Time to Talk Health. Remy Marckus & Danielle Green (Senior Psychological Therapist & Senior Wellbeing Practitioner North)

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Kelly Nelson
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1 Time to Talk Health Remy Marckus & Danielle Green (Senior Psychological Therapist & Senior Wellbeing Practitioner North)

2 Background Pilot LTC project from October 2015 October 2016 NHS England Implementing the 5 year forward plan the expansion of IAPT services into Long Term Conditions Objectives New psychological therapy provision will see physical and mental health care co-located and integrated into existing medical pathways

3 Why focus on Long Term Conditions There are over 15 million people living with one or more long-term conditions in England The numbers of people living with one long-term condition is projected to reach 2.9 million by People with long term conditions are 2 to 3 times more likely to experience anxiety and depression than the general population Depression and anxiety impair active self-management of physical health conditions

4 Aims and Objectives Breaking down the hard wired separation of physical and mental health care Supporting patients to self-manage Joint Care Planning Flexible working e.g. home visits / joint work Enhanced signposting to community resources

5 Who are we commissioned to work with? Diabetes (Type 1 and Type 2) Cardiac (CHD, Heart Failure, angina, atrial fibrillation and other conditions) COPD Coverage Horsham, Mid Sussex CCG and Crawley CCG Settings Primary Care (GP, Practice Nurses), Community Teams, (SCFT, COP), Acute Hospital Trusts, (BSUH and SASH)

6 LTC NORTH Clinical Lead Debbie Barnett (Full Time) Service Manager Vicky Fenwick (Full Time) Senior Therapists Remy Marckus (4 days) Barry Moye (half day) Senior Administrator Paul Earl (Full Time) Administrators 1 post to be filled Senior Wellbeing Therapist (PWP) Danielle Green (Full time) Wellbeing Therapists (PWP) Dennis Benniman (Full Time) Philip Thrasher (Full Time) CBT Therapists Amparo Domenench (3 days) Claire Dunlop (3 days) Gill Portet (3 days) Michal Ann Abott (3 days) Trainee Wellbeing Therapists Neelofar Mohammed Kesha Wheeler Trainee CBT Therapists Louise Harper Charlotte Irving Junaid Khan Kolawole Osinnowo Dane Olliver In Service: Wed, Thurs, Fri

7 Referral pathways Professional referrals Voluntary Sector referrals / Community Referrals Self referrals Professional Referrals: GP, Consultants, Specialist Nurses, ATS, Practice Nurses, Dieticians. All ATS referrals are discussed beforehand with the Senior Clinicians for Horsham to ascertain suitability for the service. Self-Referrals: Telephone

8 When to Refer Inclusion Criteria: Low mood and depression Anxiety disorders (Panic/ GAD/Phobias/OCD/PTSD) which are exacerbating and/or complicating the management of the underlying physical health condition Difficulties with adjusting to a diagnosis Difficulties with burn out or managing the physical health condition Difficulties suitable to be treated in a time limited way Willingness to engage in therapy and capacity to establish therapeutic alliance Clients aged 18 years and over (no upper limit).

9 When to refer on Exclusion Criteria: Psychosis Bipolar Affective Disorder (though we may consider if stable for at least 2 years+) Personality Disorders Eating Disorders Significant current risk to self or others Clients who have recently attempted suicide or active self-harm with likelihood/possibility of escalation. People with active substance misuse issues that require treatment. Clients who are receiving treatment from secondary care services (unless treatment completed, or in receipt of medication review only).

10 Step 2 What can be offered Via telephone, face to face, in workshops Recent onset mild to moderate anxiety or depression with minimal risk May be a useful start even for more complex patients Would not work therapeutically with OCD, PTSD, or specific phobias such as needle phobia

11 Treatment Step 2 Step 2 (i.e. least intrusive ) low intensity interventions: Guided Self-Help: Behavioural activation e.g. goal setting, increasing motivation to manage their physical health condition better and supporting patients to increase exercise levels, psychoeducation about anxiety and stress management e.g. supporting someone newly diagnosed to manage multiple demands and new information Workshops: Living Well with Diabetes, Stress management workshops for Cardiac Rehabilitation, Anxiety management Silvercloud Enhanced signposting

12 Step 3 What can be offered Face to face or in groups Moderate to severe anxiety or depression Work with complex presentations for up to 20 sessions Would work therapeutically with OCD, PTSD, or specific phobias such as needle phobia

13 Treatment Step 3 Step 3 High intensity interventions: 1:1 CBT, Counselling, Cognitive Analytic Therapy Relaxation sessions into Cardiac Rehabilitation Mindfulness-Based Cognitive Therapy (MBCT) for depression and long term conditions. An 8 week course of 2 hours per week Mood Management group. A 10 week course consisting of weekly 1.5 hour sessions Consultation

14 Measuring Success Improved recovery rates in depression and anxiety Increased patient engagement and activation levels Increased patient satisfaction

15 Any Questions? How to contact us: Our offices are at Horsham Hospital, 1 st Floor, Rose Wing, Hurst Road, RH12 2DR You can call us on You can us at sc-tr.ltcreferrals@nhs.net

Time to Talk Health. Dr Remy Marckus (Clinical Psychologist North Team)

Time to Talk Health. Dr Remy Marckus (Clinical Psychologist North Team) Time to Talk Health Dr Remy Marckus (Clinical Psychologist North Team) Setting the Scene Underpinned by Government Policy: The Five Year Forward Plan 2014 Integrating the care of people s physical and