THE RIGHT BLEND
People experiencing co-existing mental ill health and substance use may struggle to access mental health treatment because of their substance use , and struggle to access substance use treatment because of their mental health . They can become stuck , unable to get the help they need where they live .
A residential placement , with appropriate detox , could be an answer as it enables people ’ s care to be coordinated in one location , but many rehabs lack the mental health treatment capability . They ’ re not set up to coordinate care across mental health and substance use needs , nor do they provide a range of specific mental wellbeing activities . This means that people with a coexisting interdependent need can face a huge health inequality .
Accessing residential treatment requires a high level of organisation , support , and resilience . There are multiple assessments and appointments to attend , which can be difficult for people who
A blended approach for effective substance use and mental health provision is the way forward for services , says Gabrielle Epstein
struggle to express themselves , and find talking about traumatic life experiences triggering . We see people too easily labelled as ‘ noncompliant ’ or ‘ unengaged ’ when in fact a history of trauma may act as a barrier to sharing openly , or anxiety may result in non-attendance at assessment sessions . People who lack support and confidence are disadvantaged . If people can get access to rehab , then the unfamiliarity of the place , having to be with so many new people and talk about feelings so openly , can be too much .
Phoenix Futures ’ New Oakwood Lodge is a new CQC-registered therapeutic community in Derby that provides coordinated mental health and substance use care in one location . It ’ s a place where the skills needed to support people excluded from other forms of support have been brought together in a multi-disciplinary team . Essentially , we ’ ve made accessing multiple forms of treatment – which can be incredibly complicated for some people to access – simple for everyone by delivering it in one place in a single treatment episode .
The environment , protocols and treatment offering are designed to provide the necessary support and interventions on an individual basis to maximise community members ’ engagement in treatment . The programme is based on the therapeutic community approach – people live together and learn from each other . The community helps individuals emotionally , and supports the development of behaviours , attitudes , and values of healthy living . The structured group programme enables people to share and learn together in groups facilitated by expert staff .
Treatment incorporates oneto-one counselling , using CBT to support with mental health and substance use . Our ‘ Recovery through Nature ’ programme enables people to come together with a common purpose to complete conservation tasks – being with others , exercising together and working to create a positive environmental impact is proven to aid mental wellbeing . We bring together these core interventions , and other specialist interventions , so that they fit together in a blended approach to care .
The team at New Oakwood Lodge is made up of a psychologist , counsellors , registered nurse and therapeutic workers in a multidisciplinary team supported by our clinical governance committee and headed up by a senior consultant psychiatrist . They work together across different disciplines of care to create an environment and milieu to deliver coordinated and personalised care bolstered by peer support .
The length of treatment will typically be longer than usual due to an extended assessment and welcome / induction process at the start of treatment , and we also expect the discharge period to be longer and more comprehensive . We ’ re currently working toward the Enabling Environments accreditation from the Royal College of Psychiatrist and we ’ re a member of the Enabling Environment network .
At New Oakwood Lodge we take a modern approach to mental health , meaning that we treat people – not just conditions . We enable people to be themselves in the safe , open , and caring setting of the therapeutic community . We provide mental health care coordinated with drug treatment , and vice versa . Mental health interventions are specific to individual needs and equip and empower people to feel included , safe , and able to receive and offer support to others . They exist in a reciprocal loop with drug treatment , so that one-to-one behavioural interventions for depression , for example , focus on helping people engage with their peers in groups and activities that make up the everyday routine of residential treatment . Similarly , the safe and caring community of the service is an ideal environment for people to practise what they learn from one-toone CBT interventions for anxiety .
There are a number of targeted outcomes that we aim to achieve with our blended approach – for example , improvement in peoples ’ mental wellbeing and health , including treating anxiety and depression , reductions in mental health crises and suicide / self-harm attempts . Alongside these , there ’ s improved retention , reduction in the number of early leavers , and a potential reduction in psychiatric medication .
Gabrielle Epstein is head of clinical intervention at Phoenix Futures
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