Download Ward Booklet - Rharian Fields

Rharian
Fields
specialist eating disorder service
“The service that has been offered to me
has been a life saver,
and I mean that literally.
It provided me with
support, information and understanding.
If this service had not being here,
I don’t think I would
be able to get better,
in fact,
I know that I wouldn’t.”
Contact Us
Write to: Rharian Fields
The Gardens
Second Avenue
Grimsby
N. E. Lincs
DN32
Telephone: (01472) 302482
Email: [email protected]
1
Welcome to Rharian Fields
Our eating disorder service offers a multi-disciplinary and comprehensive
provision to individuals suffering from complex eating disorders that require the
assistance and support of a specialist service.
We provide specialist treatments determined by individual need, based on clinical
expertise and good clinical practice, working to NICE guidelines (2004) and The
Marsipan Report (2nd Edition, 2014)
The Rharian Fields service is designed to deliver specialist secondary and tertiary
services to adults age 17 and 6 months and above. There are four levels of services
that an individual can receive: outpatient, day patient and an inpatient services.
Our specially designed inpatient unit (based in North East Lincolnshire) has five beds
overseen by Dr Fadahunsi, consultant psychiatrist, who is responsible for service
user therapy. The small nature of our unit means that we are able to offer a highly
personalised level of care with a high staff to client ratio.
Wherever possible we will try to care for our clients on an outpatient basis with
individual therapy in order to help maintain their day to day life and routine.
However if there is not a significant improvement in the client’s
symptoms, the team will look at either a combination of individual / family work,
day care or inpatient care.
2
Our Aims
Rharian Fields offer a service that not only maximises engagement and
encourages choice in treatments to promote recovery but also improves
quality of life and social functioning while developing positive coping
strategies to prevent physical and psychological deterioration as well as
preventing/assisting in the management of relapse.
We ensure a comprehensive assessment (specialist, psychological, and
psychiatric) for all clients accepted into this specialist service. Assessment
safeguards that health, social care, physical and risk needs are identified and
acted upon and our resources are used to gain maximum benefit for the client.
We feel strongly that the client is an equal partner in the management of their
eating disorder and we respect that they are the expert in their individual illness.
We aim to deliver a service that focuses on the individual, working with each
client to develop a bespoke treatment package to suit them and their stage of
recovery.
We also know that family and carers have an important role to play on the
journey to recovery and so we ensure that their needs are met and that their
opinions are heard and, where appropriate, they are offered their own carers
assessment.
“I always feel much better about things when I leave the clinic.”
3
The Rharian Fields philosophy: Our Approach to Care
At Rharian Fields, all of our staff take the time to develop and build an
empathic, supportive and collaborative relationship with our clients based on
compassion, professionalism, and respect.
Our staff are sensitive to the suffering and fluctuating motivation to change that
our clients often exhibit and strive to promote change motivation during their
treatment while maintaining a deep commitment to try to relieve their suffering.
Staff have an acceptance of the highly positive value some symptoms have on
the client and their denial of the potentially life-threatening nature of their disorder.
Our approach is holistic in its nature with a great emphasis on empowering our
clients to reach their full potential.
We understand that eating disorders often start at an age where most of us are
finding ourselves through new and exciting things and that having an eating
disorder can sometimes mean that individuals do not experience these events in
the same way meaning that development of the self can be limited.
4
Our programme of psychological therapies aims to assist the individual in making
sense of their disorder, its precipitating and maintaining factors and ultimately how
to manage symptoms to allow them to reach their full potential.
This goes hand in hand with our philosophy that normal life co-exists with the eating
disorder so we aim to pull this into all aspects of our therapy and recovery by
allowing the individual to focus on their potential lifestyle as a motivating factor to
change.
While we strongly aim to continually work collaboratively with our clients, we
recognise that there may be occasions when we will need to focus on life
preserving weight restoration. At these times it may be necessary to use treatment
under Mental Health Act, such as nasogastric feeding* however we always aim to
make voluntary treatment the goal of our clients.
*Nutrition support in adults: oral nutrition support, enteral tube feeding and parenteral nutrition.
NICE 2006.
5
Urgent
BMI < 15 and one or more
of the following:
• Rapid/severe weight loss
• Evidence of system failure
• Daily purging
• Electrolyte disturbance
• Recent discharge from inpatient care
• Co-morbid diabetes
Rharian Fields (in hours) or
NAViGO crisis service
(out of hours) to contact
the referrer within four hours
of receiving the referral
to develop
a management plan
Assessment within 48 hours
by Rharian Fields team
All health and social care referrals to
complete Rharian Fields
referral form in full and fax to
NAViGO Single Point of Access
(01472) 252375
Routine
(all other referrals)
Rharian Fields
specialist eating
disorder service
Referral reviewed
at the Rharian Fields
weekly team meeting
(Tuesdays)
Referral not
meeting
specialist
service criteria
Referral
information not
sufficient to
make informed
decision about
care
Rharian Fields
team contact
referrer by
letter to suggest
other possible
care options
Rharian Fields
team to request
further
information
from referrer
Triage
assessment
offered
Referral to other
service
GIFT group offered
Further
information
received
Rharian Fields
outpatient service
offered
Rharian Fields
day patient service
offered
Rharian Fields
Care Pathway
Rharian Fields
inpatient service
offered
Medical
admission
Rharian Fields
unit
Services Available at Rharian Fields
Rharian Fields offers a range of services for people who are suffering from
eating disorders. Each service is detailed in this booklet, however should you
require any further information, please do not hesitate to get in touch with the
team.
Outpatient service
....................................page 8
Day patient service
....................................page 10
Inpatient
..................................page 12
7
Outpatient Service
The Rharian Fields outpatient service offers assessment and treatment to
individuals aged from 17 years 6 months and above who meet the eligibility criteria
as detailed below. Service users may be new referrals, they may have had treatment
in our community group programme (GIFT), or have been discharged from the day
or inpatient service.
The treatment is highly individualised therapy focussing on promoting psychological
and physical recovery, a healthy BMI, healthy eating, treating other comorbidities
(depression, OCD, anxiety disorders, etc.) and improving quality of life.
Dependent on the severity of symptoms treatment can last for a longer period; this
will be discussed in the review at session 15.
Eligibility Criteria
From 17 years and 6 months
and above
Male or female
Need to meet diagnostic
criteria for Anorexia Nervosa,
Bulimia Nervosa, Binge Eating
Disorder or Eating Disorder Not
Otherwise Specified (EDNOS)
which are Atypical Eating
Disorders and usually include a
Exclusion Criteria
Severe and florid psychosis
Obesity without the presence of an
Active illicit substance use
Moderate or severe learning
disability
8
Expected Outcomes
9
Improvement in symptoms or recovery
Better quality of life
Greater psychological functioning and
Ability to nutritionally support
self in the community
Ability to maintain or develop new
relationships
Ability to support self in the
community
Improved understanding of their
eating disorder and how to manage
Relapse prevention
Day Patient Service
The Rharian Fields outpatient service offers assessment and treatment to
individuals aged from 17 years 6 months and above who meet the eligibility criteria
as detailed below. Service users may be new referrals, they may have had treatment
in our community group programme (GIFT), or have been discharged from the day
or inpatient service.
The treatment is highly individualised therapy focussing on promoting psychological
and physical recovery, a healthy BMI, healthy eating, treating other comorbidities
(depression, OCD, anxiety disorders, etc.) and improving quality of life.
Treatment usually consists of two sessions per week for the initial three weeks then
weekly sessions for at least 14 more sessions.
Dependent on the severity of symptoms treatment can last for a longer period; this
will be discussed in the review at session 15.
Eligibility Criteria
From 17 years and 6 months
and above
Step-down care following
inpatient treatment
Male or female
Medically safe to attend day care
including the travel to and from the
Need to meet diagnostic criteria for Anorexia Nervosa, Bulimia Nervosa, Binge
Eating Disorder or Eating Disorder Not Otherwise Specified (EDNOS) which are
Atypical Eating Disorders and usually include a combination of Anorexia Nervosa
and Bulimia Nervosa
Has previously received outpatient treatment that has not been sufficient to
support recovery and requires more intensive input from the team
10
Exclusion Criteria
Severe and florid psychosis
Active illicit substance use
Obesity without the presence of an
eating disorder
Moderate or severe learning disability
Medically unstable
BMI <15
Expected Outcomes
11
Healthier weight
Improved psychological
Improved family and social
relationships
Improved quality of life and social
functioning
Improved understanding of their
eating disorder and its management
Return to employment/education
or have the skills to seek new
employment/education
Inpatient Service
Our inpatient unit provides a safe and tranquil space where individuals can learn
to gain control and mastery over their difficulties with the support of highly skilled
professionals committed to aiding recovery.
Rharian Fields is a five bedded specialist eating disorder inpatient unit situated within
The Gardens, in the grounds of the Diana, Princess of Wales Hospital, Grimsby.
Inpatient admission will be the preferred option when there is a high risk to the
individual should they remain at home.
Wherever possible, so long as care can be managed effectively, the first option for
any inpatient admission would be the specialist eating disorder unit.
If this is not immediately possible and a general hospital admission is the only option
to manage the physical risks posed effectively then the eating disorder team will stay
in close liaison with the general hospital offering advice where necessary.
This will be seen as high priority within the workload of this service and the general
hospital can expect to have regular contact with this team to offer joint care and
specialist
advice.
Transfer to the Rharian Fields specialist inpatient unit will be arranged by the team as
soon as it is safe to do so.
12
Treatment
Treatment will include both psychological and physical interventions with the
goal to increase weight by 0.5 - 1kg per week to achieve weight restoration and
psychological wellbeing.
Psychological treatments will focus on eating behaviour and attitudes to weight
and shape and on wider psychosocial issues. There will be a structured daily
programme and protected, supported meal times.
Approximate treatment length will be discussed prior to admission with both the
referrer and the service user and will be dependent upon physical risks and weight
gain required to reduce these risks.
All service users will have an identified, named worker/ therapist who will oversee
their care while they are an inpatient.
All service users will be assessed by the consultant psychiatrist qualified in
management of eating disorders on initial assessment and throughout their whole
treatment to ensure that their medical and psychiatric needs are met.
Additionally, all service users will be reviewed by the dietician on admission and
throughout their admission to ensure that their nutritional needs are met.
All service users will see their named worker on a 1:1 basis at least three times a
week.
5 Core Pathways
1. Physical Monitoring
2. Nutritional Development
3. Physical Acitivity and Leave Planning
4. Psychological Development
5. Discharge and Transfer Planning
13
Mental Health Act
While we strongly aim to continually work collaboratively with our clients, we
recognise that there may be occasions when we will need to focus on life
preserving weight
restoration.
In high-risk cases where the service user does not wish to engage in treatment,
the Mental Health Act 1983 should be considered to ensure that the service user
receives the
necessary care at the appropriate time.
Under the Mental Health Act service users will have access to all statutory legal
support and appeals procedures.
1.1. In the case of children the Mental Health Act can be used but should be considered in relation to the Children’s Act (2004).
1.2.
The Mental Capacity Act 2005 assumes all adults have capacity. It defines where an adult does not have capacity that treatment can be given in their best interest so long as the principles of the Act have been followed.
The Mental Health Act supersedes the Mental Capacity Act in all cases and so should always be used where appropriate to do so.
14
Eligibility Criteria
From 17 years and 6 months
and above
Physical complications
associated with rapid weight
Male or female
Formal and informal admissions,
although we would always look to
the least restrictive option and work
Support from the individuals
local CMHT care co-coordinator
Need to meet diagnostic criteria for Anorexia Nervosa, Bulimia Nervosa, Binge
Eating Disorder or Eating Disorder Not Otherwise Specified (EDNOS) which are
BMI <15 and need for re-feeding with one or more of the following:
Daily purging
Diabetes
Recent self harm episode
Falling weight (1kg per week)
Electrolyte/ECG abnormality
Pregnancy
Exclusion Criteria
Moderate or severe learning disability
Active illicit substance use
15
Severe and florid psychosis
Expected Outcomes
Weight restoration and
establishment of regular and
Improved understanding of their
eating disorder and its management
Stable biochemistry
Clarification of diagnosis
Improved psychological functioning
Improved social functioning
Improved family and social
Identifying and understanding
underlying emotional problems
Following discharge from the Inpatient or Day Patient Service, Rharian Fields offer
an ongoing, free, support group up to 6 months following discharge. It is held
once per month and focusses on relapse prevention work. For more information
contact us using the details in the front on this booklet, or ask a member of staff.
16
Weekly Timetable for Day Patients and Inpatients
Monday
7:30-8:30
Breakfast, Rest and
Reflection
9-9:30
Planning Meeting
Wednesday
Thursday
7:30-8:30
Breakfast, Rest and
Reflection
9-10
Planning Meeting and
Community Meeting
7:30-8:30
Breakfast, Rest
and Reflection
9-9:30
Planning Meeting
9:30-10:30
MDR with Dr Atkin
7:30-8:30
Breakfast, Rest and
Reflection
9-9:30
Planning Meeting
and Meet with Catering
9:30-10:30
Crafts
9:30-10:30
Games
10:30-11
Snack and Rest
11.00-1
MDR with Dr Akin
10:30-11
Snack and Rest
11.15-12.15
DBT group
10:30-11
Snack and Rest
11-1
1:1 Time
9:30-10:30
Getting to Know
You
10:30-11
Snack and Rest
11-1
1:1 Time
1-2.15
Lunch and rest
and Reflection/
relaxation/
distraction
1-2.15
Lunch and rest
and Reflection/
relaxation/
distraction
1-2.15
Lunch and rest and
Reflection/relaxation/
distraction
1-2.15
Lunch and rest
and Reflection/
relaxation/
distraction
2:15-3.15
Meal Planning with
Bex and Liz
2:15-3.15
Life Skills group/
Anxiety and stress
management
2:15-3.15
Education with ward
Doctor
2:15-3.15
Nutritional Group
with Bex
3.30-4
Snack and Rest
3.30-4
Snack and Rest
3.30-4
Snack and Rest
3.30-4
Snack and Rest
3-6
Reiki with David
4-6
1:1 Time
4-6
1:1 Time
4-6
1:1 Time
6-7.15
Tea and Rest and
reflection
Reflection
6-7.15
Tea and Rest and
reflection
Relaxation
6-7.15
Tea and Rest and
reflection
Mindfulness
6-7.15
Tea and Rest
and reflection
Relaxation
Evening Activity
Goal Setting
Evening Activity
Games
Evening Activity
Pamper Night
Evening Activity
Quiz
Mandatory Groups
17
Tuesday
Optional Groups
Friday
7:30-8:30
Breakfast, Rest and
Reflection
9-9:30
Planning Meeting
Saturday
Sunday
7:30-8:30
Breakfast, Rest and
Reflection
9:30-10
Planning Meeting
7:30-8:30
Breakfast, Rest and
Reflection
9:30-10
Planning Meeting
10:30-11
Snack and Rest
11-1
Therapeutic art group
10:30-11
Snack and Rest
11-1
Community Outing
10:30-11
Snack and Rest
11-1
Arts and Crafts
1-2.15
Lunch and rest and
Reflection/relaxation/
distraction
1-2.15
Lunch and rest and
Reflection/relaxation/
distraction
1-2.15
Lunch and rest and
Reflection/relaxation/
distraction
2:15-3.15
Body Image
2:15-3.30
1:1 Time
2:15-3.30
1:1 Time
3.30-4
Snack and Rest
3.30-4
Snack and Rest
3.30-4
Snack and Rest
4-6
1:1 Time
4-6
1:1 Time
4-6
1:1 Time
6-7.15
Tea and Rest and
reflection
Mindfulness
6-7.15
Tea and Rest and
reflection
Relaxation
6-7.15
Tea and Rest and
reflection
Mindfulness
Evening Activity
DVD Night
Evening Activity
Bingo
Evening Activity
Pamper Night
9:30-10:30
Pamper Session
18
Treatment and Interventions
Staff within the Rharian Fields team will adhere to NICE guidelines for the treatment
of individuals with eating disorders.
Treatment will include evidence-based interventions such as CBT-E, motivational
enhancement work, cognitive remediation therapy, dialectical behaviour therapy,
emotional freedom technique, mindfulness, family interventions, art/drama
therapy, nutritional interventions, supported mealtimes, physical monitoring, Indian
head massage, Thai foot massage and reiki (this is not an exhaustive list).
There are a wide range of groups offered as part of the service, designed to aid
service users’ recovery in all aspects of their life.
These include psychological therapies, education, social and leisure, self-esteem,
relapse prevention, anxiety, diet, relaxation, tai chi, body image and flexibility (this
list is not exhaustive).
The full range of our group programme can be seen on the previous page.
Service users will be given information on all proposed treatments to enable them
to make informed choices at all stages of their treatment.
Where formal psychological therapy is indicated discussion will take place with the
team clinical psychologist.
19
Our Facilities
Rharian Fields’ specially designed unit based in North East Lincolnshire offers a
highly personalised level of care with a high staff to client ratio.
Our inpatient unit is based at The Gardens, Diana, Princess of Wales Hospital,
Scartho Road, Grimsby, North East Lincolnshire, DN33 2BA.
We offer modern, stylish accommodation that fosters a relaxed, calm atmosphere.
We have five individually designed bedrooms that allow our clients privacy and
space. All the bedrooms are en-suite.
There are two living areas, both are individually styled and offer comfort and
homely yet sophisticated areas.
We have a main kitchen and dining area which offers a modern but inviting
space, this area lends itself well to supervised cooking and dining. Our other
kitchen offers a space for the preparation of snacks and offers an area for more
independent dining.
We have dedicated therapy rooms for use for individual or group therapy.
All accommodation looks out onto beautiful private gardens where we will
encourage the growing of fruit and vegetables.
Our garden offers a tranquil area that is large enough to facilitate privacy and
dignity for individuals using it. We also have a sensory area within our garden for
relaxation.
20
Meet the Team
As Rharian Fields is a small team, we’d like to introduce each member to you and
the role they play within the ward. During your loved ones stay, you will come into
contact with most members of the Rharian Fields Team.
Dr Akin– Consultant Psychiatrist
Dr Bodo– Speciality Doctor
Amanda Simpson – Eating Disorder Service Manager
Mandy Barker – Eating Disorder Service Lead
Natalie Minard – Senior Eating Disorder Nurse Practitioner
Hayley Batchelor – Senior Eating Disorder Nurse Practitioner
Kerry Green – Senior Eating Disorder Nurse Practitioner
Laura Hammond – Senior Eating Disorder Nurse Practitioner
Susan Popoola – Eating Disorder Nurse Practitioner
Alison McMullen— Eating Disorder Nurse Practitioner
Sarah Heaton—Eating Disorder Nurse Practitioner
Janette Hodgson—Eating Disorder Nurse Practitioner
Emma Nixon—Eating Disorder Nurse Practitioner
Liz Scott – Nursing Assistant
Mellissa Robbins – Nursing Assistant
Linda Harpham—Nursing Assistant
Carrie Strandt—Nursing Assistant
Jennie Hudson– Nursing Assistant
Romana Knight-Nursing Assistant
Dawn Harris—Nursing Assistant
Rebecca Kilby – Team Dietitian
Hollie Ingoldby – Trainee Health Psychologist
Victoria Wolfe—Team Admin
Genevieve Cummings—Team Secretary
21
Referrals Process
Referral to all the services provided by our specialist team can be made via the
NAViGO single point of access.
Call(01472) 302482
Fax(01472) 302311
[email protected]
[email protected]
Referral forms can be obtained from the contacts above or can be downloaded
from our website: www.rharianfields.co.uk
To increase the accessibility of our service, we accept referrals made by any health
or social care professional.
All relevant information is required before a referral will be considered. This is so that
the team can make an informed decision about the risks associated in each case, to
aid decision making and ultimately in the client receiving the most appropriate care
package for their identified needs.
All referrals will be reviewed for seriousness on the day they are received (or on the
following Monday if the referral is received at the weekend) by a senior eating
disorder practitioner.
22
Urgent Referrals
Urgent referrals will need to meet the following criteria:
BMI <15 with one or more of the following:
Rapid/severe weight loss
Evidence of system failure
Daily purging
Electrolyte disturbance
Co-morbid diabetes
Pregnancy
Recent discharge from inpatient
Urgent referrals are those that pose a physical risk or a risk of suicide or self-harm.
Urgent referrals will be actioned within four hours of receipt by the eating disorder
manager or nominated deputy during working hours, out of working hours this will
be done by the NAViGO crisis service.
This will involve a senior practitioner contacting the referrer via telephone to discuss
the referral and the joint establishment of a management plan.
Following urgent referrals, priority will then be given to those at medium risk and
who meet the following criteria:
BMI <17.5 and one or more of the following:
History of self-harm
Depression
Recent in-patient care
Purging 2-3 times weekly
Falling weight > 0.5kg/week
Please note that GPs will retain responsibility for the physical risk management of all
referrals including clients in community treatment.
23
Out of Area and CAMHS Clients
We recognise that transferring to a new service can be daunting which is why we
proactively manage the transition into the specialist service in collaboration with our
CAMHS colleagues.
We will be able to ensure a professional transition for young people with eating
disorders moving from our CAMHS service into adult services and our approach
will prevent those clients from long inpatient admissions. All out of area and local
CAMHS referrals will be required to complete a funding acceptance form prior to
any treatment being delivered.
Working Alongside the General Hospital
Wherever possible, admission to our specialist unit would be the first option, so long
as care could be managed effectively.
If this is not immediately possible and a general hospital admission is the only option
to manage the risk posed to the individual, then we are ideally placed alongside
our acute colleagues on the Diana, Princes of Wales Hospital site to have close
liaison and offer advice where necessary. Transfer back to the Rharian Fields unit
would then be arranged by our team as soon as it is safe to do so.
24
Safeguarding at Rharian Fields
At Rharian Fields we are dedicated to adhering to the six safeguarding principles,
with our primary objective being the prevention of neglect, harm and abuse. We will
empower individuals by involving them in all aspects of their care and treatment so
that they maintain as much control over their lives as is possible.
We will protect individuals by supporting and advocating for them at all times and we
will endeavour to risk manage in the least intrusive way possible while maintaining the
individuals safety and preventing harm.
We will ensure that we work with the individual’s local community to ensure multiagency involvement. In our vision to ensure safeguarding procedures are transparent,
open and honest and that we learn from any issues raised we will support our staff to
raise concerns.
We will ensure that individual safeguarding concerns are identified immediately and
managed safely.
Collaborative Links with Local Specialist Services
We have a proven track record in liaising closely with local specialist services,
such as systemic family therapy and the personality disorder partnership to ensure
service users are supported where necessary and have straightforward access to
other specialist care should it be needed.
25
National Collaboration
The Rharian Fields team have received several comprehensive training courses in
the last three years delivered by leading academics and clinicians in ED field (Prof.
Chris Fairburn, Prof. Janet Treasure and Deanne Jade from National Centre for
Eating Disorders) leading towards advanced diplomas or master practitioner in ED
and obesity as well as diplomas in CBT.
Other Qualifications and Skills
Mindfulness techniques, emotional freedom techniques, motivational interviewing,
cognitive remediation therapy, body image, supported meal times, working
with carers, DBT module, systemic family therapy, nutritional interventions, anxiety
management, relaxation, self-esteem and confidence building, art therapy,
physical monitoring, nasogastric feeding, Indian head massage, reiki.
Rharian Fields also has collaborative links with both The Institute of Psychiatry in
London and The National Centre for Eating Disorders.
26
Outcome Measures
Service user experience is important to us and so we ensure that everyone
who accesses our service is given the opportunity to provide feedback on their
treatment. A service user satisfaction questionnaire is given to all service users.
We also value their opinion of carers and so they too are issued with a feedback
from.
Outcome measures at Rharian Fields are based on the Quality of Life scale (QLS),
Eating Disorder Examination Questionnaire (EDE Q5) and Clinical Impairment
Assessment (CIA) which are given at assessment and on discharge from this
service. These are audited on an on-going basis to ensure the quality of our
service.
Beck depression inventory scores are also conducted at both the beginning and
the end of treatment which are audited on an on-going basis.
Payment by results scores will also be audited on an on-going basis and
effectiveness of the treatment provided by Rharian Field is subject to regular
audits.
Training and Consultancy
We provide basic to more advanced level training and consultancy for other
eating
disorder professionals, mental health staff, dieticians, health trainers, primary care
staff, and doctors.
In October 2010 the North East Lincolnshire eating disorder specialist service held a
national conference to raise awareness of eating disorders and nutritional
interventions. The event brought together a number of well-recognised national
speakers and covered a wide range of topics relating to both eating disorders and
nutritional interventions.
27
NAViGO Health and Social Care
Rharian Fields is part of NAViGO Health and Social Care Community Interest
Company, a not for profit social enterprise providing award winning mental health
services in North East Lincolnshire.
Previously part of North East Lincolnshire Care Trust Plus, NAViGO CIC was
established as an independent provider as of April 1, 2011 as part of the
Government’s Right to Request scheme.
NAViGO is a unique membership organisation made up of staff, people who use
services, carers and interested parties from the local community, all with equal
rights and an equal say in how the organisation is run.
NAViGO also provides a wide range of training and consultancy, both nationally
and internationally, on mental health and related issues such as employment.
Award Winning Services
Overall winner
The Guardian Public Service Awards 2011
Winner: Medipex NHS Innovation Award in the
Mental Health and Wellbeing Cateogory
Social Enterprise of the Year 2014
Winner: Employee Ownership Rising Star Award
Philip Baxendale Awards 2011
28
A Service User’s Perspective
Prior to my admission at Rharian Fields Eating Disorder Clinic, my life was controlled
by anorexic thoughts. The thoughts seemed so real, I imagined them as a person
who became my closest and only friend. She encouraged me to engage in
compulsive exercise and restrict my diet to dangerous levels.
Anorexia took my energy and passion until I became numb, emotionless and
alone. As my weight decreased, the thoughts became more powerful and
convincing, I had no time or energy for a social life and my efforts at college were
poor. I saw eating as unnecessary and only allowed myself to eat once I had
exercised. Soon, I understood that I wasn’t healthy and I faced the realisation that I
was killing myself.
Walking through the door of Rharian Fields, I immediately sensed the calming,
caring, family atmosphere. I was so excited by the modern furniture and surprised
by the efforts of the staff choosing the furniture and design. Picking my room
was the first bit of excitement I had experienced for a while and I subconsciously
accepted that the clinic would be my home for a while. I was able to hand over
the intense control I had been harbouring over my eating disorder and allow staff
at the clinic to support me in my recovery.
At the beginning, my thoughts made me dislike and mistrust the staff but now
I have so much to thank them for. I appreciate the care, sensitivity and efforts
integrated into my care.
As my health improved, I saw food as my medication and became determined
to lead a healthy lifestyle. My sense of humour and personality began to return. I
became passionate again and excited to study to become a midwife and aim to
help people as the staff at Rharian Fields helped me.
29
Goddess of the bountiful harvest and the nurturing spirit
In Greek mythology the goddess Demeter was the most generous of the great
Olympian goddesses. She was beloved for her service to mankind in giving them
the gift of the harvest, the reward for cultivation of the soil.
Also known as the Roman goddess Ceres, Demeter was the goddess of the harvest
and was credited with teaching humans how to grow, preserve, and prepare
grain. Demeter was thought to be responsible for the fertility of the land.
The Rharian Field was located in Eleusis in Greece and was supposedly where the
first plot of grain was grown after Demeter taught humanity agriculture.
She was the only one of the Greek goddesses who was involved on a day-to-day
basis in the lives of the humans. While others occasionally “dabbled” in human
affairs when it suited their personal interests, or came to the aid of “special” mortals
they favoured, the goddess Demeter was truly the nurturer of mankind.
Demeter also was the only one of the Greek goddesses who could truly empathize
with the human experience of suffering and grief, having experienced it fully
herself.
The story of Greek goddess Demeter illustrates the tremendous capacity of a
woman to love and nurture, within her own family and the world at large.
It also reminds us to stand firm for what is good and right, even in the face of
adversity, when powerful forces are aligned against us.
The goddess Demeter’s message also reminds us of the seasons of a woman’s
life, that even though there are times of great sorrow there is also great joy to be
found.
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