Download Bipolar Education Programme Cymru (BEP

Storyboard Entry Form 2014
Main author: Professor Ian Jones
Email: [email protected]
Telephone: 02920 688 399
1. Storyboard title:
Bipolar Education Programme Cymru (BEP-Cymru): the
development and delivery of a psychoeducation programme
for bipolar disorder in Wales.
2. Brief outline of context:
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Where work was done – Wales and beyond
Unit/department – Collaboration between the Cardiff and Vale
University Health Board (UHB), Betsi Cadwaladr UHB and Cardiff
University
Staff/client groups – BEP-Cymru was developed by
psychiatrists and community psychiatric nurses (CPNs) from
Cardiff and Vale UHB and Betsi Cadwaladr UHB. It has been
driven forward throughout Wales by a steering group made up
of psychologists, CPNs, psychiatrists and user representatives.
This ambitious project has been delivering psychoeducation to
patients across Wales in both a group format and via a novel
web-based delivery called BeatingBipolar.org.
3. Brief outline of problem:
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Problem - Medications are effective for bipolar disorder but
NICE guidelines suggest they should always be combined with
psychosocial interventions for maximum effect.
Simple and
effective interventions, such as psychoeducation should be
made
available
in
Wales.
The
lack
of
structured
psychoeducational interventions for bipolar disorder within the
NHS in Wales is a major issue for mental health professionals,
many of whom would like to be able to deliver these
interventions but find it difficult because of a focus on the
management of severe crises.
How tackled – This project provides two psychoeducational
interventions for patients and a programme of clinician training
on psychoeducation approaches. The patient interventions are
(1) a 10 week course of group psychoeducation sessions and (2)
a course of 8 interactive on-line psychoeducation modules
(www.beatingbipolar.org).
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We have so far delivered 36 courses to 396 people across Wales
covering all health board regions. Courses have been delivered in
Aberdare,
Bangor,
Barry,
Brecon,
Caernarfon,
Cardiff,
Carmarthen,
Denbigh,
Llangefni,
Llandudno,
Newport,
Pontypridd, Port Talbot, Swansea and Wrexham.
Further 3250 people have accessed Beating Bipolar on-line.
We delivered high quality training in bipolar psychoeducation to
mental health staff so that this approach could reach as many
patients and families as possible. At least 11 NHS trusts in
England (e.g. Leicester, Devon, Oxford, Hereford, West London,
Tees Esk and Wear, Brent, Sussex), 3 trusts in Northern Ireland
(Northern Health and Social Care Trust, South Eastern Trust,
Belfast Trust) and 2 in Scotland (NHS Forth Valley, NHS Greater
Glasgow and Clyde) have delivered our programme. The BEP-C
programme has also been delivered in New Zealand, and we
have given BEPCymru training to over 60 psychiatrists in Turkey.
How it affected patient/client care – Participants in both
interventions have an improved awareness of their disorder, a
better understanding of treatments and an ability to implement
self-management techniques. Our psychoeducation training
packages for clinicians are benefiting the NHS across the United
Kingdom.
4. Assessment of problem and analysis of its causes:
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Problem – A lack of formal structured psychoeducation
treatments for patients with bipolar disorder in Wales (despite
NICE recommending that such interventions are effective, costeffective and should be widely available).
Staff involvement – The programme has been developed by
psychiatrists, CPNs and a project co-ordinator, along with
considerable user input. We have been training mental health
professionals to deliver psychoeducation approach across Wales.
Cause of problem - Structured psychosocial interventions for
bipolar disorder have not been a priority within the NHS despite
the evidence for their effectiveness.
Solutions/changes needed – Develop and deliver a
comprehensive psychoeducation programme in Wales targeting
patients and professionals.
5. Strategy for change:
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How the proposed change was implemented – We
successfully applied for a £782k Big Lottery grant and
implemented both group and online psychoeducation
programmes in close collaboration with NHS services, Bipolar UK
and user representatives.
Clear client or staff group – Individuals with bipolar disorder,
their families and mental health professionals who deliver care
for bipolar patients across the NHS in Wales.
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How they disseminated the results of the analysis and
plans for change to groups involved – We are raising
awareness of these new interventions within our local Health
Board and Boards across Wales through workshops,
presentations and written reports to key clinical contacts. We
have also developed two websites: www.ncmh.info/bepcymru
and www.BeatingBipolar.org
Timetable for change – Project has run over the past 4 1/2
years and we have plans to seek further funding to ensure
continuation beyond the current grant ending in July 2014.
6. Measurement of improvement:
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A detailed qualitative analysis using standard thematic analysis
techniques with 20 individuals following completion of the
package showed that users felt benefits in terms of insight into
their illness, health behaviour, personal routines and attitudes
towards medication. Quantitative feedback from 240 individuals
following completion of the programme indicated; 99% felt they
had a good understanding of bipolar disorder, 97% would
recommend the intervention to fellow-patients and 88% said
they found group healthcare programmes such as this very
helpful.
7. Effects of changes:
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Statement of the effects of the change – Patients have been
positive about self-management capability. Clinicians feel this
programme fills an important gap.
How far these changes resolve the problem – We have
clear evidence and feedback that BEP-C represents a valuable
programme for patients, their families and professionals.
How this improved care – Participants are more engaged with
making decisions about their own care and with implementing
self-management strategies. Clinicians are now using
psychoeducational approaches.
Problems encountered – The main focus of workload of
mental health professional across Wales is on crisis management
of severe mental illnesses and hence the take up of the
programme by staff was not initially as widespread as we would
have wished. However, over the period the programme has been
running there has been considerable change observed with
many staff around Wales now very active in referring clients to
our service. We currently have a waiting list of 243 individuals.
8. Lessons learnt:
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Statement – We have learnt that there is a massive demand
amongst service users for such approaches and when staff learn
about our programme and experience their patients benefiting
from attending our groups they give strong support.
What would be done different next time – More intensive
liaison with Health Board management to ensure more effective
take up by mental health professionals.
9. Message for others:
 Psychoeducational approaches are very effective in engaging
bipolar disorder sufferers with their illness and (as per NICE
guidelines) should be offered alongside other treatments within
the NHS in Wales. Clinicians in Wales are eager to have training
in psychoeducational approaches so that they can deliver best
possible care to their patients.