Mental Health Network (Greater Glasgow) “Let’s create a safety net.” Peer-Promotion of Advance Statements Project.

Who are we? Mental Health Network (Greater Glasgow) is a ‘service user led’ charity which acts as a collective advocacy voice for people with a lived experience of mental- ill health and their carers in the Greater Glasgow area. We as this we have a membership of c.600 people and have been in existence since We currently jointly hold a contract with NHS Greater Glasgow & Clyde to facilitate ‘user involvement’ work relating to mental health services. In 2009 we were asked to support an initiative to increase the uptake of Advance Statements in Brand Street Resource Centre. From this we began to look at how we could best support people who wanted to make a statement. In 2013 we received funding from Voluntary Action Fund to develop the peer promotion aspect of our work and in April 2015 this year we received further funding to continue our work looking at increasing the uptake of advance statements.

So what do we do? We facilitate Peer Led Sessions to promote the uptake of Advance Statements. In these sessions peer volunteers who have used an Advance Statement talk about their experience of receiving treatment and the difference having made an advance statement made. We then facilitate a discussion about what a participant’s Advance Statement might include. This approach allows for a natural discussion of illness, crisis and support, can challenge any preconceived notions that might prevent a person making a statement and can even motivate a person to make a statement. Our aim to equip people with a previous lived experience with the ability to create a well-written, practically useful Advance Statement that will improve crisis response and treatment, inform the decision making process and protect a person’s rights. These sessions take about an hour to facilitate, are free and can support existing work you are doing with a patient.

So what’s different about what we do? Our Target Group: People who are currently well, but foresee becoming unwell again at some point in the future. This is a significant percentage of people currently within the mental health system and a large majority of admissions within GG&C are in fact subsequent admissions. Our approach is about prevention, particularly of foreseeable crisis. Peer Approach: Our volunteers are peers who have used their Advance Statements to improve their treatment. Some have had multiple admissions, some have had a statement for nearly ten years, all have developed their statements as a result of their experiences of detention and compulsory treatment.

So what’s different about what we do? We focus on treatment and prevention: People engage with this topic much better through the prism of their own lived experience and this often means they leave the session motivated to make a statement. Practitioners are also more comfortable with this approach in our experience. The work is holistic and encompasses the social aspects of a person’s life: We also discuss the personal statement in order to capture many of the important issues relevant to treatment but not under the aegis of an advance statement (e.g. physical health, children, finances, housing, religion, advocacy). This is often seen by participants to be MORE IMPORTANT than the Advance Statement in many cases.

So what’s different about what we do? We discuss distribution: The statement has to be available when needed otherwise there is little point in having one. NHS GG&C has two computer systems which means that the statement should be available to mental health services 24/7, 365 days a year. This also means that the statement can be used as a tool to improve crisis response. The aim is to develop a statement that is CREDIBLE: Our acid-test of a statement is whether a total stranger could read it and it would seem well reasoned and thought out. The statement should be balanced and useful as a means to improve treatment, e.g. highlighting both positive and negative views, giving insight into a person’s ‘recovery’, a statement that is of practical use in improving a person’s treatment when acutely unwell.

Results: Session take up: We’ve done over 41 sessions with c.90% take up (37). Some people have required additional support to develop their statements and to discuss them with significant individuals (e.g. Carers and family). Evaluation: Even people who haven’t made a statement have been positive about the concept. Social isolation appears to be a barrier limiting the development of support mechanisms for some as does not having regular access to a dedicated mental health resource (particularly as a signatory). The greater the delay the more likelihood a statement won’t be developed. Resource development: As part of the project we will be seeking to develop dedicated resources to enable this topic to be discussed in a much more informed and person- centred way (video and accessible formats). We will be supporting work by the Mental Welfare Commission to this end also.

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