A couple of quickies before we turn to the stunning services at Sandwell Park, Hartlepool. The now regularly featured Wotton Lawn in Gloucester have come up with another inspired activity for patients – The Great Chili Off 2007!! Each patient has been given a chili plant to love and nurture in their room, or wherever else they like. As the plants produce their fiery fruit there will be a competition, prizes for 1st ripe chili, most chilies and biggest chili. Like all the best ideas, it’s simple, fun, participative – and costs very little.

The survey revealed a multitude of ways that you’re letting people know about your Star Wards’ developments. I was very taken by Sefton and Kirby’s practice of laminating all previous e-newsletters which are then put in a file for general circulation on the wards.  Future e-newsletters will be blown up to A3 size, laminated and prominently displayed on the ward.

News from trusts – Sandwell Park, Hartlepool.

If patient choice ever extends to where we can get sectioned to, I’ll ask the ambulance if they wouldn’t mind just going a bit north of north London… up to Hartlepool. Next time I visit there, I’m definitely bringing my toothbrush and i-pod. Not that there’s time to retreat into music, there’s so much going on there. As always, there isn’t space here to describe half of them, but we’re going to have a new feature on our website with fuller details from each trust. In the meantime, many thanks to Ian Trodden and colleagues for letting me visit and find out about the following.

Perhaps the most striking aspects of the hospital are that staff are highly motivated (“There’s not a day we don’t look forward to coming to work”), management are explicitly validating of colleagues (“One of the things that D does particularly well is manage the bank staff”), it’s a beautiful, affirming environment and there’s not just the provision of talking therapies but a range including dialectical behavioural therapy and trauma focused therapy. And another thing. The ward is very connected in with community services – ‘mainstream’ as well as mental health ones.

They have a meticulously, and consultatively, designed new building. The first thing that greets you is a lovely framed local photo, with an accompanying narrative about the photo – a welcome change from the usual sign about not assaulting staff. The ward has a smart, hotel-like feel, with large pieces of stylish art, from specially commissioned local photos of nature. There are cleverly designed transparencies (taken from the commissioned photos) on some of the glass external doors and a few windows to increase privacy. Refreshingly, wards aren’t named after trees but after local ships (the marina is right by the hospital) and ward doors have a photo of the ship and a short description of it. Interestingly, they decided not to have noticeboards as these were felt to give too institutionalised a feel. Leaflets etc are on display on sideboard.

1. Recreation and conversation

• Once a week patients can go to user-led community arts group, Atrium. Is an integrated resource – i.e. not just for mental health service users. Patients might decide to continue going to there when they leave hospital
• Integrated Day Service takes patients into the community for activities, including detained patients wherever possible, on s17 leave. 7 days a week. Local sports, library etc. Popular visits to local farm will in future include opportunity to help with grooming and caring for animals. Team also supports assertive outreach team.
• Visiting librarian talks to patients about their interests then suitable books are delivered.

2. Physical health and activity

• Go walking in Dales – minibus takes them.
• Conservation Group – looking at developing allotment.
• Someone from leisure centre may be coming to work with patients.

3. Visitors and carers

• Provide psychoeducation in partnership with Hartlepool Carers.
• Run a service-users and carers’ leadership programme.

4. Care Planning

• Two post-discharge staff. Community in-reach – care co-ordinators work on wards with patients.
• Abolished ward rounds. Very successful new arrangements of consultant appointments, co-ordinated by nurse. Patients have information about other times when consultants are available. (Wow!)

• Are developing Personal Recovery File, to include:
  • photo sheet of staff rather than on poster on wall
  • info re: aims and benefits of each activity
  • ‘security plan’ – risk management including how patients can support their own safety
  • Case formulation group is forum for qualified nurses to get support re: clients emotions and behaviour.

5. Talking therapies and self-management

• Clinical psychologist runs drop-in consultations for staff.
• Nursing staff trained in psychotherapy and ‘alternative’ therapies eg aromatherapy.

6. Ward community

• Flexibility re: upper age so patients can stay on past 65 if their situation requires this.
• Patients get pre-briefing – a ‘warning’ about what tricky things might happen on the ward. Research suggests this reduces PTSD etc.
• There is a charity fund. It could be used for patient-determined budget, decided by patient meetings.
• Women can eat in the women-only lounge if they don’t want to eat with men.

7. Patient responsibility

• Mountain leader training being looked into for a patient. Could lead to him becoming a STaR worker.
• Patients contributed to making a stress management CD in local studio, eg relaxation techniques.
• Patients were involved in choosing which artist to commission for the displayed artwork

All this (and more!) raises the interesting question of why patients would ever want to leave. (Happily, staff retention is high.) But as with all effective mental health interventions, they motivate us to recover and enable us to do so sustainably.

All the best

Marion