Launched in 1994 MHM’s Support Matters Helpline has grown from a service that delivered telephone support to our own housing tenants, to a 24/7 digital support hub, receiving over 92,000 contacts a year. Through embracing technology and developing and expanding our offer, we deliver a service that never closes to those in need, their families / carers and those involved in their wider support. Our purpose and aims are to simply reach as many people as possible who would benefit from our support, and help them to develop the skills and coping strategies to integrate into their communities and reduce the demand on over-stretched statutory services.
Webpage for service (if available): https://www.mhm.org.uk/Pages/Category/helpline
From start: Yes
During process: Yes
In evaluation: Yes
PP Collaborative: Yes
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Julie Haley - Director of Community and support matters Mental Health Matters
Please briefly describe your project, group, team or service, outlining what you do and why it makes a difference.
Launched in 1994 MHM’s Support Matters Helpline has grown from a service that delivered telephone support to our own housing tenants, to a 24/7 digital support hub, receiving over 92,000 contacts a year. Through embracing technology and developing and expanding our offer, we deliver a service that never closes to those in need, their families / carers and those involved in their wider support. Our purpose and aims are to simply reach as many people as possible who would benefit from our support, and help them to develop the skills and coping strategies to integrate into their communities and reduce the demand on over-stretched statutory services. This is achieved through the delivery of a wide range of support and contracts (e.g. 24/7, in hours, out-of-hours, emotional, crisis support) where technology is used to break down the barriers into service. Methods of contacting Support Matters include: • Telephone • Text message • Email •Webchat •Bookable 121 sessions• Wellbeing calls •Voicemail • Voicemail ‘by choice’ – This gives individuals the option to leave a voicemail if they need to talk, but don’t yet feel comfortable speaking to a person. • We are also now actively testing video calling facilities, which will allow us to work with people face-to-face, regardless of their location.
Co-production forms the very foundation of our services. MHM pride ourselves on delivering excellent services and we cannot do that without the involvement of key stakeholders. All feedback is used to enable us to further enhance the services we offer Examples include: In the development of a service to support Cornwall NHS Trust and their crisis teams, we held a series of face-to-face and online meetings with MHM and Cornwall NHS (including 60 representatives from their 5 CMHTs, experts by experience, police mental health lead and switchboards). These meetings were used to establish and understand EXACTLY what was needed locally, the challenges they face (e.g. demands on teams out of hours, stresses staff face when they go home and are unable to switch off). From here we developed a system and service which meets their needs through establishing robust pathways and digital support and efficiencies which then allowed their staff to focus on those clients most in need, as well as their own wellbeing. A key challenge included the shared coverage of the “duty” line, which meant that staff, when office based, answered the phone to crisis callers. This impacted greatly on their ability to support their existing caseloads, forming significant backlogs and bottlenecks in support. Using technology to deliver efficiencies in healthcare across localities where we are just one of multiple providers also highlights how our service delivers real cost savings for commissioners, whilst ensuring that those in need are supported in the most timely way. In 2017 MHM were commissioned to deliver 5 of 10 contract ‘Lots’ of a community wellbeing and recovery contract in Leicestershire and Rutland. In total there were 3 providers, and MHM are the provider of a Single Point of Access for all 3 providers and 10 lots.
We are also part of one of the highest performing veterans service across Essex, Lincoln and Coventry and Warwickshire acting at the Veterans Single point of access and tracking the veteran all the way through their pathway ensuring no-one slips through the net. This means that regardless of who requires support, or where they live in the area, they can refer into MHM via one telephone number or email address and we will take those assessments and ensure that they are matched to the appropriate provider. This reduces admin time of the other stakeholders and allows them to direct their capacity to delivering face-to-face interventions, widening the impact of commissioner funding and improving the experience of those accessing the service. Our service is accredited by the Helplines Partnership, which is a rigorous assessment process where every element of caller experience, service quality and safety is reviewed. Only once the Helpline Partnership is assured that the service is of the highest quality is the accreditation awarded. MHM have held this accreditation since 2013.
What makes your service stand out from others? Please provide an example of this.
We do not CLOSE EVER! We deliver “a service for all” involved in the care of an individual with mental health support needs. Whether you are a client, a carer, a family member, a professional needing advice, we provide interventions which make a difference and strengthen support networks. Whereas other helplines close at 5 or are only open out of hours, we never close. 365 days a year we are there to support those who need us. Client feedback shows the life-changing impact our service has: • “This helpline has been the best support I have received recently, I don’t know what I would have done without out it. You really listen to me and that means a lot.” • “It’s very re-assuring to know if you wake up panicking there will always be someone there.” We embed ourselves within the fabric of local service delivery, making every effort to understand what support is available, and that services know who we are and what we do. Connecting over the phone, by social media and physical attendance at local provider forums. This brings provision closer together, building robust referral pathways, reducing duplication and breaking down the barriers to support. We focus on staff wellbeing, offering not only advice and support, but also the relief of caseload. Where caller crisis presents at 4:55 on a Friday, staff are able to pass the individual’s details to Support Matters to de-escalate, and also maintain the individual’s wellbeing over the weekend. This means that staff can go home in the knowledge that personalised support is being delivered, and the correct agencies engaged where appropriate. This allows staff to relax, and return to work refreshed the following week, ready to deliver high quality, effective interventions without the mental fatigue which would otherwise have occurred.
Support Matters is also key in the reduction of avoidable suicides, as demonstrated by our involvement in the “Release the Pressure” campaign in Kent (funded by Kent County Council) which aims to reduce the number of suicides in the county by encouraging men feeling under pressure to seek help by contacting Support Matters. Through our digital hub, we deliver confidential support via trained and experienced staff 24 hours a day 365 days a year. We continue to deliver on the release the pressure campaign. As the campaign continues, there has been a steady increase in the number of people accessing the helpline. One caller told us how much our Telephone Support Workers had helped, saying: “ my life is miserable and am struggling but you are always there and I feel safe’’ “I am in my 50’s and never felt so alone, you are always there and I can cope , you pick me up and always make me feel better , you know just what to say even when I am grumpy.” Other feedback includes: ‘Getting your number was the best thing that has happened to me.’ ‘Your organisation is my lifeline; if it wasn’t for you I wouldn’t be here. I appreciate you all talking to me.’ ‘I’m so glad I called – I had no idea it would leave me feeling so positive just by talking to you.’
How do you ensure an effective, safe, compassionate and sustainable workforce?
Our values based approach to recruitment is supported by clearly publishing our expectations around the role and service, and in turn we attract the ‘right’ candidates for the posts. This approach has been refined through the staffing of our varied and expanding Support Matters service and continues to help us achieve positive outcomes and impact. As a company who deals on a daily basis with callers and individuals who present significant and complex conditions including mental health and substance misuse, we know that providing appropriate levels of staff support and training is paramount to maintain safety and wellbeing. With the changing landscape of government funding, and the need to deliver more for less, it is essential that this is not at the expense of Service Users through lack of staff expertise. Therefore, MHM continues to invest in staff training and technology to support staff to deliver effective, high quality services. We align to the principles of valuing employees and provide rewarding careers for local people, with a good work-life balance, on-going development opportunities and internal progression routes. All staff are trained in counselling and receive specialist training in areas such as substance misuse, dementia and autism, ensuring we can deal with any call constructively, coaching people to overcome problems and de-escalating crises. Staff development and support – Training plans provide opportunities for staff to consolidate their training by receiving dedicated time and access to appropriate callers/cases to practice recovery interventions and promoting reflective practice, ensuring all staff are competent to provide a high standard of recovery advice/support. Our approach to performance management is made up of: • Appraisal: a formal approach to performance management, delivered through an annual cycle, which enables the objectives, behaviours and personal development aims of an individual to be set out, reviewed and assessed. • Personal Development Plans (PDPs): all staff members have an up-to-date PDP in place at all times, developed and reviewed as part of the annual Appraisal and Interim Appraisal review.
The purpose of this plan is to identify the development needs of the staff member which need to be addressed in order to achieve their Appraisal objectives. • 1:1: a less formal and more frequent review of performance (at least every 6 weeks, led by line manager) which also provides an opportunity to discuss current work priorities, encourage progress and identify possible problems. • Caseload Quality Monitoring: regular discussion (led by Practice Lead/ Locality Manager) which supports the continual development of our staff and enables the organisation to ensure services are being delivered safely, effectively and in line with both MHM policy and procedure and contractual requirements. There is a wealth of evidence demonstrating clear links between good employment practices and positive business outcomes. We create an environment where staff are valued, rewarded, appropriately trained and developed, regularly appraised and properly managed. We always put the development of our staff first, which has a positive impact on the people who use our services and their families. This also creates a system where we always have individuals in post who are ready to step up when the opportunity arrives (either planned or unplanned). We also see the impact of this approach in the calibre of applicants who wish to work for MHM. This is how we continue to attract and retain high quality staff who are consistently high performing, highly motivated and flexible. Without fantastic staff we cannot deliver fantastic services to the people we serve. We have an employee of the season scheme which staff can be nominated for, by going above and beyond their job roles and duties. Staff receive regular feedback and compliments from clients and callers which is fed-back through supervisions and documented. Changing caller presentation and new/ expanding contracts inform and influence training within our services. Recently, Support Matters saw an increase in calls from individuals with neurological injuries caused by self-harm. To ensure that interventions were safe, sound and effective, we engaged a neurological specialist who provided all telephone support workers (TSW’s) and management with a 2 day training course/ workshop on how to handle calls, techniques and role-plays. The specialist then spent time within the helpline following the training, shadowing TSW’s and offering feedback on calls. This ensured that callers, carers and families felt confident and assured of the support they received, and that TSW’s were empowered and supported to deliver to this new caller group.
Who is in your team?
To deliver over 80,000 contacts per annum, Support Matters currently employ: 1 x National Support Matters Manager 5 x Team Leaders (ensuring 24/7 management cover) All with minimum Level 3 counselling and Level 4 leadership qualification and minimum 2 years delivery experience 29 x Telephone Support Workers – All with Level 3 counselling and 2 years delivery experience 5 x Administrators with minimum Level 3 NVQ in business 1 x apprentice
How do you work with the wider system?
MHM work right across the health, social care and voluntary sector through our Support Matters service. We currently deliver 36 contract areas, including: NHS Trusts in; Gloucester, Cornwall, Devon, Northumberland, Coventry & Warwickshire, Hertfordshire, Warrington, Lincolnshire, Essex, Oxfordshire, Leicestershire & Rutland, York, Bristol Local Authority, Newcastle, Durham, North Tyneside, South Tyneside, Staffordshire, Plymouth, Coventry and Warwickshire, Leicestershire & Rutland, Kent Housing Associations in Northamptonshire, Leicestershire, Staffordshire, Warwick, Rugby, Milton Keynes, Surrey, East Sussex, Kent and Medway, . To deliver real digital innovation to our service offer, voluntary sector engagement and signposting is supplemented by Support Matters 365 days a year. For each area in which we deliver services, Support Matters scope the area and map existing service provision and add the details of specialist local services to our bespoke knowledge base, used by TSW’s for signposting when linking callers to specialist additional support. This ensures that regardless of when an individual needs our support, MHM are there when other services are closed. MHM also work with the police, fire brigade and ambulance services working together to get support to the people we care about when they really need it and that includes serving professionals.
Do you use co-production approaches?
Co-production forms the very foundation of our services. MHM pride ourselves on delivering excellent services and we cannot do that without the involvement on key stakeholders. Examples include: In the development of a service to support Cornwall NHS Trust, we held a series of engagement sessions with managers, experts by experience and their crisis teams. It was identified that these teams were receiving significant call volumes from newly discharged crisis clients, who remained overly reliant and attached to the service, but were no longer in need of the high level support. This added huge workload and emotional pressure to an already stretched team, and was also adding avoidable stress to the callers who still felt they needed support. MHM worked to establish a system whereby we would, with consent of the clients, take referrals for their most recently discharged clients.
Through Support Matters, we would offer them the emotional support that they needed in line with their care plans. This immediately alleviated significant pressure on the Cornwall teams, and has allowed their crisis workers and home treatment teams to focus on those clients in true crisis when they need that support. The service in underpinned by robust safety protocols and pathways, meaning that both Cornwall and MHM teams always have the most up-to-date information and the callers are always supported when and how they need. By engaging experts by experience in this way, they are able to influence and shape services from the very beginning, and this continues throughout service delivery. In our Cornwall service we also added the ongoing assurance measure that each caller (where appropriate) is asked a few questions about the quality and effectiveness of their support today. This is delivered in a very unobtrusive way, and allows us to immediately reflect on the way in which we delivered advice and support and where we should adapt our practice moving forward. Where callers are linked to a contract (e.g. our housing services), Engagement workshops are used to identify where clients feel services can be improved. The workshops are co-led by clients and Recovery Workers, who support clients to fully discuss their experience of services (either with MHM or other agencies) and to identify things that have worked well and things that could be delivered differently. This practise ensures that clients have an integral role in shaping services. In addition to service-based meetings, MHM adopt a wide range of feedback platforms.
Using a client satisfaction survey approach on an annual basis and at the point when clients exit the service, we gauge views about the overall experience of people using our services. To ensure objectivity, surveys are managed by MHM’s central support team. Clients have the opportunity to complete the survey anonymously online; alternatively they can post a hardcopy survey to our central support team. While not specifically aimed at them, the survey may also be completed by a client’s carers and family members. Survey results are then used to inform the ongoing service improvement plan. MHM has a feedback coordination team who respond to all compliments, complaints and suggestions. In addition, we provide a dedicated telephone number and email address for clients to report any concerns about service delivery. We take all feedback seriously and responses identify any recommendations for improvement and actions taken to achieve these. An example of this is that personality disorders training now forms part of our mandatory programme as a direct result of client feedback. All feedback helps MHM to understand and enhance the experiences of clients and their families/carers, by identifying trends or pockets of good or potentially outdated practice, where there may be an apparent gap in the knowledge base or skill set of a staff team or a staff member. MHM have successfully involved clients in the recruitment and selection process where clients can sit on recruitment panels for the wider organisation. Our belief is that every recruitment panel should have at least 1 client and this is formalised through our policies and procedures manual. Everything we do ensures that support remains client led and reflective of the needs of the people who access our services.
Do you share your work with others? If so, please tell us how.
Before we deliver on any contract, MHM cast a ‘spider’s web’ over the locality. This means that we map and gap all local service provision and engage with providers to learn about what they do, before then sharing information about our service, support and pathways to join together knowledge and networks. We use our attendance at local provider forums to share best practice and to ensure the needs of the client are met and to ensure they are receiving the best possible support. Support Matters is responsible for running the Local provider forum in Coventry and Warwickshire, and MHM’s website is used to host information about this, including meeting dates, key providers and the groups terms of reference so they are available for anybody to access and invites/ encourages providers to attend the forums
What outcome measures are collected, how do you use them and how do they demonstrate improvement?
MHM adopt an open approach to performance management and use technology and expertise to support a collaborative approach to outcome collection/reporting. We provide access to business intelligence dashboards providing ‘live data’ evidencing service performance. This forms the basis of review meetings with commissioners facilitating two-way sharing of information about emerging trend/issues and opportunities for further developing the service. We make effective use of both quantitative and qualitative processes and systems. Quantitative – Performance is monitored using telephony and CRM systems and can be accessed at TSW and management. This enables us to effectively manage performance within agreed criteria such as average call duration and availability to answer calls. Qualitative – Calls into and out of the helpline are recorded. While all callers may opt out, contacts that may be logged as incidents (such as those where we contact emergency services) are recorded. Each TSW receives four contact monitoring sessions monthly, spread across the different channels. These are assessed against agreed criteria and behaviours and (together with call handling statistics) used to feedback and coach TSWs. Team and peer supervision is also used and well received by TSWs. Contract outcomes are directly captured in MHM’s CRM system ensuring this takes place at the point of contact with the caller and in a standard format. Dashboards detail helpline performance in an interactive and intuitive manner, depicting contractual KPIs together with trend analysis and time series forecasting over future periods. Helpline management use dashboards to monitor and track performance in relation to call metrics such as: answered and abandoned calls, contact duration, repeat callers, number of voice mails, SMS messages, instant messages etc. They monitor performance on a daily basis. Weekly and monthly review meetings will be held by the management team and plans developed to continually improve performance. Overarching this MHM has a performance management team who, on a monthly basis, generate service related information and dashboards and report performance against plan to commissioners.
Has your service been evaluated (by peer or academic review)?
Our service is accredited by the Helplines Partnership (The CQC of Helplines!). Helplines Partnership is the membership body for organisations that provide helpline services in the UK and internationally. The Helplines Standard defines and accredits helpline practice. This quality framework is an excellent way of ensuring our helpline is effectively meeting the needs of service users. This rigorous assessment process reviews every element of caller experience, service quality and safety, standards include: • Service User experience at every contact • Appropriate technology and resources to deliver excellent services • Recruitment, retention and training of skilled, motivated staff • Confidentiality, data protection and risk • Workforce planning and forecasting to meet changing demands • Quality and performance reviews planned and carried out regularly Only once the Helpline Partnership is assured that the service is of the highest quality is the accreditation awarded. Accreditation last for 3 years, with an 18 month interim report/ assessment carried out. MHM have held this accreditation since 2013.
How will you ensure that your service continues to deliver good mental health care?
The quality of our service delivery is outlined and established from the very first dialogue with our commissioners. By building pathways, services and offering digital solutions to their challenges, we ensure that the service we deliver on day one is the service which their clients, carers, families and valuable staff teams need. However, our experience shows that there is always the need to be flexible with our service offer, and we maintain constant dialogue with callers, support networks and commissioners to ensure that we are always delivering high quality, effective interventions. The evidence of this can be seen in our contracts where we see contracts and funding reviewed consistently by commissioners, and in the powerful feedback we receive from callers. Here are just a sample of the many, many compliments Support Matters receive: • “your more than just a Helpline you’re a lifeline” • “What you all do is brilliant. It’s not just a phone call, it’s like someone pulled me back from over the edge.” • “When I had no one to talk to I found you and that meant everything to me, it still does.” • “you saved me” • “without you I would not be here” • “Being referred to the Veterans Service and talking to the Helpline helped save my life, I was on the verge of committing suicide.” We use our attendance at local provider forums to share best practice and to ensure the needs of the client are met and to ensure they are receiving the best possible support. Support Matters is responsible for running the Local provider forum in Coventry and Warwickshire, and MHM’s website is used to host information about this, including meeting dates, key providers and the groups terms of reference so they are available for anybody to access, attend and become a member. Additionally, our service is accredited by the Helplines Partnership, which is a rigorous assessment process where every element of caller experience, service quality and safety is reviewed. Only once the Helpline Partnership is assured that the service is of the highest quality is the accreditation awarded
What aspects of your service would you share with people who want to learn from you?
MHM are happy to share their challenges, solutions and lessons learned with those who wish to commission a service. We see it as our responsibility to help to shape a more efficient, effective healthcare sector, and by sharing our 30 years helpline & digital experience, we can positively influence services moving forward
How many people do you see?
Support Matters deliver inclusive services, and therefore we are not restricted by the referral process in many of our contracts. This approach allows us to deliver over 92,000 contacts over the course of the year. Contacts include telephone, webchat, email, and texts with support delivered to individuals needing mental health support, their families and carers, as well as professionals (including GP’s). Over the past 12 months, on MHM’s main website (www.mhm.org.uk) the Support Matters service page was visited over 5000 times over the last 12 months.
How do people access the service?
The great thing about our service is that even when you are in a room full of people we can support you via text and webchat its discreet and its someone to talk to even when our users feel they have noone. It also stops the social isolation the great part of our services is no matter where you are we have got you!!! Support Matters can be contacted via various channels, including telephone, e-mail, text and webchat, which we developed to ensure support is accessible to anyone in need. We use social media and our web presence to promote our services to those who find it difficult to access more traditional methods of support or who are more comfortable using technology
How long do people wait to start receiving care?
Support Matters operate 24/7 365 days per year. This means that people do not need to wait to access our support. In the event that all of our Telephone Support Workers are busy, a voicemail can be left, where we return calls no later than 45 minutes from the time the message is left. So 45 mins is all it takes as long as you leave the number and name then we will come back to you within that time!!!!!
How do you ensure you provide timely access?
All Support Matters contracts have their own unique contract requirements (e.g. operating hours, eligibility, and call volumes). All contracts are staffed to meet the demands of that locality with the service managers and team leaders using our technology and data available to forecast when callers need us the most. Staff rotas are built accordingly to meet this demand, ensuring that we have staff ready to speak to a caller via their preferred method. In addition to our telephone support workers (TSW), we always have a manager on shift (24/7) who is not rota’d to take calls. This means that should a TSW require support on a call, or a high priority call is received, the manager can step in and add additional capacity and expertise, ensuring that callers continue to experience timely access and support.
What is your service doing to identify mental health inequalities that exist in your local area?
We keep an eye on who is using the services and make focused and direct contact where we know there is a cohort of people not using us. Even talking to elders in the community to tell them what we can do and how we can support. We run a provider forum for our Coventry & Warwickshire contract area, and also attend provider forums in the other areas which we deliver. We ensure our signposting directory is up to date and look at client feedback to the services in their area to create service improvements. These activities help us to understand the local health and wellbeing landscape, engage with providers and gain access into underrepresented and hard to reach groups. These methods and approaches are underpinned by our approach to social media, whereby we seek to engage these groups through tailored messages to local population needs. We meet quarterly and share trends in our data with other service providers to ensure we are supporting clients to the best of our ability.
What inequalities have you identified regarding access to, and receipt and experience of, mental health care?
We have identified that people from minority ethnic groups are less likely to access our services, despite being contracted in a vast range of areas. As a result, we are targeting these areas online and physically attending events to challenge stigma and show clients that our service can benefit them. We now have a learning disabilities contract in which we are exploring the use of app based technology to support individuals and promote independence. This has been a learning curve for Support Matters, but we have adapted our service to meet the delivery of this contract in line with feedback, and further evidences that we will continue to explore new and emerging technologies to deliver quality services, but always with the client’s wellbeing in mind
What is your service doing to address and advance equality?
As previous, and we also adhere to Equality Act 2010, Care Act 2014 & Human Rights Act 1998
How do you identify the needs of a person using the service ?
We talk we read we listen!!! this is not a spotlight this is a real service with real people walking about real needs. We know people make contact because they need something and we spend time finding out what that something is.
How do you meet the needs of people using the service and how could you improve on this?
People want to be heard they want to have a voice and they want that service to be faceless, non judging and meaningful. according to our feedback we are all of those things and not just from users of mental health services but serving professionals.
What support do you offer families and carers? (where family/carers are not the service users)
We support a number of Veteran Carers and loved ones and help them prepare from their loved ones to come home from service. we also work with carers of loved ones that have had a recent brain injury. we dont do carers assessments we do carers support and we signpost into the community for more conventional support.
Have you implemented any of the mental health care pathways developed by the NCCMH (on behalf of NHS England)?
Liaison Mental Health Services for Adults and Older Adults
If you have implemented any of the above, what were the benefits and challenges?
Direct route into psych liaison spending up the clients Journey getting them seen quicker by being a trusted assessor
Commissioner and providers
Commissioned by (e.g. name of local authority, CCG, NHS England): CCG, Foundation trust, LA
Provided by (e.g. name of NHS trust) or your organisation: MHM
Brief description of population (e.g. urban, age, socioeconomic status): MHM take over 92.000 contacts a year supporting people from every background with varying needs. 1-3 calls in a crisis call and our team could be saving a life
Size of population and localities covered: Kent and Medway 1,554,600 Coventry and Warwickshire 362,700 Cornwall 561,160 Devon 789,405 Gloucestershire 629,166 Herefordshire 189,300 Plymouth 264,000 along with 36 contracts Nationally
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