Medium secure services need a recovery academy
Tammi Walker and colleagues extol the benefits of focusing on a better future even for people who are detained in secure services
Recovery is a personal journey of discovery. It involves making sense of and finding meaning in what has happened, becoming an expert in self-care and building a new sense of self and purpose in life.
Mental health services can help people in this journey, but it requires services to move beyond a focus on symptom reduction, to helping people rebuild lives that they find satisfying, meaningful and valued.
This change is reflected in the key outcomes of the mental health policy strategy No Health Without Mental Health (Department of Health 2011)
Secure care recovery
Recovery in a secure hospital can be difficult, because individuals are detained under the Mental Health Act and have less control over their lives while in hospital. Other people can hold the keys, decide when they can come and go, and even decide when they have a cup of tea. Recovery is still possible in a secure hospital, but it may be slower and it may be hard work.
A development supporting this process is the recovery academy in the adult forensic services of the Greater Manchester Mental Health NHS Trust, which opened in July 2016. This service offers recovery learning opportunities for 225 patients who currently access the secure care pathway at the Edenfield Centre in Prestwich.
It is a dedicated recovery-oriented learning resource centre, delivering recovery learning and well-being skills for service users, especially those who have limited leave or access to opportunities outside the secure perimeters.
Although recovery opportunities are available throughout the adult forensic services in a myriad of forms, what makes the academy unique is that it adds significant value to a service user’s progress through secure care, by offering recovery opportunities and activities in a collaborative way.
All the programmes and interventions are developed collaboratively with experts by experience, who are current or former service users, and experts by occupation, who are current staff with specialist expertise.
The principles for the sessions are hope, personal responsibility, education, self-advocacy and support. The sessions are also linked to the eight domains of the NHS England ‘My Shared Pathway’ recovery care plan, which supports involvement in decisions about patients’ own treatment and care. This enables service user learners to link their session attendance to their personal recovery plans and progress.
The academy also acts as a focal point for action planning around the recovery opportunities available to individual acute forensic service users. In doing so, the academy can support service users to take greater ownership and control over their recovery pathway, as they develop their recovery-oriented resourcefulness. This means that for some service users, the academy can simply act as a guide, coach and support for their recovery activities taking place elsewhere in the service. For others, frequent participation in some of the academy’s programme of sessions is an important part of their recovery learning.
Plans for the future
The academy acts as a focus for service users’ recovery oriented change and development in the adult forensic medium and low secure settings. This supports the promotion of service development that enhances the recovery experience for service users.
Future developments will aim to improve service users’ preparation for maintaining or reconnecting links with their friends and family networks, and local communities on discharge. They will also help in building purposeful and meaningful lifestyles that will support service user recovery beyond in-patient secure care.
- Department of Health (2011) No health without mental health: A cross-government mental health outcomes strategy for people of all ages.
- My Shared Pathway
About the authors
Tammi Walker is a reader in Forensic Psychology at the University of Huddersfield.
Michelle Morgan is a recovery academy team member at Greater Manchester Mental Health NHS Foundation Trust.
Laura Thompson is a recovery academy team member at Greater Manchester Mental Health NHS Foundation Trust.
Kevin Scallon is recovery academy team lead at Greater Manchester Mental Health NHS Foundation Trust.