Respond is a unique multi-agency simulation training package for professionals involved in mental health crisis care. By increasing collaboration and knowledge, it equips staff to respond quickly and appropriately to improve patient experience. The training allows professionals such as police, mental health nurses, psychiatrists and AMHPs (Approved Mental Health Professionals) to learn alongside colleagues from other agencies as well as ‘Experts by Experience’ – people with lived experience of mental health crisis. During the training all participants explore real-life scenarios together, discussing possible responses in a crisis and taking decisions, all in a safe environment where mistakes and challenges can be made with no fear of long term consequences.
Please briefly describe your project, group, team or service, outlining what you do and why it makes a difference.
Respond is a unique multi-agency simulation training package for professionals involved in mental health crisis care. By increasing collaboration and knowledge, it equips staff to respond quickly and appropriately to improve patient experience. The training allows professionals such as police, mental health nurses, psychiatrists and AMHPs (Approved Mental Health Professionals) to learn alongside colleagues from other agencies as well as ‘Experts by Experience’ – people with lived experience of mental health crisis. During the training all participants explore real-life scenarios together, discussing possible responses in a crisis and taking decisions, all in a safe environment where mistakes and challenges can be made with no fear of long term consequences. Respond training aims to increase collaboration and knowledge, equip staff to respond quickly and appropriately to improve patient experience, reduce delays and enhance decision making. Respond is fully CPD-accredited and is governed and managed by a multi-agency steering group, made up of Northumbria Police, Northumberland, Tyne and Wear NHS Foundation Trust, Tees, Esk and Wear Valleys NHS Foundation Trust, North East Ambulance NHS Trust, Newcastle City Council, and Fulfilling Lives Newcastle Gateshead.
What makes your service stand out from others? Please provide an example of this.
Respond training models the collaborative behaviour that is essential to an effective and joined-up crisis response. With active involvement of those with lived experience, Respond brings together everyone in the crisis pathway from police officers to mental health nurses, doctors and Approved Mental Health Professionals (AMHPs) to experience the emotions and thinking of someone in a stressful situation. The training offers a safe learning environment to explore problem-solving and decision making skills, where mistakes can be made with no long-term consequences. Working alongside professionals from other agencies, participants are presented with a series of real-life situations using audio and video clips. Over the course of the day’s training session all participants will in turn take on the roles of various professionals as well as crucially the person in crisis, and examine in detail the various perspectives, priorities and feelings of each role. There are currently three scenarios in the training package, covering mental health crises in a public place, private dwelling and inpatient unit. Work is in progress on a fourth scenario set in an emergency department, and a fifth scenario is planned for the future. A police officer approaching a person in crisis may bring a significantly different set of priorities to the situation than a psychiatrist, whose view in turn may differ sharply from that of a mental health nurse.
One of the key benefits of Respond training is the detailed and free-flowing discussion at every stage of the crisis scenario between the different professionals in the room, aided by dedicated Respond facilitators who assist in pulling out essential learning throughout the day. Respond-trained professionals take their learning forward with a clear understanding of each other’s roles, so that every agency in the crisis pathway can respond quickly and effectively, without the tensions and time delays that can arise from uncertainty about who should do what. We are not aware of any other mental health crisis training like Respond: developed by the different agencies together, delivered and attended together, with input throughout from those with lived experience of crisis. The involvement of these ‘Experts by Experience’ has been highlighted in our evaluation as one of the key areas. Their involvement encourages participants to understand how situations and actions can affect the person in crisis and to see things from their perspective.
Selected feedback for Respond training includes: “Respond is a totally immersive experience. It encouraged me and my professional colleagues to leave the comfort zone of role and remit and face more honestly the considerations of a critical incident which involves mental health crisis. As a learning tool this cannot be underestimated.” Anthony, Police Officer “Respond is a great learning experience, and it will make a real difference if it is rolled out to all emergency services. As an Expert by Experience, my voice was listened to and valued, working as an equal throughout the process.” Terry Nelson, Fulfilling Lives “An excellent opportunity to reflect on the vital role that other professionals play” Crisis Nurse “I have attended many training sessions, and can confidently say that…Respond simulation training created more engagement in the subject and more challenges to my thinking than I have experienced in other formats, leading to a far better understanding of mental health and its impact on multi-agency reactions to situations.” Michael Orde, the High Sheriff of Northumberland
How do you ensure an effective, safe, compassionate and sustainable workforce?
Respond provides vital training and continued professional development for staff from multiple agencies who deal with mental health crisis care. The training also closely involves individuals with lived experience of receiving crisis care by ensuring that at least one such ‘Expert by Experience’ is present at each training session and able to give their unique viewpoint.
Who is in your team?
Respond has one full time Band 5 project coordinator, and is governed and managed by a multi-agency steering group, made up of Northumbria Police, Northumberland, Tyne and Wear NHS Foundation Trust, Tees, Esk and Wear Valleys NHS Foundation Trust, North East Ambulance NHS Trust, Newcastle City Council, and Fulfilling Lives Newcastle Gateshead.
How do you work with the wider system?
Respond brings together the many different organisations who work with people experiencing a mental health crisis so that they can understand each other’s roles better and share their expertise. As much of this has already been described.
Do you use co-production approaches?
Co-production is at the very heart of Respond training, which was developed by the by multiple agencies including Northumberland, Tyne and Wear NHS Foundation Trust, Northumbria Police, North East Urgent and Emergency Care Network, Fulfilling Lives Newcastle Gateshead, Tees, Esk and Wear Valley NHS Foundation Trust, North East Ambulance Service NHS Trust and Newcastle City Council. Individuals with direct experience of mental health crisis care are closely involved with both the delivery of each Respond training session and the Respond steering group’s ongoing work to continually refine the training, improve the experience provided for all participants and develop new training scenarios.
Do you share your work with others? If so, please tell us how.
Respond training has been shared with others at a number of presentations at national conferences across the UK. This has led to interest from other organisations outside the North East. The success of Respond training has also been shared via news stories on the websites of both Northumberland, Tyne and Wear NHS Foundation Trust and other partner organisations, as well as with local press. The training has received positive recent coverage from local media including the Newcastle Chronicle (https://www.chroniclelive.co.uk/news/health/police-nhs-partnership-sees-fall-11892776) and Sunderland Echo (https://www.sunderlandecho.com/news/police-tell-of-pioneering-mental-health-scheme-in-sunderland-1-9529588).
What outcome measures are collected, how do you use them and how do they demonstrate improvement?
All participants are asked to fill out a feedback survey at the end of each Respond training session: the feedback from these is used to drive future improvement of the training. Respond training has also received a professional evaluation from the Academic Health Science Network as well as a service user-led evaluation from ‘Experts by Experience’ (see next answer for more details).
Has your service been evaluated (by peer or academic review)?
Respond training has independently evaluated by the Academic Health Sciences Network, who commented that ‘for the majority of the participants involved in the evaluation, the training has been highly successful in improving the understanding of and collaboration and communication between different professions and agencies working together to care for people experiencing a mental health crisis. It has led to changes in behaviour, approach and work practice for all those involved in the post impact interviews.’ You can view the full evaluation report on the Respond web page at https://www.ntw.nhs.uk/resource-library/respond-multi-agency-mental-health-simulation-training/ The training has also received a separate evaluation from ‘Experts by Experience’, who found that “the roles, responsibilities and demands on professionals in dealing with people in crisis were the most valuable things that respondents took away…The majority of ‘Experts by Experience’ (75%) reported that they had much better understanding of the roles of professionals after the training.” You can view the full evaluation report on the Respond web page at https://www.ntw.nhs.uk/resource-library/respond-multi-agency-mental-health-simulation-training/
How will you ensure that your service continues to deliver good mental health care?
Respond is a training package, not a service delivering care directly. However we hope that our training contributes to the ability of professionals from multiple agencies to continuously improve the quality of mental health care they deliver.
What aspects of your service would you share with people who want to learn from you?
Respond training assists its participants in providing more efficient crisis care, which can bring clear benefits to patients, professionals and agencies alike. Specific benefits of the training include: • Professionals are shown how to provide a safer and better patient experience, with service users getting the right care at the right place, in a timely manner • Reducing the stress of a crisis to improve clinical outcomes • More efficient use of time, through better understanding of the role of each agency and increased confidence in individual roles • Improved understanding and knowledge of mental health, with participants better equipped to recognise mental health problems, ensuring they are identified and treated more quickly • Improved knowledge of legislation and what different agencies can and cannot legally do, such as when the Mental Health Act can be used, and when restraint is appropriate • Continuous professional development (CPD) credits for trainees. We have also learnt many lessons with the Respond project and continue to develop and continuously improve the training. Specific lessons learnt include how best to maximise attendance at training sessions, what we expect from the group facilitators representing the Respond brand, ensuring the wellbeing and support of our ‘Expert by Experience’ attendees, promotion of the Respond brand locally and nationally, and managing the involvement of multiple agencies.
How many people do you see?
Since being set up approximately 2.5 years ago we have held 66 Respond training sessions with a total of approximately 1,188 attendees.
What is your service doing to address and advance equality?
Respond training helps to reduce stigma around mental health by foregrounding the perspective of service users in a crisis situation. All professionals taking part in the training are encouraged to ‘wear the hat’ of service users and see the situation from the viewpoint of the individual as well as the perspective of other professionals in turn. All training sessions also include at least one ‘Expert by Experience’ who can provide a personal view on their lived experience of receiving crisis care. We hope that all professionals who complete Respond training will in turn share their increased appreciation of the viewpoints of service users and other mental health professionals with their own peers, further helping to reduce stigma.
How do you meet the needs of people using the service and how could you improve on this?
Participants on Respond training are asked to complete a detailed survey at the end of the training session. The Respond steering group review all feedback to check we are meeting all participants’ needs and look at ways we can continue to improve the training experience.
Brief description of population (e.g. urban, age, socioeconomic status):
The Respond training being submitted for this award is aimed at a ‘population’ of professionals from different disciplines providing mental health crisis care. Northumberland, Tyne and Wear NHS Foundation Trust primarily serves the population of the North East, and provides services for children, adults and older people across a mix of urban and rural areas in Gateshead, Newcastle, Northumberland, North Tyneside, South Tyneside and Sunderland. As well as serving the regional population, some of the Trust’s specialist services receive referrals from across the UK.
Size of population and localities covered: NTW serves a population of approximately 1.4 million people, across the localities above.
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