Mental Health Improves EI Offer

Mental Health is one of the five components within our Early Intervention programme.  It is currently strengthening its services and mental health offer across the EI programme. Here we talk to Derek Tobin (Associate Director BSMHFT), Charlotte Ward (EI Team Manager BMHFT) and Ann-Marie Westwood (Clinical Nurse Manager Specialist Mental Health Services for Older People), from the Birmingham and Solihull Mental Health Foundation Trust (BSMHFT) about their work within the Early Intervention (EI) programme and their short, medium and long-term focus.

What services does BSMHFT provide within the EI programme?

Currently we have a focus on our older adult services which include our acute inpatient units at the Juniper Centre and Reservoir Court. Our Community Mental Health Teams have also supported pathways with EICT and discharge planning.

How does the mental health service integrate and complement the other four modules within the EI programme?

It complements EI services by promoting the integration of mental health and raising awareness that people with co-existing mental health and physical health problems need a joined-up approach to enhance and improve outcomes.

Mental health input within EI helps to improve knowledge and awareness around mental health and the impact that mental health can have on physical health – and vice versa. The key is to look to improve pathways and to support the whole concept around “home first” – to keep people in their own homes with an advanced offer integrating physical and mental health.

This is key to EI making a difference in terms of looking at the whole person and what their needs are. For us it is all about enhancing the concept of “no health without mental health”. This means that in all EI programmes people’s mental health should be considered as part of the overall offer across the Birmingham & Solihull health and social care system

Did this change during Covid?

I think it did. One of the things that COVID did was that it got us to make decisions that would probably have taken a lot longer to make before. Initially, in the early part of COVID, we started an MDT with the Early Intervention Community Teams (EICT) to support in managing the impact for mental health and look at people who may have been discharged from hospital sooner due to COVID and whether there was any support that we could provide around delirium and challenging behaviours within nursing homes and discharge pathways.

COVID helped to move that agenda forward and advance the work that we were doing. This has helped in terms of how we take mental health forward, how we share our learning and how we develop the learning from COVID as we move forward and focus on recovery.

What are the achievements to date? 

The biggest achievement to date  is that the EI program has been very supportive in terms of the development of an integrated approach to mental health. We’ve had our challenges along the way but my experience of working in EI is that the willingness for integration has been a major feature in terms of all of the programmes. Our colleagues across the programme do consider mental health and the need for us to provide quality services for all of our service users.

As we are emerging (hopefully) from Covid – what are the key priorities for the mental health service?

The key priority for mental health moving forward is to widen our offer. As I said previously, a lot of our focus has been on older adult services, which has been really positive. However, what we now need to look at is the impact for our adult services and links to the EI programme. It is important that we make this a collaborative process between BSMHFT and other EI partners.  As we develop mental health and physical health integration we need to ensure that support to mental health from EI is also supported by mental health to the EI components, this will be an area of development over the coming months.

What current EI related initiatives are you working on at the moment to improve the offer to patients/service users?

We have a few areas of work on the go currently, some of that is ongoing work with EICT to enhance pathways and to establish better joined-up working between the various teams and across localities. We also have a pilot running between OPAL Plus and Reservoir Court to support decision making on serious physical health problems and the appropriateness of transfers to acute hospitals. We will look to really build on this. We are also very much involved in the revised processes around the integrated hub to enhance discharge pathways

What are the next steps for mental health within EI?

The next step is considering how we include our wider mental health services and mental health offer across all EI components. This will help to enhance a system wide offer of an integrated approach to mental and physical health and enable the BSol system to be innovative in this approach. I believe we have firm foundations in place and now need to take our opportunities to build and develop our approach.