HOW IT WORKS
The North East Hampshire and Farnham Vanguard, Safe Haven Café, is designed for individuals seeking help during a mental health crisis. The community program coordinates the work of nurses, social workers, and psychiatrists, as well as peer support and secondary care services. It also works collaboratively with organizations to provide links to voluntary and community resources and to help integrate health and social care services. The widely advertised, easily accessible drop-in service is available for extended hours, evenings, and weekends. An on-site psychiatric nurse provides an initial assessment and acts as the patient’s first point of care. Client data are maintained on a shared information system. A separate service, the “recovery college,” offers courses to increase knowledge and skills about recovery and self-management of mental health conditions. With an explicit focus on caregivers, the program offers support services such as caregiver liaison workers.
The program has stable funding and is being replicated at other sites. The program routinely collects data on program activities and has been evaluated by an external research organization.
A coordinated, patient-centered approach supports primary and secondary care providers by linking patients to community, integrated health, and social care services in new ways. Primary care physicians have a local resource for clients with mental health conditions and addictions that offers direct access to after-hours services to replace emergency room care.
Patients who would typically seek services at primary care offices or visit an emergency room for a mental health crisis can now directly access care in a non-institutional community-based setting. They have immediate access to support workers and peer counselors who can refer to acute or specialist care as required. Clients and their caregivers gain access to a wide range of National Health Service (NHS) providers as well as community and voluntary care providers. The program emphasizes working with clients on program design, shared decision-making with clients and caregivers, and self-management.
Clients and caregivers contribute to the design of the service, selection, and recruitment of staff, service evaluation, and feedback. Meetings of NHS and community providers assess operations using key performance indicators, such as accident and emergency attendances, psychiatric hospital admissions, mental health-related calls to the police. The program relies on partnerships among voluntary and community resources and NHS service providers.
A policy framework that supports data-sharing is embedded in a broader strategy within the North East Hampshire and Farnham Vanguard to integrate health and social care for high-need populations in innovative ways. One key policy is to actively engage client and caregiver populations in developing and running the program.