(up to 31/3/10)

a) Pilot process

Implementation was piloted during a two year period fifteen mental health provider trusts across the country - Wave One (2006 - 2008) and Wave Two (2007 - 2008).

At the outset, within the Wave One trusts, the following surveys were carried out:

• Staff service audit on the level of awareness and knowledge of staff in relation to abuse issues. Download the Overview Report on Staff Service Audit

• Consultation with mental health services users and user-led sexual abuse survivor groups/organisations to explore their perceptions of how abuse issues were being addressed. Download the Service User Consultation Report

The independent evaluation of the pilot process, in short, indicated that the implementation process was in fact ‘doable’ and confirmed the efficacy of the one day sexual abuse course.

Overview Evaluation Report (Wave One) & Evaluation Report, Executive Summary (Wave Two)

This is the testimony of one survivor about the impact of the sexual abuse training for her:

“Following the training, at my CPA review, my care co-ordinator asked me all the abuse questions now included in our CPA forms. Although he thought he had probably covered this ground already, he used the questions to check this. He is much more confident now in talking about abuse with me and so much more sensitive and empathic. He gives me time and really listens and actually thanks me for talking with him about things that are so painful. He makes a point of saying that he hasn’t experienced abuse himself and that he can’t imagine how he’d have coped with what happened to me - he has alot of respect and admiration for how I’ve coped now he has a better understanding of the impact of sexual abuse.The training helped him understand some of the problems within my relationship with him and we have been able to address them. As a result, our relationship is more trusting and I’ve been able to progress hugely in the way I’m learning, and trying out ways of relating with him that I can then transfer to other relationships. This training has definitely benefited my mental health care and my personal life. (Overview of Evaluation Findings (Wave One), www.dmss.co.uk)

The National Team - Liz Mayne, National Lead and Chris Holley, Clinical Lead - then planned the national rollout informed by the ‘lessons learn’t’ from the pilot stage.

b) National rollout

Understandably it seemed a daunting process to trusts initially and central support - by the National Policy Implementation Team - assisted them in ‘getting started’ on a region-by-region basis:

• Each trust initially appointed a Senior Violence and Abuse Lead eg Deputy Chief Executive; Director of Adult Mental Health Services or Operational Services; Director of Nursing; Medical Director; Director of Clinical Governance.
• A planning meeting was held with each individual trust comprising a range of senior management and frontline staff.
• A two day ‘training the trainers’ course then took place to equip trust trainers to cascade the one day sexual abuse course.
• Additional support - clinical and project management - was then provided if and when necessary.

As at 31/3/10, (bar four) every mental health provider trust had a designated Senior Violence and Abuse Lead and:

• South West, North West, Yorkshire/Humberside, North East, West Midlands, East Midlands SHA regions were at some point along the implementation journey.
• South East (2), London and Eastern SHA regions were at the commencement stage.

For a comprehensive overview of the policy, pilot implementation process and subsequent national rollout, download NHS Confederation Briefing: Implementing National Policy on Violence and Abuse ... A slow but essential journey (June 2008). Download a copy of the briefing

c) Higher Education sector 

Whilst time was limited, some inroads were made in this sector e.g. :

• Delivery of eight one day sexual abuse courses for Specialist Psychiatric Registrars around the country (in collaboration with the Continuing Education Training Centre of the Royal College of Psychiatrists).
• Delivery of a series of two day sexual abuse workshops to eight higher education institutions to explore the means of embedding sexual abuse into their pre-registration core curriula.
• A number of presentations/papers to, for example, Royal College of Psychiatry; Mental Health Nursing Academic Board; National SHA Education Commissioners Group.
• Contribution to DH submission to the Nursing and Midwifery Council’s Review of Nursing Standards with regard to abuse issues (to be published in September ’10).

The National Mental Health Development Unit (NMHDU) is the agency charged with supporting the implementation of mental health policy in England by the Department of Health in collaboration with the NHS, Local Authorities and other major stakeholders.