Working with community

00:14

this film brings together professionals

00:17

from Health social care and education to

00:20

discuss some of the situations

00:21

highlighted in two parental mental

00:24

health case studies featured on social

00:26

care TV Wendy a mother story and Kate a

00:30

young person's story each professional

00:33

has experience of dealing with parental

00:35

mental health issues in the voluntary

00:37

sector in education in community mental

00:40

health and in family centers the

00:43

discussion is mediated by rows to pay

00:45

strong head of strategic development at

00:48

Family Action a charity that supports

00:50

disadvantaged families throughout

00:52

England she's joined by Paul Taylor

00:55

assistant head teacher with

00:56

responsibility for safeguarding young

00:58

adults at Belle Reve fcj Catholic

01:01

College in Liverpool Allen O'Leary

01:04

community mental health team manager

01:06

with Mercy care who works with adults

01:08

with mental health issues and Ruth hake

01:11

Ferguson who manages a number of

01:13

children's centres in central Liverpool

01:15

they begin by reviewing the story of

01:18

Kate whose mother has mental health

01:20

problems my name's Keith I'm 18 years

01:25

old and I care for my mum who has am a

01:28

few mental health problems

01:31

kate has been caring for her mum since

01:34

the age of seven and over the years as

01:36

her mum's mental health deteriorated

01:38

Kate's responsibilities grew when

01:40

affairs started happening we used to

01:43

live in a flats and we had a balcony I

01:44

should want to go outside try go over

01:47

the balcony basically she's waking me

01:49

off and we just sit there talking trying

01:51

to distract her from like the voices and

01:53

a head and sometimes I should go to

01:56

sleep at about 4,000 more and I like to

01:59

stay away and I can't go round to my

02:01

house where or something because I

02:05

always feel awake by then to go back to

02:07

sleep

02:07

brought about by six o'clock maybe seven

02:11

I've been a fence again and I have to

02:12

sleep in it'll either make me late for

02:15

school or if he's don't wear the right

02:17

chair for that day and ask who consoles

02:19

usually how their mentor

02:21

she was there to be a proper counselor

02:22

she used to say things I here just acted

02:24

out to get attention of stuffin Oh miss

02:28

Lee I was poor not for the reasons she's

02:31

thinking I'll she even knew don't mean

02:33

my my mental health problems because she

02:34

asked me what was happening at home and

02:35

then she said well don't bring it to

02:37

school goes well what was the point in

02:39

me telling you if we should pause there

02:43

cos Kate was just saying quite a lot

02:44

about some of the issues for her I

02:46

wonder if the same would be true for

02:48

Kate today if that was happening to her

02:50

no as opposed to happening a few years

02:52

ago what I would hope would happen if

02:54

there was a case of my school was the

02:57

person that she felt confident enough to

02:59

open up to would have had the necessary

03:02

input to realize that there were certain

03:06

textbook signals about Kate's lifestyle

03:08

you know and straightaway realize not

03:11

everything is good for this child I need

03:14

to get someone else involved rather than

03:17

say to her we've that sort of stuff at

03:19

the school gates when you come in that

03:22

was a story that was crying out for a

03:24

common assessment framework to be done

03:26

and quite frankly as a teacher I

03:29

wouldn't have been able to know all of

03:32

the different things and for me what

03:34

pops up there is that whole issue about

03:35

training what I would like to see is

03:37

that every member of staff at some level

03:40

of training so that if they are the one

03:42

who can pick up on the little nuances

03:44

that suggested this is a child crying

03:47

out for help

03:48

and while the person might be the one to

03:52

address all her needs they will turn to

03:55

someone within the organisation who does

03:58

know the contacts and the other agencies

04:00

and has got the confidence to ring those

04:02

agencies and start the dialogues that

04:05

will lead to support for Kate and I

04:08

think so often what you come across

04:10

these parts on Children's Services side

04:12

the fear of mental health issues and

04:14

then sometimes on adult size the fear of

04:16

you know and kind of dealing with

04:17

children's

04:18

you know I'm just thinking through the

04:19

how we can actually work collaboratively

04:22

with colleagues in Children Services

04:24

because those of us who work and focus

04:26

on adults with mental health problems

04:28

you know the issue for us is that's who

04:30

were focusing on and that's where our

04:33

skills and expertise

04:34

is lie it's not where the needs of the

04:37

children so there is that apprehension

04:39

and anxiety about treading into areas

04:42

that we've got no expertise in it's the

04:44

joint training isn't it so that the

04:46

staff from the different teams as we do

04:48

fairly well with safeguarding we need to

04:50

do it more I think with more skills

04:52

sharing so that's the adults workers can

04:55

relate to workers with children and

04:58

share their skills and knowledge and

05:00

understanding what they all do doing the

05:02

joint training yeah would be really

05:04

beneficial but again it's about

05:06

releasing staff members to do that when

05:09

it's not their core work perhaps we

05:11

could have a champion within each team

05:13

that could go off and do that joint

05:16

training who could then be you know the

05:19

spokesperson within the team to keep it

05:20

on the agenda for those of us who work

05:22

specifically with them I think named

05:24

individuals in both to do that liaison

05:26

work is really good because obviously

05:28

there are practical issues that that are

05:30

difficult because the other elements are

05:32

fear a thing can be that actually I

05:33

might ask a question that I almost don't

05:35

want to hear the answer to because it's

05:37

gonna open up such an enormous area and

05:39

I as a practitioner I'm afraid of how to

05:41

deal with that I'm afraid of what might

05:43

be involved and particularly perhaps of

05:44

practitioners who already have a rather

05:46

bulging caseload and perhaps on a bad

05:48

day it can just feel like one thing too

05:50

many but it's I think it's it's also not

05:52

to say to each group of worker that

05:54

we're actually taking over your work

05:56

what we're doing we're still just doing

05:58

our own but we're going to ask for your

06:01

expertise and seeing that in a concrete

06:03

example that for Kate I think it would

06:06

have helped if if the school worker

06:08

would have been able to have access to

06:10

adult mental health services to ask

06:12

their advice but if Kate was happy with

06:14

that worker

06:15

you wouldn't want Kate overwhelmed with

06:17

three or four different workers so I

06:19

think it's it's how that's done yeah but

06:21

it's just sharing that the the expertise

06:23

and then no no I can call on them you

06:25

helped me breaking down those personal

06:28

barriers I think sometimes and it's

06:30

interesting that isn't it because if

06:31

once you know someone then it obviously

06:32

makes it easier doesn't it either to

06:34

drop by the office or pick up the phone

06:36

one of the things raised by

06:38

practitioners is that sometimes with

06:39

staff turnover in teams you might get to

06:42

know

06:43

you know sue and she's the person that

06:46

you link with but then maybe in six

06:48

months goes by and you've not had much

06:50

contact for whatever reason and then you

06:52

pick up the phone and all that she sues

06:53

golden and again I think is there

06:56

something wrong confidence to then

06:57

continue and not just say all fight and

06:59

forget it but actually say oh well sorry

07:02

you know Sue's not there but actually is

07:03

there someone else I can talk to that

07:04

builds the confidence of the

07:06

practitioner or an either side to be

07:07

able to say well actually I do need to

07:09

talk to someone I think before we move

07:11

on from Kate's story it's very important

07:13

that when Kate finally has the courage

07:16

to disclose well this is what's going on

07:18

in my life if the member of staff even

07:22

gives away the slightest hint that

07:23

they're making some judgments they Kate

07:26

will either think right well I need to

07:28

protect my mum from there or we'll

07:31

communicate that judgements and and the

07:34

parent themselves will think right well

07:36

I'm not going to involve myself with

07:38

someone who's already made the judgments

07:41

on me and therefore if you try to

07:43

instigate a calf because it doesn't need

07:46

parental involvement then it's gonna go

07:49

nowhere because right away all those

07:51

things start to kick in about well if I

07:54

admit to my problems there's a chance my

07:56

children will be taken away I think

07:58

that's something you're right I think it

07:59

takes us into that whole issue of stigma

08:01

and a like sort of brought in the

08:02

conversation so we start thinking about

08:04

things more from the parents side and

08:07

which was you know thinking about the

08:08

other film and Wendy's story so I wonder

08:12

whether it'd be helpful just to have a

08:13

look at that briefly yep I was married

08:16

for 18 years had three children and the

08:20

marriage broke up we've just basically

08:22

grew apart I met somebody else and

08:25

meeting that somebody else I got myself

08:27

pregnant

08:28

with my son I had to fight for my

08:33

children had to go from a house where I

08:35

had absolutely everything security in

08:38

tuganda living with someone else in one

08:39

bedroom and in that relationship just

08:43

before I gave birth to my son I found

08:47

out the partners wolf was cheating on me

08:50

then he started hitting me all the money

08:53

was going because he was gambling

08:54

everything but i bottled everything up

08:58

kept it to myself and when I gave birth

09:00

even then when they just give you the

09:02

baby I didn't want him people were

09:04

coming he was just laying there crying

09:05

because I just think when I hold him and

09:07

when family come over I put on a front

09:09

for them and I've done what I had to do

09:11

looked after him and done what I had to

09:12

do but completely rejected him I

09:14

remember the health visitor coming round

09:17

and she got me to fill in this form

09:19

which are filled in and she said that

09:22

there's signs of postnatal depression

09:24

did I feel fine I told her I did

09:26

obviously I did and I said yeah I'm fine

09:27

it's fine and then because the way I was

09:30

feeling I didn't like going out so I

09:32

never took Dominic to the health

09:33

visitors for checks I need to go for his

09:36

jabs where they where before with my

09:37

four kids I took them every two weeks to

09:40

get weighed but we've done that I didn't

09:41

do that

09:42

okay well that's some pause Italy I

09:45

think we heard quite a lot from Wendy

09:47

about what the issues were for her I

09:50

think again at the senator Kate in some

09:52

ways there seem to be a lot of missed

09:53

opportunities of the early intervention

09:56

for example children Santa's could have

09:58

had that have they been made aware from

10:01

say that the midwives and the house was

10:03

just an early stage could have got in

10:05

there sorted out some of that the

10:07

housing problems the kind of benefit

10:09

problems looked at the issues with some

10:11

of the older children and why she was

10:13

feeling as she did giving her more

10:16

support at that stage even prenatally

10:18

there's a lot of things that could be

10:19

done and with our relationships I think

10:21

with with midwives and house visitors we

10:23

know that people will say things are

10:26

okay but actually we need to probe a

10:28

little bit deeper and one of the things

10:29

that we're asking it within the Women's

10:32

Hospital and the early antenatal visits

10:34

is to ask the right questions I know she

10:37

was asked but I think it's asking was

10:39

you know

10:40

an increased awareness if you like I

10:43

think for me it's also being mindful of

10:45

the situations that some people are in

10:47

in the alarm bells would have been going

10:50

off for me

10:51

in terms of her living in one room with

10:54

four children hmm yeah that's and you

10:57

know it's also the her pride in trying

11:01

to keep everything together and she said

11:03

she wasn't sharing that with with family

11:04

members but she was clearly struggling

11:07

again that's bound to have be having an

11:09

impact on her general well-being as well

11:12

as a mental health yes and it's how we

11:14

engage those people who were involved in

11:17

her life significant others because it's

11:18

not just about family but significant

11:20

people in that person's life you know

11:23

within the community mental health teams

11:25

we were to attempt to engage them

11:27

because it's about their degree of

11:30

understanding and what the issues might

11:31

be it's a fine balancing issue around

11:35

the service users are agreeing to that

11:39

and also being very clear around what

11:41

information we may share with them you

11:44

know within Liverpool we will provide

11:47

significant others where the carers

11:50

assessment and that's about you know

11:52

what their needs may be in caring for

11:54

them for that individual yeah absolutely

11:56

and I think practical things that can

11:58

help actually working directly both with

12:00

them sort of parents and and children

12:04

young people the working in people's

12:05

homes is sometimes it might be something

12:08

as simple as actually just sort of going

12:10

through a drawer full of bills which are

12:11

piled out port unopened envelopes so

12:14

firstly the fact that some you know

12:16

that's showing all that parent has the

12:18

confidence to let you into their home in

12:20

the first place I mean that isn't always

12:21

a straightforward and easy thing as I'm

12:23

sure many practitioners will recognize

12:26

but just about establishing a

12:28

relationship of trust and then being

12:30

able to have offer quite practical help

12:31

as well as the emotional help that goes

12:34

along with that but I wondered if you

12:35

have other other thoughts about some of

12:38

the sort of practical helps it you know

12:39

that you know well it's rare that

12:42

somebody are thinking when his position

12:43

will walk through the door of a

12:44

children's and she needs to be guided

12:46

and learned but once that relationship

12:48

has been made and the trust is that she

12:50

could introduce her to a peer group of

12:52

people

12:53

in a similar position and then maybe

12:55

colleagues even from extended school for

12:58

the older children can come into the

13:00

Children's Center where she is she is so

13:01

she doesn't need to do all that running

13:03

around practically yeah that's one of

13:05

the things they can do is bring in and

13:07

contact those people see someone from

13:09

within a community mental health team or

13:11

anything else can be done in the one

13:12

place kind of one-stop-shop thing one of

13:14

the practical things I do when I'm

13:16

meeting people for supervision

13:17

staff members is ask are there any

13:21

children how are the children

13:23

how would you know you know just keeping

13:25

that prompt and making sure that it's on

13:27

the agenda clearly getting it right it's

13:29

hard because you know otherwise I guess

13:30

we'd have done it by now

13:31

we saw them but I just wondered whether

13:33

you've got any thoughts about you know

13:35

what do you think the real barriers are

13:36

that gets in the way because we've we've

13:38

probably identified some of them around

13:40

some of the sort of fear that can be

13:42

around or perhaps their need for

13:44

confidence but I wondered whether

13:45

there's anything else that you know from

13:48

your own experience that even you would

13:49

like to add we're all very busy

13:51

practitioners aren't we try to remember

13:52

that there are you know a need to just

13:56

make those links I think I think

13:58

sometimes it's not delivered it's just

14:00

another awareness and a time factor and

14:02

it's just making that extra effort I

14:04

think there's an issue for me in terms

14:07

of how we deliver services now because

14:10

when I originally trained as a social

14:11

worker 25 years ago I trained as a

14:13

generic social worker so I worked with

14:15

with children with with families with

14:18

adults with physical health problems

14:20

older people people with mental health

14:22

problems and you carried a generic

14:25

caseload and over over time you know

14:27

we've moved into specialist teams

14:29

because we wanted to deliver the best

14:31

service but people don't fall into neat

14:34

categories and yes and it's it's really

14:38

encouraging to see these Skye guidelines

14:41

come out because it's getting us back to

14:43

think family think parent to think child

14:46

and with the guidelines as well it's

14:48

it's challenging some of the stigma

14:50

that's around with mental health it's

14:52

getting mental health up onto the agenda

14:54

again yeah yeah absolutely and I think

14:57

that you know having that framework

14:58

there I think it's you know what you

15:00

were saying both in terms of different

15:01

disciplines it brings people together

15:03

and it probably in terms of

15:05

from you know within organizations

15:07

actually recognition that you know

15:08

there's a role for senior management to

15:10

make sure that they're engaged and

15:12

making sure that messages are

15:13

communicated you know as well as

15:15

actually on the ground practitioners

15:17

linking up with you know sort of

15:18

colleagues from different different

15:20

disciplines I think I think the

15:22

guidelines give gives all the senior

15:24

managers that the kind of backing to put

15:27

that message across and then is that

15:29

there's a kind of reason and a reference

15:31

point for why they're that they're

15:33

giving it to their staff the manage it

15:35

is I think it is filtering down yeah

15:46

you