Working with friends and family during times of crisis: Islington Acute/Crisis strategy for carer engagement Dr. John Hanna, Consultant Clinical Psychologist, Highgate Mental Health Centre January 2012 Islington Acute/Crisis Services • • • • • • • • Mental Health Liaison Team Two Crisis Resolution/Home Treatment Teams Two Crisis Houses Assessment Ward Four Acute Treatment Wards Specialist Services for Aging in Mental Health Ward Psychiatric Intensive Care Unit Access to Women-Only Acute Treatment Ward Unique challenges for acute/crisis • Confidentiality – When paranoia interrupts close, positive relationships – Assessing service user’s reasons for denying carer involvement – Confidentiality of carer disclosure • Sharing information – Pre-admission advance directives – Carer disclosure leading to MHA assessment – Leave, discharge arrangements – Complex categories: General, personal, personal-sensitive • Carer expectations of acute admissions • Separation—temporary and longer term • Family/social network dysfunction, abuse, absence • Young carers • Out-of-area carers Triangle of Care Self-Assessment Findings—9 teams within Islington • Lack of carer-aware training for staff • Variable “carer champion” support across teams • Identified challenges relating to parameters of confidentiality/information sharing • Limited service information available to carers A renewed carer strategy for Islington Acute/Crisis Services • A working party on improving working with carers and delivering the Trust’s Carer Strategy—representatives from all acute/crisis service line services, alongside Islington Carer’s Centre, IBUG, BUF, FT’s carers lead (Set up in early 2011) • Co-production toward three shared objectives – Information leaflet for carers, family and friends on acute/crisis service pathway to support informed engagement—completed and ready for formal approval and dissemination – Confidentiality/sharing information strategy for carers, service users and staff—completed and ready for formal approval and dissemination – Staff training on working with social networks during crisis—delivered to service line managers • Carer champions to be established within each acute/crisis team – To receive staff training as above (Spring 2012) • Good practice adherence projects undertaken within each team (Spring 2012) • Working toward concordance with NICE guidance on family work within Acute/Crisis service line