A pioneering mental health partnership in Sheffield, that has just received national recognition, is making a difference to the lives of people across the city. Laura Drysdale reports.
Lifeline. In that one word, Sandra Perry encapsulates the impact that a pioneering mental health partnership has had on her life.
For nearly five years, she has been supported by an NHS team that is changing the way that care is delivered for people with mental illness.
The Community Enhancing Recovery Team (CERT) offers rehabilitation packages to people in their own homes, as an alternative to hospital admission or a pathway out of it, helping in particular, those placed in inpatient units miles away from Sheffield to return to the city.
Working with South Yorkshire Housing Association (SYHA), under the banner of the LivingWell partnership, it provides intensive help to adults with mental health issues ranging from bipolar to personality disorders, schizophrenia, anxiety and OCD. Staff work together to offer a home to service users and tailor a bespoke package of care for each individual for up to 24 hours a day.
Support can include cooking, cleaning and house maintenance, assistance with integrating into the community and accessing services, help to overcome anxieties such as using public transport, and help with sorting benefits and bills, as well as nursing and medical care.
'Nothing is too much trouble'
“The CERT team have supported me in every way,” says Sandra. “They never judge. Nothing is too much trouble.”
The 65-year-old was placed in hospital care after struggling with her mental health following the loss of a family member.
She was helped by the partnership to leave Sheffield’s Forest Close inpatient rehabilitation centre and move into a flat, where she receives regular support visits. “They’ve been a lifeline to me,” she says - and she repeats over and again her wish for a similar model for children. “If they are late, I’m on the phone saying please don’t discharge me, please don’t kick me out of my home.”
“If they didn’t come, it would be quiet, very quiet,” she adds. “If it weren’t for my visits I would be isolated and lonely. It’s so nice. I can’t wait for them to come.”
On the day we meet, she is given a lift by staff to a community band, where she plays tambourine, sings and dances. “There’s nothing they won’t do,” she says. “I can’t thank them enough.”
Making a difference
So far, the partnership has supported around 50 people and CERT, set up by Sheffield Health and Social Care NHS Trust, was recently presented with a national award in recognition of the work.
It says it has not only transformed patients’ lives but has also reduced the number of costly out of area treatment bed nights by 99 per cent, as well as cutting emergency department attendances and hospital admissions, saving the NHS hundreds of thousands of pounds.
“We are an alternative to inpatient care, so if our service wasn’t available, people would generally be in hospital,” explains Emma Carr, a recovery coordinator with CERT, which marked its 5th anniversary last month. “We are quite intensive and because of that we can enable people to stay in the community.”
It is a pioneering model, offering housing and wraparound care in one package. Other trusts have already been invited to see the scheme and its impact, and it is hoped it will be rolled out more widely.
“If we can reproduce this across the country, it means there will be even more money reinvested in patient care,” Professor Tim Kendall, NHS England’s National Clinical Director for Mental Health, says. “But the really key step is having the housing to be able to bring people back to.”
Referrals to the partnership are typically made from locked rehabilitation centres, inpatient wards, forensic services and community mental health teams. Some of those people, with complex mental health conditions, have spent more than a decade in inpatient care. There is no tenancy length as part of the scheme. People are able to stay in the homes they are given for as long as they want.
“South Yorkshire Housing is used to working with a wide range of people who would be considered by most to be quite high risk to be living independently,” says Charlotte Murray, director of care, health and wellbeing at SYHA.
“With the right support, for the individual, and the neighbourhood as well, there is absolutely no reason why those individuals shouldn’t form part of the community and live in properties that are not hospital environments.
“Despite perceived risk that these people may be a danger to themselves, a danger to the neighbourhood, a danger to the community, a danger to the property, in actual fact we have found with the right level of support we haven’t had to evict anyone.”
Sandra says support from neighbours in her community in Heeley has helped her too, but she has still experienced stigma, including people shouting at her in the street. “They think you’re a danger to yourself. It’s not fair, but they don’t understand me. It’s important people do understand though because one of these days it might be them.”
The partnership sees part of its role as working with neighbours and the community to aid greater understanding around mental health. “Sometimes behaviours, especially when people are at their worst point, can be quite frightening,” says Charlotte. “A lot of the time it’s that people don’t understand the wider picture and they’re frightened.”
“No one wants to live in hospital, as good as they can be,” she adds. “People aren’t having freedom and independence whilst they are in hospital. By being in the community, they can integrate with society.”
The association’s ethos is that a stable home is needed as a foundation for people to build on and the partnership is focused on people receiving help in their local area, close to support networks.
“Quite often people are placed miles and miles away from home in hospitals that are in quite remote places so there’s no push towards reintegration into the community,” Charlotte explains. “On top of that, if they’re placed in Huddersfield, for example, and they’re from Sheffield, it makes it really difficult for their family and friends to visit and so they then become very isolated and their whole world becomes at the hospital.”
When service user Terry Proudfoot was placed out of area in Bradford in 2010, experiencing emotional distress, depression and self-harm, she says she didn’t have chance to tell her family and felt “completely on my own”.
After a placement on a rehabilitation ward in Nottingham three years later, she was then supported by CERT to return to Sheffield. “For me it’s quite important being back somewhere that I know,” she says. “If I go out the door, I know where I am, I know which way to turn...It really is that familiarity, that comfort of being in a place that you can call home.”