Our new strategic plan, Changing Minds. Changing Lives., documents a number of new service delivery developments that St Patrick's Mental Health Services (SPMHS) is committed to introducing. These were rapidly progressed during 2018.
Digital and Tele-Health Service Developments
Digital and Tele-Health Service Developments
Centre for Innovative Mental Health and Technology
As part of Changing Minds. Changing Lives., the foundations for the establishment of the Centre for Innovative Health and Technology were put in place. This centre will focus on developing cutting-edge technology-based interventions and supports for a range of mental health difficulties. Progress was made with partner organisations to identify projects that will produce measurable and meaningful solutions.
Prompt Assessment of Needs
Following the introduction of the Prompt Assessment of Needs (PAON) in December 2017, 2018 saw the consolidation of this free-of-charge assessment, with the delivery of 1,078 adult PAONs. The PAON is a telecommunications-based assessment provided free to people referred by their General Practitioner (GP). An experienced Registered Nurse carries out the PAON and, based on their assessment, creates a care plan with the person, which can include referral to the SPMHS Dean Clinics, day services, inpatient assessment, or services outside of SPMHS. The PAON has been very effective in providing prompt engagement with service users (including risk assessment), and ensuring the most appropriate care pathway is defined quickly following their referral to SPMHS.
eSwift: Transforming Mental Health Care and Information
Launched in 2017, the eSwift electronic health record (EHR) system was consolidated across the service in 2018. In what was a significant milestone for SPMHS, for the first time, our Mental Health Commission inspections were facilitated electronically at each of our three centres. The next step is our Patient Portal, which will allow all service users to access their own clinical record; in 2018, a structure for a service user advisory group was agreed to guide this development.
Following an agreement to use Healthlink to facilitate GPs wishing to electronically refer to SPMHS in 2017, uptake on the use of this service by GPs grew significantly, with a total of 1,050 electronic referrals received. In addition, during 2018, we introduced Healthmail, a secure clinical email system which allows healthcare providers to communicate clinical information safely between primary and secondary care.
Online Cognitive Behaviour Therapy (CBT) Pilot
In 2018, we began a pilot programme to deliver technology-mediated Cognitive Behaviour Therapy (CBT). This allowed for provision of CBT online, with therapist and client interacting via computer screens. This avoids service users having to travel long distances to access the expert therapy that we can provide.
We work hard to ensure that service user information is treated confidentially, held securely, and processed appropriately. In 2018, work continued through the Data Protection Office and our Information Governance Committee to ensure compliance with Data Protection legislation and to address recommendations made by the 2017 Office of the Data Protection Commissioner’s Hospital Sector Audit. The number of requests for information significantly increased in 2018 following the introduction of the European Union (EU) General Data Protection Regulation (GDPR). A total of 317 requests for information were received in 2018, compared with 200 in 2017.
Day Service Developments
Day Service Developments
Increase in Day Service Clinical Activity
2018 saw a sustained increase in day service clinical activity. In April, our Pathways to Wellness Programme added an extra treatment stream, with a monthly average attendance of 36 attendances. This brought to three the number of discrete Pathways programmes, which aim to focus on community re-engagement and support for those who may have complex needs.
The Access to Recovery programme continued to grow and expand during 2018. This programme is a rapid access day programme, which seeks to address the needs of those requiring recovery skills and relapse prevention immediately after inpatient discharge.
Also in 2018, the Bipolar Programme became exclusively a day programme. Service users can now be assessed for the programme as inpatients, and receive their initial information from the coordinator of the programme. They then return as day patients to complete the programme using a stepped care approach.
Expansion and Review of Psychology-Based Recovery Programmes
SPMHS provides a wide range of inpatient and day service psychological and recovery programmes, including those which care for and treat young adults, depression, eating disorders, bipolar disorder, old age, alcohol dependence, dual mood and addiction disorders, memory, and anxiety management. In 2018, we facilitated over 4,000 attendances at these innovative psychology-based group psychotherapeutic programmes, providing essential care and treatment to hundreds of individuals. The biggest increase was seen in the Living Through Distress programme, where now most attend as day patients rather than inpatients, which is a radical development.
In 2018, our existing Radical Openness treatment moved to a Group Radical Openness (GRO) variant that constitutes a new therapy: this is the first time that a novel psychotherapy has been delivered in SPMHS. The GRO team will commence an Open Trial in 2019 to formally evaluate this approach. Meanwhile, demand for the Compassion Focussed Therapy (CFT) programme also increased, and a new member of staff was recruited in light of this.
As well as engaging in best practice at all times, we continually review and evaluate our multidisciplinary services and programmes so that they can be enhanced and expanded to ensure our service users can take advantage of the latest innovations.
New Open Dietetics Lecture Series
An Open Dietetics Lecture Series commenced in 2018. This weekly lecture is open to all inpatients, as well as a number of our day patients, as part of their programme. The lectures cover all relevant aspects of dietetics, including weight management, heart health and healthy eating, and the introduction of foods that support mental health. A dietetics assessment was also included as part of all new Dean Clinic assessments for the Eating Disorder Service.
Opening of New Dean Clinic
Opening of New Dean Clinic
The Changing Minds. Changing Lives. strategy seeks to centralise the various Dean Clinics in Dublin, and, as a result, in June 2018, the new, purpose-built North Dublin Dean Clinic was opened on the SPUH campus. The objective of consolidating the North Dublin clinics into one clinic is to allow for the implementation of a more holistic and coordinated approach to this essential component of our services. This development further serves to enhance the transformation of the SPUH campus into the Jonathan Swift Campus for Mentally Healthy Living. The services provided at our Cork and Galway Dean Clinics continue to be developed and the Associate Dean Clinic model will expand as we strive to serve as many areas as possible throughout the country.
We provide a free mental health Information Centre based in SPUH. The centre is run by hospital staff, with the assistance of a team of volunteers, and it is open to current service users, family members, supporters and the general public. Staff in the centre can provide guidance and help in accessing the most relevant mental health information and services, as well as information on support groups and service user rights and entitlements. There were over 7,500 visitors to the Information Centre during the year. In 2018, all handouts and programme brochures were updated, and all SPMHS literature available in the Information Centre was revised to ensure it complies with National Adult Literacy Agency (NALA) guidelines.
Support and Information Line
SPMHS provides a confidential support and information telephone and email service, staffed by experienced mental health nurses from 9am-5pm, Monday to Friday, with an answering and call-back facility outside of these hours. There is also an online support and information form that can be filled out on our website.
This service is for current service users who may need low-level support, early intervention or general queries, and is also an information service for the general public regarding their own mental health or that of a relative/friend or for healthcare professionals seeking advice on the services we provide. More broadly, it functions as an information point of access to mental health services in St Patrick's or in someone’s local area.
The number of contacts received to the Support and Information Service increased substantially in 2018, with 13,744 contacts in 2018 compared with 10,735 in 2017.
Human Resources Service Delivery
We deliver care and services to our service users through our staff, employing over 700 staff across a range of disciplines, both clinical and non-clinical. To ensure we are always able to deliver the highest standards of care, we are committed to creating and maintaining a working environment within which all staff are empowered and encouraged to reach the fullest extent of their potential. We realise this vision by working in partnership with the wider SPMHS organisation to provide leadership, support and guidance in the development and implementation of the policies, procedures and practices required to achieve our objectives. This is the mission of our Human Resources Management (HRM) strategy.
In order to meet our objectives, we need to be able to respond to recruitment challenges in a timely manner, and to maintain and develop our existing skills base. To this end, in 2018, our Human Resources (HR) department continued to lead and support the organisation in meeting recruitment challenges across all departments and disciplines, against the backdrop of an increasingly competitive labour market. Overall staff turnover for 2018 stood at 5.3%, which was consistent with the figure for 2017.
Ibec KeepWell Mark
In 2018, we became the first hospital in Ireland to achieve the KeepWell Mark, Ibec’s new evidence-based accreditation and award which recognises Irish employers for investing in workplace health and wellbeing. We underwent a rigorous assessment in late 2018 and obtained the award at the first time of applying. The KeepWell Mark confirms that we are on the right track in improving our workplace wellness and in making SPMHS a great place in which to work. We are committed to staying on this journey, and we have a very active Staff Wellbeing Committee in place to help ensure that we retain the KeepWell Mark into the future.