Alternative Approaches to Crisis

1
Alternative Approaches to Crisis

• Learning from Leeds Survivor Led Crisis Service

2
Who we are

• Established in 1999 by a group of campaigning
  service users
• An alternative to hospital and statutory services
  for people in acute mental health crisis.
• The service is governed and managed by people
  with direct experience of mental health problems.

3
What we do

• Connect Helpline open every night of the year,
  6-10.30
• Dial House Place of sanctuary and support, 6pm
  2am Friday Sunday
• Group work
• Coping with Crisis
• Coping with Christmas.
• Visitors Social and Support Group

4
Who we work with

• During 2007
• 149 people made 921 visits to Dial House.
• There were 3585 calls to the helpline.
• 38 of visitors to Dial House were suicidal.
• Self Harm was a presenting issue in 30 of
  visits.
• Abuse in the past or present was a presenting
  issue in 22 of visits

5
Therapeutic Approach

• Person Centred Approach
• Core conditions of empathy, congruence and
  unconditional positive regard
• Self Actualising Tendency
• Non Directivity

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An Accessible Service

• In the voluntary sector without statutory powers
• Taxis transport people to and from Dial House
• Childcare provided

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Pure Madness

• Pure Madness, how fears drives the mental health
  system
• By Jeremy Laurance (Routledge, 2003)
• a system driven by fear, in which the priority
  is risk reduction through containment by
  physical or chemical means.

8
Our approach to managing risk

• Not living in fear
• Trust
• Giving people as much control as possible.

9
Talking Openly

• We believe that talking openly about suicide
  takes away the stigma and opens up opportunities
  for positive change.
• Maytree website
• www.maytree.org.uk

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Trust

• We believe that the seemingly high risk option
  of sticking with trust often, in the end, carries
  less risks
• An Evaluation of the Maytree Respite Centre, By
  Dr Stephen Briggs et al of the Tavistock and
  Portman NHS Trust.

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Visitor and Caller Feedback

• Collected through
• Visitors books and questionnaires
• Postal questionnaires
• Visitor Reviews
• Evaluation of group work
• Narrative work with visitors
• Visitor and Caller Focus Group

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OUTCOMES

• Reducing risk/ Preventing worse happening
• Supporting people to resolve or better manage
  crisis

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Reducing Risk

• Thank you so, so much. Id be dead now if it
  wasnt for you or somebody else would be. It is
  good that you are always here
• I have had an extremely difficult week
  culminating in self harm again but coming here
  has prevented that and I think when I go home
  will be able to take my meds and go to bed
  without harming myself.
• By preventing me from self harming and ending
  up in hospital. By listening, not judging and
  involving CRT when Ive needed them.

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Supporting people to resolve or better manage
crisis

• By talking about whats going on for me. It has
  helped alleviate some pressures even if it is for
  one hour, one night or short term. It helps with
  the right now.
• Trust, by coming here Ive learnt to trust .You
  in turn help me to trust others outside Dial
  House for support when I need it,
• The help I have had to deal with my immediate
  crisis I try to use with regards to things long
  term. I have attended the coping with crisis
  group which helped me identify coping strategies
  and I now try to put them in place.

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The five elements of effective support

• Listening
• Treating People with warmth, kindness and respect
• People dont feel judged or assessed
• Being in a different and calm environment
• Peer support.

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Listening

• Because of the way he puts himself across
  people in mainstream would not take him seriously
  and listen properly. In this centre, people are
  listening with extreme compassion.
• It has made me feel wanted. I can talk to
  someone who listens. I leave feeling warm, rather
  than with a cold heart as if Ive got nowhere.

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Treating people with warmth, kindness and respect

• Id like to thank all the staff for being
  supportive towards me, I find it a bit strange,
  cos I am not used to it
• The staff are so nice theres not one member
  of staff you cant get on with theyre all nice
  and helpful. They dont talk down to you. They
  talk to you like youre a normal person they are
  not cold. How staff talk to you makes a
  difference.

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People dont feel judged or assessed

• You listen, you dont judge, you dont tell me
  what to do.
• It is different to other services it is
  easier to talk to staff. Staff are nice. They
  dont judge you or put a label on you saying
  thats whats wrong with you.

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Being in a different and calm environment

• Thank you for getting me away from the funny
  farm for a couple of hours, the peace and quiet
  was a nice change from the noisy, hectic, crazy
  ward.
• Its like a sanctuary here, I calmed down as
  soon as I walked in, feel safe and more like me
  again.
• What a lovely place! Dial house is calm,
  peaceful and welcoming.

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Peer Support

• It has given me comfort to know there are
  others with similar problems to me.
• I couldnt trust strangers before coming here
  and now I have made some friends and met some
  lovely people.
• It gives me a break. By being around people in
  the same situation as you you are not having to
  feel ashamed.

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How is it different to other services?

• Self referral rather than going through a
  damaging NHS system.
• Staff caring, house calming, you feel welcome
  respected.
• Arrive in a crisis/panic before you need a
  drink/tablets etc (other services wont take you
  until you have self-harmed or in real emergency
  i.e. police turn up)

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External Recognition

• Guardian Public Services Award for Customer
  Service (2006)
• Guardian Public Services Award for Service
  Delivery Complex Needs (2007)
• Community Care Excellence Network (2008)