Supporting our Local Services

The PFG weekly meeting focussed on giving feedback on the mental health crisis team.  The group presented individual experiences of the local service and were pleased to welcome Gus and Paula from RDaSH to the meeting.  We are particularly proud of our members who shared their individual experiences and hope that everyone found the meeting beneficial.  We are really pleased that RDaSH attended our meeting and listened to the groups views. We hope that this will be the first of many opportunities to work in partnership with RDaSH to support our local services to be something that we can all be really proud of.  (Read more on what our members said)

The PFG are committed to supporting the improvement of local services and value the opportunity to feedback information and be involved with strengthening local support services.

The PFG asked 36 citizens who have a mental health diagnosis their views and experiences of the crisis team in Doncaster.

30 people from the citizens we asked had accessed the crisis team within the past four years.

Of the 6 people who had never had contact with the crisis team, 2 advised that they had strong family support in times of crisis and 3 advised that they had not contacted the service because of negative views expressed by their peers and 1 did not know about the crisis team.

7 people had accessed the crisis service in the last twelve months.

1 person reported regular contact with the crisis team.

The main themes expressed:

Lack of empathy or understanding from professionals

A constant theme appeared to relate to the inter-personal skills of professionals working within the crisis service. Many people expressed that they felt ‘dismissed’, ‘invisible’ and ‘worthless’. Most people reported that they felt that their problems were minimized. Some people advised that they were not ‘listened’ to.

Three people reported getting ‘told off’ for contacting the crisis team which has prevented any further use of the service through fear of being perceived as a time waster.

A number of people described being made to feel ‘weak’ when they had self harmed.  One person described that at times when they self harm they already feel inadequate and worthless and the staff attitude reinforces this perception which leads to more acts of self harm.

Lack of consistency

People described receiving visits from the crisis team as ‘frightening’ and often led to increased anxiety.  It appears that the main reason related to never knowing who would be coming and having to go through the same things time and time again with strangers.  Lots of people felt that if daily visits required that every effort should be made to have consistent staff. 

Clarity about the Crisis Teams role

A constant theme related to people being unsure of the role of the crisis team and what they should expect from the service:

Is it a service where you can phone and talk to someone for reassurance to stop problems escalating to crisis point?

Is it a service that will come and see people face to face? People described great difficulties in securing a visit during times of crisis.

Is it to provide a pathway to hospital or other safe place?

People also asked how he teams remit had been developed and whether people who use services have had direct input into what is needed. 

Information Sharing

Most people reported that they had not seen a care plan or any written documentation about their contact with the crisis team or what would happen after involvement stopped.  People described feeling confused about where the crisis team fits with the other mental health services.

Confusion over name change

People reported confusion about the change of the service name and what the remit of the team is.

Lack of service user involvement in decision making

A number of people reported that decisions were made about their care without their input or involvement.  This seemed particularly evident when people expressed the need to be in a safe place.  People felt that not enough weight is placed on people understanding their own mental illness and having insight into their periods of decline.  People described having insight appeared to be a barrier to receiving support rather than being recognised as an expert in their own experiences. Lots of people said that they felt crisis periods and acute hospital admission would be prevented if their opinions were taken seriously at the point of requesting support.

Defining Crisis

People recognised the individual nature and perception of crisis and felt that their interpretation of crisis was often dismissed.  People accepted that what for one person is not a crisis may be for another person.  People also understood the difficulties that staff would have in assessing what is a crisis? People felt that there needs to be a broader agreement of crisis definition that places more weight on the individual’s perception and experiences. This included recognising social crisis as opposed to simply medical crisis.

People also reported greater confusion caused by services ‘accepting responsibility to respond to need’.  There were numerous accounts of the crisis service advising that people needed to contact the local authority and then the local authority saying that it was the crisis team they needed.  People described ‘giving up’ on trying to secure help by both services saying it was not their responsibility, this was particularly evident where there were both physical and mental health needs.

People said they were not actually bothered who responded as long a someone did and felt that it was too much to ask for them to ‘argue’ with the services.  People felt this should be a professional role to agree responsibility but it needed to be done swiftly.

Value of the Crisis Service

The overall views expressed that they believed that a Crisis Service was an integral and valuable service within mental health.  It was named as one of the most important services as this was felt to be the service that supports people when they are at their lowest.

What people said they would want to change and how they felt that this could be done:

1. Clearer information for people about the crisis service.  It was felt that this information should clearly cover – how to contact the service, what to expect from the service and what to do if people were unsatisfied with the service received. This should be written in clear, understandable language as in times of crisis people can not take in lots of information.
2. People felt that it would be beneficial for the staff of the crisis team to receive real service user feedback explaining how their responses impact on people using the service.
3. Development of a ‘customer service’ charter.  Written by service users as a minimum requirement of how people should be treated.
4. Increased honesty in decision-making and increased inclusion in decision making processes.
5. A minimum time allowance for calls made to crisis team so people felt that they had an allotted time which was just theirs.
6. Increased community alternatives to hospital.  Many people identified that often there is a need for ‘respite’ of between one night and one week that is easily accessible to prevent deterioration or acute admission.
7. Swifter and easier access to community support.  People identified that during periods of crisis a Personal Assistant for a time limited period would prevent deterioration and possible hospital admission.
8. Improve service user confidence in the service.  People felt that most of the information they heard about the crisis team related to negative accounts. People felt that more effort should be made to share positive accounts.  People felt that they may be more inclined to use the service if they knew of people who had positive experiences.

The Personalisation Forum Group would like to work in partnership to achieve a full co-production model to improve our local services.