1. Carers’ Support Services in Middlesbrough
Involving carers in service development and evaluation
Heather Watson
Carers’ Support Team Lead, Middlesbrough and Stockton Mind
Dr Deborah Harrison
North Of England Mental Health Development Unit (NEMHDU)

2. Service Background
Born from an existing group of mental health carers in 2004
Funded by the PCT now CCG
Flexibility to shape the service to meet 6 key outcomes
Flexibility to offer support as and when needed

3. What does the service offer?
1-1 emotional support
Information and advice
Peer support groups
Workshop style courses focused on wellbeing
‘Me Time’ groups
Advocacy
Carers’ Support Plans
One-off information events

4. The Triangle of Care, Carers Included: A Guide to Best Practice in Acute Mental Health Care (Carers Trust, 2013)

5. Consider the Carer Training
Aims of session:
To increase the understanding of the mental health carer role
To understand the needs of mental health carers and establish more effective ways to support them
To recognise the value of including and involving carers in the care of their relatives or friends
To recognise the valuable contribution that carers make to society
What the session covers:
Who are carers?
What do mental health carers do?
Carers rights and legislation
Communication and confidentiality
Relapse and recovery in relation to carers
How we can support carers better

6. Evaluation Methods
Aim to explore carer experience of the service and any reported health, wellbeing or wider outcomes
Client survey of 85 carers (40% response, n=34)
Semi-structured interviews with carers (n=11)
Qualitative session with the programme team
Carer involvement/engagement included providing feedback on study aims and evaluation tools, monthly newsletter updates and a final dissemination event
Aim was also developmental, in the sense that the service team wanted to use the study to help them look at how data can be collected moving forward, any gaps in current processes etc.
Survey explored a) Experience of using the service and b) subjective perceptions of any changes to health, wellbeing, quality of life. Profile, service-related journey, satisfaction ratings with different aspects of the service, any changes to overall health, stress levels, family relationships, other aspects of life etc. Agree/disagree items statements related to confidence, coping, perceived ability to achieve goals. Also opportunities for open-ended response.
Interviews took place over the telephone to maximise resources, however other options were offered.

7. Key Findings Extremely high levels of satisfaction
Improvements in self-rated health and wellbeing, stress levels, family relationships and leisure time activities
Improved confidence, ability to cope and emotional strength; reduced isolation
‘I have worked myself from a very dark place to somewhere I feel more comfortable, and with their continual support I become stronger on a daily basis… without that service, in all honesty I don’t know where I would be at this moment in time.’ (R27, questionnaire respondent)

8. Success Factors Skills, characteristics and knowledge of the team
Flexible approach – responsive to changing need and variety of support options
Accessible service – fast response, easy access and readily available
Long-term, dependable and consistent
Holistic, person-centred approach
Carer support workers described as hard-working, compassionate, easy-to-talk-to, non-judgemental, conscientious.
Service described as ‘rare’ and ‘unique’. Unconditional, dependable part of carers’ lives – allows intensive support at times of crisis, and there in the background as a ‘safety net’ at other times.

9. Contribution of core service elements
1. One-to-one support
Opportunity to talk openly – ‘I matter’
Safe, non-judgemental environment
Outside perspective and a sounding board
Tailored, individual and flexible
Not just listening – information, practical help, action plans, signposting
2. Peer support groups
No longer alone
Meet others with similar experiences
Share a joke, ideas, information
Reassurance: ‘I’ve been there and things will get better’
‘Pool information’ to identify service issues
3. ‘Me Time’ craft group
Response to identified need for ‘time out’
Socialise, relax and take time for yourself
No longer ‘just a carer’ – feel energised
Can ‘just be’ - no pressure or expectation
Leave caring responsibilities at the door
4. Information sharing and training
Source of information and practical advice
Things that matter: Legal info, finances, rights, diagnoses
Developing skills and building insight into services and conditions
Platform for discussion, catalyst for change
Point of interest emerged around contribution of individual service elements to overall carer experience. Distinct, unique contribution to the service as a whole. Carers able to dip in and out as needed.

10. Positive Experience
‘It was just the instant connection with people who knew what I was talking about, understood the kind of difficulties we were having, accepted the situation… The fact I didn’t have to wait, just an instant referral and we were put in touch with somebody who over a long period of time has in all sorts of different ways and at different levels provided help and support…
It’s not that I’m forever on the doorstep at Mind but it’s just there in the background and I get involved with things as and when.’ (R01, interview discussion)
Report itself has lots of examples and stories to illustrate the success factors – this one summarises quite well (Page 23 of full report).

11. Recommendations
Enhanced routine collection of accessible, in-depth client data (including demographic details, referral routes and outcomes measures)
Further exploration of support requirements for under-represented groups (including male carers, those who work full-time, younger carers, more diverse ethnic backgrounds)
‘Looking outwards’: Continued awareness raising, professional training and service promotion (including outreach work and making the Carers’ side of Mind more visible)
… In addition, carers also made some specific recommendations for future development, such as the development of additional ‘time out’ style groups with alternative foci, more information sessions with invited speakers, and development work around the physical health of carers.

12. Full report available online:
ts-services/carers-support.aspx
Full report is available on Mind website and on NEMHDU website. We also have some copies of the executive summary here with us.