Complex Emotional Needs Support Service

People with severe and complex psychological needs face many disadvantages - in the NHS and in wider society, including reduced life expectancy, inadequate access to treatment, barriers to employment, and stigma. This is particularly unjust when we know approaches that are effective in supporting people to live more fulfilling lives. Individuals presenting with emotional dysregulation and associated high levels of risk, can be placed outside ABUHB for intensive residential treatment (including low-secure placements) and can be challenging to repatriate or integrate into the community– often resulting in hospital admissions away from home for many years.

Transition from Children’s Mental Health Services to Adult Mental Health Services has continued to be a priority following the recent Welsh Government Guidance on the management, handover and accountability of healthcare services for young people. There is an expectation from the Welsh Government that public services will work in a more collaborative way, identifying and capitalising on opportunities to work together to improve services for the people of Wales. Welsh Government has recently reinforced the need for Transition between children’s and adult services to be prioritised and to ensure that the child or young persons’ transition is as well coordinated as possible and that service users have a say in the process.

The Acorn Project is an innovative partnership project with United Welsh Housing Association, commissioned by Aneurin Bevan University Health Board (ABUHB).

The project includes two properties – both of which contain five individual flats and communal spaces. Acer House is a new, purpose-built facility, which focuses on providing support to females. The service at Acer House has been developed to support the discharge of individuals in high-cost placements or blocked beds and/or to aid the transition between Child and Adolescent Mental Health Services (CAMHS) and Community Mental Health Teams (CMHTS)- through the provision of psychologically informed, relational support, within a 24/7 supported setting. The intended length of stay at Acer is 6 – 24 months in order that tenants are prepared and supported to gain full independent Living. The intended age range will 18-25, though engagement could begin with individuals from the age of 17 to prepare them for the next step in their pathway. In addition, if someone falls outside of the age range (25 +) and would benefit from staying here this would need to be agreed and discussed by the project group.

The expectation would be that the commissioned provider works in close partnership with the Hiraeth Team. The Hiraeth Team would be responsible for identifying who might benefit from a placement at Acer House and will work collaboratively with the commissioned provider to develop an individualised repatriation/prevention plan, based on a clear, detailed psychological formulation of clinical need and risk (and how to manage this within minimal restriction). It is anticipated that the support team and the clinicians from the Hiraeth Team will work as part of an integrated support/clinical team, with clinicians attending weekly team meetings, and providing daily (within working hours) clinical input to the house.

Very close working between the providers and the Hiraeth Team (based within Aneurin Bevan) is essential to ensure optimal outcomes for the patients and to support the sustainability and well-being of the staff group. Hiraeth clinicians will support with recruitment and provide training.