Exploring the many factors that contribute to the decline of a person’s mental health is difficult to do in a 15-minute visit with a general practitioner (GP), says Teresa Harrison, a Community Mental Health Navigator (CMHN) with Mental Health UK. That’s when patients are referred to a CMHN. “My role is like trying to put together a jigsaw puzzle that is not quite fitting,” she explains. “At the end, hopefully, I can put the right pieces in place to help the patient feel whole again.”
Last May, at the height of the COVID-19 crisis, Mental Health UK with support from Johnson & Johnson UK and the Johnson & Johnson Foundation, pioneered the CMHN program in Grimsby, a once-thriving fishing community in the UK now facing socio-economic and healthcare challenges. With her broad experience in mental health in the Grimsby area spanning over 15 years, Harrison was hired to take on the newly created CMHN role.
Initially this involved working with one of the primary care networks (PCNs) to identify people struggling with mental health issues due to the isolation caused by COVID-19 lockdowns. She assisted with services including food and medication deliveries, arranging transportation to hospital appointments, as well as providing emotional support and checking on the general well-being of people.
Currently Harrison serves as a single point of contact to support the non-medical needs of patients, including housing, finance, employment, physical well-being and social connections—all stressors that can contribute to poor mental health. Overstretched GPs now have a partner trained in mental health to provide the wider support patients need, allowing them to provide care to more patients.
It starts with having a conversation and establishing a relationship with the patient, says Harrison. “I’m trying to get to the bottom of what the patient is experiencing and to get them the help they need before it reaches crisis point.” When a person’s mental health needs are more severe, she refers them to the UK’s National Health Service (NHS) mental health team. Other times, she helps connect them to the right resources—be it cognitive behavioral therapy, debt counseling or help with housing resources.
Often, it’s the simple things, she adds, like delivering a stove to a disabled mother caring for her three kids with disabilities. “I found out she was cooking in just a pot because she didn’t have a cooker and we were able to deliver a proper stove free of charge. Now she can cook a meal for her kids. That’s one of the simple things in life, isn't it? If I had not had the chance to speak with her, we wouldn’t have got that far.”
By adopting this holistic approach and moving support into the community, the project aims to both help people navigate what is often a complex patchwork of support as well as lower the need for emergency crisis care and lessen pressure on acute medical services.
Early outcomes provide a blueprint for the wider NHS strategy for mental health
Harrison is excited by the results of the program in Grimsby. Referrals now come to her from many teams including nurses, ambulance services and hospital liaisons, aligning with the NHS Long Term Plan in England to integrate care to meet the needs of a changing population in areas such as mental health and maternity services. Eventually Harrison can see the NHS’ single point of call system providing users the option to see the GP or the Mental Health Navigator.
Currently Harrison is the single CMHN in Grimsby. She sees close to 40 patients every week, and because of the pandemic, many of these meetings are by phone. “Ironically, the social distancing has allowed me to meet with and help more patients. I couldn’t manage 40 patients if I were seeing them all face-to-face.”
The work has its tough moments and Harrison makes sure to stay mindful of her own mental wellbeing. But ultimately giving people choices and helping them see the light at the end of the tunnel makes it all worthwhile.
Recently Harrison met with a patient who presented as struggling with his mental health. “When I talked to him, he said, ‘I don't really want any tablets,’ and he said, “I have COPD, my wife has to lift me into the bath every time.” He was 78, his wife was in her 70s. I went off and told our support team he needs a wet room. It’s about this man’s dignity, he can’t wash himself. Two weeks later he had a wet room. This man never went on antidepressants, absolutely loves his wet room, and feels he doesn't need mental health services anymore!”
Harrison has many such stories to share and is hopeful that the success of the CMHN program in Grimsby will provide a blueprint for providing mental health support in other communities. “The work we have done and are continuing to do in Grimsby has proven to be absolutely amazing,” says Harrison, “I hope they will look into having Mental Health Navigators in every primary care network. Some models will look different, but we can now show that it works in Grimsby. It’s a much needed service, it really, really is. In all my time of work in mental health, I can't think of anything more worthwhile than this role.”
As part of the Johnson & Johnson partnership with Mental Health UK, three more Navigators have now been appointed across the UK.
Date of preparation: April 2021