Prevention and Recovery Care (PARCs): mental health support in a home-like setting

This is an edited version of our 2020 two-part podcast Celebrating PARCs, hosted by Chief Marketing Officer Robyn Haydon.
Prevention and Recovery Care services (PARCs) are short and extended residential and day programs that provides 24-hour support in a “home-like” environment to people experiencing mental ill health and whose recovery can be supported without hospital admission. PARCs also supports people discharged from hospital who are not quite ready to return home.
ermha365 delivers PARCs in South Yarra, Barwon and Warrnambool for partners Alfred Health, Barwon Health and Southwest Healthcare.
Guests: Karenza Louis-Smith (ermha365 CEO), Sally Wall, Senior Manager, Mental Health, Forensic and Community Services, Kez and Sharon (PARC participants).

ermha365 provides mental health and disability support for people in Victoria and the Northern Territory. Find out more about our services at our website.

Helplines (Australia):
Lifeline 13 11 14
QLIFE 1800 184 527
13 YARN 13 92 76
Suicide Callback Service 1300 659 467

ermha365 acknowledges that our work in the community takes place on the Traditional Lands of many Aboriginal and Torres Strait Islander Peoples and therefore respectfully recognise their Elders, past and present, and the ongoing Custodianship of the Land and Water by all Members of these Communities.

We recognise people with lived experience who contribute to GET REAL podcast, and those who love, support and care for them. We recognise their strength, courage and unique perspective as a vital contribution so that we can learn, grow and achieve better outcomes together.

Transcript

ermha365 tean: 0:00

Get Real is recorded on the unceded lands of the Boon, wurrung and Wurundjeri peoples of the Kulin Nation. We acknowledge and pay our respects to their elders, past and present. We also acknowledge that the First Peoples of Australia are the first storytellers, the first artists and the first creators of culture and we celebrate their enduring connections to country knowledge and stories.

Robyn Haydon: 0:24

celebrate their enduring connections to country knowledge and stories. Welcome to Get Real. Talking Mental Health and Disability. I'm Robyn Haydon and this week on Get Real, we are celebrating parks. So if you haven't heard of one before, what is a park? Well, park stands for Prevention and Recovery Care Services. Parks are short-term mental health treatment services located in the community. They're residential programs with a recovery focus, helping people to get well and to stay well. So what PARC's do is they provide early intervention for people who are becoming unwell, as well as help for people who are in the early stages of recovery from an acute psychiatric episode and who need support to strengthen and consolidate the gains that they've made in an inpatient setting. ermh a 365 has been managing parks for more than 10 years as a psychosocial support services provider, working with our clinical mental health partners, so our team set up the very first women-only park in Victoria. Today, I'll be talking to a whole bunch of people about celebrating our parks. First I'm talking to karenza Louis-Smith, who is the CEO of e rmha365. Karenza, why are we in the business of parks? Why are parks so important to erma365?

Karenza Louis-Smith: 1:43

ERrma, I think what a PARC does, robyn, is it provides that what we call a step up or a step down from acute mental health care. So people in the community who are starting to become unwell may not need to go into a hospital setting, but they do need some more intensive support than they would perhaps get at home or in a community service. So it's a residential program that sort of sits halfway between a hospital and halfway between the community. So it's not a ward, it doesn't have hospital beds, but it does have staff from a hospital setting. So it has a psychiatrist, psychologists and nurses in there, as well as what we would call psychosocial mental health workers who help people to set some recovery goals and help them to think about how to get themselves feeling well again so they can go back home.

Karenza Louis-Smith: 2:30

And it's also that gap between you know, when the hospital discharges you and you have to go straight home. That can be really frightening and overwhelming for people. So it bridges that gap too. So it might be that I've been in hospital for an acute stay so I've been very, very unwell. It enables me to have that step down so I can start getting ready to go back home. So a park really bridges that gap and it's a fantastic part of the mental health treatment system here in Australia.

Robyn Haydon: 2:59

So what is it about ermha PARCs that make them a bit different from other park services?

Karenza Louis-Smith: 3:06

The value of support at park is that every moment is a learning moment. So it's an opportunity for us to work one-on-one with people on their individual needs, what's happening and going on in their lives, and our model, with a blend of group and individual support. It's underpinned by routine and so it really helps to encourage and enable that. So we've heard from people I mean, we talk often to people that come through our parks to tell us what is it that's different, what is it that's worked for you? And they say that you know, what makes a stay at Irma different perhaps to other parks is because we're actually out in the community, in that space, in the park, with people. We're not stuck in an office, we're not behind a door, we're very much part of this therapeutic community that we're building that helps people to start to recover and really think about how to, you know, getting well and staying well.

Robyn Haydon: 3:57

Right now I'm joined by Kez, one of our consumers who's had the benefit of experiencing Irma 365 Park Support. Can you tell us a little bit about your background? How did you actually come to the Park Service? How did you find out about us?

Kez: 4:14

I had a case manager with Monash Health and one day told me about parks and I was really nervous and anxious about coming because I don't deal with change very well. It took me a couple of days to settle in, but after that, like I just got a lot out of it and what was happening for you before parks?

Robyn Haydon: 4:35

Where were you going before parks to get help with your mental?

Kez: 4:38

health Hospital admissions. I'd have to ring the police to get taken to hospital to get help. The hospital staff would argue that it was a police matter, not a mental health. And the police would argue it was a mental health matter, not a police matter, because I hadn't done anything.

Karenza Louis-Smith: 4:53

Right.

Kez: 4:53

And they would stand there arguing and I'd be there. Well, shut up and someone help me.

Robyn Haydon: 4:59

And that's the struggle, isn't it? It's how do you get the help that you need when you know that setting maybe was nobody knew what the right way was to to help you. So thank goodness you got referred to parks because in speaking to you early you were telling me how much park has helped you over that very long period of time. So when you first came into park know how often were you coming back to Parks, would you say.

Kez: 5:27

Initially about once, twice a year, but I'd end up rather ill and for about two and a half years I was coming three monthly and then, after Park started, which is a group that arose out of parks, and going to that, I've only been coming six months away again now?

Robyn Haydon: 5:56

Yeah, that's amazing, isn't it? So you know you've experienced the park support in the park, but then it sounds like After Parksarks has been something that's allowed you to stretch out your time between parks visits. Can you tell me? A little bit about the Afterparks support and what that's like and what that does for you.

Kez: 6:15

It's just a place that we can go to. They run various types of groups, some arts and crafts, sometimes an outing, but I really love the self-help recovery group because it gets me to keep looking at myself and helping me to continue to grow and recover from my mental health, because, with the help of PAPs after PAPs and my psychotherapists, I'm aiming at coming back only once a year.

Robyn Haydon: 6:44

What does that mean for your life? To be able to manage your mental health better in that way?

Kez: 6:50

Pups has encouraged me to talk more instead of internalising. I still internalise a lot, but I'm getting better. That's my next stage of recovery is to talk about what's going on inside me, even if I don't understand what's happening. I've always had to look after myself from a very young age and I've never had anyone there to help me and I was never believed as a child, what Parks has done for me. They believe me and they genuinely care about me and it's really helped my self-esteem and self-confidence Knowing that I've got a safe place to come and get well without being judged. It would have to be my fondest memory of Parks. Feels like a home. It's not clinical. Don't be afraid to reach out for help. Even though change is scary, it's a good thing. It's very empowering changing. Sometimes you've just got to white-knuckle it to get through.

Robyn Haydon: 7:57

Yeah, absolutely. That is great advice and the best possible advice for anybody, from somebody who's been there and has done it and is continuing to do it.

Kez: 8:08

I don't know where I would be without Parks today. It's played such an integral role in my recovery and that's what Parks stands for Prevention and Recovery Care.

ermha365 team: 8:20

Services.

Robyn Haydon: 8:22

So let's have a chat about the After Park Service. What is an After Park Service? What is that all about? I believe that is also one of our innovations that Irma365 has introduced.

Karenza Louis-Smith: 8:35

Yeah, thanks, robyn, for asking about that. What we wanted to do was to make sure that when people left parks, they had all of the support that they needed in the community so they could stay in the community. What we found, and why we introduced it, was after, you know, you'd stayed in a park for 21 days it might be three months later you start to become unwell again, and clients were saying to us you know, the first few months were okay, but as they began to get unwell, all those things that they learned became a bit harder. They told us it was really important. They didn't feel abandoned after they left the park setting and they needed to know that there was ongoing support if they needed it, and that support was provided by people that already knew them and knew about them, so they didn't have to tell their story over and over and over again. And so we took that feedback and we said, right, let's pilot a special program for people when they leave parks.

Karenza Louis-Smith: 9:21

And so we set that up, and what we found was peer support is a really important element of the after parks experience. So we set up peer social groups that have formed as a result of after parks, and so people have actually stayed together in those peer networks. So we found that park residents began to support each other as well as being able to dip in and dip out of support with Irma that they know is there and available for them. So it created a whole new network for people. And the goal really, robin is, when you've come into a park is to get those skills that you need, those relapse prevention strategies, and to have your relapse prevention plan but also the supports around you so that when you do leave the park you've got multiple things to draw upon. And that might be the peers that have gone through the program with you. It might be the Irma staff, who you know and trust, and then it might be other people in your life as well that are part of your then bigger recovery community.

Robyn Haydon: 10:15

Yeah, those relationships are really important. Can you talk about how we've adapted our park's practices to respond to our partner's needs in the various locations in which we operate?

Karenza Louis-Smith: 10:27

A park is a collaboration between clinical mental health and a community mental health service and it's really driven by the needs and the demand that clinical mental health is seeing, which means that we, you know it's essential that we work in partnership and we actually help clinical mental health services solve their problems.

Karenza Louis-Smith: 10:44

So so, for example, at Barwin we increased park beds and we increased them from six up to eight because we found there was a demand and a need for beds, a greater need for beds, and so being able to provide more beds in a park can actually help to reduce some of the pressure on clinical beds and if we can do that, that can reduce clinical presentations, take the demand off. You know a service system that we know is under huge pressure and we know that demand for clinical beds in Victoria far outstrips the number of beds that are available. So by saying, yep, let's put some more beds in a park, that really helps the clinical mental health service manage the demand for its clinical bed. So those people who are most unwell get into a clinical bed, but they can step down as they become stable straight into a park, which means that clinical bed is there for someone else who's acutely unwell.

Robyn Haydon: 11:34

Here's Sally Wall, our Senior Manager of Community Services. Sally, can you tell us a little bit about the type of people that are supported by Irma's Parks?

Sally Wall: 11:44

Obviously it's people with a mental illness and have experience with a clinical mental health service. They're often referred by their clinician or a lot of people also make self-referrals. So people have a whole range of diagnoses. They may have had depression, they may have schizophrenia, they may have you know the whole gamut of mental health conditions. One of the things that PARC is is a step-up model, so that's actually supporting people before they end up in a clinical space, or also a step-down model, which is people exiting out of an acute clinical space.

Robyn Haydon: 12:24

So what is it about Irma Parks? Would you say that make them a little bit different from other types of park services?

Sally Wall: 12:32

Each park's really different, and that's one of the things that we celebrate at Irma that all of our parks are very different and they're based on the people that we're supporting. But I think the thing that makes our parks really special and different is the team that we provide. When someone comes into parks, they're there for up to 28 days, so obviously it's not just 28 days of free time. We have a whole range of group activities. One of the really interesting parts about PAR is every opportunity is a chance for learning and for growth.

Sally Wall: 13:11

So that is about the people that we support in parks having, you know, having one-on-one conversations with workers about some of their aspirations, their fears, a whole range of things being in the moment, doing some mindfulness with someone if they need it there. And then it's about having a presence with people. The teams of our parks are never locked away in an office, except if there's a, you know, a team meeting or what have you. It's absolutely about having a presence out in the facility. They're just being so. It might be doing a jigsaw with someone, it might be working in the veggie garden, it might be doing some art with someone, cooking a meal together. It's always about having conversations and doing stuff with people, because often people you know sitting talking to someone one-on-one can be quite challenging.

Sally Wall: 14:03

But if you're doing something alongside someone, for instance, you know digging in the veggie garden picking beans. You know digging in the veggie garden picking beans. You know cutting up the veggies for dinner. But it's those incidental conversations that are so powerful, and I guess one of the things that's important about parks is that relationship that develops between our workers and the people who are having a stay there and the people who are having a stay there.

Robyn Haydon: 14:29

Now we'll hear from one of the people who has visited our Barwon Park, sharon, and Sharon has agreed to share some insights of her experience there, so welcome Sharon.

Sharon: 14:44

Can you tell us a little bit about yourself and why you came to Park? I was in hospital with a mental illness a reoccurring mental illness and I was asked if I wanted to come to Park. I pretty much didn't have anywhere else to go, as good as what Park is. It was the best option for me and it was the right move, definitely the right move.

Robyn Haydon: 15:06

So what were you experiencing when you came into park as much as you feel comfortable sharing with with listeners and what were your goals? What did you want to achieve while while you were at your park stay?

Sharon: 15:19

I was in a pretty bad way before I come to park. Physically, mentally, I was completely drained. I didn't know where I was completely drained, I didn't know where I was pretty much, and I just wanted to get well again. And I knew I couldn't do it on my own. And I don't think I'd be where I am if I hadn't have come here. There was no judgment, the staff were so good, all the activities, the help. I couldn't have asked for a better place.

Sharon: 15:52

I'm pretty good at isolating myself, or have been in the past, so it took a bit of courage. But I felt very safe and I was encouraged to do as much as I felt comfortable with. I loved to meditate. I learned so much. I could never meditate, I couldn't stop my mind. But at Park, in the room that we had, didn't matter which staff member, I just felt so comfortable and at ease. I'd go back to my room completely relaxed, back to my room completely relaxed. I'd been through a lot of trauma, a lot of things had happened and I just gradually started to feel better, with the help and support from everyone. As I said before, I learnt so much. I felt like I had everybody here sort of heading me into the right direction, where I wanted to go. I honestly don't think I'd be here if I hadn't have come here and had the help and support that I had, I don't know where I would have ended up.

Robyn Haydon: 17:03

Thank you. That's a very brave thing, I think, to share with listeners that that's where you were at the time. I know you mentioned that you'd had some outreach support after you left Parks physically.

Sharon: 17:17

I had a little unit to go to through the Department of Housing. I had assistance going to have a look moving in, to have a look Moving in. Once I got there I was on the outreach program. I was really worried that I was just going to be sort of dumped there and left on my own. But I was on the outreach program and that was really good too, knowing that that support was there for me all the time, heading me in the right direction.

Sharon: 17:48

Simple things like I hadn't caught a bus for probably 40 years. I didn't know how to look at the timetable, especially on computers and things like that, and some people might think it's a silly, simple little thing I should have known. But if I'd never done it or hadn't done it for 40 years, that was a big thing. So I had all sorts of support and I was encouraged as well. Once again, as far as I could push myself and that was a big part of my recovery it's the dedicated staff. They just give 100% to every single person. They might be busy with one thing, but as soon as they get a chance they'll be back. They'll get back to you the encouragement.

Sharon: 18:38

If I had a negative, I was taught how to try and turn it into a positive. I was encouraged. I was taught so many things. If I had gold medals to give, it would go straight to the staff, because I don't know where I'd be without them. Fantastic people, fantastic team. They really are a team and they put effort into all of us. I was really unwell but looking back, I just think I was privileged to have such a positive experience. I do consider it to be a privilege to have been able to come here and get the help that I needed.

Robyn Haydon: 19:21

Through our parks. The Irma 365 team provides tailored, specific, individual and group-based support to people who really need it. Of course, our staff are instrumental in providing that support.

Sally Wall: 19:36

It just wouldn't happen without them. You've been listening to Get Real talking mental health and disability brought to you by the team at Irma 365. Thanks for listening and we'll see you next time.

ermha365 team: 19:45

We recognise people with lived experience of mental ill health and disability, as well as their families and carers. We recognise their strength, courage and unique perspective as a vital contribution to this podcast so we can learn, grow and achieve better outcomes together.