Mental health unscheduled care services: resources

4 Learning and Training Opportunities with Resources

4.1 Introduction

This section contains information on learning and training opportunities for staff providing mental health and wellbeing support in unscheduled care settings. It also provides associated resources where available.

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4.2 Suicide Prevention and Self-Harm

4.2.1 Time Space Compassion

When we seek to support people experiencing distress, crisis, and suicidality, it’s key that we:

• offer them time to talk and feel listened to,
• give them space to make sense of what’s going on for them, and
• show compassion in how we respond and what we do next

The Time Space Compassion principles and approach brings together lived and living experience, practice, evidence and expertise in the form of:

• a set of principles that you can use to guide your work and stay focused on what it means to provide a human and compassionate response
• an approach and resources that you can use on your own and with others - to reflect, learn and take actions that grow our collective ability to do this well
• ways to build and share what already works with others who share a commitment to improvement and positive change.

Time Space Compassion is an important part of the culture we are building around suicide prevention in Scotland.

You can find out more by:

• exploring the activities and resources covered by the introductory guide to Time Space Compassion along with the easy read guide
• reading examples ofTime Space Compassion in practice, through this practice story collection and the Suicide Prevention Scotland’s Medium pages
• listening to the Time Space Compassion podcasts, with contributions from people with lived and living experience and practice expertise.

4.2.2 Suicide prevention learning resources

The Knowledge and Skills Framework for Mental Health improvement, and prevention of self-harm and suicide covers the promotion of good mental health, improving quality of life, tackling mental health inequalities, supporting people in distress or crisis, promoting resilience and recover, preventing self-harm and suicide. The resources on this site have been co-produced by NHS Education for Scotland and Public Health Scotland and are aimed at those working across health and social care settings, and beyond.

The Framework is designed to enable individuals, teams and managers to identify and understand the values, knowledge and skills expected of them in mental health improvement and the prevention of self-harm or suicide. It will also help identify gaps or strengths in staff knowledge and skills. The framework articulates the knowledge and skills required across 4 levels of practice: informed, skilled, enhanced and specialist.

Informed Level - Target Audiences

The essential knowledge and skills required by everyone, in any workplace, workforce or community who has the opportunity and ability to positively impact on their own and other’s mental health and wellbeing and contribute to supporting people experiencing mental ill health and preventing self-harm or suicide.

Skilled - Target Audiences

The knowledge and skills required by ‘non-specialist’ frontline staff working in health, social care and wider public and other services, who are likely to have direct and/or substantial contact with people who may be at risk of mental ill health, self-harm or suicide.

Enhanced – Target Audiences

Focuses on the knowledge and skills required by staff working in health and social care, and wider public services, who have regular and intense contact with people experiencing mental distress, mental ill health, and my be at risk of self-harm or suicide, and whose job role means they can provide direct interventions.

Specialist Practice – Target Audiences

Focuses on the knowledge and skills required by staff, who because of their role and/or practice setting, play a specialist role in mental health improvement and the prevention of self-harm or suicide, and includes specialist mental health/public health professionals.

Information on in-person suicide prevention training courses and learning resources aligned to the Framework (e.g. ASIST, safe TALK) are available from Public Health Scotland.

Appendix 5 also includes links to the training resources for each of the different levels.

Suicide Bereavement Support Service

4.2.3 Self-harm training

NHS Education Scotland’s Learning Byte 4: supporting people at risk of self harm is available on TURAS.

The learning covers: reasons why people self-harm, understanding self-harm as communication of distress, some common misconceptions surrounding self-harm, impact of thoughts, feelings and emotions on self-harm, adopting a sensitive, compassionate and non-judgemental approach when talking about self-harm, risk and protective factors associated with self-harm, ways you can positively respond to and talk about self-harm.

The Self-Harm Network Scotland also provides public and professional training to raise awareness, improve understanding and reduce stigma of self-harm. There are a range of different training opportunities that will enable you to choose the best option for you, your organisation and your training needs. All of the training is free and more information can be found at: Training - Self-Harm Network Scotland Penumbra (selfharmnetworkscotland.org.uk).

Self-Harm Network Scotland

4.2.4 National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH)

The National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) produces free evidence based reports, videos, learning resources, quality statements and improvement toolkits, designed to support safer services for people impacted by suicidality and self-harm.

4.2.5 Creating Hope for Peer Support

Scottish Recovery Network, through their work with Suicide Prevention Scotland, have produced learning resources to support community based peer support, including services working with and as a part of community settings.

4.3 Recognising & Responding to Distress e-learning module

The Recognising and Responding to Distress (RR2D) is a new standalone e-learning module, designed and developed by the University of Glasgow and funded by the Scottish Government as part of the wider Distress Brief Intervention programme. The module enables and empowers organisations to provide a compassionate effective response to people who they encounter in distress. NB this module is for organisations which are not part of the core DBI programme, i.e. they can provide support to people in distress, but they cannot make referrals to DBI Level 2.

Interested organisations can contact the University of Glasgow via the email shw-rr2d@glasgow.ac.uk to request access to the module.

4.4 Trauma-informed Practice – Training and Support

Psychological trauma, including adverse and traumatic experiences in childhood and adulthood, is more common than we often assume.

Many of us will recover without the need for professional therapy or treatment, but if we are not supported, it can have a wide range of negative impacts, including on our physical and mental health and wellbeing. People experiencing multiple forms of trauma and adversity are more likely to experience greater inequalities in outcomes.

Trauma and adversity can impact our ability to feel safe in relationships, to manage strong emotions, and to view ourselves as worthwhile. Many settings can unwittingly provoke strong reminders of the trauma we experienced. For these reasons, and others, our experience of trauma can create invisible barriers to many services and opportunities in life.

What helps people to cope with and recover from such experiences includes having safe, supportive and compassionate connections with others, and trauma-informed care. Every interaction made with someone affected by trauma is an opportunity to support their recovery.

It is also important to remember that, as members of the workforce, we are also members of the general population and are likely to have experienced the impacts of trauma too, whether in our personal lives or through the course of our work. We know that we need to be well in order to support others to the best of our abilities. It is vital that as staff we feel safe and supported when we are caring for and supporting others, particularly because those of us directly supporting people affected by trauma and mental health difficulties can face an increased risk of experiencing vicarious trauma, moral injury and compassion fatigue.

The National Trauma Transformation Programme was established in 2018 to support a trauma-informed workforce and services across Scotland. Its aim is that services and care are delivered in ways that prevent further harm or re-traumatisation for children, young people and adults affected by trauma and adversity, and that support everyone’s unique journey of recovery.

The key components of the National Trauma Transformation Programme are:

• A Knowledge and Skills Framework for Psychological Trauma, which sets out the level of knowledge and skills that anyone in the workforce needs, depending on their role, to be able to recognise and respond to trauma appropriately.
• A Transforming Psychological Trauma Training Plan, which should be read alongside the Knowledge and Skills Framework, provides essential guidance and planning tools.
• Evidence-based trauma training resources and tools, guidance and support for implementation, including animations, e-learning modules, skills based training and resources to support staff wellbeing. Here you will find an overview of the resources.
• A series of companion documents has been developed to support people strengthen their understanding of how taking a trauma-informed approach can support both improved outcomes for the people they support and staff wellbeing and safety. Some examples include a trauma-informed practice and domestic abuse companion document, and a care experience and trauma-informed practice companion document.
• A Roadmap for Creating Trauma-Informed and Responsive Change: Guidance for Organisations, Systems and Workforces in Scotland was published in November 2023. This resource is designed to help services and organisations identify and reflect on progress, strengths and opportunities for embedding a trauma-informed and trauma-responsive approach across policy and practice.
• Transforming Psychological Trauma Implementation Coordinators, based in each health board, provide trauma expertise to organisations and Trauma Champions in their local area to support training, coaching, implementation and collaborations with people with lived experience of trauma. To find out who your local Transforming Psychological Trauma Implementation Coordinator is please contact Psychology@nes.scot.nhs.uk.
• A Local Trauma Champions Network, consisting of senior leaders from Local Authorities, Health and Social Care Partnerships, Health Boards, and key community planning partners is responsible for overseeing, encouraging and raising awareness of trauma-informed and trauma responsive practice across all services in their area. To find out who your local Trauma Champion is please contact trauma@improvementservice.org.uk. More information on NTTP networks and support can also be found here.

Violence Against Women and Girls

4.5 Learning Disabilities and Autism Lived Experience Resources

People with learning disabilities and autistic people co-created a package of lived experience resources. The resources are for professionals throughout health and social care and are designed to support more accessible mental health and health supports and services for people with learning disabilities and autistic people. They are also designed to support professionals to improve their knowledge and understanding about what it is like to live with learning disabilities and/or autism.

4.5.1 Lived Experience Resources

The Learning Disability package, which can be accessed here consists of:

• Top Ten Tips Film
• E-poster
• Behind the scenes film showcasing the involvement of people with lived
• E-booklet around the top ten tips
• 3 things about me card

The 3 things about me card is a person centred intervention tool created by people with lived experience to support communication and conversations and build relationships and trust between people with learning disabilities and autistic people and professionals. It is particularly helpful where sensitive and difficult conversations may take place.

4.5.2 Autism Package

The autistic drivers package, which can be access here, consists of an:

• 8 minute film and two E posters designed for GP practice staff.
• E-booklet including 5 films on being autism informed for mental health practitioners. The films include; masking, social interaction and communication, sensory differences, appointments and different identities and intersectionality.

Different Minds

4.6 ICD-11 Guidelines for Mental, Behavioural and Neurodevelopmental Disorders

The World Health Organisations (WHO) has developed specialist training for clinicians including 15 modules which cover specific areas of the International Classification of Diseases (ICD) -11 Mental, Behavioural and Neurodevelopmental Disorders. Each unit is designed to take approximately one to one and a half hours and focuses on a different disorder grouping.

The Royal College of Psychiatrists have produced a series of free webinars and the NHS a learning module which is specific to Scotland. You will need to login to your Turas account to view it. Turas is the NHS Scotland’s platform. If you do not have a Turas account you can sign up for one. It is free.

ICD-11 is the international standard for the collection and reporting of health information by WHO’s 194 Member States, which allows for comparison of health data worldwide. To explain the key changes, the Scottish Government and NHS Education for Scotland have developed an animation which provides information for patients, families and carers on what ICD-11 is in an easy to understand and accessibly way, you may find it helpful to view this animation or to signpost patients to this.

4.7 Domestic Abuse Awareness Raising Tool

The Domestic Abuse Awareness Raising Tool is an online training resource for professionals. It provides an awareness-raising introduction to domestic abuse and coercive control. The tool provides an overview of the main considerations when responding to domestic abuse, however it does not replace specialist domestic abuse training. A map to local support services is available at the end.

Violence Against Women and Girls

4.8 Equality, Diversity and Human Rights essential learning

This eLearning module is an update to previous training and is an introduction to equality, diversity, and human rights for health and social care workers in Scotland. It has been developed to meet the essential learning needs of the health and social care workforce in Scotland. By the end of the module, you will be able to:

• State the non-discrimination, equality, and human rights responsibilities you and your organisation have.
• Identify discrimination, harassment, and inappropriate behaviour where you work.
• Identify actions you can take to challenge and prevent inappropriate behaviour.
• Identify the meaning of key words and why language is important.

4.9 Care Planning

Involving people in decisions about their care is intrinsic for all care plans. The Social Care Institute for excellence research on mental health and wellbeing demonstrates people who use services, their families and carers are experts by experience, bringing their knowledge and ideas on how their particular needs for care and support can be met. The Mental Welfare Commission for Scotland have developed Carers, consent and confidentiality, good practice guides at how families can be involved in their relative’s care and treatment.

Health Care Improvement Scotland ihub page explains why person centred care is important, putting the person receiving care at the centre of decision-making creates a personalised, holistic approach to their care and in partnership through shared decision making, helps them feel listened to.

Having person-centred conversations between individuals, their families and/or carers, and professionals helps people communicate their goals and preferences, and gives them opportunities to consider realistic options, and plan for future changes in their health and care. These conversations and any decisions made can be recorded, shared and reviewed. Their involvement leads to improved service outcomes and enhances mental wellbeing.

Health and social care professionals should offer individuals opportunities to take part in care planning conversations, which means talking about what matters most to them when making plans with them.

4.9.1 Personalised Care and Support Planning

Personalised care and support planning is a systematic process based around ‘better conversations’ between the person and their health and social care practitioners. The overall aim is to identify what is more important to each person for them to achieve a good life and ensure that the support they receive is designed and coordinated around their desired outcomes.

The Scottish Social Services Council have developed a range of free resources to improve workers’ understanding of a person outcomes approach and share examples of practice on the Personal Outcomes Network website. The resources have been co-designed with a range of partners, including carers, this ebook focuses on personal outcomes and enabling conversations.

4.9.2 Future Care Planning

Future care planning was until recently referred to as anticipatory care planning (ACP). Healthcare Improvement Scotland have developed a Future Care Planning Toolkit which is a person-centred, proactive approach to help people consider what is important to them and plan for their future care. Undertaking future care planning is particularly beneficial for those:

• living with one or multiple long term health conditions
• living with disabilities and/or complex health and care needs
• whose health and wellbeing is changing or deteriorating due to physical and/or mental health issues
• approaching the end of their life, and
• children and young people with life-limiting conditions.

Future care plans help improve shared decision making but is not a legal document. To find out more about the Future Care Planning toolkit you can visit the Healthcare Improvement Scotland ihub.

4.10 Cultural humility

Cultural humility is the practice of self-reflection used to consider how our backgrounds and the backgrounds of others can impact our relationships. Being culturally humble means being aware of social power imbalances, biases, and respecting other’s values. This eLearning module has been designed to support the development of positive cultural humility values, attitudes and behaviours in the health and social care workforce in Scotland. This is an important introductory learning resource for building a culturally humble workforce.

This resource helps us to begin the journey of developing a cultural humility mindset through being open to what we haven’t learned yet, embracing continuous learning, and promoting equity and inclusion across health and social care. The module explores experiences related to race, ethnicity, language, age, gender, religion, values, and beliefs which have been shared by health and social care professionals working in Scotland.

By the end of this resource, you will be able to:

• understand the concepts that underpin cultural humility
• identify the key behaviours for developing an inclusive workplace
• apply a reflective approach aimed at transforming practice in health and social care.

The module also includes a resource pack of further activities which can be used to guide further learning within your team.

Cultural humility acknowledges that nobody can ever fully understand or master every aspect of a culture, and it encourages a lifelong commitment to understanding and respecting others’ experiences, values, and worldviews.

4.11 Sensory e-learning modules

NHS Education for Scotland TURAS offer a wide range of educational resources which provide guidance and support enhance your ongoing professional development. In order to access the learning, you will need to create an account or log into Turas, and search for ‘sight loss’, ‘hearing loss’, ‘deafblind’ and BSL and Tactile BSL.

Sensory Impairment section

4.12 Unpaid Carers

A carer is anyone who looks after a friend, family member or neighbour who due to old age, illness, disability, a mental health problem or an addiction cannot cope without their support. Within your work, it is highly likely you come into direct contact with unpaid carers. Unpaid carers have a unique role in the life of the person they care for. They have valuable knowledge to contribute to the care and support of the person they care for, and any decision will have an impact on them and on their caring role. If unpaid carers, the person they care for, and workers from health and social care work together as partners they increase the chances of achieving better outcomes for all involved.

Caring, particularly more intensive or stressful caring roles, can also impact on carers’ physical and mental health. The introduction of the Carers Act established rights for all carers to support, information and advice; and to be listened to in decisions about the care and support of the person they are caring for, including a responsibility on health boards in relation to carer involvement in discharge planning. The Triangle of Care helps mental health services support carers in exercising these rights by providing the information, advice and support that carers require to continue in their roles as expert partners in care.

NHS Education for Scotland, has created Equal Partners in Care (EPiC), an educational resource designed to support learning that enables health and social care staff to identify, support and work with unpaid carers as equal partners.

EPiC is intended for all staff who come into direct contact with carers in their day-to-day jobs. It is also intended for anyone with a workforce education and learning role, and/or managers who support the workforce to improve outcomes for carers and the people they care for.

Unpaid Carers

4.13 Digital

4.13.1 Near Me e-learning modules

Near Me is a web-based system which is a safe and secure video consulting service powered by the Attend Anywhere platform, offering video call access to their services.

To access the eLearning modules, you will need to have a Turas Account. Anyone who works or volunteers in or with the public sector in Scotland (including third/voluntary sector or if you work in care homes, care at home or day care) can sign up for a Turas account.

New to Near Me video calls training aims to equip service providers with the capability to carry out a Near Me consultation with confidence.

Near Me: video consultation skills eLearning aims to leave service providers aware of, and confident in applying, the different skills required for video consulting, compared to in-person or telephone consultations.

The Guidance Notes and Case Studies are aimed at staff members. More information can be found in the digital section and in the further reading section, Appendix 2.

The new Digital Health and Care website is aimed at professionals working in the health, care and housing sectors providing access to relevant strategic and policy related information, programme updates, news, blogs and events. Local Digital Health contacts can be found in Appendix 4.

4.13.2 Thriving in a Digital Age Pathways

The Thriving in a Digital Age Pathways are intended to build understanding of the role of digital in health and social care. By working through the pathways you will be challenged to think about what you know and your understanding of working with a digital mindset.

There are four cumulative pathways; Explore, Embed, Drive and Shape. Each pathway contains five steps for you to work through. Each step consists of links to a resource (something to read, watch, or listen to) and accompanying activities to help you reflect on what you have learnt, and consider how you can apply the learning in your own organisation. The themes chosen are developed over the course of the pathways, with each building on ideas introduced in the pathway before.

4.13.3 Digital and Data Capability Framework

The Digital and Data Capability Framework has been developed by NHS Education for Scotland on behalf of Scottish Government and COSLA, and is designed to support the development of digital capabilities for everyone working in health and social care in Scotland.

The framework applies to the entire health and social care workforce in Scotland – NHS, Local Authorities, Health and Social Care Partnerships, Social Work, Social Care, Care and Support Providers, Housing, Third and Independent Sectors – including managers, leaders and those in strategic positions.

Hosted on the Turas platform, the framework identifies the digital skills, knowledge and behaviours everyone needs do their jobs and deliver safe and good quality care and support.

The framework complements existing organisational and professional learning and development frameworks and should be used to improve individual, team and service digital capability and identify any specific learning needs.

Digital Services

4.14 Substance Use Support Resources

4.14.1 Substance use and mental health training

Substance use and mental health training is available on Turas from NES, with specific modules which link to:

• Medication Assisted Treatment (MAT) Standards 6,9 and 10. All are related to psychological interventions.
• MAT Standards 4,6,8,9 and 10. All related to addressing stigma.

In order to access the learning, you will need to create an account or log into NHS Education for Scotland TURAS

4.14.2 Scottish Families Affected by Alcohol & Drugs

Scottish Families Affected by Alcohol & Drugs have developed information sheets which can be printed and posted out to people and include:

• Coping skills – Managing Emotions, the first step in managing emotions is to learn to identify and tune into our feelings and the feelings of others.
• Coping Skills – Ways of Responding, living with and/or caring for a loved one who uses alcohol and/or other drugs is stressful.
• Understanding Substance Use – How do People Change, stopping or reducing substance use can be a difficult process. As well as your loved one’s behaviour, there will be other areas in their life they may have to change.
• How alcohol and drugs can impact your work or education as a family member.

4.14.3 The Scottish Drug Forum

The Scottish Drug Forum (SDF) provide a mix of e-learning and face to face training. Completing SDF training can count towards continuing professional development (CPD) and revalidation for Health Care Professionals. CPD is also applicable to workers registered with the Scottish Social Services Council.

Substance and Alcohol Use Support

4.15 Scottish Recovery Network - Peer Support

Scottish Recovery Network promotes and supports mental health recover. Their work makes sure people with lived experience are involved in a meaningful way in the design and delivery of mental health support.

• Let’s do Peer2Peer – this short animation (1 minute 21 seconds) explores what Peer2Peer is and how to get involved.
• Jasmail is a Recovery Practitioner (Peer) and WRAP Facilitator in Aberdeen with mental health charity Penumbra. In this short animation (2 minutes) she tells us about her experience of bereavement and the positive impact peer support has on her life both personally and professionally.
• Andy’s story – Peer support worker shares his experience of receiving peer support and how it helped him to recover from mental health illness.

To find a peer support service near you, go to ALISS.