Hello Lovely Members!

We hope you received our recent newsletter about Ward Buddy, our exciting new Recovery Companion. Ward Buddy is here to accompany inpatients through various experiences of ward life; from arriving on the ward to the rediscovery of hope, amongst other themes. We hope you love Ward Buddy as much as we do and that you feel enthusiastic about introducing it to your patients (including it in the welcome pack is a great way to do this). Wed really appreciate your feedback and comments about Ward Buddy so do please get in touch! Ward Buddy is an example of self-directed learning; it combines reflection, peer-support and is focused on moving forward. And this nicely leads us on to the theme for this newsletter: patients learning and developing, through group and self-directed activities. During my hospital admissions, Ive found it invaluable to be able to understand more about my illness and to expand my (dodgily limited!) constructive coping techniques. This has made a real difference when Im back home without the intense support of expert ward staff and just Buddy to keep me on track! Group activities are at the heart of an active ward life, but you may be less familiar with Recovery Colleges, although some of you will be working in Trusts which provide this fantastic new opportunity for service users to learn and teach alongside other service users, staff, friends, family and anyone else interested in learning more about mental health. Were really excited about this impressive development. Recovery Colleges are all about co-production and working together; they convey messages of hope, empowerment, possibility and aspirations. And now that many patients arrive with smartphones, the recent explosion of mental health apps include those which can neatly complement the intense help provided by staff and other patients. These days you can get an app for almost anything! And its no different when it comes to mental health, with apps supporting people with information, hope and support. As well as including almost 1,000 examples of great practice, Wardipedia is full of many brilliant examples of creative, therapeutic group activities being run by wards. If you havent already done so, please do take a look its a great source of ideas for ward activities and other opportunities for patients self-development, including through their involvement in how the ward, hospital and Trust are run. Were very grateful to all the contributors to this newsletter, and would love to hear from you about anything you might like to write (draw, sing...) for a future newsletter.

Contents
In this newsletter youll find: Introducing Ward Buddy Wardipedia a great source of ward activity ideas and more! Ward Activities: Pointing to Life Beyond the Hospital Walls. By Nick McMaster Why do we do? By Kate Fletcher Star Group Activities. By Kee Hean HCAs Running Groups. Pauline Cooper Providing Meaningful Activity on a Busy Ward. By Sam Wilson The Therapeutic Liaison Worker. By Nic Higham South West London Recovery College. By Debbie Cleaveley Recovery College East. By Sharon Gilfoyle The New Smart Phone App from Northumberland, Tyne and Wear NHS Foundation Trust Top 10 Mental Health Apps. By Sandra Kium

Ward Buddy

Ward Buddy Your Recovery Companion

What is Ward Buddy and how can it be used? Ward Buddy is here to accompany inpatients through various experiences of ward life; from arriving on the ward to the rediscovery of hope, amongst other themes. The booklet is filled with experiences of recovery and mini snippets of ward life that have been kindly offered and beautifully illustrated by people who have had stays on mental health wards. A little note from Marion During my hospital admissions, one of the hardest things has been coping without Buddy, my constant, slightly ridiculous, loving companion. But she does come with me on our many visits to hospital wards around the country, and we both appreciate the enthusiasm with which shes always greeted by patients. (One of us instantly flips over onto our back to have our tummy stroked. Frankly its the better behaved one of the pair.) When Ive been in hospital, Ive been frustrated with the lack of selfhelp materials with which I could reflect, plan, rant, organise, doodle, learn and accelerate my recovery. We really hope that Ward Buddy helps your patients make best use of their time in hospital, however reluctantly or sadly they may be there. Im very grateful to all the service users who have contributed ideas and thoughts about what helps them not just tolerate or cope with being in hospital, but actually make progress, on their own terms, day and night. And a big, huggy thanks to Nic and our SU Crew for creating this delightful recovery companion.

Download and print Ward Buddy here:

www.wardipedia.org/wardbuddy/

Wed love it if Ward Buddy were to be used in all sorts of ways on your ward! Read below for some ideas on how to use it.

Ideas on how to use Ward Buddy Include it in patient welcome packs! Ward Buddy provides a gentle and useful introduction to ward life, with a strong peer support approach. As a journal or diary. Expressive writing can have a significant therapeutic effect on our mental and emotional health. You might encourage patients to use Ward Buddy as a journal. Users can jot down their thoughts and feelings, as well as their recovery-focused plans and goals. Throughout the booklet there are boxes which can be written in (or drawn in, if preferred). The short recovery stories and mini ward life snippets on each page are intended to inspire and motivate. For example, after reading one of these, patients may want to write down some of their own reflections on its theme. They could do this in the form of creative work like poems or drawings in facilitated sessions or on their own. They may even want to try out some of things the stories and snippets describe, or tell someone else about them. As a note pad. Yes, Ward Buddy can also act as a trusty, simple note pad. Patients can scribble down phone numbers, appointment dates, any important information and ideas they have while on the ward. As a way to plan and remember what to speak about with staff. Ward Buddy can help prepare and prompt your patients to share the things that matter to them with nursing staff and their doctor as well as other key people. As conversation starters. The little snippets of ward life throughout this booklet are great conversation starters and topics to chat about with others, including in ward activities. Use it alongside recovery plans. If your ward provides a recovery tool (for example, Wellness Recovery Action Plan or the Recovery Star) your patients might like to use Ward Buddy as inspiration. You could print it and bring it along to recovery planning sessions. Simply read it. Theres absolutely no pressure to write or do anything; patients may just want to read through Ward Buddys pages in their own time.

Wed love to hear what you think about Ward Buddy and how your patients are using it. Please do email us: wardbuddymail@gmail.com

Wardipedia a great source of ward activity ideas, and more!

Have you seen our new web site, Wardipedia? This online, collaborative compendium has numerous features to support ward staffs amazing work including 77 ideas for enhancing patients experiences, the evidence base for these, ideas from related sectors and links to hundreds of useful sites, practical resources and documents.

www.wardipedia.org
The scaffolding for Wardipedia is provided by the seven domains of our IMAGINE acronym:

Imagination whats it like for the patient? Mindfulness chilling out

Involvement influence, information, independence Neighbours friends, family, fellow patients Empathy for self and others

Activities social, recreational, physical

Generosity sharing, kindness, giving

Clearly the activities section is the one most packed with examples and inspiration on this theme, but most of the 77 featured ideas have potential activity spin-offs. Here are some which we find particularly delig Animals Creative communicating Mindfulness and silence Bingo and jigsaws Gardening Art Football Charities Pointless national days Complementary therapies Talking therapies

Ward Activities: Pointing to Life Beyond the Hospital Walls

By Nick McMaster, Lead Activities Facilitator Sussex Partnership NHS Foundation Trust Nicholas.mcmaster@sussexpartnership.nhs.uk

In the fifteen years I have been in my role of coordinating the inpatient group programme of a mental health unit in the city of Brighton, the attitudes to what constitutes appropriate activity for this client group have changed dramatically. When I first started I found an activity programme that appeared to be solely built around the interests of the facilitators. Namely, there were a lot of art groups and guitar led sing-a-longs. Every group involved the copious drinking of tea, and patients appeared to be bribed with cake and biscuits to attend. The facilitators were well meaning and very talented in their fields but were stuck in a rut of low expectation, both on them from other staff and from them towards the patients. In art groups for example (where the rooms were much better equipped - as was often the case in old bins) the default position was to offer the patient a colouring-in to do. No discussion about previous art experience or an invitation to look through the materials. Instead: straight out with a line drawing of a cat overlooking a country scene. The system appeared to facilitate the lowest form of common denominator diversion, which just got patients off the wards. However, even I would admit that they these old school approaches did have a level of socialisation and a pace that seemed so humane. And how nice it was to be able to let someone just have a sit down with a cup of tea and chat. How it has all changed. Gone are the days of several year admissions, gone are the low expectations for our patients, gone are even the rehabilitation approaches of keeping someone in hospital, engaging in activity until they are well as they can be. Now we have the fast paced world of acute inpatient care where the wards are locked, where the aim upon admission is to immediately start planning discharge, where the emphasis is based on a decrease in risk rather than an increase in engagement, where the community is king. But we do still have art groups and the occasional sing-a-long. So how do you provide activity when the patients are in for less time but are more unwell? When they may be going back into the community perhaps still not at their best?

How do you avoid the lowest common denominator diversion, not because patients are in hospital for ever without hope, but because they are in hospital fleetingly, with hope and recovery encouraged mainly, appropriately, beyond inpatient walls? Over the last few years the group programme of activity, chiefly facilitated by the Occupational Therapy team has had to adapt. Our group work is much more focused towards helping facilitate discharge and so we have much more of an overlap with the community. Examples include our service user volunteer led knitting group. One of her weekly session is in hospital, another in a caf bar. A recent Yoga project in the hospital also led to patients attending sessions in the community. Another example is my five a side football group run from a local leisure centre. Most of the members started coming whilst inpatients. Most of the members are no longer inpatients. The Acceptance and Commitment Therapy group I co-run is based on a continuous four cycle programme that can be accessed at any time, that is designed to be impactful if even only one session is attended, and is available to attend post discharge. The group also takes referrals from the community, further blurring the boundaries of inpatient care. We are developing a similar structured group for Recovery work. Patients can start using their recovery packs or continue using ones created in the community. Ultimately this should help those who do come into hospital, not to necessarily see hospital admission as the worst part of their journey, but as an opportunity to seek more intensive support. Even the traditional (in other health care settings) Pets as Therapy visit have a dynamic input. Its still a dog (called Princess, Marion) going onto the wards to be petted, but it appears to lead to conversations that take patients not only to happy memories but to thoughts of the future, about being away from hospital. Most of our activities now are orientated to life beyond the hospital walls. There still is a place for a nice comfy art group, but the conversations we have during these are now about empathy, not sympathy, about hope not just happiness, about direction not just diversion, about carrying interests developed in hospital away. We have also focused on bringing more things into hospital. Socially inclusive input is an easy thing to say but harder to do, and very powerful when received. Highlights have been placing the hospital on the mobile library circuit, alongside book drop offs for our ward libraries. The police come in to do fortnightly surgeries and the football group now has regular input from the local professional football club.

Then there are the little things that can unite us all. We have used national events as a way of celebrating just being a part of life, wherever we are. So anything form national sausage week, world mental health day, national poetry day to Remembrance Day and eclipses have all at one time or another been given the Mill View Hospital treatment! Change in the world of the NHS can be a real challenge to both staff and service users. In providing activity we are still subject to these changes. Though the current way our inpatient services are run may not be perfect, they have helped us review our activities and create a much more dynamic, thoughtful provision that is a part of the whole recovery cycle rather than seen as an entertainment cul-de-sac that has value only for the admission. Now like our patients, we too look beyond the walls and towards the rest of life.

~
Why do we do?
Kate Fletcher, Head Occupational Therapist Greenwich Recovery and Complex Needs Occupational Therapy. Oxleas NHS Foundation Trust

Have a think about your typical day. What do you do for 24 hours? Is there any time in your day when you are doing absolutely nothing? The answer may seem like yes, but in fact we are constantly doing. To do means to take part in activity, be that activities that allow us to self-care e.g. getting washed, getting dressed, eating, sleeping; activities that allow us to pursue leisure e.g. watching TV, playing sport, going on holiday; or productive activities e.g. work or education. Activities, though, must have meaning and purpose to allow us to distinguish between existing and living. So what makes activity meaningful and purposeful for a person? Relevant to their culture Falls within their own beliefs, values and preferences Forms part of their normal roles and habits Usually influenced by society Person has an interest in the activity

Pause for thought

Lets think about the ward setting for a moment. A Muslim service user declines to join in the ward activity of making Christmas Cards. When asked to feedback about their involvement with ward activities what do you say?

When an activity is purposeful it is a natural user of time. Without a sense of purpose people are likely to be bored, depressed and can even be destructive. Also without activity people experience time as passing very slowly. This is because when engaged in purposeful activity people may experience flow. From the works of Mihaly Csikszentmihalyi, Flow is the mental state of operation in which the person is fully immersed in what he or she is doing . This loss of consciousness or loss of a sense of time, is linked to happiness.

What does a ward do for doing?

Imagine being in a situation where you are unable to take part in your normal habits and roles. Where you are restricted to a routine you dont have control over. You are told when you should sleep, when you should eat and in between these times there is a lack of activity that you find purposeful. How would that make you feel? Bored? Frustrated? Angry? Depressed? Added to this there may be other feelings: Feeling alone Missing family, friends and familiar roles Often result in feeling out of control with no choice

A study by Radcliffe and Smith (2007) showed that at any one time 84% of in-patients are socially disengaged and mainly inactive. Only 4% of in-patient time was spent in organised group activity. Its no wonder that in many in-patient surveys patients say they are bored with nothing to do. Time is likely to pass very slowly indeed. Therefore it is beneficial to provide purposeful, fun and enjoyable activity for service users.

Benefits of activity in a ward setting

On wards we often hear that Joe Bloggs needs something to occupy his time. Is this an acknowledgement perhaps that having something to do on the wards would provide a better experience for both staff and Joe Bloggs? Lets see what the Department of Health said about it: High therapeutic intervention and interaction environments diminish disturbance, violence and boredom. Poor amenities and lack of structured activity and individual attention promote untoward incidents and create risk. Inpatient units that provide appropriate stimulation and structure as part of individual care plans have a more therapeutic and safe environment. (DH 2002) So, in short theres less boredom and incidents on the ward and a better experience for service users. Also if there are fewer incidents on the ward, it also improves the work environment for staff, and makes for more satisfaction in their jobs.

Here are some more benefits of activity Gives purpose to time Allows for social interaction Improves skills Stimulates interest Allows for choice Provides a role Encourages problem-solving Improves confidence and self-esteem Improves concentration and attention Gives an individual more sense of self Improves motivation and energy So, now that we can safely say that its important for people to be engaged in purposeful activity, lets think about group activities and the value of group on wards.

Types of groups
Throughout our lives we find ourselves naturally involved in groupsfamily groups, school groups, social groups, groups of people on the bus, groups of people in the supermarket. Whats similar about these groups is that the people within them usually have a common interest or goal. When an individual is admitted to a ward environment they immediately become part of that community or group. If an individual does not interact within that group they may feel isolated, despite others viewing them as a group member. As shown above there are loads of different types of groups. In mental health we usually classify groups into activity groups and support groups, or a combination of the two. Some examples of each can be found in the table below:
Activity Groups Cooking Games Sports Art activities Movies Support Groups Psychotherapy Psychodrama Art Therapy Both Community meeting Anxiety Management

We are going to focus mainly on activity groups, however a community meeting is an essential part of every well-delivered ward programme. Some benefits of the Community Meeting are: Encourages sense of belonging Allows service users to contribute to ward development Encourages participation Allows people to negotiate rules Builds relationships between services users, and service users and staff Encourages Interaction Allows people to express feelings Allows people to experience support and sharing Improves motivation

So lets focus on activity groups. In particular activity groups aim to develop skills and/or encourage social interaction. When these are on-going project groups, they encourage basic sharing and interaction (Hagedorn, 1998). However on acute units there is often a quick turn over of service users and therefore they often do not allow for on-going projects. Groups also give us a chance to assess how people are able to relate and interact with others, which may be an indicator of how they would be off the ward and in the wider community. Remember anyone can help and facilitate running a group activity; it doesnt take any particular qualifications. If youre interested, get together with others (staff and service users) and get going!

References
Csikszentmihalyi M (1990) Flow: The Psychology of Optimal Experience. Harper Perennial NY, USA. Department of Health (2002) Policy Implementation Guide: Acute Care Provision. Department of Health, London UK Hagadorn R (1998) Foundations for Practice in Occupational Therapy. 2 Edition. Churchill Livingstone UK Radcliffe J & Smith R (2007) Acute in-patient psychiatry: how patients spend their time on acute psychiatric wards. Psychiatric Bulletin, 31 167-170
nd

~
Star Group Activities
By Kee Hean LIM, Lecturer and Researcher in Occupational Therapy MSc Occupational Therapy in Mental Health Module Leader Brunel University

Introduction Group activities on the acute ward can take different forms depending on their focus. Not all groups need to have a therapeutic focus, although the potential for any activity group to be therapeutic may be obvious from the enjoyment, esteem, improved communication, concentration and social relationships that develop as a result of clients engaging in the group. Group activities within the ward, provide a focus, structure and an opportunity for clients to engage and participate. They also have the potential to improve the quality of the clients admission and stay on the ward.

Some group activities may have to be organised within the ward environment, whilst others could be organised within the hospital based resource centre or may involve venturing into the wider community. Creativity, energy, zeal are essential ingredients in making groups activities happen and work. It is also important to have a positive attitude, that all things are possible and to promote positive risk taking. Crucially we need to remember that the client despite being unwell and in hospital has the capacity to contribute, support, enhance, improve the experience of other clients and promote their own personal recovery.

Group Activities
So what groups and activities can we provide within a Star Ward? Each potential activity will now be introduced, the activity described and the benefits highlighted. Big Breakfast Club. The smell of a cooked breakfast is always a good incentive for waking up and joining in. This group activity provides the opportunity for clients to engage in cooking for themselves, but more importantly in cooking with and for others. Clients can decide on what they are going to make, divide the task between each other and work towards making a delicious breakfast. The Big Breakfast club can also start off the days Community group, where instead of settling for just a cup of tea and biscuits, clients can instead have a nicely cooked breakfast with all the trimmings. On a practical level it will require the ward to be equipped with a kitchen where clients can prepare and cook food. A reasonable budget to buy ingredient is essential and staff need to be organised in deciding with the clients what they want to cook and to accompany (where required) clients to purchase the ingredients needed. It is also important to ensure that the kitchen is well equipped with the basic ingredients, utensils and equipment.

The benefits of making breakfast together include promoting interactions, social relationships, conversation, decision making and division of task. The activity can be highly motivating in getting clients up and about and also enhance the self-esteem of participants, when they receive compliments or notice others enjoying the breakfast. Additionally, staff with the supervision of occupational therapists will also be able to access how clients decide, budget, concentrate, sequence and observe their relationships with others in the group and their general safety within the kitchen. Star Fitness Club. Sport activities have often been regarded by many clients as a meaningful, relevant and beneficial activity. Sport activity groups can be organised at different levels of rigorousness and can take the form of a warm up or stretching group, which can be facilitated by support staff who have some supervision from say a sport instructor to active gym sessions that may take place on the ward and be facilitated by a trained sports instructor.

Supervised staff and support workers may be able to run morning and evening light exercise sessions lasting between 15 to 45 minutes dependant upon the level of fitness of the clients. Some basic equipment like exercise mats, CD player, light weights etc. maybe required for the group. Several acute wards have also in recent time been kitted out with mini gyms; these are good for enhancing the fitness of clients, whilst also providing a productive and positive channel for excess energy and aggression. In all situations supervision of ward staff from light exercise sessions or in the case of a mini gym, having a qualified instructor is essential. Necessary training must also be delivered in preparation, to ensure that health and safety is upheld and not compromised. An assessment of the physical fitness of clients and staff wishing to participate is a necessary step in this process. The Star Fitness club provides fun and fitness, reduces stress levels and improves the overall health and well-being of both staff and clients involved. Some of the obvious benefits of exercising are that it keep you fit, helps to reduce weight gain and promotes overall health and well-being. Exercising also produces endorphins which are the bodys natural remedy in improving mood and well-being. Additionally the ability of the individual client to follow instruction, concentrate, functionally perform task and movement can be evaluated too. Friday Night. The focus of this group is to get clients involved in pampering themselves and one another. This can involve where possible clients having a bubble or scented bath and progress to getting clients involved in styling each others hair, doing their nails, applying make up or giving each other a face or hand massage etc. The success of this group will require the availability of some essential products, from manicure sets, nail varnish, hair curlers, hair strengtheners, essential oils, make up and also a collection of ethnically appropriate products for clients, so that everyones skin and hair needs can be given suitable attention. Clients can also get dressed up for a special evening, which can include a movie evening, a disco or even a karaoke evening. Care needs to be taken to ensure that personal request and requirements are respected. The staff involved in this group may need to have some basic training or instruction and need to also be aware of some of the differing needs.

This activity will promote interactions, safe touch and enhance awareness and respect for self and others. Additionally it can be used to promote a more positive self image and increase self-esteem. Client may also become more aware of their self-care needs and begin to be more motivated in looking after their appearance.

Factor X. This group could be a follow-on from the previous activity, theme nights can be organised including a karaoke night, or say a 60s evening where music of the period could be made available. This could be a weekend event where clients have the opportunity to get dressed up, relax and a light buffet could also be provided. Clients could perform their favourite songs, play the guitar, tell jokes, perform specific skills or even exhibit their art or creative works. Some organisation and pre-planning is essential to making this works and the necessary resources and equipment need to be made available. Staff must not just watch from a distance but need to join in and not exclude themselves from being with the clients, enhancing the rapport between both parties. This is a good activity for all to be involved in terms of performing, cheering, exhibiting, encouraging others etc. Some of the benefits include having fun and enjoyment, stress relief, increasing self-esteem, awareness of others, creative and self-expression, building rapport and even reducing incidences on the ward due to boredom. Comedy Club. Laughter is often considered a good source of stress relief and a good way of breaking down barriers. Laughter and humour have the benefit of promoting health and well-being through the body producing endorphins, natural pain suppressors. As a start, the group can be facilitated by just having some videos/dvds of such humorous television programs or movies as Mr Bean, Only Fools and Horse, Vicar of Dibley, Kumars at 42 etc. This can be then be expanded to include comedy or stand-up performers. This may encourage the group participations to discuss what makes them laugh and if they think humour helps. It may also encourage participants to engage in sharing their own jokes and performing their own stand-up. Essentially it is important to have basic equipment such as a television and dvd player etc. Dvds and recording of television programmes could be borrowed from staff, local, libraries and clients alike. A microphone, perhaps from a karaoke machine, can also really add to the atmosphere. The benefits of the group include a space for clients to have fun, be distracted from their problems, interact and socialise with others. Additional information and ideas can be sourced from www.freewebs.com/laughtertherapy. Some caution may be necessary in the selection of video/dvd materials to ensure that the content of the programmes are not in any way discriminatory or offensive. Window box and vegetable garden. There is something uplifting about seeing things grow and feeling responsible for their growth. If the specific ward is on the ground floor with a garden, then cultivation of a small vegetable garden or flower garden is ideal. Clients can get involved in planting flowers, fruits and vegetables which can be used to beautify the ward or in the case of vegetables harvested and used as ingredients for the breakfast club or other cookery groups. If such a space is not available the cultivation of a window herb garden or flower box, or even simple house plants would be a possible alternative. Basic knowledge around different types of plants and what conditions suit their growth best, would help the process.

Clients can also use the internet, library or resource books to familiarise themselves with different plants and could also take on a role in educating others in the group and demonstrating different gardening skills. The necessary equipment and tools must be available, depending on what is being grown and where, including spades, shovel, watering can, flowerpots, seeds, grow bags, window boxes, hanging baskets etc. The potential benefits include improved self-esteem from growing and harvesting what you have grown. The physical benefits and improved fitness derived from planting, raking, weeding, harvesting. The opportunity to get some fresh air, spend time outdoors and doing some physical work. Further, there is the social benefits of meeting others, communicating, team work, sharing equipment and tackling a task together. Pet Club. The presence of pets and animals on a ward has the potential to immensely improve the ward environment. This could involve simply having a large plastic or glass fish tank, with say an array of tropical fish, or even a resident cat. The idea is not only to improve the ward environment, but to have a group of clients involved in caring for the pets and animals. Clients can for example be involved in changing the water in the fish tank and feeding the fish etc.

This can also promote discussion topics for the group, where clients can get hold of books or internet information about the different types and characteristics of different types of tropical fish and exchange ideas. It the ward does not have the facilities to have pets, it is important to explore the opportunities of inviting regional or local organisations, which are involved in pet therapy. It is becoming more common for such organisations to be involved in bringing pets such as dogs, cats or even hamsters on the ward for patients and clients to handle and stroke. The benefits are obvious from those who have benefitted from such schemes, as it has the potential to reduce stress, provide comfort, improve mood, increased social contact and promoting conversation and discussion. There may be some ward or hospital restrictions in terms of health and safety and hygiene. However, many mental health wards have agreements in place with their health and safety colleagues about being able to have pets on the ward and attempts should be made to see how such requirements can be met rather than them being viewed or used as barriers to making the group happen. Art Gallery. The idea behind the Art gallery concept is to provide the client with the opportunity and facilities to express their creative self. This can take the form of art, pottery, ceramics or even graffiti sessions. The availability of an allocated space whether it be an art room on the ward, or the use of existing rooms for client to undertake their creative task with minimal interruption is key. Basic art material and equipment such as paints, paper, card, brushes, charcoal, clay, mosaics is essential and some supervision from an art instructor or occupational therapists may be required initially.

Staff can pick up the skills required by joining in on the session and then facilitating these sessions, during the day, evening and weekends. The creative sessions could be free expression where individual clients can do what they like, or have a specific theme. Clients in this latter case could be using the different creative media and work on a common theme like Summer, Peace, Friends, Recovery Home, Fun for example. This could lead to an exhibition of the clients work and the ward could act as an art gallery displaying the various works and creative expressions.

Some of the benefits include having a space to be creative, have fun and enjoyment, stress relief, increasing self-esteem, awareness of self and others, self-expression and reducing incidences on the ward due to boredom. You may also be able to assess the concentration, relationships with others and decision making abilities of the client. Star Caf. The idea here is to bring the Caf culture to the ward. The free availability of fresh coffee, tea, herbal tea, cold drinks and little snacks will enhance the atmosphere of the Star Caf. Clients can have excess to a couple of computers with internet/e-mail access, allowing them to keep in contact with their friends, family etc and also be able to surf the internet and gathering information around their areas of interest. Some allocated space is of course required and a couple of older computers can often be donated by the Trust IT department, with some initial help from the IT department to set it up and to introduce any programme restriction if required. The benefits here include providing clients the opportunity to keep in touch and in contact with their friends and family. It further provides access to resources that are widely available and are a ready part of current contemporary culture. Clients can also keep up with their computer and keyboard skills and build on their concentration and attention span. This can be a positive alternative to boredom as clients can productively occupied in searching for information on areas of interest and continue with some productive work. Cultural Carnival. The idea here is to provide an opportunity to appreciate and learn more about others. This could be a specific event with several individual activities that lead up to it. The Carnival could be organised within the ward with the attendance of say a Steel band and different types of ethnic food that clients have prepared within the individual sessions during the week. There could also be a session around Henna painting, making ethnic delicacies or getting dressed in a sari and a contest could be held on the day around different skills for a bit of extra fun. Ethnic music, cultural art and craft and information about different cultural events and festivals could be shared. Clients could get made up, wear carnival themed mask made previously and dressed up for the event. Community and religious leaders could be invited to widen participation and promote greater partnerships. The festival shop at www.festivalshop.co.uk , is a good resource for activities for such a day and provide general information about different ethnic and cultural groups.

The benefits of such an event are that it promotes understanding, respect and awareness of self and others. It would allow clients to be engage in several activities that can lead up to the actual event. It promotes interaction, communication and socialisation amongst clients and staff on a different level and as equals. The fun and enjoyment from the event will also break the monotony of the ward environment. It may have the added benefit of promoting a more positive view of the acute ward and encourage links between community resources and mental health services. Conclusion The groups and activities suggested above are just a collection of potential group activities that can be introduced and organised on the ward, with benefits far beyond stimulating conversation. They have the potential to be stand alone activities or grouped together providing multiple benefits. However, for these activities to take place and be a success, all relevant staff from the hospital, Ward Manager and both professionally qualified and non-qualified staff must share the same desire to make the client experience richer and better. Occupational therapists are a valued resource having the skills and training to assist other staff in the planning, delivery and evaluation of such group activities on the ward and their expertise must be sought and recognised. Being positive and focused on how things could happen is essential as opposed to being too risk cautious. Indeed, the provision of a health and well-being enhancing environment on the ward where clients can enjoy, participate, relax, be involved, influence change and contribute positively to their own recovery and the experience of others must not be overlooked and in fact positively encouraged and supported.
A reading list to accompany this article can be downloaded here: http://bit.ly/12vPMI5

~
HCAs Running Groups
Pauline Cooper, Head Occupational Therapist Pauline.Cooper@oxleas.nhs.uk

The issue of boredom experienced by mentally ill inpatients is high on the government's agenda and new ways of working are being sought to tackle the problem. Research shows that the word 'bored' means: patients feel the activities offered are not meaningful, are too difficult, they don't like participating in groups, or perceive activity as an overload of information experienced as noise (Farnworth, 1998, Helbig & McKay, 2003). If you are an HCA facing the prospect of leading activities you may feel understandably daunted, not only because you may not see it as part of your role, but also you may lack confidence in how to run groups or motivate clients. It can be a long day on the ward for everyone! Meaningful activities can change all that! Here are twenty tips to tempt all HCAs in picking up the challenge:

1. Motivating yourself! - Patient Engagement Time is now an expectancy - it has become part of your role, but there are benefits and can make your job much more interesting and rewarding. Your activity can inspire the patient's desire to become well and lead to a faster recovery. 2. Is this PET possible? Before you take up this challenge, you will need to negotiate time to prepare and run an activity. Think about your current duties and discuss with your ward manager how the activity can be scheduled as protected time into your shift. 3. The aim of the activity. This isn't just about giving people something to do, it is a way of normalising their day, helping them socialise, concentrate, apply their minds and have some fun! 4. Choosing an activity? What are you interested in? Ask the clients if they are interested - if not - what are they interested in? You need interest - theirs and yours! Use resources, like the internet, borrow ideas don't re-invent the wheel improve on it! 5. Be Prepared - What information do you need to know? Keep it simple. If it's a game - do you know the rules - have you played it before? Do you need a specific number of players? If it is task-based - do you know how to do it? Do the patients have the skills to complete the activity successfully? 6. Be yourself. Have a think about which of these leadership style you have: Authoritarian: who might say: 'Today we are going to do x,y,z.' Participants listen, discuss things and, hopefully, learn something helpful. Laid back might say: 'what would you like to do?' This can be creative or hard for participants who are indecisive or fear the task is too difficult. Democratic might say: 'we decided to do x last time, how shall we organise doing this task?' Does your style fit the activity? 7. Find out what resources are already available. Games? Newspapers? Pens? Arts materials? Can you raise money for your activity from the ward manager? 8. Consider the associated risks with using this activity. Eg: Scissors, sharps etc. Ask nursing staff or Occupational Therapists to help you think this through if you aren't sure - it is important for everyone's safety. 9. Choosing the right time. What else might the clients have on offer today? What would be an appropriate time for this activity? Are there other groups running eg: Occupational Therapy programme or Art Therapy? Can yours be at a different time? 10. Finding a suitable place and environment. What venue is available? Is it big enough? Warm enough? Light enough? Do you need furniture or water? Is it safe? Is it always available or do you need to book it? 11. Think about interruptions. Clients that are unwell may disrupt your session. How might this impact your activity? Discuss with trained staff how you might prevent/minimise this? 12. Decide the timing. How long have you got? Will it retain interest over time or will it need a change in focus? Can you introduce variety? Does it have a beginning, middle and end? If not, do you need to store work between sessions? Where might it be kept safely? How long will clearing up take?

13. Keep the ward informed. Missing clients on obs/levels can cause panic! Let people know where you are if you go into a side-room. 14. Confidentiality is important. Remember that if a client shares personal information it is your responsibility to remind the group to respect confidences. You will need to decide, probably with advice from your manager, whether or when to explain that as a member of staff you work as part of a team which needs to share information about patients. 15. Consider a co-worker. Will you need some help? Does it need to be a working colleague or can a patient help you? This could do wonders for his/her confidence and help get other patients on side. Think about how you could share tasks and make sure that you have a Plan B for emergencies! 16. Market the group. Be enthusiastic! Sell the group to the patients, ask them to help you make posters and recruit participants. Remind them the day before or early that day. Knock for them in good time. Make sure they know all the details. 17. Ending the session. Organise the group to have clearing up or debriefing time. Reinforce with them the benefits of attending/sense of achievement and promote the next group. Check - if anyone has shown signs of emotional distress/agitation this needs to be handed over to trained staff. 18. Evaluating and reporting the group. What might you write in the patients' notes? Consider the clients' care plans. If your group strengthens the clients' identified needs - can you add it to their plan? 19. Gaining professional support. Negotiate supervision and support with your line manager, make it an established part of your job and enlist ideas and encouragement from other ward staff. Is there a staff member available for a debriefing session if needed? 20. Time to relax and reflect Running groups is usually a very satisfying and enjoyable activity for you. But sometimes they can also stir up strong and perhaps difficult feelings in you as well as the clients. So de-stress. Pat yourself on the back. Evaluate how it went. Decide how you might do it differently or keep it the same next time. Write a reflection for your Continuous Professional Development portfolio!
Helbig. K. and McKay. E. (2003) An Exploration of Addictive Behaviours from an Occupational Perspective. Journal of Occupational Science. Volume 5. No.3. pp.140-146. Farnworth. L. (1998) Doing, Being and Boredom. Journal of Occupational Science. Volume 10. No.3. pp.140-145.

Providing Meaningful Activity on a Busy Ward

By Sam Wilson, Therapeutic Liaison Worker and trainee psychotherapist

Hi Im Sam. Im a Healthcare Support Worker and I work in inpatient psychiatry. In this role I work alongside talented professionals such as qualified nurses and occupational therapists to provide therapeutic sessions to our inpatients. In this feature I hope to provide you with a few ideas you could use in the therapeutic sessions you create, an insight into how we tackle some of the challenges we face in inpatient therapy and give you a brief account of some of the success stories weve had. Fun stuff. Providing therapeutic groups can be extremely challenging and busy events. In this whirlwind of activity there is always an opportunity to create moments that will melt away some of the chaos, create loads of laughs and help make recovery from an acute phase of illness a little easier. Sanctuaries. Being an inpatient can be an anxious and even scary experience, being given time to relax, a place to think and the opportunity to talk through issues and problems can have a positive impact on a patients wellbeing, mental state and in their recovery. Be creative and be inspired. Getting creative and being inspired by the patients I work with has helped me to create activity sessions that patients love to come along to again and again. Often the most simple of ideas can turn in to a session that everyone can be involved in and everyone can enjoy including staff. Wii-habilitation. We are fortunate on the ward that I am based to have access to a TV and Wii console. One of the greatest cures for a bad day is laughter, setting up a Wii and watching a nurse or doctor strut their stuff on a dance mat can put a smile on anyones face and anyone can have a go! Its great to see staff and patients mingling together especially in an activity everyone can get in todancing! One or two sugars? Where a Wii or even a DVD night may be an expensive option, why not give a few minutes to set up a few tables and chairs and have a chat about the latest football results, the latest news about x-factor or strictly come dancing after all who doesnt enjoy a chat over a coffee, tea or cup of juice? Trusting safety. Often time restraints, a busy ward environment and lack of staff can prevent some sessions from going ahead but remember one-to-one sessions only require two people, and even a quick chat, can give a patient that opportunity to discuss their thoughts and feelings, which can help them to feel safe, looked after and may lift their mood.

Green fingers and smiling faces. Ward rounds, appointments, and assessments can be stressful events for patients. There can be a big build up of tension, anxiety and worry before appointments. Why not get the gardening tools out and discuss any issues over the daffodils and pansies?

In my experience, male patients especially love being able to get their green fingers in to the latest planting project. Where an inpatient ward may not have a garden area big enough for large scale gardening projects, charities such as Thrive can provide advice and guidance about projects such as window boxes and herb growing. Even growing a potato head with hair made of cress is a creative way of growing on a small scale and is an activity a patient can take home with them. Talking it through. We are fortunate to have access to a clinical psychologist who helps us run therapy groups and individual sessions. Recovery groups, independent living and anxiety reduction and coping sessions can be extremely beneficial to inpatients. They can provide a safe environment for issues to be discussed, problems faced during the week to be faced and for patients to learn and gain skills they can use in their recovery. At times however these types of professionals arent available, there is no need to be disheartened or deterred from putting on an informal therapeutic session or activity. The rewards for patients are boredom levels are reduced, new strategies and invaluable skills in stress reduction and symptom coping skills can be developed and the most important they can have fun!

~
TLC from the TLWs!
The Therapeutic Liaison Worker: A humble idea from the shop floor that took on a life of its own
By Nic Higham Inpatient Care Consultant @ Star Wards

The year was 2009, it was about two AM and my weariness was gradually turning into elation. Its amazing what ward night shifts and the sleep deprivation that comes with them, can do to ones own mental state. The staff nurse I was working with was just reaching her night shift manic phase (her words, not mine). While she went about obsessively cleansing the office of the days mess, I sat down to read a curious blue and white booklet with a very happy Tibetan Terrier on the front. Wed recently caught the Star Wards bug and its 75 ideas for making the most of in-patients time were igniting all sorts of ideas of our own for enhancing the ward.

I whole-heartedly agreed when I read Professor Louis Applebys (National Director of Mental Health) view of Star Wards: This is a recipe book for doing things right, rather than another list of what is wrong. How refreshing! How can that not inspire you? The Deputy Ward manager at the time (also the wards Star Wards lead) was also working that night. This stuff is really brilliant I said to her excitedly as she walked into the office. Star Wards didnt just provide us with loads of inspirational great practice ideas; it was hugely validating and reassuring. Within the 75 ideas we recognised a lot of stuff wed already been doing. What would be amazing I said to Louise, Is if I could be a Star Wards Link-Worker. Maybe I could spend some time each week focusing on implementing these ideas, as well as co-ordinating other staff members input. It felt like a slightly cheeky and over-ambitious longshot, but I felt passionate about developing my skills and contribution as a Healthcare Support Worker on the ward. At the time I was training to be a counsellor and life coach and was also thinking about how to bringing some of what I was learning to my role. I felt lucky to work within such a supportive and encouraging ward team. That sounds like a good idea to me. You should put some ideas down Louise replied. So over the subsequent months, with the go ahead from my ward manager, I started planning - cooking up ideas with my recipe book - and thinking about what the role would entail. I chatted with lots of staff as well as patients and researched various Star Wards great practice suggestions. I spent time with nurses, support staff, occupational therapists (OT), chaplains and some therapy and psychology colleagues. Louise and I attended the Trusts monthly Star Wards group to discuss the progress we were making and receive input and feedback. We repeatedly returned to Star Wards vision of acute wards set out by Marion Janner in the first volume. This became our own vision: talking therapies play as substantial a role as medication patients are supported in enhancing their management of their symptoms and treatment there is a strong culture of patient mutual support, with the potential for this extending once theyve left hospital a full programme of daily activities doesnt just eliminate boredom but actively contributes to accelerating patients recovery patients retain and build on their community ties.

Eventually, I plucked up the courage and presented a proposal to the units General Manager, who to my delight also loved the idea. It was so great to get his support and sense his belief in my suggestion. After a few months of further shaping up and working through certain organisational formalities, the project evolved into the Therapeutic Liaison Worker (TLW) role. By chance, around this time a couple of consultant psychologists were seconded to help ward staff develop and deliver ward-based therapies. They gave me heaps and heaps of support, guidance, wisdom and helped steer my project. Likewise, the Trust were implementing the Releasing Time to Care improvement initiative which also helped to significantly reinforce things. In addition to this, the Star Wards website helped spread the word by publishing an article written by one of the nurses about our progress.

The TLW role aims to support and enhance a therapeutic model of care for patient and seeks to further embed such an ethos within the ward culture. In 2010 the TLW role was eventually piloted on my ward and was favourably evaluated. I was happy to receive a lot of positive and reassuring feedback from colleagues and patients: The TLW has established a robust timetable of activities that are suited to the wards particular client group. Therapeutic groups, practical activities which help occupy patients, give them structure and help to alleviate boredom. Staff Nurse Made me feel very relaxed and helped me feel better about myself. Patient 'This is a fantastic example of how staff are responding to the needs of patients. It's a real pleasure to see such initiatives develop and make a tangible difference on wards.' - Chief Executive

What the TLW role involves:

establishing and designing appropriate therapeutic groups for inpatients overseeing, coordinating and running a programme of therapeutic group work on the ward facilitating groups alongside OTs and other staff and volunteers liaising with the wider multidisciplinary team in order to develop the package of care on offer liaising with key nurses to help implement care plans offering patients additional protected one-to-one engagement time.

At the end of 2010 the Trust decided to roll-out the TLW role across the other wards. Each ward identified a Health Care Support Worker to develop a programme on their wards. This phase of the project was also evaluated. Heres a snippet of the evaluation report (Leicestershire Partnership NHS Trust, 2010): This evaluation has found that both staff and patients who have been involved in this work have identified a positive impact. Substantial positive changes on the wards are evident as a result of the implementation of the TLW role. The role enables wards to be orientated around patient focused care. TLWs have established robust timetables of meaningful and constructive activities which have resulted in the minimisation of boredom and incidents on the ward. 92% of patients felt the programmes helped them engage more with staff. 90% of patients said that the new programmes helped them feel less agitated. 83% of patients found that the programmes helped them feel less anxious. 83% of patients felt less angry due to taking part in the activities. 94% of patients said that the programmes helped them feel more relaxed. You can read the entire report here: http://www.wardipedia.org/3-therapeutic-liaison-worker

In December 2012 a job advertisement for the role was released on the national NHS Jobs website. Its so great to see how far our initial idea has come, and incredibly heartening that the trust has recruited new TLWs. I absolutely love that its given unqualified staff opportunity to develop and express new ways of making the inpatient journey even more therapeutic. I hope this article has given you lots of ideas, and inspired and encouraged you to inject some Star-Wardyness into your own setting! With a large helping of passion and commitment, support and the right ingredients thrown into the mix, ideas conceptualised on the shop floor really can grow into something big and impacting. They can truly help make the inpatient experience a positive, purposeful and healing one. To read more about the TLW role visit: http://www.wardipedia.org/3-therapeutic-liaison-worker

~
South West London Recovery College
By Debbie Cleaveley BA (hons) RMN. Debbie is a recovery practitioner trainer and user of mental health services.

Usually a mention in the House of Commons is not a good sign for mental health services. It normally precedes a damning report in to a failure of care or systematic fault lines so there was a sense of trepidation upon opening an email entitled mention in Hansard. However, on this occasion, it was a source of joy. Local MP, and at the time, Minister for Care Services, Paul Burstow proudly told the house that: When I visited the South West London Recovery College, I heard powerful personal testimonies from people who were living purposeful and fulfilling lives, and who were living with their illness rather than having to be cured of symptoms or illnesses. It is important that recovery is not just seen in medical terms, but is selfdefined. Students at the college learn not only how to manage their condition, but skills to help them back to work and to form new relationships. Some become lecturers at the college themselves. I was told that being called a student, rather than a patient, helped student, rather than a patient, helped people take control of their recovery, gave them more confidence and, crucially, made them feel normal, as opposed

to being treated as a helpless, passive recipient of care. Part of a good recovery is the ability to exercise more control over ones life. In health care, that means that there must be more shared decision making and choice. Hansard HC Mental Health Debate, 14th June 2012, column 527 Wow. Wow is often a word we hear used at South West London Recovery College. Now halfway through our 3 academic year, we are the first NHS college of its type in England and Wales. Using equality and co production as our core values, practitioners and peers develop and run educational courses together with no distinction between our student population which is made up of those who use our trust services, care for someone or whom work for the trust. Our courses cover five core areas: Understanding mental health conditions and their treatment, Rebuilding your life the road to recovery, Developing knowledge and skills, Family and carer educational courses and Getting involved. In the last year alone, 1260 students attended one or more of the 431 courses that we ran in various venues across South West London. 95% of those students found the courses met their expectations, 84% felt more positive and hopeful as a result of the courses and 85% were able to set reasonable goals within their reach. 44% of students have a diagnosis of schizophrenia and 60% of students are in the higher need clusters of the payment by results framework. However, this article is not simply an exercise in marketing or statistics (well not quite!), but an opportunity to show the power of recovery and need for education in relation to mental health difficulties, self management and treatment options. Our students have demonstrated that there is a huge thirst for knowledge, education and learning skills to be able to move and live beyond the limitations of diagnosis and services. The college services operate under a hub and spoke model whereby a central hub provides a suite of training rooms, resource library, internet facilities and office accommodation for training, and spokes run courses in community facilities such as community centres and libraries. Two of the biggest barriers to recovery are low expectations and stigma. Low expectation can come from service providers, loved ones or indeed the individual themselves. There are few public figures role modelling successful life with psychosis. The public understanding and basic knowledge of conditions such as schizophrenia is woefully poor. Stories of mad axe men and women sell far more newspapers than ones about those who have quietly rebuilt their lives. Even within mental health services, a fairly downbeat wait until youre better and we know best paternalism still prevails in some quarters. Despite what the PR and Ad men tell us, I dont think that awareness campaigns and posters change a public mindset. In my limited experience of such matters, those drawn to the positive messages are inevitably those already open minded and interested and so the impact is lessened and the risk of preaching to the converted increased. Sometimes actions have far more impact than words; let us not forget how rapidly interest in HIV and AIDS awareness changed after the Princess of Wales was photographed shaking hands and hugging people who were HIV positive.

A parallel can be drawn with the learning environment at the college. This week, one course had 25 students consisting of carers, people who use services, trust staff, volunteers and pre registration nursing and occupational therapy students. All were treated equally, there was no them and us, and all worked towards a shared goal of learning. Nobody claimed to know best or be an expert, nobody complained that their views were ignored and it was first names terms for all with not a sniff of titles, diagnostic labels or qualifications. All that was expected of students was to respect each other and try to keep an open mind. The participation was lively, fun, insightful and the feedback showed that people had found it helpful. By the first break, most people, myself included, didnt care who were users, carers or staff or had forgotten. Being the first of its type means that precedents can be set rather than followed. We had a blank canvas to start with and from that the following themes and learning points have emerged which may be useful for all of us in mental health. 1. Act like a college not a hospital or a school. We modelled the college principles and operation on adult further education and run things accordingly. Rather than a raft of rules, a clear student code of conduct is in place along with a charter of expectations that we have of students and what students should expect from us. Students are welcome to drop in to use the library and internet resources but we are clear that we are not a drop in, day hospital in drag or coffee shop! We have lots of information about centres and services that offer more social settings and can signpost people on as necessary. We only offer courses on mental health and do not replicate mainstream adult education, but again, have information about local colleges and training. 2. Customer service. We have very high standards of customer service and care ensuring that everyone feels valued and not judged from the moment they walk through the door. Although we are not a clinical service, we do ensure that people who become distressed get the care and support that they need before contacting care coordinators or duty workers. A few moments of kindness and the offer of a cup of tea often works wonders. 3. Equality. Easy to talk about, not so easy to put into practice. As the example above shows, there is great value on many levels on treating everyone with the same expectations, boundaries and care. Interestingly it is often staff that find this the most difficult, especially as we charge for tea and coffee! Most courses are open to all students (users, carers and staff) although there are some more specific courses aimed at the needs of particular students such as our carer education programme. 4. Education not therapy. We do not prescribe or insist that students follow the suggestions that we make. The vast majority of self help suggestions and ideas have been road tested ourselves so that we can suggest with authenticity rather than preach but not necessarily practice. 5. Co-production. Using the joint expertise of peers with lived experience and practitioners is essential at the college. It provides a far richer, balanced and real rounded learning environment and again helps to challenge the them and us division that often exists within services. Both user and staff groups can be wary and territorial of each other leading to conflict of ideas rather than joined up ones. The beauty of co production lies in equality and open mindedness enabling the territory to be a shared open joint vision.

6. Working with others. We are very clear in our remit of education and work with teams to see how we can support and augment what they are doing. Recently we linked what we can offer against trustwide team objectives so that our colleagues can see at a glance what we offer. We visit teams regularly to share practice and also harvest ideas about other ways we can help or support. We also host other groups and courses so there is a wide range of things going on from smoking cessation to a dementia support group, and evening activities such as AA and a hearing voices support group. 7. Considering risk in a balanced way. The NHS is very good at worrying about risk and thus finding reasons not to do things because they might be risky to someone somewhere. The paradox with this approach is that the risk stakes are inevitably raised as some people do not like feeling controlled, labelled, treated as if they are slightly deviant as a default or told what to do. The college is mindful of risk but is pragmatic about it, using positive control measures such as clear boundaries, respect, listening, choice and having expectations of adult behaviour, rather than restriction and monitoring. We have escalation procedures in place for emergencies but again are based on a college rather than hospital approach. 8. People not labels. We do not ask students what their diagnosis is nor do we have access to clinical notes. We work with individuals by focusing our expectations on strengths rather than weaknesses whilst acknowledging distress and experience. Striking a balance between relapse, crisis and natural and normal life experiences can be challenging for us all but is an important step in making sense of life and moving on. 9. Doing things differently. We pride ourselves on being different and one of the biggest complements is to hear people say that we are not like they expected. We work really hard to provide a bright, positive, friendly environment where its ok to laugh or cry. I have a support dog Widget who comes to work with me and likes nothing better than someone to tickle her tummy. Like all other services, we are not immune to the threat of redesign or reduced funding. Our challenge remains to augment and compliment what our clinical colleagues are doing and to continue to encourage, support and educate our students whilst prove our worth and value to future funding. If youd like to visit the college, we run a monthly open day for individuals and services to come along, meet with us and have a look around. Please contact us at recoverycollege@swlstgtr.nhs.uk for further information and booking.

South West London Recovery College

By Sharon Gilfoyle, Peer Employment Project Manager Cambridgeshire and Peterborough NHS Foundation Trust

Helping service users, staff, students and carers become experts in self-care on their recovery journey is the main ethos behind the launch of the East of Englands first recovery college. Recovery College East was recently launched by Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) and partner agencies. It is a collaborative educational learning environment for people who have accessed secondary services, their loved ones, partner agencies, and students. The recovery college is a new national initiative that is being developed in a number of areas throughout the UK and is based on some key principles: All courses are co-developed and co-delivered by at least one person who has their own lived experience of mental health challenges. The courses are delivered as an educational rather than therapeutic model The courses are available to people who have accesses services, carers, partner agencies, and students. Everyone enrols as a student regardless of their previous experience or any other identities The college conveys messages of hope, empowerment, possibility and aspirations. It celebrates strengths and successes rather than highlighting deficits or problems, celebrating the diversity of everyone The college staff take on more of a coaching approach rather than a therapeutic one. Recovery College East, launched in November 2012, is currently a virtual college with courses being delivered in community resources across the county. There are plans to have a college building in the near future, which will enable students to gain more information, share recovery stories, access a recovery library and access the internet. All students will complete a registration form and then will meet with a member of the college to complete an individual learning plan to ensure they are enrolled on the course most suitable for them. The first term starts in early February and will see 15 courses on offer, including: Introduction to recovery Telling my story Taking control

Getting ready for work Staying well at work Getting a good night sleep Introduction to Peer Employment Managing a home Physical health Stigma and disclosure Shared decision making Getting the best from mental health services Spirituality and recovery Creative steps forward Getting ready for study.

The most popular courses so far are getting a good nights sleep, spirituality, introduction to recovery and introduction to peer support. Dr Attila Vegh, Chief Executive of CPFT, said: Recovery College East will offer a range of interesting and aspiring course to promote recovery and wellbeing for all. This is a really exciting time for us. I am very pleased that CPFT is working with partner agencies to deliver the courses and host the course venues for us. I look forward to the future growth and development of the college. Some of the comments that were posted on our wall at the launch highlight how important Recovery College East is for people: The shift in focusing from symptoms, illness and problems and what you cant do, to focusing on what you can do, your potential, hopes, dreams etcits so refreshing! This is so inspirational and would really help me after I leave the inpatient ward I cant wait to become a student I am excited about Recovery College East because its a chance to develop a real partnership between students, professionals and carers to make fulfilling lives for people with mental illness. Im excited about Recovery College East because it is about valuing individuals from all areas working together with all. Not one person being more important Implementing Recovery through Organisational Change (ImROC) has produced a briefing paper that is a helpful guide for any organisation wanting to establish a college in their organisation. This can be found at: http://www.nhsconfed.org/Documents/ImROC%20Briefing%20Recovery%20Colleges.pdf More information about Recovery College East can be found: www.cpft.nhs.uk/recoverycollege.htm

Top 10 Mental Health Apps

Sandra Kiume is a mental health advocate. Along with contributing to World of Psychology, she writes Channel N, PsychCentral's brain and behaviour video blog, and is the founder of @unsuicide. She lives in Vancouver, Canada.

Were very grateful to Sandra Kium and psychcentral for letting us reproduce this excellent feature on the latest exciting development in e-health.

With so many apps on the market, its hard to know which are useful. Many are designed by software developers instead of psychologists, without scientific testing. They range from beneficial, to harmless but useless, to bordering on fraudulent. The apps selected for this list make no hucksterish claims and are based on established treatments. Progressive Muscle Relaxation, for example, has been used for a century and is likely just as effective in this new medium. Knowledge from Cognitive Behavioral Therapy and Dialectical Behavior Therapy enrich two apps on this list. Others mix solid information with ingenuity.

Dont forget to download the free PsychCentral app to keep up with the latest mental health information. 1. BellyBio Free app that teaches a deep breathing technique useful in fightinganxiety and stress. A simple interface uses biofeedback to monitor your breathing. Sounds cascade with the movements of your belly, in rhythms reminiscent of waves on a beach. Charts also let you know how youre doing. A great tool when you need to slow down and breathe. 2. Operation Reach Out Literally a lifesaving app, this free intervention tool helps people who are having suicidal thoughts to reassess their thinking and get help. Recommended by followers of @unsuicide, who report that this app has helped in suicidal crises. Developed by the military, but useful to all. Worth a download even if youre not suicidal. You never know if you might need it. 3. eCBT Calm Provides a set of tools to help you evaluate personal stress and anxiety, challenge distorted thoughts, and learn relaxation skills that have been scientifically validated in research on Cognitive BehavioralTherapy (CBT). Lots of background and useful information along with step-by-step guides.

4. Deep Sleep with Andrew Johnson Getting enough sleep is one of the foundations of mental health. A personal favorite I listen to all the time, this straightforward app features a warm, gentle voice guiding listeners through a Progressive Muscle Relaxation (PMR) session and into sleep. Features long or short induction options, and an alarm. 5. WhatsMyM3 A three minute depression and anxiety screen. Validated questionnaires assess symptoms of depression, anxiety, bipolar disorder, and PTSD, and combine into a score that indicates whether or not your life is impacted significantly by a mood disorder, recommending a course of action. The app keeps a history of test results, to help you track your progress. 6. DBT Diary Card and Skills Coach Based on Dialectical Behavior Therapy (DBT) developed by psychologist Marsha Linehan, this app is a rich resource of self-help skills, reminders of the therapy principles, and coaching tools for coping. Created by a therapist with years of experience in the practice, this app is not intended to replace a professional but helps people reinforce their treatment. 7. Optimism Track your moods, keep a journal, and chart your recovery progress with this comprehensive tool for depression, bipolar disorder, and anxiety disorders. One of the most popular mood tracking apps available, with plenty of features. Free. 8. iSleepEasy A calm female voice helps you quell anxieties and take the time to relax and sleep, in an array of guided meditations. Separately controlled voice and music tracks, flexible lengths, and an alarm. Includes a special wee hours rescue track, and tips for falling asleep. Developed by Meditation Oasis, who offer an great line of relaxation apps. 9. Magic Window Living Pictures Not technically a mental health app, it makes no miraculous claims about curbing anxiety. However, there is independent researchindicating that taking breaks and getting exposure to nature, even in videos, can reduce stress. This app offers an assortment of peaceful, ambient nature scenes from beautiful spots around the world. 10. Relax Melodies A popular free relaxation sound and music app. Mix and match nature sounds with new age music; its lovely to listen to birds in the rain while a piano softly plays.
Source: Kiume, S. (2013). Top 10 Mental Health Apps. Psych Central. Retrieved on February 13, 2013, from http://psychcentral.com/blog/archives/2013/01/16/to p-10-mental-health-apps/

NTW App
Northumberland, Tyne and Wear NHS Foundation Trust have a launched their very own smart phone app! The App can be downloaded directly from Apples App store and via Google Play store for the Android version. Just type in the initials NTW. The App stores useful information such as a list of and location maps for our services. Users are also able find out more about whats happening across NTW and give feedback on the service they have received. NTWs award winning self-help guides on subjects such as sleep deprivation and anxiety can also be downloaded directly from the App.

For more info visit: www.ntw.nhs.uk/app

I recently downloaded the excellent new NTW App from the App Store, and I am very impressed indeed. It is very user friendly and looks great also, utilising our instantly recognisable Trust Corporate colours and Lighthouse Logo. The app incorporates a Service Directory, Locations of main Trust sites and a News/About us section and how to become a member sections amongst others. I particularly like the fact that its very easy to navigate and that it has the information you may require at tap of a finger! The app includes helpful information which is aimed at carers, people experiencing mental health issues as well as a directory for ethnic minorities. There are over twenty guides covering a range of mental health issues such as anxiety, depression and stress. As the Senior Clinical Nurse in Urgent Care I would strongly encourage everyone to download this excellent App and just like the best things in life, its free!!
Rod Bowles - Clinical Nurse Manager at Northumberland, Tyne and Wear NHS Foundation Trust

Get even more out of Star Wards!

Wed love to hear from you! We need to hear from you! Email: marion@brightplace.org.uk with your good practice examples, ideas, challenges, articles, tips and pictures for future newsletters.

If youve enjoyed this newsletter, please forward it to colleagues and friends. Thank you! If youve received it from someone else, we hope youve enjoyed it. You can subscribe for yourself on the home page of our website to receive future editions.
About Star Wards: Staff up and down the country are doing superb work, despite extraordinary challenges, and are creating healing, imaginative and fun opportunities for thousands of patients. Star Wards core is practical, mainly low-cost and easy to implement ideas, but our role is increasingly as a catalyst to change through inspiring, collecting and disseminating best practice in inpatient care. We work collaboratively with the full range of mental health wards from acute admission to high secure, to improve inpatients experiences and outcomes. Our publications, blogs, tweets etc make us sound like were very appreciative of ward staffs skills and commitment. Thats because we are. We hope youll enjoy reading examples of superb inpatient care and if you work on a mental health ward, wed like to give you a big virtual hug.

www.starwards.org.uk

www.wardipedia.org