The Lead Worker Peer Mentor service is a ‘navigator’ service, helping service users access the most appropriate provision from organisations within Birmingham Changing Futures Together’s No Wrong Door Network. According to the evidence, it’s the combination of the Lead Worker with a Peer Mentor that really triggers change. Peer Mentors have lived experience. They have been in the position service users are in now; they understand their thinking and the drivers of their decision making. As a result, they quickly build the trust of service users who, in turn, commit to the
change process, accessing the services they need with the expert help of the Lead Worker.
Realising the value of this approach, Birmingham and Solihull Mental Health Foundation Trust’s Liaison & Diversion (L&D) service began integrating Peer Mentors into its approach in partnership with Birmingham Changing Futures Together’s Lead Worker Peer Mentor service in March 2017. Most referrals to the team come from the police. The behaviour patterns of the individuals are entrenched; something new was needed to catalyse change.
Two Peer Mentors, Riaz and Paul, shared their story and explained the way they are making a positive impact on the lives of people with multiple and complex needs.
“I was in active addiction for 22 years, from the age of 12,” explained Riaz. “I had tried to detox many times over the years. Then, about six years ago, I was in a Mutual Aid meeting in a treatment centre when someone shared their story. Clean at that point, they talked about their addiction, describing their experiences and behaviours. It planted a seed; sustainable change is possible.
“I went to a few more meetings when I left the treatment centre and finally went through detox again in 2015. I’m in abstinence -based recovery and haven’t looked back. “Now, I recognise when I need help and have learnt it’s okay to get it. The really big change is my acceptance of my vulnerabilities. “Sometimes the work as a Peer Mentor can be really challenging. The team, though, is incredibly mutually supportive, which helps, but I know never to be complacent about my recovery. I need to be secure in my own well-being if I’m to help others.”
“I took the wrong path at 11,” said Paul, “and stayed on it for the next 26 years. I was in and out of jail and suffered mental ill health; I was trying to kill myself almost every day.
“When I was 30, I met a drug worker who had lived experience. They asked me if I wanted to change. Then I didn’t, but the suggestion sat in the back of my mind and knowing they had turned their life around gave me hope.
“Eight years later I went into rehab and have never look back.
“At the route of my problems were rejection and abandonment issues; I’d suffered violence and abuse from a young age. While
everyone’s story is unique, I hear the same sort of issues again and again from the people I work with now.
“I put a lot of myself into the work. It’s draining and there is always the risk of being triggered so I’m careful to off-load to my colleagues. I never lose focus on my own recovery and do what I need to maintain it.”
The Peer Mentors at work
For the Peer Mentors and the wider L&D team, a person-centred approach is more than just a meaningless phrase; they embody it. With the lived experience of Peer Mentors permeating the whole team, services users’ needs and priorities, rather than those of the organisation, are front and centre.
The Peer Mentors’ history means they truly understand the experience of the individual and so can quickly build the trust-based relationship needed for change. Their perspective makes them powerful advocates on behalf of the service user; having been through the system and struggled with its complexities and challenges, they now know how to get things done.
The Peer Mentors in the L&D team work only with people with mental ill health who are getting ‘sucked’ into the criminal justice system and who have three out of four multiple and complex needs (homelessness, mental health, substance misuse and offending behaviour).
“Practitioners in the L&D team, who are based in police custody or the courts, refer to us anyone with three of the complex needs,” explained Riaz. “Once the individual has accepted the referral we go to the custody suite with a practitioner – for example a social worker or mental health nurse. If for one reason or another we can’t contact them there, we meet them at the Magistrates court and if that’s not possible we reach them in prison. The bottom line is we don’t let them fall between the gaps.
“When we go and say hi the individual often recognises a ‘kindred’ spirit. With a connection quickly made we identify their priorities and get them the support they need and want. We can make a very practical difference. We’ve seen people in the custody suite and got them housed by the time they get to court and, as a result, they’ve stayed out of prison.”
Paul continued: “We stay with our clients as long as they need us, which varies from person to person. For some, with a little practical support, their own resources ‘come back to life’ and they move forward quickly. Others need more sustained involvement. Either way, we focus on their needs and stay with them until they are established. We see it as ‘getting their engine running again’.”
“The people we work with have some of the most entrenched and destructive behaviour patterns” said Matthew Brayshaw of the Liaison & Diversion Team. “To reach and really engage them we have a different, flexible approach, structured entirely around their needs.
“Our thinking always centres on what’s possible for the individual. How likely are they to turn up for the appointment or meeting and what can we do to help? Do they need a bus pass? Would a mobile phone make the difference? We never discharge an individual just because they’ve missed an appointment. We work really hard to find them and will always open the file again if they get back in touch.”
Riaz concluded: “It’s all about the service user. What do they need from us? How can we empower them to take charge? It’s never about the processes of the service provider. Knowing what it feels like to be in their position we’ll advocate on their behalf and challenge other professionals if their processes don’t benefit the client.”
Being part of the No Wrong Door network makes the difference
Working collaboratively with service providers as part of the No Wrong Door Network, the team can access information quickly and easily. This makes it possible to provide valuable practical help in an incredibly short time frame, which can be the difference between a custodial sentence and bail.
Facing a 16-week prison sentence
A 26-year old was in court facing a 16-week prison sentence. The presence of the Peer Mentor and support worker in court providing active support gave the judge the confidence to release him on bail. The young man is now on Birmingham Changing Futures Together’s Beyond the Basics programme.
Onto the essential ‘script’
A client who had not engaged with support services in over three years needed a new prescription. The formal process meant the discussion was about detox, but for someone who had not interacted for three years this was meaningless. Riaz intervened and changed the conversation. If there was ever to be any progress, the client, first and foremost, needed a new script.