Paula Mills

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• Paula Mills
• Clinical Specialist
• The Meriden Family Work Programme
• paula.mills_at_bsmht.nhs.uk

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The Meriden Family Work Programme

• The Meriden Programme was launched in 1998 in the
  West Midlands region and is currently funded by
  the 13 NHS Trusts providing mental health care.
• Small multidisciplinary team of 7 staff, managed
  by Dr. Grainne Fadden.

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Aims of the Meriden Family Programme

• To provide services that are family-sensitive.
• To ensure that evidence-based family approaches
  are available to families across the West
  Midlands.
• To support the implementation of government
  policy (i.e. NSF, NICE guidelines).
• To ensure that staff have the skills necessary
  for carrying out this work.

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PROGRAMME MODEL

• Cascade training model we train staff as
  trainers who train staff from all disciplines on
  in-service training courses and provide
  supervision.
• Close involvement with management on an on-going
  basis to problem-solve issues relating to
  implementation.

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The Meriden Programme Model

• Cascade training programme
• Supervisory groups ongoing
• Ongoing training for trainers
• Special interest groups (4)
• Regular meetings with managers in all services,
  and feedback to services
• On-going problem-solving with management

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Why work with families?

• Common sense
• Moral/ethical argument
• Research evidence
• Policy

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Effects of Mental Health Problems on Families
Concrete

• Financial difficulties
• Constraints on social activities
• Effects on work/employment
• Effects on children
• Effects on health
• Disruption of household activities

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Effects of Mental Health Problems on Families
Emotional

• Stress
• Sense of loss
• Effects on own mental health
• Family relationships strained
• Emotional reactions anxiety about the future,
  fear etc.

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Family Intervention StudiesRelapse Rates at
6-12 months
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Recent reviews and meta-analyses

• Pitschel-Walz et al (2001) Psycho-educational
• interventions are essential to schizophrenia
  treatment.
• Bustillo et al (2001) Psycho-educational family
  intervention should be available to the majority
  of persons suffering from schizophrenia.
• Pilling et al (2002) Family intervention should
  be offered to people with schizophrenia who are
  in contact with carers.

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Government Policy Endorsing Family Work

• National Service Frameworks (1999)
• NHS Plan P.I.G (2000)
• Developing services for carers and families of
  people with mental illness (November 2002)
• NICE guidelines for Schizophrenia (December 2002)
• Delivering Race Equality (2005)

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NSF 6 The Carers Standard

• All individuals who provide regular and
  substantial care for a person on CPA should
• - have an assessment of their caring, physical
  and mental health needs repeated on at least an
  annual basis
• - have their own written care plan which is
  given to them and implemented in discussion with
  them

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NICE Guidelines on Schizophrenia
Standard Family interventions to be offered to
100 of families of individuals with
schizophrenia who have experienced a recent
relapse, are considered to be at risk of
relapsing, or who have persisting symptoms, and
are living with or in close contact with their
family. All individuals who receive family
interventions should be offered more than 10
sessions, the course of treatment lasting for
more than 6 months.
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Psychoeducational Approaches

• What is offered is based on an assessment of the
  family and family members
• Strong educational component
• Focus on skills acquisition and communication
• Collaborative working relationship

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Psychoeducational InterventionsGeneral
Guidelines to Ensure Effectiveness

• Service user and family seen together
• Educational and behavioural orientation
• Skills acquisition is essential
• Well trained staff

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Behavioural Family Therapy

• Assessment
• Sharing of Information
• Enhancement of Communication Skills
• Problem Solving and Goal Achievement

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MERIDEN - current numbers

• Current number of therapists trained - over 2000
  across the West Midlands.
• Current number of trainers 123 across 13 Trusts.

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Trainer Profile - Profession(n 123) June 2005
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Professional Breakdown of TraineesJuly 2005
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Pre-Registration Training

• 5 day training currently running with
  Wolverhampton University (Nurse Training).
• Positive feedback received.
• Further details contact Mr Robert Peumalu
  (Lecturer Practitioner)
• robert.peumalu_at_smhsct.nhs.uk

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Pre-Registration Training

• Potential Benefits
• Increased likelihood of Family Work being seen as
  core business?
• Students more open-minded to new ways of
  working?
• Increased implementation rates?

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Contact Details

• www.meridenfamilyprogramme.com
• Telephone [phone]