-sustainability-mental-health-care
The conference itself had interesting speakers and themes, many of which aligned with the sustainability agenda. For example the CEO of NAViGO Health and Social Care CIC (a not for profit social enterpise running all local mental health services in North East Lincolnshire) opened a debate about how revolution in older peoples mental health is the only way forward to confront the challenges of an ageing population and increasing resource constraints.
Overall a successful trip to Nottingham!
Great question Frances,
Yes it was a lively debate entitled: 'Care and Older Peoples Mental Health. Revolution is the only way forward'. The NAViGO CEO was proposer, citing examples of the NAViGO initiative itself and challanging the audience to imagine the possibilities of a social supermarket, whereby socially isolated older people who may otherwise be in traditional care homes, might teach skills such as healthy cooking to younger disadvantaged or mentally ill people, thus generating a social environment/network, a transfer of skills, a sense of worth, a resilient community, health promotion etc etc.
The opposer was a consultant looking at development of current services, ie. evolution rather than revolution.
Interestingly the audience was against revolution prior to the debate, but afterwards the majority had swung in favour of the revolution!
Interesting! Does NAViGO already run a "social supermarket" for older people then? How would it interface with more traditional services, or would it replace them?
Frances
I'm not entirely sure if the 'community supermarket' is theoretical or if they have actually put something similar into practice. It would be great to find out because if so it could act as a blueprint. The idea could first be as a supplement to provide alternative income and be an innovative way to promote healthy communities. Perhaps this could then be expanded to somehow replace certain services...
Without too much detail I proposed broadly two things -
Organisations that are fully geared to concentrate on the needs of vulnerable groups of people. We know MH and LD and I suspect older people with complex needs fare badly in generic systems where everything (cancer, GP, diabetes, A+E etc, trumps the complex needs of such groups. Organisations that can pose and enable any solutions to the major issues and support needs of such folk. Where health, social care, education, support are simply not concepts for boundaries. Where what works is simply the focus. Navigo is somewhere along that continuum and gains mostly great results. Providing health, social care, employment, training, accommodation and many other things either ourselves of via others (but with us taking responsibility). We will happily do anything that works. If isolation is a key issue for older people (and it is) then lets ensure our whole system is geared to provide opportunities to alleviate this. We do not have a community supermarket yet, we do have a fully commercial garden centre and it increasingly provides community presence, jobs, protected training, education, social supports etc. The community supermarket idea goes further alongside other services to trade direct with the community, provide community support without stigma and meet many problems in diet and habit in long term illness without overly clinicalising. Also creates a community cohesion, you invest here profits go to helping your community. Such schemes try to address the appalling situation of long term mental health and early mortality from preventable illness. Teaching people to use food, changing habits and subsidising from profit of trading with the rest of us meeting our needs, healthier diets for a period early in care. They would also make a real difference to isolation, without the unwitting possible demeaning of people by giving charity in 'come and receive' models that ask nothing in return. Or am I just beholding?
Complex topic happy to discuss further/debate as this does not do it full justice. But connecting people back to their organisations and their needs is vital. Our membership is staff, people who use services and carers all with equal voting rights.
The other part is being able to do new models as present ones don't work well. Care 'homes', standard DGH units for delirium where independence is lost etc. Such orgs can and do think differently whilst having the clinical skills to do so safely. Home from home our scheme with the DGH inreach outreach covering the whole acute phase back to home is one example. Relatives get to stay and be admitted, same staff do acute community and beds, staff a mix of MH, physical etc, social needs met directly all contribute to great results. There are many more.
Finally cant resist it - scrap this daft expensive and crazy system of commissioning where contracts are abused and huge amounts of money is wasted in bureaucracy!
Enjoyed the chat and welcome a chance for a longer more in depth one. Psychiatrists really need to get together more and offer more powerful solutions to an MH world that is floundering a bit at present.
We haven't finished the revolution comrades!
Kevin Bond
Chief Executive
NAViGO Health and Social Care CIC
inspiring stuff, really does embody the idea of social sustainability. Thanks for clarifying the details for us Kevin
That debate at the conference sounds like it would have stirred up a few delegates!
I agree with your comments Kevin about psychiatrists needing to be more involved and thinking more broadly and into the future. This scholarship has certainly given me that opportunity and it would be nice to see some CCG's being more brave and diverting funds to involve such community collaborations (power to the people!). However, I don't believe there is a 'one size fits all' and see this debate as a useful reflection for people to see what would best work for their local population on the spectrum of revolution-evolution - I don't think it need be one or the other. I do agree though, that the current trend has been too far towards evolution with an 'innovative' label - we really do need to harness the potential which exists in our communities, which I believe is in heart of all the four principles of sustainable mental health. It is really a sad state of affairs when you reflect upon statistics such as these: http://www.ageuk.org.uk/health-wellbeing/relationships-and-family/befriending-services-combating-loneliness/