Before the COVID-19 Pandemic Linkworking project had 20 Linkworkers covering 13 wards and services and running 17 sessions per week. We worked with SLaM and introduced remote Linkworking Sessions, and prioritised the inpatient wards, Gresham 1 & 2, Tyson West, Fitzmary 1 and Gresham PICU. Our Linkworkers would remotely contact service users on these wards using iPads. In January 2023 we will be restarting face-to-face Linkworking sessions across all of Croydon’s mental health inpatient and community services.
During the COVID-19 Years, we have been running virtual Linkworking sessions at the Bethlem Royal Hospital on the following wards:
We introduced a new service called Linkwork Champions in October 2018, to work closely alongside SLaM service leads, ward managers and occupational therapists. Meeting monthly, our champions identify areas of concern and make recommendations for change that have direct impact on people’s recovery and speed up discharge from inpatient services. This works builds on previous learning from our patient engagement work (helping people with mental illness develop a voice in their care).
Before COVID-19, March 2020, we would reach around 2750 vulnerable service users each year to discuss their care and treatment. We achieve this through 20 to 25 Linkworkers volunteering at any one time. Their volunteer role is to connect with people with severe mental illness. We train them to ‘Listen’, ‘Support’ and ‘Signpost’ their peers to aid their recovery, improve their well-being and reduce their isolation. Peer navigators provide a new tool for health services in that we aid recovery (whilst costing far less than statutory interventions).
Our peer navigators (like the service users they meet) have recently or are currently using the same mental health services provided by South London and Maudsley NHS Trust (SLaM). Most volunteers join after encountering this project themselves. People are given back their dignity – we give them time to talk about the confusion of thoughts and voices in their heads; anxieties and worries that will not leave them and delusions of paranoia. Linkworkers are not judgemental – they experience these same symptoms too.
What are the problems or issues that this project addresses?
Linkworkers meet with people with a severe mental illness; the most vulnerable people in our communities. Most are sectioned on locked psychiatric wards, isolated away from friends and family. Psychiatric wards can feel clinical and cold environments and are noisy, lonely, scary places, filled with tension. Many service users pace up and down ward corridors like caged animals; often forced onto a regime of powerful medication, which sinks them into vegetated state.
Our Linkworkers break the monotony of ward life – for many on the ward, Linkworkers are the only visitors they get. Psychiatric wards are merely containment areas where doctors medicate people in severe crisis or psychosis. They are not effective at supporting vulnerable people to move towards recovery (they struggle due to underfunding of mental health services and staff shortages).
Linkworkers are able to connect with service users because of their own lived experiences. People with mental illness die 15 to 20 years earlier then people without an illness. People with a mental illness, particularly men, dis-engage with health services (GPs, hospital and even dentists). Most service users also struggle with finances due to additional issues and then use cigarettes, drugs and alcohol to self-medicate.
Two examples of how our Linkworkers have helped address key issues: Acting as a link between staff and users, peer navigators achieve great results:
Listen: “We are there to listen and not to judge. Having had our own mental health problems, we know how helpful it is to have someone to talk to in confidence and have their own lived experiences of services. As Linkworkers, we offer a safe space to talk about any issues without any fear of repercussions, so that service users can get the help to feel better.”
Support: “If any issues are raised or someone shares something that is worrying them, we are there to support them and try to help get the issues resolved. To do this, we can either support them to raise the issue themselves, or raise the issues on their behalf, anonymously or directly, depending on what is preferred.”
Signpost: “Sometimes what’s on someone’s mind might be something that we can’t help with directly but we can usually point them in the direction to get help. For example, someone might be worried about benefits or need support to find work. In these cases, we can usually let them know about other organisations that are available to help.”