1 December 2008 Good Evening

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Recovery and self empowerment WRAP, Hampshire

Summary

The WRAP Project is an innovative project aiming to embed the principles of recovery and self-empowerment within the mental health services in Hampshire. New types of worker roles have been created to co-ordinate, promote and train both service users and staff in this approach.

Description

A WRAP (Wellness Recovery Action Plan) is a plan based on the principles of recovery and self-empowerment. In developing a WRAP, an individual uses a range of tools which help them identify the things that promote their wellbeing. This approach is in stark contrast to some traditional approaches, which focus more heavily on illness. Noone can write a WRAP for you, it’s something you have to do yourself (with the right support).

The WRAP Project aims to embed WRAP within Hampshire Partnership NHS Trust by providing co-ordinated training in the approach. Rather than work with individuals themselves, the team trains service users and workers to support people who want to write their own plan. WRAP is very much a user-led approach, and so those with lived experience of mental distress are involved at all levels, from the steering group to trainers & project support workers.

The new types of workers created in this project are:

Project Co-ordinator
Responsible for: running the project; marketing & promotion; developing, and delivering, the training; developing links with both statutory and non-statutory agencies

Project Support Worker
Responsible for: administrative support; assisting the delivery and development of the training; promoting the benefits of WRAP. Personal experience of emotional distress is a requirement for this post.

In addition to this, a New Type of Manager is required to support and supervise the co-ordinator. In the WRAP Project, this has been a small part of the manager’s role within the Trust. However it has proved essential as the co-ordinator has had to navigate uncharted territory.

Outcomes

• WRAP training has been provided to 250 service users, staff & carers
• Trainees have gone on to facilitate WRAP groups in local inpatient and community settings
• Training is co-facilitated by people with lived experience of mental distress
• Workers report an improvement in understanding, communication and trust in the therapeutic relationship
• Service users report a greater self awareness, ability to assert themselves and ask for what they need
• The WRAP project team have shared their work in a number of forums and conferences, including: The trust’s Clinical Governance forums, The Guardian’s ‘Managing New Realities’ Conference, Mind’s National Conference March 2007 and The University of East Anglia’s Mental Health & Aging Conference
• A website (www.recoveryinhampshire.nhs.uk) has been set up to promote WRAP and associated recovery focussed projects

Themes/Issues

• There is the potential for WRAP to be rolled out to anyone with a long term health condition
• WRAP is a proactive approach to mental wellbeing in which the individual is in charge. The level of self awareness raised should help people stay well more of the time, saving money in the long run.
• The WRAP team is very small in contrast to the size of the area covered by Hampshire Partnership NHS Trust. This means that the greatest successes have come from areas where the networks to roll out the training already exist. Gaining ground in harder to reach areas takes more time.
• The role out of WRAP has been most successful in areas that have existing service user networks
• Although recovery-centred approaches aren’t new, they are often ‘add ons’ to a person’s care. By rolling out WRAP training in a co-ordinated way it is hoped that WRAP will be available to everyone and become part of the mainstream.
• There has been some resistance to the idea, with staff already feeling overburdened and being suspicious of the ‘latest trend’. This highlights the need of the co-ordinator’s skills in promoting the idea, highlighting its uniqueness and getting people ‘on board’.
• All service users of the mental health trust should already have a CPA (Care programme approach). Whilst this plan should be made in conjunction with the service user it is often driven by the needs of the service. WRAP can function alongside the CPA, helping the service user to say what they need/want. The CPA process is under review and it is hoped that it will incorporate some of the WRAP principles.
• With the ultimate aim to mainstream WRAP within the trust, the project’s lifespan may be limited.