Hafal is one of the largest charity providers for people with serious and enduring mental health issues in Wales. It is founded on the belief that people who have direct experience of mental illness know best how services should be delivered. In 2013 Hafal received £291,174 of National Lottery funding to develop the Gellinudd Recovery Centre in the Swansea Valley over four years. The Centre was the UK’s first in-patient mental health centre designed by service users and their carers. We spoke with Alison Guyatt, manager of the Centre about how they have put working together with Guests at the heart of their work.
Two years into her retirement from a 37-year career as a senior NHS nurse, Alison was starting to get bored when she heard about the plan to build a Centre to support the recovery of people with serious mental health issues in Gellinudd. She contacted Hafal, just “being nosey” but went on to be recruited to help set up the Centre. Alison now works as its Director.
Alison was determined to develop a service that was as non-clinical as possible, a welcoming therapeutic community where people could be supported to manage their own recovery and return to independent living. To support this, Alison wanted to enable people with mental health issues and their carers to bring their experiences to help shape the environment they thought would best support their recovery.
Over three years, Alison and colleagues consulted with hundreds of service users and carers to design the Centre. As well as involvement in formal meetings such as AGMs, potential Guests at the Centre met with furniture suppliers and architects to make suggestions about the layout and facilities. Many of those involved had experience of other inpatient facilities which allowed them to ask for features that otherwise would never have been considered. Instead of windows, people asked for French doors, so that when children came to visit they would have the opportunity to safely play outside within sight, rather than associating the Centre with having to sit still and talk.
People with experience of mental health issues also play a key role in the governance and running of the Centre, including on the Board and as part of the expert advisory group formed right at the start of its development. Reflecting the importance of integration with the community, service users sit on the expert advisory group alongside a senior lecturer from Swansea University, former Head of Complaints at South Wales Police, Professor of Psychiatry, local vicar, accountant, and solicitor.
Since opening in May 2017, the Centre has continued to put people with serious mental health issues at the heart of its services and maintained its emphasis on creating a community rather than a clinical environment.
The Centre adopts a self-management and a holistic approach, with Guests setting their own recovery goals in care and treatment plans. There’s a huge range of activities on offer, from exercise, music and art, to walking, biking and opportunities to gain formal qualifications. All Guests and staff contribute to the running of the Centre—whether the newest Guest or most senior member of staff, everyone helps clean and cook.
Alison says there’s no one who hasn’t engaged with the Centre’s approach. “Some days people want to participate, other days they don’t. This is fine—they can have a chat whenever.” Pragmatism and flexibility is key, though this needs to be balanced with carefully thought through policies.
Peer support workers play an important part of the Centre’s model. “They’re brilliant,” Alison explained. “I don’t know how I worked on wards before without them…the lived experience is so powerful.” She explains that staff have a much better understanding of Guests’ needs as there’s more of a focus on putting themselves in other people’s shoes. It’s particularly valuable when peer support workers are able to say “I’ve been there, this worked for me,” as it gives hope for recovery.
Alison’s tip for other organisations looking to develop new services is that you can never do enough consultation. “It was invaluable, it was humbling. To listen to what people wanted and to bring it to fruition was a privilege, a once-in-a-lifetime opportunity.” She explains that “the Centre’s board is made up of service users, service users are involved in recruitment—it’s more than lip service. The benefits are enormous and I’ve learnt a lot.”
To examine the impact of its distinct approach, the Centre is working with three PhD students to evaluate its model—exploring outcomes for Guests, carers and staff; recovery specific outcomes; and clinical supervision for practitioners. As well as assessing the potential cost savings of their model for the NHS (estimated at £300,000 per year), the Centre aims to develop similar recovery centres in other areas of Wales, and is developing its peer support training which it intends to cascade across Wales.
Find out more about Hafal on their website www.hafal.org/gellinudd/. If you would like to find out more about National Lottery funding for community projects, visit www.tnlcommunityfund.org.uk/funding