Having agreed to support the project, CUFC were happy to provide facilities at their stadium at Brunton Park, with support from their community coaching staff. The group meet each Tuesday at Brunton Park and initially 10-15 individuals attended. However, now 25-30 people regularly attend sessions.
What We Did
Having identified a need to encourage both an improvement in service users’ physical health and try to address their social isolation, I approached Carlisle United Football Club (CUFC) to explore whether they would support a joint community initiative with Cumbria Partnership NHS Foundation Trust (CPFT) to set up a regular football group for people with mental health problems.
Having agreed to support the project, CUFC were happy to provide facilities at their stadium at Brunton Park, with support from their community coaching staff. The group meet each Tuesday at Brunton Park and initially 10-15 individuals attended. However, now 25-30 people regularly attend sessions. In patient service users as well as those residing in the community attend the group, and though most are male, some women also take part. Since the group began attendees have completed regular questionnaires in order to understand how the activity has impacted their a) Fitness; b) Reducing social isolation and assisting in making friends; c) Losing weight; d) Reducing or stopping smoking.
There has been some considerable success. One 33 year old male who was first referred to MH services at aged 19 and diagnosed with schizophrenia, with a history of admissions (including detention under Mental Health Act) recently shared his story at CPFT’s Board Meeting. He informed the Board on 31st March this year that the football group –
“Has made me more confident in myself…my fitness has improved as well and I have lost weight and am fit again”. He also described the impact on other colleagues, who attend the group - ”They say they have benefitted and their confidence improved. They come with their social worker for the first month, ‘cos they don’t know anyone and are a bit shy, but now they come on their own, cos they trust people they come every week”
This individual has stopped smoking and although he is prescribed clozapine his Care Coordinator now has minimal contact.
The football group now also provide two teams to compete in a local “Ability Counts” League and another team competes in the North West Mental Health League. The 33 year old man described earlier is Captain and their goalkeeper is a young female with similar MH problems.
We have recently been successful in acquiring additional funds from Sports England (through Active Cumbria) specifically to promote physical activity amongst 16-25 year olds with MH problems. Consequently we have recently been targeted service users supported by the Early Intervention in Psychosis (EIP) Team. One 18 year old male, supported by his EIP key worker, has recently joined the group. Having not left his home for two years due to his levels of paranoia he is now attending weekly, with report from his family of improvements in his symptoms and a small but noticeable increase in self-confidence.
An increasing number of enquiries are being received about joining the group from Learning Disability services and Acquired Brain Injury teams but presently the maximum numbers we can accommodate is 30 people.
Wider Active Support
We have regular meetings with CUFC and both the Board of CPFT and CUFC are interested in and actively supporting the project. The regular completion of questionnaires assists to highlight the needs and future direction of the group. As a result of its’ success and in order to ensure the future sustainability of the group myself and my Occupational Therapist colleague (Laura White) have had regular communication with senior CPFT managers about funding. As previously indicated we have successfully bid for funding from Active Cumbria specifically to encourage promotion of physical activity amongst 16-25 year olds; there are specific targets which have to be met to ensure we receive the full grant.
Regular questionnaires have been completed by those participating in the group and responses have highlighted where improvements can be made. The questionnaires have also been used as an audit tool and findings presented to inpatient staff and CUFC.
Group attendees have been instrumental in ensuring the group now participates in the “Ability Counts” League and NW League, for example.
Looking Back/Challenges Faced
Establishing ongoing and secure funding has been difficult, not only because of my clinical workload but also, for example, because the group now is not a pilot (being started in 2014) some of the national access to sports funding has not been available to bid for.
However the success of the group has enabled it to move onto surer footing. In addition, framing the impact of the group from a recovery perspective is perhaps something that could have been done more robustly and this may have also assisted in developing a more focused plan for the group with the requisite recurring funding. However, use of the questionnaire has been key to capturing the improvements and impact that the group has had on attendee’s mental and physical health.
Funding: This was an issue from the start of the project. However, I attempted to overcome this by working with CPFT and CUFC Communications teams to secure positive media coverage. BBC North and ITV Border Television both ran pieces linked to initial publicity for the group and this did assist in acquiring some initial funding. Laura White, Occupational Therapist and I have now acquired assistance and advice from colleagues who can help to access funding and as a result have acquired secure funding for the project from both CPFT and CUFC.
This now enables us to respond to the ideas and wishes which are shared in the service user questionnaires to further develop the group through provision of FA coaching courses (with support from CUFC and Regional FA Representatives) and dietary and physiotherapy advice.
Monitoring of physical health: Though we requested participants to ensure they were physical fit to participate, satisfactory records of physical health screening were not initially available for many of those taking part. We now record that all group members have had basic physical health checks and more specific monitoring in accordance with Royal College of Psychiatrists and NHS England guidance regarding those who are prescribed anti-psychotic medications.
Regular meetings take place between CUFC Community Team, myself and the CPFT MH Occupational Therapy Lead and this will continue regardless of individual personnel in post. We have established, through involvement of Senior CPFT Managers and CPFT Board, secure and substantive funding.
In further developing members of the group by identifying those who wish to undertake FA coaching qualifications we have received a commitment from them to continue the group. The continuation of regular questionnaire completion and audits will hopefully ensure that the group continues to develop and respond to the wishes of those who are involved.
Evaluation takes place via the individual questionnaires and audits which have been described previously. The responses received have resulted in the further developments now taking place. In addition because of positive responses received CPFT Board asked to hear from a group member about their experience of both CPFT services and their involvement in the football group. We have also made arrangements for a group member to speak to the Board of CUFC.
The funding recently acquired from Sports England also has criteria and targets that must be met if the full grant is to be paid and consequently there is ongoing data which we have to provide them.
CUFC have noted the contribution the group is making as members have been invited to attend a local Community Sports Trust Awards ceremony we have been informed (off the record) that one of the group will receive an award.
The Football project’s activities have been publicised in the CPFT Newsletter, “Partnership News” and in the “Details” newsletter which is circulated to all GPs in Cumbria.
As a consequence of this publicity, an increase in enquiries have been received from a number of different health professionals and Carers, including Learning Disabilities and Acquired Brain Injury teams. Publicity has also resulted in the setting up of a similar group in Barrow-in Furness in the south of Cumbria.
The project has been used as an example of good practice in the section entitled “Action on …improving fitness” in the recent draft resource training package – “Improving the physical health and wellbeing of people with mental health problems: Actions for Nurses”, published by the Department of Health (15th January 2016). Leonilde Yahyaoui (e-mail: Leonilde.Yahyaoui@dh.gsi.gov.uk) from the Strategy and External Relations Directorate, Department of Health, recently requested to use the project as an example of good practice in a recent lecture.
Is there any other information you would like to add?
Due to evaluation of feedback obtained from regular completion of questionnaires we have discussed with CUFC the development of FA coaching qualifications courses and life skills sessions. The additional funding acquired from Active Cumbria will be utilised for this purpose, in particularly, but not solely, focusing upon 16-25 year olds. In addition, we’d like to acknowledge that the majority of those involved in this project are prescribed anti-psychotic medications. Consequently, in accordance with the Department of Health and Royal College of Psychiatrists commitment to improving the physical health of those with enduring mental health problems, we are in the process of implementing regular and robust physical health screening and interventions for those who attend the group.
Due to the demand for access to the group we are hoping, with support from CUFC Community staff, to further increase the number of weekly sessions available.