Hilda Campbell, CEO, COPE Scotland

Phase 1 story (Spring / Summer 2020)

How have you been able to keep a focus on what matters to people during COVID?

COPE is led by the voices of lived experience of mental, emotional, distress and health inequalities. We look to co-design solutions towards health, wellbeing and quality of life.

We have continued to be led by lived experience on a variety of levels. Our focus has included responses to specific situations created by COVID. This included co designing materials such as a tips sheet for managing chronic pain. We were led to design this as a result of the challenges people faced in managing chronic pain in lockdown (bad enough at best of times but with clinics etc cancelled some people felt abandoned).

To build capacity we shared a tips sheet on the art of conversation to encourage people to feel comfortable talking about how they feel, and to offer tips on how to listen. Motivation behind this was around building capacity for people to talk/listen who maybe at this time aren’t accessing services.

We are picking up uncertainty and worries about the future. People are worried about their jobs, their health, their relationships and about their families and what the future holds. We are talking to partners about how we make best use of our resources in continuing to provide support.

What have you had to do differently and what made this possible?

During lockdown we noted a reduction in our usual rates of referral (we think because GP practices aren’t operating as usual and 50% of our referrals come from GP’s). People don’t always think to come to us, so we invested a lot of effort in marketing, targeting specific places to raise awareness that we are still here, postcards in food parcels etc. This still didn’t get us back to where we were, so we also put together a blog to let people know how to get in touch. We are striving to be proactive and reach out to avoid people waiting until they are really struggling to get the support they need.

What have you noticed that has been better?

I think COVID19 has made more people aware that we all have a state of mental health and it can be challenged by unexpected and alarming events. We need to manage the feelings generated by such a crisis because there are challenges which need to be responded to. We need to collectively support each other to deal with these feelings.

How did this make you feel?

I feel concerned about the emotional and wellbeing implications of all of this in the long term but hopeful that a continued focus on proactive, co-designed solutions can help.

What have you learned through this?

The emotional impact of COVID19 is huge and our emotions have a huge impact on our mental health. We need to build capacity to problem solve, strategise, and not be overwhelmed. The challenges are real, the stresses are real and we may need to invest more in ensuring that people can connect and access support when they need it. Mental health services need to evolve to enable people to build resilience to the emotional, social and financial challenges ahead. Kindness is more important than ever, and that includes us being kind to ourselves!

Anything else you want to tell us?

Please feel free to access our many freely available resources to support the wellbeing of people who are struggling just now including practitioners.

Phase 2 story (Autumn 2020)

What has continued to help keep a focus on what matters for people during the pandemic?

We are led by the voices of lived experience so our focus is what matters to the people & communities we serve, by their contribution to social reporting, or, by the needs expressed when seeking support. That is why we exist, to connect with people, understand what matters to them, what we can do to help and how we can help build resilience and capacity so people suffer less.

Are there changes that seem to be lasting longer term and are there things that have slid back to old ways of doing things?

We certainly continue to evolve in response to demand as new issues are emerging e.g. more people affected by cancer, more people who previously received a statutory mental health service but have been discharged, more people affected by redundancy and all the challenges that brings, more carers really feeling the strain as places perhaps their loved one attended which offered them respite have remained closed.

Our service moved to phone/post/zoom/email. The majority of people appreciate this service and recognise and adapt to the restrictions of COVID19. There is a small % of people; mainly who knew us and have re-referred due to issues around COVID19, who miss the previous face to face services offered. Sadly, we recognise while we do the best we can, it will never meet the needs of 100% of people. Others prefer phone support as means less travel, more flexibility in appointment times and less risk.

The team have adapted to working and delivering from home and reporting systems have improved from when we were a direct face to face service. Also due to COVID19 there is daily focus on team wellbeing including exercises, links to supports and workshops.

What difference has this made to people?

People using the service are sharing the support and tools we have offered have enabled them to navigate an incredibly challenging time in their life.

The team have a wider menu of supports to offer people e.g. the Oomph Booklet. This was codesigned as people and communities presented that COVID 19 had knocked the stuffing out of them. This and other tools have enabled the team to work with people on clarifying their goals and focus. As well as offering compassionate listening this has enabled a more pragmatic response to very real day to day issues. From an organisation perspective we are actually reviewing our model of support as in many ways the lockdown and working from home model has taught us a lot about more flexible ways of working and highlighted even more the need for more ‘practical’ mental health interventions when the source of distress isn’t illness but life and is challenges

How did this make you feel?

The feeling across the team is one of excitement and hope, we feel energised that what we are doing and how this is evolving is being part of a solution to incredibly stressful times. Being able to do something tangible, to hear people feeling better and sharing how more able they feel to cope, keeps us grounded and positive that we can come through this, that even when life is challenging there are things we can all do to suffer less. Here is an extract from just one of the many feedbacks we receive on the new service:

Thank you for all your help these past few months.
We started our sessions at a very uncertain time and hadn’t actually met one another face to face. This however didn’t cause any issues as we held sessions over the phone. I feel these sessions were successful as it allowed me to go into my own ‘safe place’ at home and give my full attention to our session. As well as phone calls, I received tools by email and post that I can use throughout my life.
Overall, you have helped me change my attitude towards life as a whole, you have taught me to change within myself and my way of thinking instead of focusing on a problem. You have helped me to believe in myself and I am forever grateful for that! Even though I feel I am in a place to bring my sessions to an end, I know I could contact you by email if I needed a bit of help and guidance.

We do our own inhouse touching base around how the team feel about what has happened, here are some comments

What works well from working from home?

Less traveling,
Appointments not having to be cancelled due to office closed due to bad weather. Not sharing facilities with others.
Less disruption (noise) from others.
Clients not having to travel or arrange childcare to attend appointments

Do you think us working from home is working for clients?

Personally I feel it works very well and clients on the whole are happy to engage by telephone- there seems to be less missed appointments – even with new clients I’ve never met and they haven’t met me , I’m still able to build rapport with them over the phone and as I said works well. We are able to offer more flexible appointments which is great

What isn’t working, working from home?

Clients wanting face to face appointments.
Not really having everything at hand when needed
Lack of contact with people
Receiving mail
I don’t think it’s that things aren’t working i think it’s more of takes time to adjust and forgetting things aren’t on hand i.e. new blank diaries, notebooks, blank Client cards, Tips sheets. Not being able to go to the office and collect things because its locked up and we need others to let us in

Reflecting on your experiences what have you learned?

Sometimes just being able to get on with it and respond to emerging issues you find solutions you would perhaps never have considered before. The way we are working now and the materials we are using now we think are proving more effective than before.

We recognise a drop in referrals from GP’s we suspect as they are still working in new ways, however, self-referral remains as it was and we are finding more people are being linked to us from housing, social work, carers centres.

We have always been an organisation which embraces change. If you watch who moved my cheese, then COPE Scotland would be one of the wee mice.

What difference has it made to you to tell your story as part of this project?

Good reflective log

Anything else you want to tell us?

We are keen to promote widely the tools we use e.g. the Oomph Booklet We are delighted since the end of June more than 1800 people have accessed it, not including the people we have worked with directly. One of areas which seems to offer people the most space for reflection is around the car of life and if you are a passenger, a driver or a navigator, also recognising what is within and out with our control and where to put energy , which informed another workbook coming out soon.