Community support case-study: Bristol community support services (North, South, East, and Central)
In Bristol, support for people with mental illness in the community has been radically transformed to shed the outdated model of a day centre where people would go and pass the time.
Instead, people experiencing severe mental illness and other mental health problems now receive focused, planned and carefully defined support that helps them achieve personal goals and aspirations and move towards recovery.
“We achieve and attain those goals through a planned programme of support either one-to-one, or if we identify a common need across a number of people then as a small time-limited group,” said area service manager James Gorman.
The Bristol community support service covers the full range of mental illness from schizophrenia and bipolar disorders to depression, general anxieties, phobias or obsessive compulsive disorders. It came about as part of a remodelling of existing day services, prompted partly by commissioners and partly by Rethink, which wanted to reshape its community support services to promote better social inclusion.
The service is funded by Bristol City Council and the Avon and Wiltshire Partnership Trust, which commissioned it. Commissioners were looking for more focused and individually directed services than the ones being offered, and Rethink worked with its national development team to move its service away from the traditional day centre model.
“Since we introduced the new service people do achieve goals – there are definitely more people recovering now. People don’t become entrenched within the system. There’s also an element of reducing stigma and maintaining their social independence so they can actually access resources in their own community,” said James.
Rethink staff work with individuals to draw up a recovery plan that identifies goals and aspirations that could be social, or related to employment or education. The individual recovery plan is then broken down into manageable steps and each stage is worked on in turn.
“If a range of people share the same goals we’ll set up a small group, otherwise we arrange individual support over a period of time. We work through the steps to achieve their goals and every three or four months reflect back on the plan and look at the progress that’s been made and where things need changing.”
Staff try to give positive feedback so individuals get a feeling of progress. If they succeed in meeting all their goals then they may decide together with their key-worker that they don’t need to use the service any longer.
The new style service is undoubtedly a success when it comes to recovery and social inclusion, however there were great feelings of loss for the building when the old day centre closed. After some discussion it was established that what people really feared losing was the company and contact with other people with mental health problems, rather than the day centre itself.
To answer that fear Rethink has established peer support groups as part of the new style service, which are run and directed by those who use the service and supported by staff. Several groups meet and manage themselves, including a women’s group, a men’s group and an arts group.
