The Buddy Scheme

Belinda Garnett, Geoff Turner,Belinda Garnett, Geoff Turner,

Warwick Owen, John Sherlock, Warwick Owen, John Sherlock,

Sonia LeonardSonia Leonard

Dedication• To all the service users that I have had the

privilege to work with, who have taught me and continue to teach me, so much about the experience of mental illness

• To Julia,especially, who said that

“Dying is a doddle compared to having schizophrenia”

INTRODUCTION

• Service user involvement in health care service planning and delivery, including education of mental health care professionals is acknowledged as important

• However - research indicates this has been tokenistic (Basset T, 1999)

INTRODUCTION

• Buddy Scheme developed to give value to service user input in mental health professional’s education

• True stakeholder position

• Shifting the balance of power to that of equality

• Collaborative relationship

AIMS

• To enable students to develop a greater understanding of mental illness and related issues from a service user perspective

• Students to have a service user mentor in addition to a professional mentor

• For students to develop practice which reflects learning from the Buddy Scheme

AIMS

• To reflect wishes of service users to be involved in student education

• To involve all stakeholders in student education – nurse educators, social work practice teachers, occupational therapy educators, service users and service providers

• Buddy Scheme to reflect the Trust’s student education Strategy

EVIDENCE BASE

• Concept of mentorship already validated in nurse education

• Service user input shown to have value in nurse education (Wood J, Wilson-Barnett J 1999), (McAndrew S, Samochiuk G 2003),(Felton A, Stickley T 2004),

• 12 step Minnesota Programme used in addiction work uses concept of having a recovering addict as a mentor or “Buddy”

EVIDENCE BASE

• Service user conference in East and West Kent identified that service users wanted to be involved in nurse education to improve mental health nursing care (May 2004)

• Local service user feedback identified difficulty felt by majority in classroom environment whereas a 1:1 relationship with a student would be comfortable

METHODOLOGY

• During practice placements in Gillingham CMHT students were allocated both a professional mentor and a service user mentor known as their “Buddy”

• Through 1h weekly sessions the student and Buddy work through a framework of topics developed by service users, reflecting the individual professional’s training curriculum

TOPICS

• Communication and listening skills• Experience of mental illness• Experience of psychosis• Psychoeducation• How psychosocial issues impact on mental health• Relationships between service users,carers and

mental health professionals• Service users strengths, beliefs and choices

TOPICS

• Recognising the importance of the therapeutic relationship, mutual respect

• Importance of holistic care in mental health• Experience of medication and side effects• Stigma• Self awareness• How students will use knowledge gained from the

Buddy Scheme, carrying forward knowledge into practice

EVALUATION

• Buddy and student initially identify learning needs and work through framework of topics using discussion

• At end of the sessions, both student and Buddy provide a written evaluation of their time spent together

• Student and scheme leader discuss how knowledge gained will be carried forward to clinical practice and evaluate its value in improving care in mental health services

BENEFITS FOR STUDENTS

• Students see a service user as a person rather than a “disorder”- prevents medicalisation

• Awareness and insight into mental illness from a service user’s perspective

• Humanistic view which cannot be gained from textbooks

BENEFITS FOR STUDENTS

• Appreciation of the importance of the therapeutic relationship

• Protected time with service user• Professional development• Met identified learning outcomes• Greater confidence in interpersonal and

communication skills

BENEFITS FOR STUDENTS

• Realisation of the impact of psychosocial issues to mental health, understanding of stigma attached to mental health

• Appreciation of importance of holistic care• Able to carry forward knowledge gained to other

clinical placements e.g into midwifery, paediatrics• Greater self awareness and sensitivity • Ability to develop practice which reflects this

learning

BENEFITS TO SERVICE USERS

• Feel respected, valued and empowered to speak openly and freely about their experiences of mental illness

• Appreciate being able to participate in a learning situation, as they may not be able to participate in group educational sessions e.g in a lecture hall

BENEFITS TO SERVICE USERS

• Empowered by being able to contribute positively to the education of future mental health practitioners

• Greater confidence and trust in building and sustaining relationships with Mental Health Services

• Self esteem, confidence and self worth has grown exponentially throughout the scheme

SUMMARY

• “AS THE STUDENT LEARNS, THE SERVICE USER GROWS”

• SHIFT OF POWER BALANCE TO THAT OF EQUALITY IN THE RELATIONSHIP

CHALLENGES

• Identifying Buddies- matching to professional specialities e.g Nursing, O/T, Social Work, Midwifery, Paediatrics

• Students may be at different stages in training- facilitating sessions if necessary

• Relapse, medication changes

• Boundaries and ground rules

CHALLENGES

• Confidentiality

• Dependency

• Disengagement

• Managing risk in a 1:1 situation

• PAYING SERVICE USERS FOR THEIR TIME AND TRAVEL EXPENSES

FURTHER DEVELOPMENTS

• Buddy Scheme has helped Gillingham CMHT to win Kent and Medway SHA “Team Mentor of the Year Award” and £1500-00 to equip a resource room for students and service users

• Presented at the RCN Mental Health Conference 2006 in Belfast

FURTHER DEVELOPMENTS

• Buddy Scheme won the “Community Care 2005 Award”, Mental Health Category, sponsored by NIMHE - £5000-00 to cascade the scheme across the Medway locality and PAY SERVICE USERS!

• Tafi Mushunje, nursing student, won the RCN Bursary Award to attend RCN conference with his submission about the Buddy Scheme

FURTHER DEVELOPMENTS

• Excellence & Innovation Award

Medway Council

Team Award 2006

• NESTA Grant of £40,000-00 to produce Buddy Scheme Training Manual & DVD, and to PAY participating services

RECOVERY

• Wendy Austin was Joint Runner Up in the Lilly Outstanding Achievement in Mental Health Awards 2006

• Moving Life Forward Category

“An inspiration to others”

So, Where Next?

FURTHER DEVELOPMENTS

• Buddy Scheme now used with students from other professions – social work and occupational therapy

• Social work students now including the Buddy Scheme as part of syllabus at University of Kent at Medway

• Junior Doctors now taking part in scheme

FURTHER DEVELOPMENTS

• Cascade the scheme to the other CMHTs in the Medway area.

• Cascade the scheme to other CMHTs in Kent & Medway NHS Partnership & Social Care Trust

• Cascade to other Trusts & educational establishments

FINALLY! WHY DOES IT WORK?

• Because it is so simple – just two people sitting down and talking to each other as equals!

• Both parties benefit greatly from the scheme!• The scheme has been recognised nationally as an

outstanding example of good person centred practice!

• It is highly cost effective! Both in implementation and the reduced need for services by participating services users as their recovery is enhanced!

ACKNOWLEDGEMENTS

• Gerry Bennison and Dawn Talbot for their encouragement, time and enthusiasm

• Colin, Warwick, Glen, Ann, Wendy, John, Jo for their time and support

• Canterbury Christchurch University, in particular Graeme Hardy, Practice Placement Facilitator

• All the students who have taken part

REFERENCES

• Basset T. Involving service users in training• CARE: The Journal of Practice and Development

7, 5-11 (1999)

• Wood J., Wilson-Barnett J. The Influence of User Involvement on the Learning of Mental Health Nursing Students. NT Research vol 4 no 4 (1999)

REFERENCES

• McAndrew S., Samochiuk G. Reflecting Together: Developing a new Strategy of Continuous User Involvement in Mental Health Nurse Education Journal of Psychiatric and Mental Health Nursing 10, 616-621 (2003)

• Felton A., Stickley T. Pedagogy, Power and Service User Involvement Journal of Psychiatric and Mental Health Nursing 11, 89-98 (2004)

CONTACT

• Geoff Turner 01634 331999

• Belinda Garnett 01634 331914

• buddy.scheme@yahoo.com

• Kent and Medway NHS Social Care and Partnership Trust

• www.thebuddyscheme.co.uk