Who are SIL?
SIL (part of the Lifeways Group) has been in operation since 2014 and aims to provide an ‘Enhanced Community Recovery’ service for people with complex mental health needs.Our ambition is that our services will be catalysts for partnership and innovation that challenge the over reliance on institutional care for people with complex mental health needs, helping to tackle the challenges of out of area placements and ‘overstayers’ and building confidence in the ability to manage clinical risk in the community. Our company is building a reputation for achieving positive outcomes for individuals who, because of their background and potential risk, are often hard to place. All of our service users have enduring and complex mental health needs, often with drug and alcohol problems and/or a forensic history. Our support is grounded in the principles of Recovery and in particular the concepts of ‘Empowerment’ and ‘Agency’. Our support model has moved away from a prescriptive, hours based approach that we believe contributes to a sense of dependency; adopting instead an outcomes approach that ‘flexes’ support as the individuals need it - responding to fluctuations in their mental health whilst providing a structure in which skills such as self – management and self-reliance can develop.
How has SIL improved people’s mental health in the UK?
We believe that many people are stuck in inappropriate placements due to a lack of suitable alternative options. This is particularly true for those individuals on the forensic pathway or for whom their behaviours and past histories appear to make them unsuitable or too ‘risky’ for a community Placement. SIL has developed a referral, assessment and risk management process that we believe provides a robust framework for the planning of support and the management of complex risk in the community; giving commissioners and clinicians confidence that they are working with a competent provider, capable of managing complex behaviours in a community setting in keeping with the principle of ‘least restrictive environment’, at the same time delivering positive outcomes and cost savings against continued inpatient stays and alternatives such as residential care.
How many organisations/clients currently utilise the service/solution across the UK?
SIL currently provides support to over 180 service users across 19 services and approximately 18 local authority and CCG commissioning footprints nationwide.
What do you feel are the key points delegates need to digest when considering a partnership with SIL?
Successfully transitioning complex individuals back into the community is possible against a backdrop of partnership working, positive risk taking, risk sharing and a sense of the ‘art of the possible’. Above all this requires putting time and effort into assessment and planning - making sure that we get it right for the client.
What has been your greatest achievement to date? And were there any measurable outcomes that accompanied this achievement?
That we have developed and are continuing to develop an assessment process and support model that is enabling People with complex mental health needs to transition successfully back into the community.
Case study:
Female 49 years old known to mental health services since age 9. Diagnosed with Paranoid Schizophrenia. Significant history of self-harm, history of Physical aggression and violence. Discharged to SIL in November 2018 from Secure services after 24 years as an inpatient.The biggest challenge has been countering the effects of 24 years in an institution, in the words of our team ‘bringing her back to the modern world’. Progress is incremental but she is now fully concordant with her medication, understands and is compliant with the conditions of her CTO, re-stablishing links with her family and impressing her care teams with her progress and developing independence.
Case study:
Female 47 years of age, known to mental health services since age 12. Diagnosis of emotionally unstable personality disorder. Significant history of drug and alcohol abuse. Significant forensic history of violence including assault with weapons and a conviction for ‘overuse’ of emergency services. Numerous mental health act admissions since 1995. Since coming to SIL, she has responded well, taking responsibility for her own health and wellbeing, taking part in community events to develop her social networks and is now looking for voluntary work to ‘give something back’. She has also re- established links with her family, which her mother has described as ‘getting her daughter back’.
Delivering the 5 year forward view for mental health
People want care in the least restrictive setting that is appropriate to meet their individual needs, at any age, and is close to home. People living with severe mental health problems, such as schizophrenia or personality disorder, should not be held in restrictive settings for longer than they need to be. The NHS should expand proven community-based services for people of all ages with severe mental health problems who need support to live safely as close to home as possible.A report from the independent Mental Health Taskforce to the NHS in England February 2016
If you would like to learn more about SIL please visit https://www.lifeways.co.uk/sil/
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