Befriending service acts as a lifeline for patients during the pandemic

This World Mental Health Day, Dr Mary Docherty [pictured below], consultant liaison psychiatrist at South London and Maudsley NHS Foundation Trust who works in both St Thomas’ and King’s College Hospitals, talks about her experience setting up a befriending service for patients living on their own and who have been shielding during the pandemic.

Mary DocMary, please describe your role at King’s Health Partners

I’m a consultant liaison psychiatrist and I work in an integrated service that delivers mental health and social support to people who live with long-term conditions, such as chronic obstructive pulmonary disease (COPD) and heart failure.

Where did the idea for a befriending service come from?

As we went into lockdown, my colleagues and I were concerned about our patients feeling isolated. Living with long-term conditions, many of our patients are more vulnerable to the impact of COVID-19 and most of them were advised to self-isolate. Social isolation has an impact on both your mental and physical health, and we were concerned about how we could ensure we reached people during the pandemic so that they felt supported.

We know that befriending has a positive impact on social isolation, which is where the idea for a befriending service came from.

Tells us about the befriending service and what it offers?

We trained three students from the Mental Health Studies master’s programme at King’s College London in the principles of befriending. These include forming a supportive relationships and encouraging positive behaviours to the befriendee. 

To help prepare patients for lockdown, our respiratory and cardiology teams from King’s College Hospital and Guy’s and St Thomas’ NHS Foundation Trusts introduced the befriending service to patients during consultations.

As part of the service, patients received a call once a week from one of our student volunteers to offer a friendly ear to our patients in a time of need.

Following the calls with patients, students had supervision sessions with a cognitive behavioural therapist (CBT), social support worker and myself. This was an opportunity for students to problem solve any issues or concerns that came up during their phone calls with patients.

The service lasted for 17 weeks, involving 30 participants and having more than 250 phone calls.

What do you think the benefits of the service were for patients, students and staff?

For patients, the service acted as a tremendous lifeline for those who would have otherwise been extremely isolated, and they were able to get information on Government guidance during the pandemic from their befriender. It made them feel more connected, cared for and helped them access the information they needed about the pandemic. Commenting on the service, some patients said:

My befriender was one in a million, I can’t thank her enough. She helped me tremendously. She was a real lifeline over those months.
I felt more connected and less lonely because not a lot of people called me except for my family.
I liked the befriender as she was very cheerful, and it was nice talking to her.

Our student volunteers found the experience incredibly rewarding. Not only was it a really interesting way for students to improve their communications skills and really connect with patients on an individual level, but it also gave them the opportunity to incorporate therapy techniques into general health and wellbeing settings.

Aljawharah Almuqrin, a student volunteer, said:

This placement is an enriching experience that made me grow personally and professionally. It allowed me to apply the knowledge I learned academically in a real-life working context and to gain new clinical skills, which will help me manage difficult situations in the future. I am grateful that I went through this placement as it made me realise how important my role as a psychologist is and the impact we have on people's life.

For the medical teams, there was a huge sense of relief that patients were getting a bit of extra support during the pandemic. Preliminary data showed that patients enrolled in the befriending service used the respiratory team less frequently, because they were less worried. This seemed to reduce anxiety and make patients feel more both more connected and in control.

Why is this service different from other befriending services?

The service we provided really stood out from other national befriending programmes, because of the range of experts across King’s Health Partners we had on hand to ask for advice.

Many of our patients have very complex needs and if during their befriending sessions emerging difficulties with their mental or physical health were identified, we had the benefit of being directly connected to our respiratory and cardiology teams who could provide advice. In this way, the service provided an additional safety net for patients.

Previous studies have demonstrated the benefit of either CBT or befriending for people living with COPD, but none that we are aware of have offered a blended approach – both online and face-to-face learning. Having myself and our cognitive behavioural therapist oversee the programme was also particularly useful. By around week six of lockdown, we noticed patients were starting to feel a lot lower and particularly missing their families.

Thanks to the mental health experience in our team and the strong relationships students had developed with patients, we were able to introduce some CBT echniques into the sessions, such as goal setting and behavioural activation, giving patients something to work towards in their day. 

The foresight of King’s Heath Partners to invest in mental health and social support as part of routine care within the cardiology and respiratory teams made the befriending service possible. The experience also gives us the opportunity to research the benefits of this kind of health intervention in more detail in the future, especially due to the close connections we have with research at King’s Health Partners.

What are your future plans, would there be an opportunity to do something similar again?

The befriending service was safe, useful and valued by patients, staff and students.

We are planning to launch a four-month winter befriending and activities programme. We will offer patients living with respiratory conditions a befriender, and/or access to fortnightly activities programme, including things like bingo, crafts, quizzes and singing. Our activity nights will incorporate bite size booster sessions on strategies to look after your physical and mental health. We hope this will give many patients meaningful contact, tailored health education and most importantly, some fun over these coming months.

I would like to thank Aljawharah Almuqrin, Gada Alkattab and Aneel Gill, our three students who volunteered with our patient community; Luke Gosset, CBT therapist from Improving Access to Psychological Therapies; Hugh Ballie, social support worker, for their expertise in the training and supervision and Dr Amy Dewar, respiratory consultant at Guy’s and St Thomas NHS Foundation Trust for recommending patients and championing the service. 

You can find out more information about the 3 Dimensions for Long-Term Conditions (3DLC) programme on the King’s Health Partners website.

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