imagine drop-in services report by hear us

A HEAR US REPORTImagine Drop-in Services:

Daycare - Staff Support & Service Provision

October 2014

HEAR USTo promote, educate, communicate and empower,

For the benefit and interest of people affected by mental health issues

Working Together for Change and Better Understanding in Mental Health2

The Hear Us

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CONTENTS PageAcknowledgements & Introduction 3Executive Summary 4Findings 7Recommendations 12Conclusion 13Main Themes: What Members Say 14Interview with Marie Johnson (Staff) 22Imagine: User-Led Groups Details 27Hear Us Membership Form 28

HEAR USCroydon’s Mental Health Service User Group

Charity Number 1135535 Company Number 06891337

We are Funded By:

Imagine Services Contact Details:User Led Groups Team Leader 020 8253 7078@ [email protected]

www.imaginementalhealth.org.uk

Croydon ImagineCVA Resource Centre82 London RoadCroydonSurreyCR0 2TB

Hear UsOrchard House15a Purley RoadSouth CroydonCR2 6EZ

020 8681 6888 @ [email protected] www.hear-us.org

HEAR USTo promote, educate, communicate and empower,

For the benefit and interest of people affected by mental health issues


Imagine Mental Health Drop-in Services A retrospective of the service through the eyes of it’s members

Hear Us have been monitoring the South London and Maudsley NHS Trust since 2007. We have now turned the project to look at the quality and service provision provided by the voluntary sector.

This report is produced following Linkworking that took place Summer and Autumn 2013 at Imagine’s drop-in services at Purley United Reform Church, Parchmore Methodist (Thornton Heath) and at the CVA Resource Centre (West Croydon)

We wanted to gain an insight from their members and produce a retrospective assessment report

of the service through the eyes of its members.

I would like to express my sincere gratitude to the members of the drop-ins that kindly allowed Hear Us into their lives to hear about their experiences and to those that openly expressed their views and issues that they have about the project.

Without the openness and honesty of members of the drop-in we interviewed, this report would be lacking the human element of their experiences. We hope that we have done justice to their words.

I would also like to apologise for the delay in this report being published. Throughout the year, Hear Us has been inundated; receiving over 1000 calls and visits to our office for help. Service users are often in crisis, yet, at present, we only receive limited funding to provide this kind of support. With each day we receive more calls for help which is putting considerable strain on the organisation, on our staff and on our volunteers.

Tim OldhamHear Us Coordinator

This report is dedicated to all service users, both past and present, who have contributed to the improvement of Mental Health Services in Croydon

Acknowledgements and Introduction

“There are many benefits from attending Imagine drop-ins, such as being around people that understand each other. We get to do activities outside of groups that are really enjoyable. We go to the cinema, meetings at cafes/pubs. We also go bowling and do badminton. We also go on trips to Brighton.”Drop-in Member

HEAR USLinkworking Annual Report 2012-2013


This report aims to provide an insight into the experience of the mental health service users accessing Imagine’s Drop-in ServiceProject AimsThe aims of this report were to look at Imagine drop-ins and to explore the following questions:1. What have been the

benefits of participating in Imagine Drop-in Service?

2. Is the project helping service users to become independent rather than dependant upon day care?

3. Is it helping service users to develop skills compared to being maintained?

4. Are service user able to step out of the comfort zone and take risks?

5. To understand if the groups support service users growth?

This report presents and summarises the voice and experience of the participants in their own words.

Imagine User Led Groups.Services began operating in Croydon in October 2009 providing a User Led Drop-In Groups for people accessing mental health care. User-Led Drop-in Groups are held at the following:

KingfishersMon-Fri 10:30am to 4:30pm

Purley URCMonday 1pm to 4pm.Tuesday 11am to 5pm Thursday 2pm to 5pmFriday 11am to 5pm

Parchmore MethodistMonday 10am to 4pm

Executive Summary

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CVA Resource CentreWednesday 10am to 4pmThursday 10am to 4pm

Eligibility to attend drop-in groups: Anyone 18+ years, under Croydon secondary care mental health service. User led groups are open to anyone diagnosed with a mental health problem

The aim of the User-Led groups is to empower service users to become involved in the running of their own group. Members are encouraged to be involved in all decision making, from what activities take place on a day to day basis to organising one -off events.

Each individual contributes to the fun and secure environment, whether it be offering a welcoming cup of tea or helping each other.

Supported by Imagine staff, the User-Led groups focus on providing a safe and welcoming environment and a range of activities to develop skills, support recovery and promote access to community-based opportunities.

Hear UsSince 2007, Hear Us has managed a User Focussed Monitoring (UFM) project within mental health services in Croydon. This project is called the Linkworking Project, recruiting current or ex local service users (Linkworkers) to visit mental health services and conduct consultation sessions with service users. Through these sessions, Hear Us provides an opportunity

for service users to raise their concerns, issues and needs as they arise, which can then be fed back to the service providers.Daycare HistoryIn August 2001, the Finnamore Report was published, ‘Mental Health Services in Croydon: Review of Day Services for Working Age Adults’. It stated that Service User views were mixed on the existing services:

• “Positive aspects include a strong feeling that day services offer a ‘life-line’, ‘an oasis in the desert’, ‘something to get you motivated’. They provide opportunities to develop new skills and renewed self-confidence.

• Areas for improvement stem from the users’ reported experience of having nowhere to take the new skills and confidence that have been developed, with few links between day services and thewider community. Users reported a sense of lack of purpose in their lives and alienation from wider society.”

Finnamore noted that there appeared to be a discrepancy in the daycare content and style of services between:

Independence & DependenceDaycare service generates a significant level of dependency in its users.

Managed Risk & Self ContainmentDaycare service is very good at containing users in an



environment where they and the staff feel safe. The service is less good at allowing users to take risks in a managed way.

Developmental & MaintenanceDaycare service gives users opportunities to tackle their problems and broaden their interests. It is less good at helping users to take on new challenges and achieve valued, ambitious, productive goals.

In March 2003, Hear Us held the Day Service Review Conference, in the absence of concrete implementation plans, service users were asked to make recommendations based upon their experience; where the predominant themes that arose were:

• Respect for individuals• Person centred care planning• Consistency of service and

standard• Information, Communication

and Consultation • Choice• Equality and accessibility for all• Clear pathways in and outside

of system• Removal of institutionalised

stigma

Without any clear detailed responses coming from commissioners, though I hope the above list echoed content, in 2009, day services were re-configured. Some services were decommissioned and new services like the Imagine Drop-ins were commissioned to provide

a safe place, a peer led support place, a service that service users would decide daily activity and control over where they wanted to spend their slice of the pie/funding

Changes to services have also been brought about by changes to funding. Contracts to provide social care services have moved from block contracts to personal health budget; enabling people with long term conditions and disabilities to have greater choice, flexibility and control over the health care and support they (want) to receive. Service users holding their own budgets can access services that they want to access to help them with their own identified recovery needs. Currently funding for the drop-ins is exempt from personal health budget as it is paid directly via a block contract.

This report was written with the aim to investigate the quality of the drop-in services provided by Imagine from the members view and to understand what has been gained, by service users leading their own services, compared to having a service led by professional staff.



Findings

Hear Us visited Imagines drop-in services to gain insight into how the drop-in services have developed and how service users lives have transformed following the changes made to day-care service provision in 2009.

Back in 2009, clients of the former day-care service found that the usual support network was being pulled from under their feet and that their voice was clearly not being listened to by commissioners; at the time this was the Primary Care Trust (PCT). Even when service users and providers (of day-care) were consulted by the PCT, it felt that it didn’t matter how loud they shouted, their voice was not going to be heard and services were going to change. Full stop!

Day-care service users were put through IRON (Individual Review of Needs) and obviously based around what they were saying, ‘they didn’t want change’ new services were commissioned and targeted for their needs; and they were then streamed into.

That review was made by staff that were providing and were in the process of being the new provider. Also reviews

were made after services were commissioned, reviewing someone to fit into a service that hadn’t been designed based on their needs.

And change they did. During this period I was fortunate to be able to listen to service users and follow them as they visited potential sites of the new look day-care drop-in services. Service users needed support to deal with the change and some took to their feet (and freedom passes) to make the rounds to discover what was being offered to them. Many were intrigued and many stared wide-eyed perplexed at the proposed centres.

Previous centres, one newly refurbished, both providing staff contact and support when needed, were not what the service user were going to receive. Barren empty and quite lifeless centres; centres that were not solely for the purpose of providing day-care, but spaces they were provided with reduce access, based on a timetable and a building that wasn’t accessible everyday of the week. You have to get up and travel (and know where to travel to and when) if you want day-care. No more given to you on a plate.

Many service users found that they had to jump/move between ship/service providers or struggle with the turmoil that services were not going back to what they were

“Only those who will risk going too far can possibly find out how far one can go” T. S. Eliot.



used to and/or dependant on.

For some the changes brought hospitalisation, as changes were too disruptive and difficult to deal with. Many of the shout-outs of disapproval were still not being heard and fell on deaf ears.

What were the fears?I heard that service users would fall into crisis and never receive help. Service users would be fighting on the streets as they disagreed with the daily decision of service user led services. The Kingfisher Model wasn’t what we all want. Who would have thought democracy was allowed in mental health service delivery!I heard that back in 2007 there was a review of day-care and in 2009 services were decommissioned and new services were commissioned – presumably based on need but I wasn’t hearing Service Users being offered real choice based on their needs.

That was then, this is now: Sometimes it takes courage to discover our strengths As the landscapes change, so have the service users health. What has gone is this fear, the fear that wanted to prevail, by constantly reminding service users that these services were going to have a negative affect on all?

Imagine day-care service users have adapted to their surroundings remarkably well considering the initial scare that the providers wouldn’t be

able to support them, especially around risky behaviour, crisis and relapse.

King Fisher members were very wary about the intentions of Imagine. They saw them as outsiders as forcing their model of service led user group on them even to the extent that they would not have open dialogue with Imagine Staff, and often this would lead to aggressive stances. The Kingfisher members wanted to keep their service local, attracting local service user, whilst Imagine wanted membership opened up to a wider audience. Which in a way is the only direction Kingfishers had as new members were slow in signing up whilst existing members stopped coming. I understand that this has been resolved and new members are very welcome.

Service provision changes everythingClients have made great steps in moving towards living their lives whilst taking risks

Life experiences are shaping those that risked moving with the ‘enforced’ changes, over time and with support they have reacted to the possibility that they can lead day-care services themselves. Many that have risked have responded to the challenges and have created a peer-to-peer supportive network.

Access to Specialised Support: Crisis and RelapseWhat are missing are clear



access points to crisis support care from statutory services. But then again isn’t that the same across the voluntary sector. We all have to support our clients when they relapse into crisis whilst struggling to get care teams within SLaM to respond. Whose fault is this, commissioners or statutory providers? Is there a magic wand to resolve this landscape?

Access to Specialised Support: Benefit WelfareService users have been faced with climbing anxieties caused by the ‘Welfare Reforms’. Imagine’s clients need access to specialised support to help them complete new claims and access to Mind in Croydon’s benefits service with tribunals and appeals.

Access to Specialised Support: Day-Care Staff Provision• Do we need specialised day-

care staff to hold our hands when we need comforting?

• Do we need specialised day-care staff to tell us what to do with our days?

• Do we need specialised day-care staff to be there when I need advice?

• Or can I get this from my peers?

The answers to these questions have to be both yes and no; as no one service user requires the same comprehensive service as the next person. ‘One size does not fit all’. Imagine Drop-in service meets the needs of those that are able to take steps and risks, this

is a fact. But not all service users are at the level of higher-enough recovery, and many need more specialised support before taking those sole steps of peer support or peer led services.

I can remember when SLaM Day-care was closed. I was affected and I remember facing life without day-care; which to me felt like there was no support and nothing in place stop me relapsing and being returned to the Bethlem. I was very scared.

Imagine drop-ins/groups are a great success to the many. The locations of the drop-ins change daily, one day it is at the CVA the next it is down in Purley. Many members make the rounds, travelling from centre to centre and this must be empowering and tasks their abilities to cope

Members at the drop-ins have formed committees and members decide the direction of the weekly activities, where they spend the funding which they receive.

Members have developed their skills so that individual (or small group) members have taken up roles and have excelled at them.

Members have formed friendships outside of Imagine and take them into new environments meeting in cafes, pubs, cinemas, bowling halls and clubs. They are building on their abilities to stand on their own feet and go as far as they are able to take themselves that day. They are doing this not because a member of staff with a carrot



and a stick is pushing them but because they are themselves achieving something they couldn’t face yesterday building on their recovery.

Not all days are good. Some days they stay at home in bed and pull the blankets over their heads and deal with it minute by minute, hour by hour but guess what happens; other members recognise that they are not there and call. They are supporting each other as friends not being supported by someone that has a responsibility as dictated to by a safeguarding adults policy; but truly as people looking out for each other. Leave these policies, for now, down to Imagine and their staff

Risk taking is a daily adventure, Members are responsible for their own behaviour; if they cause upsets, arguments or behave badly then the members decide on the outcomes; does that person get banned, how long for and from what activities. They as a group are making these decisions not the support staff of Imagine. Members are encouraged to take up responsibilities and own their decisions rather than falling back on staff. This is helping them to own the drop-ins as their space, their service and their club and not the property of Imagine. Real ownership delivers real health recovery.

Imagine drop-ins are not in any way mirror images of the services that have been decommissioned,

but they are still standing and achieving great opportunities for those that wish to take part. And many do. Sadly not all service users made the move and fell through the gaps.

That question that needs to be askedMind in Croydon were very encouraging, helping their members that wanted to keep the club, forge out of the Fairfield Club ashes a drop-in that Mind members would own and run themselves. Sadly this never happened. Perhaps through fear, members couldn’t take this risk further. And that question that needs to be asked: those service users that have lost out and don’t have a place that they can call upon. Did the individual review of their needs (IRON) fail them, fail to provide them with a service that fitted around their needs, fail to hear their voice or were they ignored and stepped over on the rush to the new model.

Did they need to tear up and destroy day-care services to build a new model? Was there a possibility that a two-tier, day-care umbrella service could have been commissioned based on different needs rather than one service fits all? One group of service users accessing service that requires higher support needs and another that they make a gradual transfer to. Making a pathway from high needs out to lower needs, from being supported to leading your own journey.



Maybe from looking at the Imagine Drop-ins something can be learnt from their service users. They do have the abilities and capacity to run their own drop-ins the way they want.Group outcomesProviding opportunities to Service Users to lead their own drop-in service where they deicide what activities they want to be involved in, whilst taking control of their project budgets has helped them as individuals and as a group to achieve greater potential compared to when they were provided for. Quite simple really, the group members have become empowered because they have been given the wheel to steer the groups in the direction they want to take them.

From the service users mouth, from observing and listening to members, at the groups and in other settings (many now come to the Hear Us open forum), members have gained more confidence, self-esteem and their wellbeing is evidently better, from being given more responsibility for themselves and for their project.

“Here, its your group you decide your outcomes, you decide your day’s activities”. Handing over the ‘lead’ is encouraging independence, development and managing ones own risk boundaries.

So the drop-ins/groups are helping the service user to step out of their comfort zone and take risks, to achieve empowerment

What are members achieving:Members are supporting each other through peer support. Members are taking control of their project budgets. Members are being more socially included as they are stepping out of the groups as friends and meeting up in different location/activities.

Freedom PassesMembers are able to attend the group like other services provided because they are issued with freedom passes. Take this away and the groups will stop. Solitary living will come back to this tightly formed supportive community; life without friendships that has built up between members will collapse.

So we ask the council to support its vulnerable community and keep to your commitment of supporting vulnerable people by providing the Freedom Pass.

HEAR USLinkworking at Imagine Drop-In Services


Recommendations

Firstly: Imagine drop-in/groups have been a fantastic success. Members self esteem is improving as their confidence grows in being able to lead (and run) their groups, they want, their way. Being involved in the group has led to friendships and good mental health. The members, and support from a small group of dedicated staff have created a service that is thriving and motivates service users to attend and supports them to reach a better wellbeing.

1. Commissioners need to consult with service user openly and clearly when re-configuring services. Service users have continually felt that they were not consulted and listened to fully about changes, in this case day-care, back in 2001/03 & 09.

2. Any changes to services has to review the needs of service users before service plans are drawn up. How can a new service support the needs of the intended, without knowing the full picture of service user needs

3. No one service can meet the needs of the many. A service needs to be provided for those whose needs are greater than those that Imagine drop-in can provide. Many people were unable to make the transitions from the

older staff led day-care to the new service user led. Many very vulnerable service users that need a safe place to go, have been left to struggle alone.

How healthy are they now and where have they gone?4. Imagine review the health and

wellbeing of their members. But what of those that went through IRON that are not attending Imagine. Where are they, how good is their health and wellbeing; and how good is their daily life and routine. There was a list of service users that were put through IRON so it is possible to join the dots and review these service users.

5. What was not possible to capture in this report was how day care services are impacting on inpatient beds. Understanding reasoning behind why people are being admitted to the Bethlem and also the many others attending resource centres may provide insight into the type of support service users need to keep well in the community and outside of the expensive SLaM service.

From Hear Us Linkworking project on the wards of the



Bethlem, and at resource centres, insight into why people are admitted has not shown any direct correlation to Croydon’s daycare provision. However there is evidence showing a lack of service user being aware of daycare service in the community. Many spend time in isolation, and many are

self medicating through drug and alcohol misuse and are unable to break these routines. Service users need directing from SLaM staff and SLaM staff need to be aware of community services like services provided by Imagine and other Croydon voluntary organisations

ConclusionThe Finnamore report back in 2001 noted that there appeared to be a discrepancy in the daycare content and style of services between:Independence & Dependence: Daycare service generates a significant level of dependency in its users.

Managed Risk & Self Containment: Daycare service is very good at containing users in an environment where they and the staff feel safe. The service is less good at allowing users to take risks in a managed way.

Developmental & Maintenance: Daycare service gives users opportunities to tackle their problems and broaden their interests. It is less good at helping users to take on new challenges and achieve valued, ambitious, productive goals.

These are good examples of how to monitor how your service is performing in enabling recovery. Are you creating Independence or dependence, helping to manage risk or contain users and help with development and not maintained.

Commissioning of services need to respond to service users needs but also push service users into making steps that help them with recovery.

Built into each service there needs to be the voice of the service user and the service users need to be given tools to be able to monitor their service so they can feed back their needs of independence, managed risk and self development.

SLaM (and commissioners) need to understand that mental health and wellbeing does not solely come from medication and therapy but also from relationships forged out of daily contact and activities. This is something that Imagine, Mind in Croydon, APCMH, Status Employment, Healing waters and all the other groups and networks do extremely well.

The Freedom Pass is supporting access to groups across the borough and is needed to support recovery and development of health and wellbeing



Group/Drop-‐in DateNumber of

Service UsersImagine -‐ CVA 12-‐Jun-‐13 8Imagine -‐ CVA 14-‐Aug-‐13 10Imagine -‐ Parchmore 08-‐Jul-‐13 8Imagine -‐ Parchmore 10-‐Jun-‐13 10Imagine -‐ Purley 23-‐Jul-‐13 11Imagine -‐ Purley 27-‐Aug-‐13 8Imagine -‐ Waterside 22-‐Aug-‐13 8

Total 63

MAIN THEMES:What members say

Age Total21 - 30 531 - 40 841 - 50 651 - 60 461 - 70 3Not Known 36Prefer not to say 1

Total 63

Gender TotalFemale 10Male 17Not Known 36

Total 63

Ethnicity TotalAsian 5Black British 1British 15Indian 1Irish 1Not Answered 4Not Known 36

Total 63

Sexuality TotalHetrosexual 26Not Known 37

Total 63

Equal Ops Monitoring



Imagine Drop-in Services:Daycare - Staff Support & Service Provision

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Daycare - Safe Place to go 1 11 12Daycare - Activities 2 10 12

Daycare - Social Contact 1 8 9Daycare - Crisis Support 2 2 2 6

Daycare - Drop-in 2 2 2 6Daycare - Benefits/Welfare 5 5

Daycare - Medication & Treatments 3 3

Daycare - Trips & Outings 2 2Total 7 13 35 55

“I really enjoy coming to Imagine as it feels safe. I’m

also doing a course at collage with help from Imagine. I like the way the groups are run by and for its members but I

would like longer hours and more drop-in sessions.”

“I use to attend the previous day care

services, but prefer Imagine as we get to choose what activities that we want to attend and be involved in. I’m much happier

here”



“I have stopped taking my medication as

it makes me sleep too much. I know it keeps me well, but I stopped taking it for over two weeks now. Imagine staff are aware and are helping her

address this with Tamworth Road”

“I like coming to Imagine woman’s

group as it helps me to keep motivated and out and

about.”

“There are many benefits from attending

Imagine drop ins, such as being around people that understand each other. We

get to do activities outside of groups that are really enjoyable. We go to the cinema, meetings at cafes/pubs. We also go bowling

and do badminton. We also go on trips to Brighton.”

“The Imagine relaxation group

is an excellent group, because I’ve learnt how to calm down and reduce my anxieties.”





“When I first started coming here I would only talk to staff. But now we are like a family and we all talk to each other and support each other when we are down”“Coming to the groups helps me to not drink and gamble, which in turn help me focus on the important thing in life”“I get a real ‘buzz’ out of coming to drop-in sessions, where ‘people treat me equal’”“Being on the committee helps me to express myself”“I really enjoy coming to Imagine groups as I feel safe and I am also been able to do some courses”“I really likes Imagine the way it runs, but I would like longer hours and more group sessions”“I Don’t know what I would be doing if this service wasn’t here. Imagine have really supported the groups to grow and to be run by the members. I never thought I would be able to have a say in the service”

What are members saying about Imagine:Drop-in Groups - Safe Place to go

“The group are going to Butlins!, Bognor Regis, For three days, fifteen or more of us will be going and it will cost each of us around £50 each and Imagine are putting in £50 per person. The group are really looking forward to it”“I like the trips and outings with Imagine. I also prefer that Imagine are running the drop-ins as I don’t know how to cope through each day. Other members are really supportive”

What are members saying about Imagine:Drop-in Groups - Trips & Outings



“Our group have a dog! (Owned by worker) Every one is enjoying him being there. He (the dog) will be attending all groups that Imagine hold, good therapy”“Group members are thinking of giving back to their community by cleaning up a park or following a Croydon event”“I am very focused on achieving high standards in with my activities, other members encourage me to change my aims from achieving to having fun. This has been difficult as I am struggling with my anxieties but I am trying”“I get a lot attending the groups. Social contact and activities outside of groups like going to the cinema, meetings at cafes/pubs, and bowling, badminton and trips to Brighton”“I prefer the Imagine groups, compared to previous day services as the project is run by us rather than being told what to be involved in. I really enjoy the activities and outings”“A few of the group wanted to play learn Bridge so we contacted a local Bridge Club but they didn’t take new members that didn’t know the game. Another member suggested that he teaches members how to play chess”“The group have been busy making Cupcakes for an event the tomorrow. The group were responding positively to the task ahead. Each member wanted to participate and was very motivated. Staff support was minimal but this seemed to be what the group wanted”

What are members saying about Imagine:Drop-in Groups - Activities



“I really enjoyed the company of other members here at Imagine. I have made many friends and we support each other, I don’t feel I could cope if the group didn’t exist”“I really enjoyed coming to the groups, I feel that the members make the groups happen and the groups really belong to the members”“I really enjoys coming to Imagine, previously I only had hospital, being with others that are coping is really insight into my illness.”“I like coming to group to mix with people, sharing life experiences and talking about illness shows that you are not alone”“The groups are good and have been good for me. I feel like I choose to come to the group and that nobody forces me. I really feel good that we are in control of what days we get involved with and how much we are involved in”“I came here because I was encouraged to by my friend who was using this service. I feel much happier coming here as I think I would have carried on going to the pub every day. This is much more enjoyable”

What are members saying about Imagine:Drop-in Groups - Social Contact

“I need help, I’m a hoarder, I have to much stuff”“I would like a Freedom Pass but not sure how to apply for one” Linkworker advised that they talk to their support staff to see if they could help.

“I have applied for Disability Living Allowance but haven’t heard anything yet - I am getting agitated” Linkworker advised that they ask a member of staff for support.

What are members saying about Imagine:Drop-in Groups - Benefits/Welfare



“I am going to change the time I take my medication as I am too sleepy during the day and I want to come to the group”Service user at the Bethlem: “I want to go to imagine today as it’s Marie’s leaving party but the ward will not let me”Westways R&R Service User: “I managed to go to Imagine, will go again.

Another member also stated that “I want to stop taking my medication in the morning as it makes me sleep through the day so I have difficulty attending. I will be seeing my Social Worker so I’ll discuss with them”

What are members saying about Imagine:Drop-in Groups - Medication & Treatments

“I find it very distressing that people with mental health are stigmatised and discriminated against. It is difficult to progress in life and work if people know you have a mental health illness.”“I’m currently on dialysis and I am Is very worried about up coming operation, and worried about my body rejecting my new kidney other members have been very supportive”“I have stopped taking my medication as it makes me sleep too much. I know it keeps me well, but I stopped taking it for over two weeks now. Imagine staff are aware and are helping her address this with Tamworth Road”

What are members saying about Imagine:Drop-in Groups - Crisis Support



In your opinion what do you feel; your service users are getting from the Imagine groups?

I think that Service Users feel a great sense of empowerment; they are encouraged to do and try new activities and have great sense of choice and independence. I think that group members feel a part of something and the groups are theirs rather than just a service that is just provided with or without them and they really have to buy into and feel part of it and feel commitment towards it and I think that is really powerful. I think the service offers a safe stimulating environment for people that encourages development of skills. It helps them to look at their lives, at what they want to do and look at their aspirations and encourage movement along the road to recovery. I think it is great.

What do you feel would happen if the drop-ins were closed?

I think best case scenario, because people feel levels of empowerment there’s always the hope that people would continue to meet and continue to build their own groups from that basis, but I think a lot of people would feel a massive loss and their wellbeing would decrease without having

somewhere to go, people to see, the support from the team (Staff) and each other – there is a great deal of peer support that happens in the group and without having that formally in place, I think that for many people it would be very devastating as they genuinely do like their groups, they like coming, they love coming. They feel a sense of ownership over the service they would feel it would be taken away personally rather than taken away from Imagine or Croydon. So I feel it would be a harsh blow.

You are saying that the drop-ins are very peer supportive in their nature - is there like a cliquey group forming or that has formed which alienates new members joining the groups, being excluded not welcomed in?

I don’t think so; I don’t see it like that from an internal perspective. A lot of the service users and its really heart warming, really positive for me to see how the group members have accepted people in the fold and as I’ve said they are really proud of their groups and really proud of the service being offered to everybody, so when new people come in someone jumps up and hands them a referral form and

Interview with Marie Johnson, Former Imagine Support Worker Talking about Imagines Drop-in Service



welcomes people in. I often pair people up, so if new people come, they are introduced to everybody. In the past we have done ‘meet and greet’ training where the team sat down with group members and did training on how to welcome people and what paper work that needs to be done. Because the groups are user led and that is part of that. It is really refreshing to see how kind and welcoming they are to new people and that really makes me happy.

You said that your service provides peer support a safe place to go - do you believe that the groups are helping people with their recovery and supporting them not to relapse and require hospitalisation?

Absolutely – our services supports people with recovery; we promote independence, we promote empowerment, we promote social inclusion and I’m a firm believer, that all those things and all those experiences build on someone’s recovery, and I believe that if someone is dis-empowered, if they feel they are dependant that recovery is a lot harder. In terms of people minimising relapse and minimising people needing to go back to hospital; I think we do provide preventative service, I think people know we are there, they know they can come to us, if we obviously are seeing signs that people are becoming unwell there are interventions, we can help

them access services they need. Obviously we can’t ever stop people becoming unwell because that is the nature of mental illness unfortunately, and it does happen but we are a safe supportive environment for people to come to and we do minimise as much as possible people having to go back to hospital

How do SLaM, such as Tamworth Road Resource Centre respond to crisis calls for help from Imagine?

I think they are a difficult egg to crack, we promote ourselves there by having meetings with them, we do try and build up a relationship with them. If someone is feeling unwell we support them to ring their CPN or Care Coordinator or whoever their contact is down there. Unfortunately the majority of the time, what I hear from our services users is that they are not that happy with the service they receive. Some people do say that they have a fantastic CPN and they are really pleased with them. Unfortunately they are not the majority of the people, I hear they are really not. Time and time again I hear they are told to take yourselves to A&E or I haven’t got time to see you. Someone I was speaking to yesterday was told this, they were possibly speaking about the evening so I don’t want to mislead. Usually if I speak to their point of contact there they are quite quick in saying take



themselves down to Tamworth Road and they can see ‘Duty’. That usually happens. I tend to find that if someone has spoken to them their-selves and they haven’t spoken to someone they deem as being a professional they are less quick to offer them that support – That sounds very damning I’m afraid.

You are about to leave and go off to new pastures..... What do you feel that you have gained from working at Imagine and being involved with the project, the drop-ins and being in contact with the service users?

Firstly and foremost I feel an immense amount of pride and I’m so happy and it feels amazing to see how people and have come to the services and how they have grown and how they have developed and it’s been an absolute pleasure and a privilege to be able to work with the people I have worked with. I wouldn’t change the way the projects have developed and I wouldn’t change the people I have worked with for the world. I think it’s been brilliant and despite initial anxieties within the borough and despite criticisms that have come, I can truly say that the services stand up for its self. I would be 100% proud and happy to show everybody what we have done. I have learnt the immense importance of empowering people and how powerful that can really be. We

are not treating people like they are second rate citizens and we are not treating people like they are patients we are treating people as people and they like that in the service and they really like not feeling patronised and feeling like we are all on an equal footing which I believe we all are. It’s been fantastic.

When Imagine Drop-ins first started there was a lot of friction from the services coming to the projects. They had beliefs or misconceptions about what was going to be there for them - where do you feel this came from?

I think that came from genuine anxieties about people leaving behind a style of service that they had known for decades. And I think that is completely understandable and justified and I think in the early days we worked really hard and we worked thoroughly to manage those changes and manage people through those anxieties and obviously now we are able to reflect back upon that time and say we came through that really positively and built up a service where those people who were the ones that were being particularly anxious and being particularly resistant to the changes in the beginning are now being the ones that are championing and moving the service as is now forward and I can really appreciate the fact some of the things that people were worried about with the user led aspect the fact that



people would have more choice and originally people would have seen that as being too much to take on and how was that going to help my recovery if I have to make decisions and having more choice with things – but now people can see the flip side of that which gives people so much more power to shape their own service to reflect on their own service and their service reflects their own needs and not the needs of someone high up who is telling them what is better for them. Which I don’t feel is always that helpful?

Because of our experience in Croydon, of how people first felt anxious and resistant to Imagine first setting up the groups and because of that original friction Imagine have won a tender in Redbridge

Where people feel exactly the same it is almost a carbon copy of how people felt in Croydon, where they had long standing day service which was staff led and was closed down and turned round to a user led service were service users are at the heart of what is being delivered.

I have been working up there with them – leading a consultation process with them looking at what their concerns are what they are worried about and looking at viable solutions – ways forward. And just talking to people, it really helps, just talking to people, just explaining, just clearing up any confusion, which has been great, really positive process as

well. We can build on and reflect to them what’s happened in Croydon, where people are now and how great they feel about the service now, and I feel that has really helped them in Redbridge. Help them feel less anxious and concerned.

One of the criticisms there has been in Croydon is that you don’t actually have a building, that you own as your space and that you only rent space in buildings and that’s not the model we had before. We had a flagship build(S)

Again that was one of the anxieties for people in the early day and I think we have proven 4 years down the line it seems to be ok for people an irrelevance; certainly for our service users, it’s never been an issue, people enjoy the variety moving around the borough, that means they are entering areas they might not have done before, they are accessing different opportunities within those areas. People like the flexibility. People like the fact today I’m at Purley, today I’m at the CVA, I might go up to the Parchmore next week. You find that instead of having one flag ship building we now have four and it is much more about the people rather than the building. We are interested in people growing a community out of the groups and that happens and there is a body of people who are friends and enjoy each other’s company and enjoy the space they are in. We have our own cupboards, we have our own notice boards. All of our stuff, all our artwork



all of our notices

Each of the groups has its own feel and that’s fantastic and that’s to do with the people that go there and the way they have moulded their service, and you can see that. Purley is the arty group, the more quieter group perhaps sometimes. CVA has a real vibrant feel about it – there is a lot of community activities that run out of the CVA as a base, as it is central. Parchmore is focused around the cooking group and the way that has been moulded and people cooking together and having their meals together. Each group has a different feel and that offers far greater variety for people rather than coming to the same building every day.

Do you feel that your service offers a recovery, a way of helping a person moving forward?

Absolutely; we do one-to-one work with people and we use the ‘Recovery Star’, which is focused on moving people forward. We do see moving people forward as one of our remits. Our service users set their own targets based on the star.

We are all about moving people forward whether it’s engaging people with community activities, and we often see a natural progression for people to do volunteering and that happens a lot. And the way we see the drop-ins is; a safe place for people to come to in addition to doing other things outside of the group. We don’t want to be a place

where it is somebody’s only be all and end all. We want people to make sure that there is other things happening outside of the groups, that are promoting their recovery and are moving people forward and then they come to the drop-in. So people do ‘my volunteering on a Monday and I see my family on this day and if I’m not busy then I’ll come to the drop-in’. And that’s the way we see it; empowering people as well so that there isn’t a dependency on the groups.

Anything else you would like to add about people coming to the groups.

The nice thing about using, coming to the service, is that is friendly, it’s not clique. You have a genuine opportunity to do whatever you want there. You are supported by a team to try out any activity you want to. And you really do have a say in what’s going on and you really do have a say in what you want to do and where you want to go with the support all the way. I think that it’s a misconception that there is no staff input whatsoever and everyone is left to their own devices and that is not the case. We have a core group of services users, around 150 members. And around half of them attend regularly and people drop-in.



The User Led Groups take place at a number of different venues and times throughout the borough providing social interaction and activities. The emphasis within these groups is that activities are decided on by its members. Referrals and self-referrals are accepted.

Aim of service: The four drop-in services will provide a safe place to go - a base from which users can: develop and increase their confidence and skills, without specific expectations or pressure to maintain the community spirit and environment that many see as an important part of their life. Decrease their social isolation, meeting with people they know and trust, to establish social ties reduce their dependence on secondary mental health services

[New referrals]: Who is the service for and how to access it? People in various stages of recovery from mental ill health or distress. Open access - anybody who feels they have, or are recovering from, mental illness or distress

Imagine: User-Led GroupsWhere you can find the groups

KingfishersMon-Fri 10:30am to 4:30pmTel: 01689 845 119Purley URCMonday 1pm to 4pm.Tuesday 11am to 5pm Thursday 2pm to 5pmFriday 11am to 5pmTel: 020 8253 7078

Parchmore MethodistMonday 10am to 4pmTel: 020 8253 7078CVA Resource CentreWednesday 10am to 4pmThursday 10am to 4pmTel: 020 8253 7078

Imagine Music GroupThursday 2pm & Friday 2pmRockbottom, West Croydon,Bring your own instrument if you have one!

Out of HoursMonday 5 to 7pmActivities incl. Badminton, Films, Quiz Nights, KaraokeEast Croydon United Reformed Church

Wednesday 5pm onwardsBowling/Cinema/Go KartingMeet at CVA Centre at 4pm

Saturday 12:30 to 4:30 pmFilm Making GroupWaterside Centre, 26 Avenue Rd, SE25 4DX

Health ClubFriday 10 to 1pmFootball training, air hockey, snooker and tastersessions from community-based fitness opportunities Old Town Youth Centre Duppas Hill Terrace. Call the team to meet someone to show you how to get there.

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