Valuing mental health equally with physical health

Jo-AnnOne of our Mind & Body Champions, Jo-Ann Gosine [pictured right], talks about a collaborative initiative she set up between the psychiatric liaison and general occupation therapy services at University Hospital Lewisham, to integrate mental and physical health.

Can you tell us a bit about your role? 

I am a psychiatric liaison occupational therapist at University Hospital Lewisham. For the past year, I’ve been working part time in the psychiatric liaison team. Patients are referred to our team if they have a mental health crisis, along with the added complexities of physical medical complaints. Psychiatric liaison provides mental health assessment, advice and consultation on patient needs.

What have you done to implement holistic care?

Working alongside general ward occupational therapists at the hospital, my role has provided good opportunities to develop parity of care initiatives - ones that value mental health equally with physical health. 

The ward occupational therapists and I are similar in our approach; super flexible, prioritising patient focused outcomes, before safely discharging a person home to continue their recovery journey.

I worked with the ward’s occupational therapist team to develop a better understanding of each other’s roles. I promote mental illness awareness, for example how anxiety, depression and psychosis present themselves and ways in which staff approach can be empathetic and empowering. I shared with colleagues the importance of therapeutic communication skills such as listening, patience, empathy, reassurance and giving good feedback in both peer to peer feedback and patient consultations.

We conducted joint assessments. The ward occupational therapists would do a physical functional assessment and I completed a mental health occupational therapist assessment, called the model of human occupation screening tool, which focuses on strengths and barriers to engaging in an activity.

What have you learnt from the experience?  

Sharing our expertise opened us up to the opportunity to skill swap and learn from one another. I learnt about adaptive equipment, such as walking aids, wheelchairs and specialist beds, and the impact of medical conditions on functioning from colleagues. For example, for a patient who has just had a stroke, they’ll have an individual recovery journey where they will relearn skills relating to walking, talking and making a meal. In cases like these my role provides goal setting around managing anxieties and considering practical steps which supports their care plan.

Equally, the ward’s occupational therapist team developed their confidence and communication skills in goal setting for patients with mental health problems.

This excellent example of multi-disciplinary team working has provided a smooth transition from hospital to community with integrated care plans and tailored discharge plans. We have received good feedback from both patients and staff.

What have you enjoyed about the integrating care approach?

I have enjoyed the adventure of keeping an open mind, sharing skills with colleagues, promoting mental health awareness while fine-tuning the psychiatric liaison occupational therapy pathway.

Ensuring ‘parity of esteem/care’, meaning valuing mental health equally with physical health, is vital in these cases, as is sharing opportunities for knowledge, skills and expertise among colleagues.

Can you tell us a bit more about other initiatives you’re involved in?

I am currently working on other projects with the ward occupational therapists which include devising a therapeutic discharge pack and teaching sessions around case studies, with the use of my assessments.

One project that I am currently still determined to implement is creating a ‘befriending service’ to South London and Maudsley NHS Foundation Trust patients on the general wards. The befriending service would help patients to access the Harbour café, our crisis café on site, with their befriender, giving the opportunity to socialise in a therapeutic environment, attend groups and access the internet. 

What gives you the inspiration to work on Mind & Body care collaborations?

The need for collaborative work like this is emphasised in both ‘No Health Without Mental Health’ the NICE guidelines. Research has proven that those with a physical medical disorder are likely to have co-morbidities of anxiety and depression, which is more debilitating, impacting on the quality of their life.

Mental health and physical health go hand in hand.  It has been a rewarding experience for me to be part of a multi-disciplinary team that can provide holistic care to improve patient experience, patient wellbeing and staff knowledge.

I would like to acknowledge the psychiatric Liaison team and all occupational therapists at University Lewisham Hospital, in particular Mark Wheeler (Band 5 OT) & Veronika Lechler, stroke occupational therapist lead for their support.