Reflections from practitioners

On 9th October, we brought together the practitioners who have been testing the personal asset mapping tool together for the last time. At this session, we were keen to hear more about how they’d been getting on trialing the tool out in practice, as well as listening to their reflections on the process and being involved in the project overall.

Here are some of the things that practitioners said that they had learned in the project:

“How beneficial asset mapping can be to achieve individual goals”

“I’ve learned that I didn’t know some of my clients as well as I thought”

“How the tool can be used across the board, not just about mental health”

“Potential to use the maps with individuals and groups but needs buy-in from practitioners”

“That practitioners from different backgrounds are very skilled”

Similarly, we were aware that many of the practitioners involved in the project were very used to working within set-out processes, with validated tools and that working in an exploratory way would take them out of their comfort zone. We knew this might bring a number of challenges for the practitioners, which we were keen to understand better.

We asked practitioners about some of the fears that they’d overcome throughout the project process, and one of the clear themes was developing confidence – both in using the tool, but in their own skills as a practitioner. Some examples of other factors mentioned by the practitioners include:

“Overcame the people I support’s initial doubts about the project.”

“Overcome- lack of confidence in my knowledge.”

“Making something complex simple enough to explain.”

Practitioners were clear that there were still some barriers that would need to be overcome before the approach could be embedded in practice. These barriers included:

“The future. Where we go from here? Will the digital tool be used.? Selling asset mapping to staff.”

“Becoming more practiced in utilising the tool with others with different needs and support.”

“Follow up and engagement with people who use services”

“Adapting it so that it works for the majority or at least so they will try it.”

It was invaluable to get this feedback from the practitioners, and the project team will be considering these issues as we move the project forward – particularly that of ‘selling’ and communicating the goals and outcomes of the process to other practitioners working locally.

As part of the project evaluation, and understanding the worth of the process, we will, of course, be following up with individuals to find out how they felt about their experience of being involved in the project, to understand if they felt differently after having gone through the asset mapping process and to determine any changes they might have made as a result of this. A full report will be available in due course.

We are also working together with the Connections (The Richmond Fellowship) peer-support group to develop the next prototype of the digital tool, ensuring that people who use services are at the centre of the development process.

We’d like to thank all of the people who were involved in testing the tool and process in practice – your hard work, commitment and openness has made the project possible.

Personal asset mapping – feedback session 3

On 6th September, practitioners got the opportunity to view the early prototype of an electronic version of a personal asset map programme. There was much interest with many questions asked and also useful feedback and ideas on how it can be improved (the prototype is available on an earlier blog post). Those who are interested have the opportunity to give more feedback on the later stages of development of this tool alongside any people who use services who also wish to be involved.

The next session allowed practitioners time to discuss and reflect in small groups their experience of introducing personal asset mapping to people using mental health services. From this discussion it was apparent that a variety of approaches have been used to introduce and revisit a personal asset map, that some barriers have occurred and that there have been a wide range of experiences for both practitioners and people using support. Practitioners found it useful to share experiences and to talk through the different issues that they have been facing.
Time was then spent reviewing the use of the reflective diaries. There was some discussion on the WEMWEB tool and how it fits into the overall evaluation process. As we might have anticipated, the group seemed pleased that the project deadline has been extended to the 9th October to afford the practitioners more time for these tasks to be completed!
Sessions facilitated by Paul Hart, Jenni Inglis, Gayle Rice and Fran McBride

The assets of individuals

Many times in trying to solve a problem, we start with a ‘needs assessment’. This will generally identify the problem that exists and will set about a way to finding a route for which to meet the identified needs. Using this approach means that there is a tendency to focus on the shortcomings of individuals, since it identifies the problems before the strengths.

A needs focus can sometimes make us feel overwhelmed, resigned, hopeless. Focusing on the positive – on people’s strengths can allow us to feel energised and hopeful, even.

Over the course of the project we’ve been speaking to people who have experienced mental health problems on a 1-1* basis – asking them what exisits in their lives that helps their well-being. We did this because we wanted to help them to map the assets that they had within themselves, and within their networks that might help them to keep well.

We did this using many of the same techniques described in previous posts for community asset mapping – but with a definite focus on the individual, their likes and dislikes, their friends and family and their situation overall. This links very much into the Wellness and Recovery Action Plan (WRAP) idea of creating a ‘wellness toolkit’.

I was quite weary of undertaking these exercises at first, because I was worried that people might not be able to see the positive things that they had in their life, and that going through the process might be upsetting. I was wrong.

Having conducted 10 of these discussions with a range of different people, the view is that people found it overwhelmingly positive. There was nothing new to the types of conversations that the practitioner and I were having with them, but mapping things out in a visual way that could be recorded and considered had some really encouraging effects.

Practitioners were able to tackle problems that they’d been discussing for quite some time in a new way and were able to identify factors/issues that they could work on with the individuals quite readily. Service users noted that the process was useful in really thinking about what is important and recording it so that it could be reflected upon at a later date when they were feeling less well (or indeed more well). They were also clear that the visual aspect of it was really good – to be able to literally see what they have (and how much they have) was really powerful.

Here are some examples of the maps we created (highlighting the different methods that we used):

 

Reflections

This type of planning won’t be suitable for everyone, all of the time. For the use of the tool/process to be effective, it will need to be done when the person is feeling well.
What worked best was when there was a good relationship with the practitioner and the service user – it meant that people really thought through the process, rather than coming up with superficial answers.

It also worked well when we tried out these approaches in a group – people were able to spark ideas off of one another and to think about different areas of their lives by being prompted by their peers. Some people were quite overwhelmed by the experience, though, and it is important to ensure that people are comfortable and made aware of what the activity is and how it can help them.

All thoughts welcome.

*1-1 basis isn’t strictly true, because many of the discussions we had for the project were helpfully facilitated by trained practitioners. Many thanks to the staff who helped facilitate these discussions!

Workshop 2: 25th July

Our second workshop took place on the 25th July –  a bright and sunny Monday – in Kirkintilloch Health and Care Centre.

It was great to see so many people at the workshop – some familiar faces, and lots of new ones too. In the end, we had 22 people coming along to share their experiences and ideas (this was a split of 13 people who use services and 10 people who support those who use services) which was a fabulous turnout – even if it was a bit of a tight squeeze!

What we did

This week, we worked on tasks that encouraged people to share their experiences and that enabled us to gather ideas about how people could be better supported to use community supports and assets.

We started by getting to know each other. There were lots of new faces in the group and it was good to find out a bit about where everyone was from and what their interests were.

We then split into two groups and worked on answering the question: ‘if someone new to the area was to ask you advice for keeping well, what 5 things would you tell them?’

One group looked at this in quite a general way and were able to give lots of practical advice that included:

  • taking things a step at a time. the group agreed that it can be sometimes difficult to think about doing simple things, like taking a shower. The advice was to take it step by step and think about smaller aspects of the activity – like taking the first step out of bed, opening the door etc.
  • trying to keep active – going for walks and knowing good places to get out and about can be really helpful
  • knowing that you’re ‘not the only one’ can help, and knowing that everyone needs support sometimes
  • keeping focused on one task or goal for each day – and getting it done – can feel like a great achievement
  • reminding yourself of all of the things that you’ve achieved that day and focusing on those things rather than what you haven’t achieved can boost feeling well
The other group came up with suggestions like:
  • knowing where to start – having someone or something to point you in the (next) best direction on your journey is very beneficial (signposts to what is available)
  • having someone to talk to – ‘i use them as a sounding board, a mirror. I like to have the same people to contact to go back to time and again’ (people you can rely on)
  • find a place to go and chill out – where you can get peace and quiet (this group were able to identify lots of places on the map that would be useful for this)
  • do the little things that matter e.g. one person was very keen to keep their house tidy and as long as that was done she felt a sense of achievement. Find out what your ‘thing’ is.
  • having chance meetings – you might think that you want to be alone, but you might actually enjoy bumping into people. There are lots of cafes in Kirkintilloch that make wee 5 min chats with people easy – you can just pass pleasantries and you don’t have to plan the meeting (so you don’t need to cancel if you’re having a bad day).
We talked about how we could share this information with people and how we could make something physical that would convey some of these ideas. The groups came up with a few ideas that people seemed really keen on:
  • prompt cards: small cards (that you can keep in your wallet) with words and phrases by people with lived experience of mental ill health for those currently experiencing it
  • paper maps of the area that identify key services

We then went on to build on top of the maps that we’d produced in the first workshop.

The groups were keen to add additional services outside of Kirkintilloch – stretching out to Bishopbriggs, Milngavie, and Bearsden. Many people highlighted the poor transport links between these different towns and how this can make access to services incredibly difficult.

Other assets that had not been previously identified included:

  • public partnership forum – have your voice heard
  • local carers centres
  • aromatherapy (through EDAMH) – helps relaxation
  • contact point – at the park centre, useful resource
  • different walking routes
  • the Kirkintilloch players (theatre company)
  • community addictions team
  • EDICT – painting is  brilliant!
  • Carer’s Link – a rich source of support
  • Denise’s cafe – friendly staff and good for bumping into people
  • Kirkintilloch Herald
  • The badminton group
(we’ll have a few examples of maps available in a future post – very soon)

The groups also highlighted areas for improvement, including things that were missing within the community.

One of the groups talked in depth about assessment of need and the type and amount of information that is held about people using mental health services. Many people were aware of WRAP (Wellness and Recovery Action Planning) but not many had completed one. The group were quite clear that making a plan, and being assessed should not be a tick-box exercise and that it should be based on the individual and should be made to suit individual needs. The group also talked about how making advance statements was a useful thing to do, but not many had completed these either.

Many people highlighted the lack of social day activities within the area. People referred to the old Clubhouse and were clear that some of the functions that it had provided were really useful (see previous post). A few people talked about how there were many open spaces available and that an affordable cinema could be a good place to go and meet people, and that they could be used for big events like ‘ mental health awareness week’ or ‘gala day’ etc.

Community assets: think of a heavenly experience…

We asked the groups to work on creating a storyboard of the different areas that could improve and how the experience could be better – we did this from two different perspectives

  • Heaven: no barriers or hurdles/success and
  • Hell: barriers, hurdles and complications

People tended to draw on their own experiences of services or to focus on the different types of social activities that they perceived are missing within the community. The ideas focused on:

  • Being listened to more: people being allowed more time to talk and explain themselves, and to be seen as an individual.
  • Communication between the supporting services (health and community care professionals) and carers
  • Having a place to go where people understand you – where you can choose to talk about issues, or not – depending on how you are feeling
  • A drop in centre that is inclusive, allowing people access to a range of different services – like a hub

What should we do with all this information?

A key aspect of the project is to ensure that what we are learning is shared with others and is used to help improve existing service delivery. In addition, we want to ensure that the learning is used by people who use services – so that they can better see what is available and better direct their own support.

We were keen to ask the groups their views on how the outputs of the project should be shared.

Almost all of the participants thought that it would be crucial to share the project findings amongst the mental health service providers in the area. This was part of a broader discussion that highlighted that more could be done to ensure these agencies communicate better with one another – especially linking health, social work and voluntary agencies together.

Key, was also ensuring that the information was easy to access and always kept up to date – there has been some trouble with this in the past.  In addition, people were keen that as well as online based information, that there be a physical counterpart that people can keep with them to refer to.

Reflections…

We learned a lot from the last workshop and made sure that there were plenty of breaks – to keep ourselves refreshed and alert, as well as making sure there were lots of different ways for people to have their say. Ways to provide feedback ranged from speaking out into the group, posting thoughts and comments in the post box anonymously, as well as being provided with email, phone and contact information for people who prefer to reflect on their experience and to share afterwards.

The evaluation sheets were overwhelmingly positive from the day. Everyone who provided a completed sheet mentioned how much they had enjoyed the session with the following comments being made:

‘very interesting and thought provoking look at services and what helps people stay well’

‘the ‘holistic approach’ to what you were doing was really good – not just focused on services, but taking the whole aspect of folks lives into account’

‘enjoyed the contact with people with similar lived life experiences’

‘enjoyed the information sharing and mapping all the positives in the east dun area’

‘I’ve left feeling like I could do some research into what’s available and what would benefit my situation’

 ‘I felt really good getting feedback from the group and meeting other service users’

The next session will focus on different ways to share and portray the information that has been accumulated over the past few sessions. We expect to gather insights into the sorts of things that people think should be mapped for our online visualisation. In addition, we’ll be helping individuals to think about how they could use assets outlined in the community map to help promote their personal well-being.

I’m also learning lots about how the asset mapping process can be a useful tool for engagement with people – particularly how it can provide an opportunity for people to take a step back, think about what works well and why (and what does not) and consider how we can work with each other differently to change for the better.

This seems to be one of the things that people seem to be valuing most about being involved in the project. It seems to be getting more and more difficult for people to take the space and time to listen to one another and really hear what is being said – both practitioners and people who use services have commented on the value of hearing peoples stories and coming together to think about how things might change.

And there is more to come!

As always, any comments are very welcome.

Workshop 1: 18th July

Monday’s asset mapping session brought together people using services and practitioners, to collect and collate local knowledge in and around Kirkintilloch, on the subject of well-being and positive mental health. We were really keen to ensure that the workshop brought together a range of people on an equal footing so that they could share and learn from one another.

We had a great turnout with 7 people who use services and 8 practitioners from services such as health improvement, peer support, occupational therapy, social work, the Richmond Fellowship, Ceartas (Advocacy), Connections and Carer’s Link coming along.

What we did

The session lasted for 4 hours (with lunch). We split into 2 groups and thought about the little things that we all do everyday that help to keep us well.

The types of activities that people identified included:

  • having contact with groups of friends and a support network
  • cycling in good weather (including keeping yourself organised for this and getting everything packed)
  • dog walking (for someone to talk to, who doesn’t answer back)
  • walking by the canal and expanding your routes
  • setting up breakfast dishes the night before – so that the day is easy to step into
  • going to the gym (helps with energy levels)
  • running (with people) – good for you, but you might feel the benefit more afterwards
  • having some music playing to gradually get you into the swing of things in the morning (a soundtrack to your activity levels)
  • having a local, regular place to go to meet people who are going through similar experiences
  • gardening and looking at flowers – can be really therapeutic to take some time to yourself (in the summer).
We shared this with each other and thought about any similarities and differences.
We were able to pick out different themes from the range of activities people talked about. These were:
  • social – having contact with others
  • physical – keeping busy by doing things
  • senses – thinking outside of yourself and being aware of how things look, sound, smell etc.
Mapping community assets
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We all then looked at a range of different objects, photographs and leaflets that represented current service provision locally.
We identified the assets in the community that could be useful to encourage positive mental well-being. Some of these included:
  • Seagull Trust barges (and the canal) – feels like you’re in another world!
  • Church – good place to meet people and have some space to think
  • Citizens advice – very professional service
  • Ceartas – lots of positivity around this service
  • Charity shops – places where its easy to talk to others, great for volunteering
  • Food co-op – highly visible, good produce and good place to see volunteering in action
  • Ghilloni’s – much love and admiration for this place
  • Kirkintilloch Health and Care Centre – good that it is all under one roof, but some things about it could be better.
We also thought about those that were not so positive.
  • transport – really difficult to get around east Dunbartonshire which makes it hard to get groups together. Dial-a-bus is also difficult to organise
  • out-of-hours services were not viewed favourably
  • planning meetings – it can be really difficult to get your voice heard, even though people do make an effort to make you feel welcome.
  • costs of services
  • there are not many day activities available – something that gives your day structure would be good
As a group, we shared our experiences of some of these services.
This helped us get a picture of what living in the local community is like for people and gave everyone an opportunity to discuss the assets that could be used more, and those that might need some improvements to be used more often.
We then considered how the personal things that we do every day to keep well could be supported by the assets we had identified in the community. This was quite difficult to do in the time available and due to the fact that people were very keen to talk more about their current experiences. This is something that we will focus more on in the next workshop.
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Ideas
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The afternoon session focused on developing ideas for the sorts of things that might help support positive mental health and well-being within the local area.
We focused on the following issues:
another
Meaningful engagement (planning meetings)
  • it may be necessary to have a pre-meeting to prepare
  • feedback the whole way through the process is vital
  • it should be open, honest and be true engagement
  • advertise meetings well, so that people know what to expect
  • ensure there are lots of ways for people to gather views i.e. through the post, online, in person, social media etc.
  • get rid of the jargon
  • use advocates to assist this process as much as possible.
More activities for older people
  • is over 60 the right bracket any more?
  • need to ensure people know how to access services
  • bus passes should continue
  • need to think about what is happening locally for older people (and how this links into national policies)
Central venue for meeting people
  • a central venue that people can access
  • gives people things to do, as well as developing skills and meeting others
  • a useful way to help people move on to other things
  • a community venue would be good
  • could charge a minimum amount to cover costs
Feedback for family carers
  • to have a meeting once a month to go over any problems which may arise (at the moment there is only one way to make enquiries, and it is often unavailable)
  • meetings could be advertised in local shops or libraries
  • a newsletter would be really good.
Support for those returning to work
One of the groups focused on this topic as a key issue throughout the workshop session.
  • very important to have continuity throughout the process – the same mentor and the same method of communication
  • softening of the environment so that you can take part in different types of conversations
  • one-to-one emotional support once a week is important
  • something to keep you occupied so that you are not worrying before an appointment
  • literature currently focused on absence, misconduct and discipline rather than health and well-being. It is important to ensure that the tone and language used in the paperwork is softened (as well as reducing the volume of correspondence!)
  • a back-to-work mentor is particularly useful for follow-up meetings and conversations.
What people thought of the workshop
At the end of the session, we handed out some evaluation forms to ask people what they thought of the workshop, and also to ask what we could do better next time.
Some of the things people found good about the session included: they felt safe and able to share, it was a relaxed atmosphere, they had been really inspired, it was good to get a chance to learn new tools for engagement, it was a good way to meet and share with other people and it was a good way to talk about some of the really good people and services, and to applaud them for the good work that they do.
do.
Some of the things that people did not think were so good about this session included: people would have liked to have more time for introductions (so they knew more about who was in the room), it could be difficult to raise an issue about a service when those providing the service were in the room, there were not enough breaks and that using the word ‘improvement’ implies that there is something wrong with what is currently being offered.
offered.
So, for the next session, we will make sure that there is an opportunity for people to feedback sensitive views in an anonymous way and will make more time for people to talk to one another and find out who everyone is (as well as move around a bit more!). We will also focus more on how the identified assets can be used to plug any gaps in service provision, rather than focusing on the services specifically.
specifically.
The next session will build on what we learned on Monday and we’ll think in greater detail about how we can encourage people to use the assets that we’ve identified in the community better.
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Reflections
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Some of my thoughts from the first workshop…
Many wider issues around service provision and engagement came to the fore at the first workshop, with people taking the opportunity to voice what has been concerning them most. What was really good about that, was having the chance to talk these through and to come up with some potential ideas that may resolve the issues. One of the aims of the project is to flatten any knowledge hierarchies so that the views and ideas that are expressed are considered as equally valuable. The ideas that we came up with will provide really useful recommendations for consideration.
consideration.
Having so much knowledge and experience in the room; be it experiential, service related or process related means that there are boundless opportunities to share and learn from one another. In itself, this is a huge asset, but it also brings with it some challenges around managing different perspectives and expectations about what can be done to promote well-being and positive mental health within the confines of this project.
project.
What is possible in the project, is to work together on how we can better use the positive assets identified and to consider how these can be shared with others who may not be involved in the project directly, so that they can use them too.
All comments welcome!

Let’s start at the beginning

This project is all about empowering people to think about all of the positive assets that they have in their lives and communities. It begins with the premise that, “you can’t know what you need, until you know what you have”.

In order to start finding out about what exists in the local area, the project work began mid-June with a workshop that aimed to introduce staff (mental health practitioners from the voluntary, private and public sectors) to asset mapping as a way of working.

Facilitated by SNOOK (http://wearesnook.com/snook/), we spent time with the staff to share experience and practice across the different agencies, as well as exploring how this way of working is different from the techniques that they currently use to design services around the people that they support.

We worked together to have a go at asset mapping in two different ways. Firstly, to create a community map:

Then to explore the use of asset mapping for person-centred planning (where we worked together to create a person-centred map for me!):

Many of the participants thought that the asset mapping method could work well alongside the approaches that they are already using, although they did come up with applications that we’d never thought of! Ideas ranged from using the process as a useful way to reflect on progress with people using services, to seeing the world directly through the eyes of the user.

There were lots of things that people liked about the use of the tool. These included:

  • working well as an individual recording tool
  • good for training staff
  • provided a new way to access thoughts and feelings (which can be hard when you are obsessed with thoughts and feelings)
  • helping to unstick people and staff
  • capturing the conversation
  • thinking about different routes to get to a solution.
Some things that people weren’t so sure of, included:
  • it might paint quite a stark picture for some people
  • the need to make sure that the person/people are in the right place in the recovery journey to engage in the process
  • it can generally be quite hard to get people involved
  • hard to identify assets.

Staff could see how the process linked into work that they already do, but thought that it was different in the following ways:

  • it’s 3D
  • very visual
  • bespoke (different every time, depending on who is involved)
  • holistic
  • inclusive
  • fun

This workshop and feedback was really useful in terms of designing the next few sessions, which will bring together people using services and practitioners.

Over the coming weeks we’ll be talking to lots of people who use services, gathering their thoughts, ideas and experiences in the lead up to these sessions, where we’ll work on mapping out the local area in greater detail. We’re hoping to be able to determine the difference between individual assets that people use to support themselves, and the assets that exist locally – with a view to identifying the gaps and opportunities that exist.

Watch this space!

You can view the full range of pictures from this first event here:

http://www.flickr.com/photos/openlx/sets/72157626849988211/