Mental Health Service Delivery at the Intersection of Statutory and 3rd Sector Services
Strategic insights from Mike Garner, Strategic Development Manager at Relate Derby and Southern Derbyshire, on managing mental health services overlapping statutory and 3rd sector realms. Garner discusses service evolution, funding challenges, partnerships for growth, and the impact on community well-being over 17+ years.
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Presentation Transcript
Delivering Mental Health Services in the overlap between Statutory and 3rdSector services Mike Garner Strategic Development Manager Relate Derby and Southern Derbyshire
Overview Service manager with Relate Derby since 2002 Set up Safe Speak Young People s Counselling Safe Speak set up with 3 years grant funding Project Manager and 4 part time counsellors (8 counselling days per week term time) Multiple funding routes over the 17+ years Over 11,000 CYP seen for counselling since 2002 Service level has fluctuated: 166 clients in Year 1 over 1000 clients in Year 17 Similar levels than Year 1 predicted Year 18?
Keeping it all rolling New project Shut down or Evolve Try to retain staff and knowledge base Deliver / Monitor / Report Charitable objectives Look for new funding
Keeping it all rolling Multiple funding themes evolve and partnerships get built Risk that reactive response can build rather than following clear business plan Can also increase creativity Charitable objectives
Partnerships for growth (and survival) 2004-5 2018-9 1 Parent / carer relationship Family relationship difficulties 2 Parents conflict / arguments Anxiety 3 Emotional difficulties Depression / low mood 4 Step family issues Peer relationship difficulties 5 Domestic violence Self harm 6 School staff relationship difficulties Panic symptoms 7 Peer relationship difficulties Problems with attachment to parent / carer Changing partnerships leads to: Evolving service need Additional delivery and supervision staff skill sets The need for confidence from senior staff to build through change
School-based service collaboration Over past 17 years have delivered counselling in the majority of Derbyshire secondary schools and in many primaries Initially service for free very popular new service idea! Demand led to additional direct contracts with schools Local Authority block purchased for all secondary schools in several localities Funding ended when Multi Agency Teams (MATs) set up Few Schools continued self-funded Most stopped offering counselling altogether Some bought in own counsellor direct Sudden gap in free service opened up CCG funded Health rather than Education model Funding now ended (or is it a gap again?) 2002 2019
Triage model Attended various multi-agency triage meetings since 2005: MAPS Multi Agency Professional Support meeting in 1 School Chaired by CAMHS Attended by Health and independent agencies working in school School also attending, but chaired by CAMHS Single Point of Access (SPoA) meeting Broad multi-agency structure Clinical focus using Health structures, but with MAT attendance Went for 2 years before being funded to attend Having embedded the value of 3rd Sector attendance, funding now with another agency Southern Derbyshire and North Derbyshire Access Point (SDAP and NDAP) meetings Involvement with SPoA led to invite from commissioner for new pilot Attendance plus administration of meetings Complex, but successful pilot even more complex once funding ended Community Triage now being expanded as part of other funding stream
SDAP SDAP referral options included: School-based interventions School Health 3rd Sector, eg. Relate Safe Speak CAMHS Specialist Community Advisor consultation with referrer, but with no specific referral on to full CAMHS SPoA to consider higher level service pathway CAMHS services Community Paediatrics Clinical Psychology School Health Multi Agency Team consult
Evolution (and reinvention) In the delivery process we need to stay focused on the shared organisational benefits with the client at the centre of all this: Goal: Transform current ways of working within the sector in order to improve quality and efficiency Shaping services around the needs of clients Holistic not tiered service delivery Co-ordination and development of early intervention pathways Improving access to evidence-based and community-based services Improving collaborative practice Monitoring effectively Consistency with CYP IAPT / Future in Mind principles
Evolution (and reinvention) All this equals The Cross Sector Leadership Challenge UP (to Commissioners and Managers to shape vision) DOWN (line management of staff) and SIDEWAYS (across sectors)
Realism (and acceptance) Evolution and reinvention keeps us going and helps to better shape services can be healthy, but is often forced upon us Often trying to do the same or similar service because it works 3rdSector is often seen as providing nice to not have to services Commissioner led or client led process? (Despite stakeholder discussions) Realism of where we are now Short term funding = short term staffing security loyalty stretched Costs - misconception that charity = volunteers = cheap What s the payoff? eg. reporting structures, complex NHS issues, political issues Trusting partners who could be competitors Short term working: quick fixes or efficient working? focus can work well, but for some leads to client and staff dissatisfaction
