Reducing costs in mental health care
Home to 430,000 people, Kirklees in West Yorkshire is one of the largest and most populated boroughs in the UK. Serving the community, Kirklees Council’s vision is to support vulnerable people and help them to stay in control of their own lives and supporting them to do more for themselves.
A survey of residents indicated a high prevalence of common mental health conditions, but - in line with other UK local authorities - mental health services in Kirklees were comparing unfavourably with those for physical conditions.
To solve this problem, and in line with the Five Year Forward View, commissioners from Kirklees Council worked together with providers across sectors including the NHS, social care, education, youth justice, and voluntary organisations, to develop Local Transformation Plans. It was critical to find a way to deliver the right care at the right time and improve outcomes - but, with budget shortfalls and rising demand, it was also crucial to save money.
Perspectives from a user and commissioner in Kirklees
The mental health commissioning team worked with the Assistive Technology (AT) department to identify technology-based solutions, hoping that digital support would support Kirklees' aim of delivering mental health services that empower the individual to develop skills, self-care, and resilience for future independence. This was a new area for the team: technology-based interventions had so far focused on equipment to help people overcome physical challenges.
Following an assessment of Brain in Hand, and research into the results that it had had in other health and social care settings, Kirklees decided to implement the system.
An important early decision was where to introduce Brain in Hand. The initial settings needed to demonstrate the system's effectiveness and to prove the potential to save money and create a sustainable programme of improved outcomes.
The Community Links Engagement and Recovery (CLEAR) service, a non-profit provider commissioned to deliver support to around 500 adults with mental health needs each year, provides each of its clients with a key worker who helps them to develop personal goals and plans. Brain in Hand could be used to reinforce each person's plans and strategies, allowing them to have easy access to the solutions co-created with their key worker at any time - and the key worker would be an ideal supporter to respond to contact requests made using Brain in Hand's traffic light system.
To support the council’s strategy of early intervention and prevention, Brain in Hand was also introduced within Kirklees College. Using technology to improve self-resilience at the early stages in life could prevent escalation and possible later referrals into CAMHS. It could also ease and improve the pathway when a child transitions into adult services.
The Brain in Hand team worked with these two services to implement the system as smoothly as possible. Over four days of on-site support, Brain in Hand trained staff on how the system works, how to get new users started, and how to use organisational functions for monitoring and reporting users' wellbeing and anxiety levels.
Brain in Hand also helped Kirklees to identify the first twenty system users, who could use its digital self-management tools and remote support functions alongside the support they already received from CLEAR or the College.
Giving people Brain in Hand increased independence and made services more effective: equipping users with easy access to their best coping strategies and a connection to help when it was needed resulted in people achieving more goals, recording fewer instances of high anxiety, and becoming more confident.
The critical financial savings were also achieved, with CLEAR's first year of using Brain in Hand delivering a return on investment of ten pounds saved for every pound spent.
This includes direct savings, where individuals reduced how much support they were accessing, and avoided costs, where reductions in costs such as emergency assistance and benefit payments were attributed to Brain in Hand.
Click here to download a copy of the full report, including a detailed breakdown of how savings were identified and allocated.
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