FMHS-SDC-Forensic-School-Prop-Final-8-12-04

A FORENSIC SCHOOL FOR SCOTLAND ESTABLISHING THE BUSINESS CASE PROPOSAL SUBMITTED BY SCOTTISH DEVELOPMENT CENTRE FOR MENTAL HEALTH DECEMBER 2004... FORENSIC SCHOOL FOR SCOTLAND ESTABLISHI

A FORENSIC SCHOOL FOR SCOTLAND ESTABLISHING THE BUSINESS CASE

PROPOSAL SUBMITTED BY SCOTTISH DEVELOPMENT CENTRE FOR MENTAL HEALTH

DECEMBER 2004

FORENSIC SCHOOL FOR SCOTLAND ESTABLISHING THE BUSINESS CASE

PROPOSAL

INTRODUCTION TO THE PROPOSAL

The Scottish Development Centre for Mental Health (SDC) welcomes the invitation from the Forensic Mental Health Services Managed Care Network Forensic School Working Group to submit a proposal for the development of a business case for a Forensic Mental Health School in Scotland The proposal focuses on two elements of the business case; establishing the need and demand for a forensic school in Scotland and exploring models for meeting these needs; and developing examples of training and education packages Clearly it is imperative that the school is built on a firm financial basis It is however felt that costing the school requires specialist skills and expertise beyond those available to the SDC The SDC would, however, welcome working in collaboration with those charged with undertaking the assessment of the financial basis for the school

BACKGROUND

The impetus for the development of a business case for a forensic mental health school in

Scotland comes from two sources First, The Right Place, The Right Time (2002), the

consultation on the review of the State Hospitals Board for Scotland, suggested the development of a school for forensic research and development In response a multi-disciplinary working group was set up, supported by the Scottish Executive, with a view to:

 Reviewing the provision of forensic education and training in Scotland and identifying gaps

 Identifying recent and current research in the field of forensic studies in Scotland

 Identifying disadvantages and advantages of combining research efforts within a forensic school

 Developing proposals for a school of forensic education and training

Given the identified gap in opportunities for forensic training in Scotland and of the small and unco-ordinated scale of research in the forensic field the working group recommendation was to formally ask the Scottish Executive to bring forward specific proposals for the development of a Forensic School

Second, following the consultation on The Right Place, The Right Time, the Scottish

Executive proposed the development of a Scottish Forensic Mental Health Services Managed Care Network To progress the proposals an Advisory Board was established supported by a number of working groups including one group charged with addressing issues relating to Teaching, Training and Research Building on the work of the earlier

group, the aim is to further develop a detailed business case for the establishment of a Forensic (Mental Health) School

CONTEXT

The current legislative, organisational and operational context in Scotland suggests a dynamic picture of change and development in the care, support and treatment of people with a mental disorder who engage, or are at risk of engaging in offending behaviour For example

Legislative context

 The gradual implementation of the new Mental Health (Care and Treatment) (Scotland) Act 2003

 The requirement for public authorities to be human rights compliant

Organisational Context

 The establishment of the Risk Management Authority

 Current proposals to achieve greater integration between the SPS and local authority criminal justice social work

 Community planning arrangements

 Community health planning partnerships

Operational context

 The development of medium secure units in Glasgow and the West of Scotland

 The expansion of the secure accommodation estate for children and young people

 The continued increase in prisoner numbers

 Agenda for change – the NHS pay reform package

 NHS mental health workforce planning

This changing and evolving picture has implications for both training and for research in the forensic mental health field

A FORENSIC SCHOOL FOR SCOTLAND: OBJECTIVES AND ROLES

Core objectives

As indicated in the work of the earlier group, the core objective of the forensic school is

to enhance the care, treatment and rehabilitation of people with a mental disorder who engage in, or are at risk of engaging in offending behaviour, through training, education and research, and to achieve valued outcomes for individuals, their families, for communities and for society at large

Underpinning values and principles

To achieve this objective in a way which all stakeholders can support suggests the need to make explicit the values and principle underpinning the work that the school does A part

of the process of developing the business case is to assist stakeholders to articulate these principles and values This may involve drawing on, for example, the principles set out

in Mel (5) 1999, or in the Millan committee’s report, or the convention rights enshrined

in the Human Rights Act 1998

Operating principles

More practically, as set out at the Forensic Mental Health Managed Care Network Seminar held in June 2004, the school must also have:

 Practical utility

 Be inclusive i.e.multi-disciplinary and multi-agency

 Feasible, and

 Financially viable

Functions/roles of a Forensic School

The work of the earlier working group, and papers produced by the current group suggest that the forensic school has three core functions:

Core functions:

 To provide a focal point/hub for education, training and research on forensic mental health in Scotland, ranging from mental health awareness among professionals in the criminal justice system, to more specialist forensic clinical courses

 To meet current needs across professions and agencies (including voluntary/independent sector) for education, training and research into the care, treatment and rehabilitation of people with a mental disorder who engage in, or are at risk of engaging in offending behaviour

 To develop a strategic role to assist the future development of workforce capacity within and across professions and agencies, including the opportunities for the development of new/enhanced/combined roles

Operational functions:

In operational terms this suggests four main areas of activity:

 The development and design of education and training packages in forensic mental health in response to the identified current and future needs of key stakeholders This includes education and training aimed at:

 Medical (Psychiatry, GP, Other specialties),

 Nursing (psychiatry, learning disabilities/ASD; general; hospital and community)

 Allied health professionals (physiotherapy, Occuptional Therapy, Speech and Language Therapy, Art, Dietetics, Pharmacy, Support workers);

 Clinical psychology, clinical forensic psychology, forensic psychology

 Social work/social care professionals: criminal justice social work, children and families, adult social work, secure accommodation for children

 Police

 Judges, Sheriffs, Procurators Fiscal

 Prison Services (health care staff and prison officers)

 Chaplaincy

 Voluntary and Independent sector including user and carer self help organisations e.g SAMH, Enable, SACRO, APEX, Turning Point

 Advocacy services

 Service Managers and Planners

 Co-ordinating the delivery of training packages including training the trainers This may also encompass issues of supervision and accreditation

 Providing a focal point for social and clinical research in forensic mental health in Scotland

DEVELOPING THE BUSINESS CASE

On the basis of the core and operational objectives of the school, the proposed project has three aims and two objectives

Aims:

 To ensure that the school is based on a solid foundation by:

 Identifying immediate, medium and long term demand and need for a forensic mental health school in Scotland

 Identifying the benefits as well as any potential disbenefits of a school

Two objectives:

 Consultation with stakeholders in the areas of post-graduate clinical education and training (including medical, nursing, AHPs and Clinical Psychology); local authorities, SPS, police, criminal justice service; voluntary/independent sector (including relevant users and carers groups); and Scottish Executive to:

 Identify current need/gaps in training in forensic mental health in Scotland

 Identify anticipated need/demand on the basis of knowledge of legal, policy and service developments and workforce shortages

 Identify the potential for joint training modules

 Identify issues of capacity

 Review of a sample of existing teaching materials and development of short samples

to illustrate approaches available, and outline options for developing different models e.g multimedia Computer Based Training environments

APPROACH

Objective 1: Identification of current and future need

A four-tiered approach is proposed to identifying current and future need and demand for

a forensic school in Scotland While the aim is to be as inclusive and comprehensive as possible this will clearly need to be feasible within the resources available

Tier 1 Collection of existing/readily available workforce data

Collating existing and readily available workforce data sources e.g from the ISD website

or social work statistics, the aim of this tier will be to provide a very broad brush picture

of potential demand

In discussion with the Forensic School Working Group, consideration could also be given

to contacting the existing medium secure units to obtain broad brush indicators of current staffing establishments including by profession/grades

Tier2 Interviews with key stakeholders

The second tier will comprise interviews (telephone and face to face group interviews as appropriate) with selected key groups/informants These key informants will be selected,

in discussion with the Forensic School Working Group from each of the five stakeholder groups identified in Appendix 1 It is proposed to undertake no more than 25 –30 interviews in total across these groups The aim would be to explore in more detail (as appropriate):

 What forensic mental health/forensic mental health training they currently provide and for whom

 Current arrangements for enabling staff to undertake training in mental health/forensic mental health

 The perceived need for training in mental health/forensic mental health within their area, and if so the content/format of courses required

 The current and future likely policy context with implications for the demand and function of the school

 Benefits and potential disbenefits

 Factors promoting the school/potential barriers

 Model for the school, including principles and values

 Nature of training required

 Numbers/current and likely future demand

 Sponsorship/funding of places

 Training the trainers including: funding, time, involvement of users and carers as trainers

 Other capacity issues e.g to release/replace staff; to purchase training packages

 Potential for joint management of the school and joint training/approaches

 Sources of research funding

 Potential for co-ordination of research function

 Interest in continuing to be part of a forensic mental health school development

Tier 3 Learning and connecting

Contact with:

Forensic Mental Health R& D in England

Scottish School of Primary Care

Scottish Academy for Health Policy and Management

Scottish Institute for Excellence in Social Work Education

With a view to informing processes of setting up a school including, for example, management structures, models for ‘virtual’ training/education networks, as well as exploring opportunities for shared working in the future

Tier 4 Ensuring integration

One day long workshop (10.00 – 3.30) facilitated by SDC with representatives from the Forensic Network/School working group and health, social work, criminal justice, education providers and voluntary/independent sector, including user and carer organisations (maximum of 20 people) Building on the material from the previous

‘tiers’ the aim would be to explore (and build) a joint commitment to a school in terms of: Model (including values and principles)

Management structure

Goals (short/medium and long term)

Functions (including e.g supervision/accreditation)

Potential for joint training/modules

Possible obstacles

Funding issues (individual and global)

Objective 2: Review of training materials and review of short samples

There exist a number of different approaches to interactive learning, each with different technological and cost implications For the purposes of developing a business case the aim would be to provide an overview of current and existing training materials from different disciplines to illustrate the variety of approaches available, including a sample portion of one of the existing print-based modules This would be supported by more detailed breakdowns of the advantages, disadvantages and resource implications of different options such as website-based modules and multi-media Computer Based Training on CDROM

ANALYSIS

The data from the interviews and workshop will be systematically analysed to draw out the key themes including:

 Indicators of current and possible future level of demand: including possible barriers

to using the School’s resources

 The range of training and education required and types of modules

 Opportunities (in terms of funding and for collaboration) for co-ordinating research in the forensic field

 The school model, including management and strategic development

 Issues relating to the development of training/education packages and modules

OUTPUTS

A report with an executive summary setting out:

 The approach adopted, and possible limitations of the approach

 Summary of key findings from the data collation, interviews and workshop

 Conclusions and recommendations

An illustrated example of the type of training package the school could develop, and an indicator of the implications in terms of time/cost to develop similar packages

Assessing need/demand Training/Education resources

Month 1 Meeting with working group and Forensic Network Board to

discuss model (s)

Summary of information from existing workforce data

Commence overview of existing material

Month 2 Contacts with other relevant

bodies Setting up and commencement

of interviews with key stakeholders

Commence setting up of workshop

Continue overview of existing material

Month 3 Continue interviews with key

stakeholders

Develop examples of models of training/education materials formats in different modes of delivery

Month 4 Workshop

Commence analysis Month 5 Preparation of Draft Final Report/Business Case

Month 6 Presentation to Network/Forensic School Working Group including

demonstration of sample portion of training module Submission of final report/business case

SDC PROJECT MANAGEMENT AND TEAM

The SDC team will comprise and be jointly led by Fiona Myers, Senior Researcher and John Jackson Associate Consultant (CVs attached) Design work on the training packages will be undertaken by John Wallace, Associate Consultant Day to day contact would be through Fiona Myers Additional research worker and administrative support will be provided by the SDC

Although not a member of the Team working on this project, Dr Allyson McCollam, Chief Executive of the SDC is accountable for the overall quality of SDC work and would be available to discuss the work of the organisation at any time

Throughout the process there would be close liaison with the Chair of the Forensic School Working Group Formal meetings are also proposed with the Working group and with the Network at key points through the process

THE SCOTTISH DEVELOPMENT CENTRE FOR MENTAL HEALTH

The SDC is an independent not for profit organisation that works with a wide range of national and local agencies and partnerships to enhance mental health services and to contribute to improved mental health and well-being for people in Scotland Working at the interface of policy, practice and research, the SDC brings skills that combine an understanding of strategic, service and practice development with a capacity for applied research and evaluation

Recent work undertaken by SDC relevant to the tender includes:

Support to SPS for the implementation of the SPS multi-disciplinary mental health team model (2004)

Research for the Scottish Executive on the prevalence of, and services for people with learning disabilities and/or ASD in secure, forensic and other specialist settings Report published June 2004

Review of the SPS multi-disciplinary mental health team pilot project Final report submitted November 2003

Support to the needs assessment and option appraisal for the development of secure care

in the West of Scotland

Design and delivery of mental health awareness training, including contributing to the pilot mental health first aid training programme in Scotland Evaluation report published

in July 2004