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23 Apr 2012
Jessica Agudelo, Certitude community projects co-ordinator

Care and co-production in a crisis

Alice (not her real name) lives alone and is prone to anxiety attacks. Something which might be frustrating or inconvenient to most of us - like not having the exact change for the bus fare – can, in Alice, trigger a full blown panic attack.

Jessica AgudeloAlice is usually supported by her community mental health team in Lambeth, south London. But if an anxiety attack strikes at the weekend, the statutory Monday-Friday support isn’t available.

Without family or a social network around her, Alice, distressed and in despair, heads to her accident and emergency department (A&E). After an initial assessment, she can wait for up to four hours to be seen by a psychiatric nurse (and that wait is in an area where people are in need of emergency care, an environment unlikely to do much to calm a distressed mind). Because Alice doesn’t require psychiatric treatment but social and emotional support, when she finally sees someone, she is usually sent home.

But thanks to a new peer support scheme launched by VODG member Certitude, Solidarity in a Crisis, when Alice hits this kind of crisis at a weekend, she can ring a dedicated out-of-hours number and receive valuable help.

Alice can ring one of two dedicated numbers, get straight through to either a service user or carer who engages her in conversation. The peer supporter asks how she is feeling and tries to talk about coping strategies. He or she provides support over the phone or arranges a meeting in the community, in a mutually agreed neutral and public location.

Certitude’s new Solidarity in a Crisis scheme offers telephone support with an option to meet in the communitySolidarity in a Crisis is co-designed and co-delivered by service users and carers in Lambeth, providing crisis support over the phone or in person on weekends. The service provides phone and outreach support to people in distress with the aim of reducing the number of inappropriate accident and emergency admissions.

It is rare in that it is run by people with lived experience. Our peer supporters have gone through a training programme and receive regular supervision and support. By sharing their experience and providing social support to people in distress, they aim to promote recovery, enhance feelings of belonging and hope whilst also helping to prevent people reaching crisis point.

The team includes seven peer supporters, two service user or carer representatives and a project coordinator. All are fully trained, risk assessed and employed by Certitude – they take it in turns to work in pairs on shifts every weekend (Friday 8pm to 2am and Saturday and Sunday 8am to 2pm and 8pm to 2am). We estimate that around 10-15 people a weekend could access the service. Although the service is designed for one-off crisis-driven support rather than as long-term help.

You can access the service if you’re a Lambeth resident, over the age of 18 with mental health support needs. We accept referrals from community mental health teams, A&E teams, other voluntary organisations and GP surgeries and people can also self-refer.

The project grew from the work Certitude has done with Lambeth Living Well Collaborative. Speaking to service users, there was a clear need to offer a crisis out-of-hours service in Lambeth. It’s well known that there is an increase in A&E admissions for crisis patients during weekends when maybe what they require, rather than emergency treatment, is more social and emotional support.

One challenge we’ve had has been around risk and enabling those who are already on a “recovery journey” to become peer supporters with the service. However, training and risk assessment is crucial to this kind of service, so peer supporters work in pairs on shifts.

Training for the peer supporters includes issues like client confidentiality and safeguarding. Certitude also took time to seek advice and training from a well-known user-led support service, Leeds Survivor Led Crisis Service, to ensure we were on the right track.

We envisage a positive impact on the peer supporters; they are employed by Certitude so we very much see the scheme as a stepping stone for them in terms of getting experience, training and back into work. Those working for the service come from a variety of community and voluntary groups in the area and some might have used our services in the past.

It’s vital to point out that our new service doesn’t replace existing medical or health interventions; it’s an alternative service offering social and emotional support by peers.

The role of Solidarity in a Crisis is to prevent people reaching crisis point and or guiding someone towards apt professional help. We want to stop people like Alice from further distress and from going into acute need; our aim is to put an end to the revolving door of crisis and emergency care experienced by so many people with mental health needs.

* The service operates Saturday and Sunday from 8am to 2pm on 07889 756 078 and 07889 756 080 and on Friday, Saturday and Sunday from 8pm to 2am on 07889 756 083 and 07889 756 087.

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