Can one-page profiles work in mental health?

Written by Sarah Carr, independent Mental Health and Social Care knowledge Consultant www.sarahcarrassocs.co.uk

Sarah Carr

When I wrote my one-page profile I was thinking specifically about mental health and prevention. I reflected on what helps and hinders me and what makes me feel safe. I think my profile is a very effective tool for self-management – sometimes I lose sight of what can affect me! Because I had complete control over what is in the profile, I represented myself in a way that is true to me – I didn’t have to use a diagnosis, explain my history or fit into a category. I communicated who I am and what I need without having to label myself. In this way profiles can help with overcoming the stigma associated with psychiatric diagnosis and can challenge self-stigma. Like many people with mental health problems, I have a negative view of myself and fairly low self-worth. Here, I was especially challenged by the part where I had to think about what people appreciate and value in me, my gifts and my strengths. Although it was a hard exercise, for me it was a form of therapy. Finding good things about yourself and committing them to writing as part of a profile to be shared so you can be understood fully can be a powerful exercise for someone with low self-worth or internalised stigma. At the moment I’m using my profile to remain aware of what keeps me safe and well (and to remind me of what people value in me!) but if I should experience a crisis again I would use the profile to communicate with mental health practitioners and as a way to aid my recovery – that is recovering my life and self.

As an independent mental health and social care knowledge consultant, my lived experience of mental distress and service-use informs my work. I really wanted to join the conversation about one-page profiles on this blog site because I believe they have the potential to address many of the difficulties that people who experience mental distress or use mental health services often encounter.

One-page profiles in a mental health crisis

If someone is using mental health services a one-page profile can be a powerful way to communicate and maintain their personhood in what can often be a dehumanising, medicalised system. For someone who finds themselves in crisis and is admitted into hospital, a profile can be a very effective way of communicating who they are and what good support looks like at a time when they might not have the capacity or opportunity to do so in any other way. Many people who have been patients in psychiatric hospitals say that they felt reduced to their symptoms or diagnosis and weren’t understood as whole people with interests, strengths, talents and preferences. We now know how detrimental this can be and clinical guidelines are in place to emphasise the person-centred, human elements of mental health support such as empathy, optimism, dignity, respect, support for self-management, emotional support, being known and having appropriate activities. A one-page profile, written by the person when they feel well, with support if needed, can be an effective way to support continuity of understanding about an individual in changing circumstances and fluctuating mental health. They could be used alongside more formal Advance Directives, which are designed so the individual gets a say over treatment and other practical decisions should they become too unwell to make decisions themselves.

In the workplace

Many workers and workplaces struggle with understanding how to recognise and address the stress that can lead to new mental health problems or a relapse of existing ones. Employers may find workplace accessibility and reasonable adjustments difficult to understand for mental health. Stigma continues to be very a difficult issue for people with mental health problems who are job seeking or in employment. But as in mental health services, the solutions are often rooted in simple things like communication and being understood as an individual. Both these aspects are addressed in a one-page profile which could help facilitate a person with a mental health problem to self-manage at work and help their manager or colleagues to be supportive in practical ways. If an individual is having problems with workplace stress or is recovering from an episode of mental distress, the ‘how to support me’ part of the one-page profile can help with implementing reasonable adjustments and ensuring accessibility. Mental health stigma can be reduced and crisis prevention promoted in the workplace if every employee has a one-page profile, designed to communicate individual strengths, preferences and needs to line managers and HR personnel.

To summarise, I think that if used well, in mental health services profiles could significantly improve the experience of users and if applied in the workplace, this simple approach could make it a much safer and more accessible place. In both cases, it’s about being known as a person and being able to communicate what’s important to you, which can help with prevention and self-management as well as getting through a crisis period.

The importance of being involved

An example of how using a theme for a one-page profile can help capture the imagination of the person producing it and those using it. This story shares how an avid football supporter is assisted to have a better understanding of his support team and them to him, by producing a one-page profile.

Written by Sarah Macey

Bob’s one-page profile

Bob is a 57 year-old man with an insatiable passion for football. A season ticket holder and an avid fan, Bob loves everything about Nottingham Forest FC. Bob has a learning disability and has lived in the same residential service for over 20 years.  He has an understanding of his needs and is able to verbalise his immediate desires, although bigger concepts are more challenging.

Over the years Bob has had several similar versions of the one-page profile.  These were usually initiated by new support staff wanting a simple, positive introduction to Bob’s personality without focusing on his disability. More recently the team felt that the one-page profile would assist Bob better if he had greater involvement in producing it. They felt strongly that Bob could and should help design it, which in turn would ensure that they were supporting him in the way that he wanted.

Bob is rarely interested in paperwork but immediately became interested in the profile when staff presented it in a football theme. This was the first step in encouraging his involvement and getting him to start to talk about what was important to him.

Bob used to live with his elderly parents.  Ever since moving into the residential service, Bob has struggled to comprehend the roles of support staff and the boundaries that exist, making references to ‘servants’ and ‘friends’. Using the one-page profile Bob made a correlation between his favourite football team and the support team in his service, this has helped in his understanding of roles significantly.  Bob was asked which role he would personally like to have; he chose to be the owner of the club.  The (staff) team are viewed as there to try their hardest for his club, whilst the manager’s role is to get the best out of the team and occasionally show a yellow or red card if a player (staff member) commits a foul.  Senior managers/auditors are described as fourth officials.

The new one-page profile has had an unexpected outcome for Bob. Because the football theme captured his imagination so well, it has led to him understanding the roles of everyone associated with his service, when before he did not.  Even more importantly for Bob, the profile has emphasised his passion for football.  Not only are the existing staff team more aware of this, but new staff members joining the service immediately know about the importance of Bob’s hobby across his whole life.

Having a one-page profile based on his favourite football club appeals hugely to Bob.  The familiar terms used have helped his understanding of how the staff team are structured and the roles held  by each person.  To staff, Bob is seen as a unique person with a significant social activity that helps to define his life.

Employees don’t fit into a cookie cutter profile

An example of how one-page profiles can improve employee satisfaction. Suzanne’s profile empowered her to express herself, her personality and how best to support her; creating a happier working environment that she feels she can perform well in.

Written by Suzanne Hala

Suzanne’s one-page profile

I am the Marketing and Communication Manager for Real Life Options and I have been with the organisation for over two years following a career in retail marketing. I’m currently studying for an MBA and enjoy running and being active in my spare time.

I use my one-page profile to tell people about important things to me, to make sure that I can be my best. I support various people around the organisation with their marketing projects. Some I have met on lots of occasions and some I only ever speak to on the phone, so it’s good to have a way to seamlessly add a personal touch to everyday interactions

I found out about one-page profiles from being part of the Leadership Team we formed to embed person-centred values into the organisation. Creating our own profiles was the first thing we did as a team. I had no prior expectations about how having a one-page profile might benefit me or others. The concept was very new to me, especially against a background of working in the private sector for manufacturing companies where figures, targets and finance are the only way success is measured. In retrospect it is clear to see how problems arise in organisations where people are not valued as individuals. The profiles do value individuality. They encourage you to record your own personality and to express how others can best support you. As well as finding the process personally very beneficial, it was a great team building exercise, especially when considering what we liked and admired about each other

My profile is available on the public drive on our computer system. Anyone can access it at any point to learn a little more about me. I update it when I learn something new about myself as opposed to updating it because I have changed in some way.

Having a one-page profile at work has made me feel more valued as a person. The one-page profile moves away from the old fashioned perception that employees should fit a cookie cutter profile. Being encouraged to express my quirks, strengths and preferences gives me a sense of feeling important and appreciated as an employee. It makes complete sense as most people are happiest and perform at their best when they are in an environment where they feel able to express themselves and empowered.

Every Little Helps!

An excellent example of how by using a one-page profile and a team profile this professional has been able to put the staff she is supporting at ease quickly when counselling them through difficult situations. As the ‘out of hours’ telephone contact for a social care organisation Mo found she needed a tool that would help her get to know staff on a personal level quickly and for them to feel comfortable and confident in her. Her story describes how she used one-page profiles to do this.

Written By Mo Hunstone

My name is Mo Hunstone. I am 57 years old, Mother of two and Nanna to one. I live in the Salford area of Manchester but was born in the Peak District, Derbyshire; moving away many years ago when I got married. I have worked in Health and Social Care for over thirty years and feel that it is where I definitely belong!

I have seen many cultural changes in social care over the years but none of them have excited me more than ‘Personalisation’, which I believe helps people be fully in control and self direct their own lives!  I have worked for many years for Living Ambitions, based over in Salford and have seen the organisation transformed in the last three years due to our person-centred approaches and I’m incredibly proud to be part of something that genuinely puts person-centred practices at the heart of everything we do – not just for the people we support but, just as importantly, our entire workforce. Living Ambitions fully understands that in order for supporters to deliver person-centred support, they have to feel valued and engaged.

As the organisation developed across the whole of Lancashire, I became part of a wider management team and this is when I personally recognised the importance of team one-page profiles as it really helped me to get to know the managers in other regions whom I did not have day to day contact with. And thanks to our own team’s profile, they could really get to know me too.

When I became part of my organisation’s out of hour’s emergency on-call service (meaning I am required to offer guidance to members of our workforce in other regions to support them around charged and stressful situations), I found the one-page profile an invaluable tool. I recall how hard it was trying to support and be empathetic to staff who I didn’t know very well and who were in the middle of a crisis. I found this very difficult as I don’t like to be just a voice at the end of a phone.

To remedy this, I asked those staff in other regions to complete another person-centred thinking tool called “What’s Working/Not Working” around on-call support. This identified, from their side what needed to be in place for me to give them my best support and I did the same. The outcome was that I updated my own profile and shared it with the rest of the workforce and citizens – this along with other manager’s profiles is now with the on-call numbers so there is a familiar person at the end of the phone. I am now known as Mo, not the on-call manager.

I in turn have an IPad which I am able to access support staff and citizens’ profiles on so I can really know who I am offering advice too – particularly around incident debriefs and it’s the little things such as making reference to their children or interests or telling them to go and grab that coffee with two sugars (as identified on their profiles) – that act as great ice breakers and diffuses – really supporting people coming out of charged situations. Because of this, the people I work with have told me that they feel like I actually know and value them as individuals and that they are not alone in difficult situations. This in turn leads to great workforce engagement and really promotes our person-centred culture which underpins everything we do as an organisation – helping us to stay true to our primary purpose and core values. The little things might not sound much but as Tesco puts it, “Every little helps”!

At the heart of support

A powerful reminder of how what might seem like a small gesture can significantly improve a person’s happiness and wellbeing. Mary was brought to tears when her support team introduced her to the home pet, after stating how important animals were to her in her one-page profile.

Mary’s one-page profile

Written by Lancashire County Commercial Group Care Services

Mary is 75 years old and has dementia.  She was living in a care home and we were asked to see if Mary could move to Beaconview. When we assessed Mary she was laying on her bed with the bed rails up. Mary is registered blind and has had some paranoid experiences. The staff from the home where we saw her said that ‘she liked to spend time in her bedroom’. Mary was very quiet and appeared to be quite isolated.

During our assessment, we asked Mary what her hobbies were and what her preferences were for a variety of things. We also asked her if she really did like to spend all her time in her bedroom, her answer to this was that she liked to spend some time alone. Mary also told us that she loved animals.  From this conversation we were able to create a one-page profile for Mary before she came to Beaconview.

Once Mary’s one-page profile was completed the care staff were able to read it and had an understanding of what her needs and preferences were, whilst also having a clear understanding of what was important to her.  Mary’s experience in moving to her new home was enhanced by the fact that staff were able to have conversations that were more pleasant and personal to her as a result.  Because of this all the staff at Beaconview were able to begin to build a trusting and meaningful relationship with Mary from the very moment she moved in.

We had recently bought a bunny for Beaconview and because the care staff knew from her one-page profile that Mary liked animals they decided to take the bunny to Mary so that she could enjoy its comforts.

Mary’s face lit up when she was informed that the bunny was here to see her, we asked her to put her hands out so that she could feel it. Mary was so pleased that we had ‘thought about her’ and the things she liked that she began to cry. Mary then cuddled the bunny and kept talking to him. Mary never did spend all day in her bedroom after that as she had something to focus her attention on. She felt a great sense of wellbeing each day.

Mary kept thanking the staff for what they did and although it seemed a small gesture on their part it really made a difference to her life.  The care staff were also extremely pleased that they were able to bring her so much happiness.

Having a one-page profile makes a massive difference to a person’s wellbeing, as it helps to build and form good relationships and it makes staff realise from a snap shot what is most important to a person.

The one-page profile is easy to read and easy to understand. This skill is very useful to all other professionals also.

Before we had one-page profiles it was difficult for all the staff to understand what was important to that particular person. The profiles ensure that not only is the person supported in a way that makes sense to them but that what matters to them is also included in their support.  The important bit is to act upon the individual preferences outlined in a one-page profile; truly keeping the person at the heart of all support.