Bluebell provides specialist community support for mothers, fathers and families affected by perinatal depression and anxiety across Bristol, South Gloucestershire and Devon, through a range of specialist community services including befriending, therapeutic groups, one-to- one listening and counselling, advice and information. Our successful work supports parents through of our Bluebell Buddy service, a 1:1 befriending provision, which provides mums and dads affected by pre and post-natal depression, with an empathetic listening ear, support with getting out and about and signposting to other relevant services. The Buddy service is delivered by paid and trained peer support workers who are parents with lived experience of perinatal mental illness and have recovered to the point where they feel able to support others.
What We Did
Bluebell provides specialist community support for mothers, fathers and families affected by perinatal depression and anxiety across Bristol, South Gloucestershire and Devon, through a range of specialist community services including befriending, therapeutic groups, one-to- one listening and counselling, advice and information.
Our successful work supports parents through of our Bluebell Buddy service, a 1:1 befriending provision, which provides mums and dads affected by pre and post-natal depression, with an empathetic listening ear, support with getting out and about and signposting to other relevant services. The Buddy service is delivered by paid and trained peer support workers who are parents with lived experience of perinatal mental illness and have recovered to the point where they feel able to support others. Buddies come from a variety of backgrounds, receive ongoing training and regular supervision and has become a highly regarded and in demand service.
In addition, our Mums’ Comfort Zone runs in North, South & Central Bristol and is about to launch in Torbay and the South Hams. This is a therapeutic support group programme, led by and OT alongside a Buddy, for mums who are finding life stressful, resulting in them experiencing feelings of sadness, panic, loneliness, frustration or anger and may be identified as having post-natal or antenatal depression or anxiety. The aim is that by meeting together, weekly, with other mums in a similar situation, they can have some ‘me time’ in order to help them become more positive about life as a mum and they are offered a variety of activities with the aim of equipping them with strategies to manage their depression. Every mum attending one these 12-week programmes receives their own Tool-Kit, which is a resource covering each weekly session and acts as guide they can take forward through recovery and beyond.
In September 2016 we opened Bluebell Place, our innovative city centre well-being hub; a welcoming and creative high street meeting place, offering the first informal drop in facility for mums and dads affected by peri-natal illness in Bristol and possibly the UK. As well as regular drop-ins and a cafe space for parents to meet, Bluebell Place provides therapeutic workshops, creative & relaxing sessions and a range of short courses, all designed to encourage high levels of user involvement and support positive change in the lives of families living with perinatal mental illness. Infants are cared for in therapeutic creches, staffed by an experienced team with skills and backgrounds in sensory play, sleep, feeding and other early years support.
In addition, the Bluebell service for Dads experiencing mental health concerns related to pregnancy and birth, has recently been relaunched as Dads In Mind and is being developed by Louis, a young father from Bristol with lived experience. He is running regular group meet ups for Dads at Bluebell Place, providing 1:1 support face to face and running a closed Facebook group.
From the start, Bluebell has worked closely with a range of partners, including health and social care professionals, our funders and parents. We work closely with children’s centres across Bristol, with whom we initially piloted and have been running our successful 12-week therapeutic programmes and where we base all our courses. We have developed this in partnership with them and work closely with each other regarding referrals in and out of each others services to ensure families can access all the support they need in the early years. We also work closely with GP’s, Health Visitors, Midwives, Specialist Perinatal Mental Health Teams and many other HCP’s and agencies who all refer parents into our services and with whom we have regular meetings, liaison and connections regarding the families we are supporting to ensure a joined-up approach. We have been proactively involved with working and strategy groups for the local CCG’s in the areas where we work, with the NHS strategic clinical networks and with the Bristol perinatal mental health health integration team to drive forwards change and to keep the parent voice at the heart of service development and identifying gaps in provision.
Our CEO, Ruth Jackson, also recently sat on the shortlisting panel for the NHS England specialist community perinatal mental health bids which came in from 60 CCG’s around the UK, to keep the VCS and parents voice in this process. In addition, we have close relationships with many of our funders, many of whom have been instrumental in driving forward change for perinatal mental health voluntary sector services in the UK. Comic Relief and the Big Lottery are two of our largest funders and they are both proactive and highly involved in supporting PMH across the UK, including the Maternal Mental Health Alliance of which Bluebell is also an active member. We recently welcomed both the CEO’s of the Big Lottery and Comic Relief to Bluebell Place as they wanted to see the hub which both jointly fund and it was great to hear them speak about how they’ve used this as an example of innovation in the sector. In addition, we share our practise widely at conferences, including the Comic Relief staff conference this year which was incredibly inspiring to be alongside charities from the developing world funded by them also, and share our work in the UK. The Bluebell team are also regularly involved in delivering training for professionals including midwives, academics, GPs and private sector companies who want to know more about PMH and how to keep the needs of the families at the centre.
From the start Bluebell’s services have been co-produced with parents with lived experience, children’s centres, health professionals and our staff team (most of whom are also parents with lived experience). All our marketing materials are co-produced in workshop style groups with families and our Buddy peer support service, is delivered by parents with lived experience. In all our course, we take weekly feedback from parents and have made many changes over the years, based on this feedback and continually develop our services to meet parents’ ongoing needs. We run regular focus groups, including recently one with fathers to identify the type of support they would like from our service Dads In Mind, and out of this the service is now developing. We go beyond just consulting with parents and actively involve them in delivering sessions and services for us, for e.g. a mum who came through our services is now one of our paid and trained Buddies and another mum who also cake through our service, has been running 6-week life-coaching courses for mums at Bluebell Place.
Our Dads’ worker, Louis was initially a Dad who came to access support from Bluebell and is now developing the Dads In Mind brand and service for us. In addition to co-production with parents, we also co-produce with other practitioners, such as our new Emotional Wellbeing in Pregnancy course currently being delivered at Bluebell Place with The Birth & Wellbeing partnership who are a midwife and a counsellor we have developed this new programme with and are piloting. We have worked closely with the local health care professionals to develop our services in a way that are complementary to NHS provision and we co-produce many of these with them, to ensure parents have a seamless pathway that leads from one to the other. Recently we have been working the Bristol safeguarding board who are writing new recommendations for PMH based on two serious case reviews, and for which we have been gathering feedback through questionnaires and interviews with parents to enable them to share their views on where the gaps in services are and what more could be done.
Another way we involve parents with lived experience, carers and families is through media awareness, one example being the highly successful #MumTalk campaign run by Sport Relief last year, for which many of the parents supported by Bluebell were filmed sharing their stories, which appeared nationally throughout the campaign week. Many other parents have taken part in local and national features for print and online media to raise awareness of PMH.
Finally, our new project in Torbay and the South Hams, Little Bluebell, has been co-produced alongside the DPT Perinatal mental health service, with of their OT’s seconded to run the new Bluebell groups and local mothers with lived experience recruited into the roles of the new local Buddies. This is a really great example of how working alongside our NHS colleagues, can create a safe, robust and holistic model of care for families with the link between the VCS and the NHS being all part of one pathway.
Looking Back/Challenges Faced
From staring as a new charity seven years ago based on our CEO’s personal experience of perinatal mental illness, to where we are now as a growing and in demand service, has given us plenty of challenges and learning along the way.
One of the really key pieces of learning has been how important it has been for to be imbedded in the right networks and to work closely with NHS colleagues and with social care. This has at times been challenging as in the beginning we needed to prove ourselves as a reputable and professional organisation, however we have put a great deal of work into this and it has paid dividends. We are now a very respected and integral part of the PMH community and pathway in Bristol, S Glos and now Torbay and the S Hams.
In addition, with funding we have always tried to take a very professional approach, which has been helped by the CEO’s professional background as a Director of Fundraising for large national organisations. From securing funding very early on in our life from Comic Relief and then Big Lottery, we have worked hard to ensure we can demonstrate our effectiveness and impact and as a result have received many more multi-year grants which have enabled us to grow and become more sustainable. The challenge of this at times, has been the investment we have needed to make into fundraising, which we know has been one of the best things we’ve done however it can be extremely hard as a small charity to make that investment into areas such as fundraising, when most funders only want to fund the projects. Securing core costs and ongoing running costs has been one of our biggest challenges and we are currently developing a more robust 5-year plan for this.
Finally, securing a really strong board of Trustees has been challenging at times as most Trustees are already very busy people and so finding people with the necessary time and skills to offer can be hard. However, we have spent some time over the past year working on this and now have a very strong board in place.
Over the past year we have undertaken a strengths and weaknesses review of the organisation, which was funded by the the Big Lottery as part of their funding of our new city centre hub, Bluebell Place. This was an extremely useful exercise as it enabled us to look at all operational areas of the charity and put measures in place to plan for the future and strengthen any weaker areas. Out of this, we have taken several key measures. 1.HR policies and practises were reviewed and strengthened, with new contracts and appraisal systems implemented for the team. 2. The board of Trustees was strengthened with several new members joining and all the board undertaking training with a well know UK charity governance specialist. 3. Several members of the team have been unskilled to take on more responsibility and take on more of the leadership of the charity alongside the CEO and in particular, the Project Manager who is now deputising and taking on a role of deputy CEO for the organisation.
Alongside, this the fundraising strategy is robust, as a result of the CEO, Project Manager and freelance fundraiser developing a forward plan for this and several large multi-year grants that have been secured. Finally, as part of our recent growth into Torbay and the South Hams and South Gloucestershire we have been through a recent recruitment exercise and have taken on some experienced new team members who have the skills and background needed to take on senior roles and responsibilities. In terms of financial sustainability, we are also in discussions with several CCG commissioners regarding some of our services becoming commissioned, potentially as part of IAPT talking therapies services, which would provide another income stream in addition to our grants programme and our individual donations programme.
Evaluation (Peer or Academic)
We monitor and evaluate our services on an ongoing basis in a number of different ways. For our funders, we provide regular monitoring reports which vary depending on each funder, however for the Lottery and Comic Relief, these consist of robust reports 6 monthly and annually which are based on the key outcomes we have set with them at the start of the projects they fund. These look at both qualitative and quantitative outcomes and include, using mental health screening tools such as the GAD7 & the EPDS at the start and end of each 12-week programme we run to measure recovery rates, plus weekly session feedback questionnaires to assess weekly mood and satisfaction with our services as well as knowledge cafes at the end of each 12-week programme where we gather softer data on mums experiences through drawing and poetry. We also use diversity and equality feedback questionnaires with all the parents we support to gather data on the demographics we are supporting, plus we often run focus groups and interview sessions to also gather data for our funders and for each children’s centre we are working with.
We share this data for the 12-week programmes by producing a short evaluation report at the end every 12-week programme for each children’s centre, to enable them to use this also in their reports to Ofsted and the City councils. These are deliberately short as we produce 9 of these each year (an example is attached). In addition, we have produced two larger service evaluations which have both been undertaken by PHD and MA students for us and we are currently in the process of commissioning a fuller independent evaluation of all our services over the past two years, for which we are currently seeking the right evaluation service provider. (The two larger service evaluations can be seen in this link on the home page of our website – www.bluebellcare.org – look at the home page and see ‘downloads’ to read these reports).
Some of the main ways in which our services have improved outcomes for both parents and those working in it, are:
– has reduced social isolation of parents experiencing anxiety and depression, through the Buddy service providing home support, building relationships with families and then enabling and empowering them to join our groups and access Bluebell Place. Through this, mums and dads have connected with others who share similar concerns and have felt able to form positive and supportive social networks.
– has equipped mums with strategies and techniques to enable them to manage feelings of anxiety and depression, leading to more confidence and more stable families lives. Our Tool-Kit approach in our groups has been deliberately developed to provide really simple and effective techniques, such as ‘turning negative into positives’ ‘relaxation techniques’ ‘creative sessions to inspire time out’ ‘self-esteem sessions to equip mums with confidence’ e.t.c which mums can then take forward for the rest of their lives.
– has reduced the stigma around perinatal mental health by enabling mums and dads to talk openly about how they really feel in a safe and supportive environment, leading to them feeling more able and confident to ask for the help they need from health professionals and to feel able to share more openly with friends, families and workplaces how they are feeling. Many parents who felt unable to tell anyone honestly how they were feeling have now take part in sharing their stories in the media and feel able to talk openly about their mental health.
By having our wellbeing hub, Bluebell Place on the high street, we have also broken the stigma surrounding perinatal emotional health, through normalising it, as somewhere people can just pop in and access the help they need without feeling any shame or fear.
– we have increased access and engagement with support for some harder to reach groups by providing free child care alongside our services which is sited as a huge barrier to access by many of the parents we work with, we have also produced relevant, engaging and user led marketing materials which are widely disseminated to reach people who may not normally by accessing mental health services and through peer support workers who are parents themselves with lived experience of PMI, we have enabled mums and dads who may normally find it very hard to ask for help or who may fear professional involvement a route to developing a relationship with a peer worker who can share appropriately and within boundaries some of their own experience and who parents can see has empathy, no judgment and importantly, can show them that recovery is possible.
For our staff team and those working for Bluebell:
– we have developed the skills of parents with lived experience of perinatal mental illness, who we have employed and trained to support others. This has been an empowering experience for some of our Buddies, who felt they might never get back into work and has provided a new career path for them.
– we have worked very closely with many other agencies and health professionals which has given the Bluebell team a varied and interesting role and has meant they are regarded as a vital and integral part of the wider perinatal mental health community.
– we have developed interesting and varied training opportunities for our team with a wide range of training provided on an ongoing basis, such as; listening skills, sleep, feeding, attachment, reflective functioning, counselling skills, lone working, safeguarding, suicide awareness, infant mental health, baby massage, motivational interviewing and many more which has given them a rich basis for their work and ongoing careers.
We share our work on an ongoing basis in many way, including:
– training we provide to many groups, including all the Midwives in the NBT trust recently who were training in PMH and for which we provide an overview of lived experience, case studies and ways in which the VCS can support families. We have also provided training for the UWE CPD masters on PMH, for Norland Nannies, for Children’s Nurses, IAPT teams and Liaison Psychiatry at the BRI.
– conferences and seminars – we are often ask to speak at conferences and workshops and recently have spoken to, Clinical Networks, Health & Wellbeing Boards, Mental Health in the Workplace, International Women’s Day, Comic Relief Staff conference and many more.
– We also share our work in the media on a regular basis with parents who share their stories and how Bluebell helped them as well as features on perinatal mental health in general, these have included both local and national media e.g. BBC Radio Bristol, Bristol Post, BBC Points West, the Guardian, the Mirror, JackFM, BreezeFM as well as many online channels such as Huffington Post and the #MumTalk Sport Relief campaign.
In addition, we have used our work and contributed to many local networks and strategy groups that have improved services for PMH in Bristol and nationally, such as the MMHA and CCG strategy working groups and commit to doing this on a regular basis.
Is there any other information you would like to add?
The Bluebell team and charity is still fairly small, however we feel very passionate and always willing to go the extra mile to ensure families receive the care and support they need at such a vulnerable and often devastating time. This passion comes from the personal experiences of the Bluebell team themselves, all of whom have some lived experience of PMI and know first-hand how hard and dark this can be and who have a deep desire to improve this for other parents.
It has been at times very hard working in the context of ever struggling and overload mental health, primary care and maternity services and as a small charity we have found ourselves holding very unwell mums and dads who have found it almost impossible to find any help from elsewhere as the NHS services are under so much pressure and the thresholds are so high. This has meant our team has needed to focus on additional training and develop really strong links with NHS, social care and crisis team colleagues as we are frequently liaising and working with them to keep women safe. Whilst this is very hard at times and frustrating that the NHS cannot support all those who need it, it is also very satisfying to see the difference we can make as a small charity to so many families lives and to hear the wonderful feedback from parents who we have seen recover…here are a few quotes from mums which sum this up from our positivity board at Bluebell Place:
“From black to full rainbow coloured future”
“Bluebell Place – a safe space”
“Found a Buddy who just gets it”
“feel privileged to have met other mums finding their way through”
“Bluebell Place the only place I ever go and the only time I leave the house, thank you”
“The programme helped me to identify my depression, helped me to not feel alone and give me the tools to get better”
“met new mums and now know that I’n an awesome mother who deserves some me time”
I have lots of amazing table cloth drawings I can share with you if you’d like to see some too!