Well-being pilot helps mental health service users

The Recovery and Well-Being Group consists of a programme of 12 weekly sessions aimed at improving the physical and mental well-being of people with severe and enduring mental health problems.

Designed by recovery and well-being senior adviser Dawn Jenkinson and support, time and recovery worker Stephen Jones at Barnsley primary care trust, the pilot scheme incorporates a range of educational and interactive demonstrations. It also includes group participation sessions intended to improve the quality of life for service users by facilitating small but sustainable lifestyle changes.

The programme was set up following routine assessments of physical health checks conducted at the local clozapine monitoring clinic. Patients at the clinic regularly expressed concerns about their weight as well as a lack of confidence and motivation.

The assessments also revealed high rates of smoking and its associated risks and an increased risk of diabetes, as well as concerns about adopting a healthier lifestyle.

Pioneering pilot

The scheme was the first of its kind in Barnsley that underpinned the chief nursing officer's review in 2006 recommending the need to adopt a holistic approach to well-being.

The programme is also in keeping with the Department of Health paper Our Health, Our Care, Our Say, which calls for better service user involvement and service delivery.

The scheme has been presented to the recovery clinical governance board and forms an integral part of the PCT's overall nursing strategy. Service users are currently referred to the group from community mental health teams; early intervention, recovery and assertive outreach teams; and the rehabilitation ward. Attendance at the group is voluntary.

Each one and a half hour session includes contributions by specialist practitioners such as pharmacists, dieticians and medical staff, as well as participants from past programmes who have asked to help facilitate future sessions.All participants are assessed in their first session to record baseline observations, including resting pulse, blood pressure, body mass index, weekly units of alcohol, nicotine intake and physical exercise. Mood, psychological well-being and anxiety are measured using self-rating scales.

The initial assessment highlights specific areas to focus on and identifies the level of input required by each participant. This ensures a tailored, targeted session based on each user's needs.

Recording achievement

Each participant has a handbook or folder in which to record their achievements. Although each session is designed to stand alone, service users are encouraged to attend all 12 sessions. Once sessions have finished, the scheme provides the added benefit of signposting other specialist services and ways to help participants help themselves. Forexample, the cook and eat session involves participants cooking their own meals and eating them in a social setting with others. The handbook provides a useful reminder for participants to continue to improve their skills and maintain motivation at home.

To increase the accessibility of information in the handbook, an interactive CD-ROM is being developed that can be taken away by participants. For those without access to a computer, there is a DVD with audio commentary that can be played on a home DVD player. Written information can be translated into several different languages.

The programme, now in its second year, has recently been through its second audit, with glowing feedback from service users. Recovery and well-being team leader Jane Taylor says: "Historically, people receiving these services have been difficult to engage with and therefore reluctant to access mainstream activities. However, we've found that because the programme is open to all ages and is service user driven, it promotes empowerment and social inclusion."

The audit results support this, showing that the programme managed to increase feelings of social inclusion, motivation and self-esteem considerably among the group.