Junction 17 Brochure - Greater Manchester West Mental Health
Transcription
Junction 17 Brochure - Greater Manchester West Mental Health
our service Junction 17 – Adolescent Mental Health Unit D R EA MS HAPP IN ES S H CO G URAGE E A LIN Junction HO E P R E BE Page 2 LIEVE F U T U Our Service Junction 17 Contents Welcome ..................................................................... Page 04 Services at Junction 17 .......................................... Page 05 Some key facts about the service Where we provide our services ......................... Page 07 Cloughside College Our Teams .................................................................. Page 09 Psychology Nursing Medical Occupational Therapy Social Work Day Service Dietician Journey Through Junction 17 ............................. Page 13 Referral Pathways Models of Care Mental Health Pathways Beth’s Story Spreading the word about mental health .... Page 16 Our Promise to you ................................................ Page 17 Jargon Buster ............................................................ Page 18 Map .............................................................................. Page 19 All the artwork seen within this brochure was produced by patients of Junction 17. Greater Manchester West Mental Health NHS Foundation Trust Page 3 Welcome G ill Green, Director of Nursing and Operations at Greater Manchester West Mental Health NHS Foundation Trust ‘Our professional teams work with young people to build coping skills, confidence and improve relationships with those who are close to them. The services we offer at Junction 17 promotes positive mental health and wellbeing and the specialist care we provide helps ensure each young person overcomes their most challenging times and goes on to lead a positive and productive future.’ “ I’m happy that I got the opportunity to meet a lot of nice people – I’m actually going to miss it! Gill Green ” “ “ Thank you for saving my life ALEXANDRA, YOUNG PERSON The service was fantastic and couldn’t be bettered. I feel J17 has given me back my daughter. ” ” JIM, YOUNG PERSON BEVERLEY, PARENT Page 4 Our Service Junction 17 Services at Junction 17 J unction 17 is a Specialist Adolescent Mental Health Service for young people aged 13-17 who require assessment and treatment for a range of complex mental health difficulties. Junction 17 provides support to those young people with the most complex of needs and who require admission into a specialist unit or require enhanced community services. This includes young people with serious mental illness including: psychosis bipolar affective disorders eating disorders dual diagnosis young people with emerging personality difficulties. Junction 17 provides a wide range of services both in the community and within the state-of-the-art inpatient unit 24 hours a day 7 days a week. In order to support young people in their recovery, we provide a range of interventions for them and their families and carers. These include: building positive relationships engaging them in activities, education and sport supporting them in daily living skills such as cooking, budgeting and shopping. More formal psychological therapies such as cognitive-behavioural therapy, family therapy and art and music therapy are also provided. These may be delivered individually or in a group. Greater Manchester West Mental Health NHS Foundation Trust Page 5 SOME KEY FACTS ABOUT THE SERVICE What the Royal College of Psychiatrists said about the service… Staffing and Training: ‘Staff generally feel supported and valued as members of the team’ ‘The review team were also impressed with the strength of the Multidisciplinary Team’ Care and Treatment: ‘Young people are thoroughly involved in their care planning and the team work hard to ensure this’ Information, consent and confidentiality ‘The unit does as much as possible to provide young people with a good understanding as to why they are on the unit and what plans are in place for them, they are given a welcome pack’ As part of an independent review by the CQC (Care Quality Commission) in 2013, Junction 17 governance structures and discharge pathways were found to be delivering highly commended standards. In July 2013 the Care Quality Commission (CQC) visited junction 17. When reviewing safeguarding systems, the CQC reported that: ‘There was an effective structure in place to protect patients and support staff.’ Some comments from the patients within the report included: “Staff are helpful, friendly and are always approachable” “I do feel respected” “They (the staff) are all very fair and not unkind in anyway” “I am in the right place and I feel staff do everything they can to support me” AWARD WINNING DESIGN In 2014 Junction 17 won ‘Design project of the year’ at the first ever Design in Mental Health Network National Awards (DIMHN). DIMHN Awards showcases outstanding mental health design from around the world whilst bringing together those involved in mental health environments to collaborate and improve outcomes. Junction 17 also won a ‘Building Better Healthcare Award’ for best mental health development in the Building Design Class category. Page 6 Our Service Junction 17 Where we provide our services I n 2013, Junction 17 opened its doors at our site in Prestwich, welcoming young people into the new £10million facility. The two-storey, purpose built inpatient unit also includes a day area for patients attending assessments, therapy, support groups and consultations. “ We enabled the needs of young people to be met in an environment that is fit for purpose, therapeutically designed and age appropriate. The condition of the clinical environments has a significant influence on how patients feel. Research has even suggested that recovery times can improve when patients are cared for in an attractive and therapeutic environment. Dr Shermin Imran ” DR S H E R M I N I M R A N , C O N S U L T A N T P S Y C H I A T R I S T ’ Throughout the design and planning stages, young people, their families and staff have influenced all aspects of the built environment. Also at Junction 17 there are two visitor’s suites for families, a therapy space including an art room, ADL kitchen (Activities of daily living kitchen used by young people supported by staff), activity areas, laundry and kitchen facilities, Clinical Team offices, outside spaces including courtyards and gardens. The onsite college offers a sports and recreational hall, gym and bespoke learning environments. Junction 17 holds twenty bedrooms in total (including five low secure beds) all with ensuite bathrooms. Greater Manchester West Mental Health NHS Foundation Trust Page 7 Male and Female areas We offer five male bedrooms and a male lounge area. We have ten female only bedrooms provided in a female only area with bathing facilities and a separate female lounge. We also have a five bedded area which is open to future development. Two disabled bedrooms are available within the unit. Both males and females will have access to a gender specific outside space on the main ward. Our facility allows us to offer: Provision of services in a safe and secure environment with modern up to date facilities Provision of services that maintain privacy and dignity and meets the needs of a mixed gender service user group Continued provision of high quality and effective models of care CLOUGHSIDE COLLEGE Cloughside College provides education for young people admitted to Junction 17. Cloughside College plays a vital role in the rehabilitation of young people receiving care as an inpatient by allowing them to continue in education with students sitting exams to achieve accreditation in a wide range of subjects. The college ensures that when young people are admitted to junction 17 their education will still be supported by a team of dedicated teachers with specialist skills. The college provides students with full time education promoting their self-esteem and allowing them to reach their full potential, which makes a huge difference to their future academic success and long-term recovery. The college complements the work of the specialist inpatient adolescent service with highly dedicated and skilled staff who encourage their students to take responsibility for their personal development and equip them for their immediate future with support individually tailored for each student. Page 8 Our Service Junction 17 Our Teams J unction 17’s team is made up of highly skilled individuals from a variety of professional backgrounds including Psychiatrists, Clinical Psychologists, Nurses, Occupational Therapists, Social Workers, Arts and Psychological Therapists, Teachers and Dieticians. Domestic staff, Administration staff and Management are also part of the dedicated Junction 17 team. “ What was really good was the work that they have done for me and they have reassured me I will get better. The people in my care are brilliant, a good team of people ” JENNIFER, YOUNG PERSON Every young person at Junction 17 has a dedicated team of people surrounding them to meet their every need. This Team often referred to as the Multidisciplinary team or ‘MDT’ will meet regularly to discuss the young person’s recovery. Multidisciplinary Teams will include: PSYCHOLOGY TEAM “ In order to support young people in their recovery, we provide a range of interventions for them and their families including: building positive relationships with staff and other young people, engaging them in fun activities, education and sport. We also support them in daily living skills such as cooking, budgeting and shopping, and more formal psychological therapies such as cognitive-behavioural therapy, family therapy and art and music therapy. The young people are supported in a developmentally appropriate way to return to challenges and rewards of their daily lives as quickly as possible ” SUE KNOWLES, CLINICAL PSYCHOLOGIST AT J U N C T I O N 17 Sue Knowles Greater Manchester West Mental Health NHS Foundation Trust Page 9 Some staff at Junction 17 NURSING TEAM The nursing team consists of a Matron, Nurse Consultant, Ward Manager, Senior Nurses, Practice Nurse, Team Leaders, Staff Nurses and Nurse Assistants. On admission, young people are allocated a Primary and Associate Nurse who will assess their needs and work with young people to develop care plans aimed at reducing risk and aiding recovery. Nursing staff undertake regular 1:1 sessions with young people throughout admission to monitor progress, maintain stability and provide support to aid the recovery process. “ A lot of the people who come through here find a real comfort in someone just simply lending them an ear and allowing them to talk about their issues. As a nurse, something as simple as talking and being a friendly face can help develop a flicker of hope that their situation can get better. When you see those young people you’ve helped making progress it’s something that makes you come back into work each day. ” M E N T A L H E A L T H N U R S E , J U N C T I O N 17 The nursing team work seven days a week on the ward to provide 24 hour support to young people and carers. The nursing team work alongside the MDT to support ongoing assessments and treatment. The nursing team contribute to weekly review meetings with the MDT, feeding back the nurses perspective on the presentation of the young person to support what treatment options are suitable, and will implement plans of care tailored to the individuals’ needs. The nursing team promote a structured routine to the day, whilst engaging young people in therapeutic activities to promote recovery MEDICAL TEAM The Medical Team achieve best patient care by applying an integrated biopsychosocial model with the multidisciplinary team in understanding, diagnosing and managing mental illness, emotional and behavioural disturbance in adolescents. This is achieved through using knowledge of child development, physical health, pharmacology, psychiatric disorders and substance misuse as well as emotional health and interpersonal relationships. In addition to their clinical role they are involved in leading a safe and good quality service with our operational managers and play an active role in teaching and training the next generation of psychiatrists. Junction 17 medics include Junior Doctors, Advanced Practitioners and Child and Adolescent Psychiatrists who have training and expertise in assessment , diagnosis and Page 10 Our Service Junction 17 management of neurodevelopmental disorders such as Autism, ADHD (Attention deficit hyperactivity disorder), eating disorders, mood disorders, psychotic disorders ,emerging personality disorders, complex emotional and behavioural disturbance in adolescents. The Medical Team ensure a holistic treatment plan takes place for the young people bringing together all disciplinary perspectives to determine what is required for the young person to make progress and ultimately be discharged. OCCUPATIONAL THERAPY Artwork created by a Junction17 The Occupational Therapy Team supports young people Service User through day to day activities and works to increase the young person’s independence and ability to engage in meaningful activities. The Occupational Therapist and Occupational Therapy Assistant encourage and support young people through the use of individual and group activity which can help to contribute to a young person’s recovery. The Occupational Therapy Team facilitate a range of groups during the academic term, in the evenings/weekends and during school holidays. “ Many young people have not worked with an OT before and it is important for them to understand how I may be able to help them as part of their treatment and begin to build a therapeutic relationship with them. I try and find out more about that individual such as their hobbies, interests, likes and dislikes and what makes them tick. I aim to find out how the experience of the illness affects the young person. ” O C C U P A T I O N A L T H E R A P I S T , J U N C T I O N 17 SOCIAL WORK The Social Work Service at Junction 17 provides all young people and their parents/carers with a social care assessment. This looks at identifying further support and help that could be given to the young people that the family could access such as help with housing difficulties, debts or support to claim benefits. The Social Work Team are responsible for the protection of vulnerable children, safeguarding and ensuring that all young people are screened on admission for any safeguarding concerns. The Team liaise with community agencies in planning for discharge and support community social workers who are already involved from the community for example if they are a looked after child. Greater Manchester West Mental Health NHS Foundation Trust Page 11 DAY SERVICE The Day Service is a highly skilled Nurse – led team including, Nurse Consultants, Nurses, Art Therapist, Support Time Recovery [STR] Workers, Teachers, and a Dietician. The Day Service supports young people and their families before, during and after admission, with a range of approaches including individual, group and family work. “ Very impressed with the general expertise and support towards us and our daughter making her stay manageable at a very difficult time emotionally for her ” DAWN, PARENT The Day Service provides alternatives to admission including therapeutic care, specialist mental health interventions, meaningful activities to maximise recovery and specific individual programmes of care including art therapy, dietetic sessions, family/carer therapy, group activities and therapies. Patients may also be discharged and still receive ongoing support from the Day Service. The Day Service works in partnership with Community Adolescent Mental Health Services (CAMHS) and offers assessment, rehabilitation, transition from hospital, more intensive community support and an alternative to hospital admission. ART AND PSYCHOLOGICAL THERAPY Artwork created by a Junction17 Service User The Art Therapist at Junction 17 works with young people both individually and in groups depending on the needs of the young person. Art Therapy assessment can serve to contribute to the overall assessment process and to a multi-disciplinary understanding and development of formulation. Following initial assessment, a decision is made in collaboration with the young person about engaging in ongoing work during admission and the suitability of group and/or individual work. Art Therapy is practiced within a psychodynamic framework with attention to thinking about a young person’s internal world and relationships. The aim is to provide a safe and containing space in which a young person can be supported to engage in art making as a means of self expression. For some young people the opportunity to use art as a way of thinking with someone else about themselves can be less threatening than direct verbal communication. DIETICIAN “ People understood the problems that my child came in with and tried their best to solve them ” The dietician works on an individual basis with young people who are identified as having possible/diagnosed RHYS, PARENT eating or nutritional problems, within the inpatient unit, day service and out-patient service. Individual dietetic work includes dietetic assessment, nutritional education, dietary advice and treatment planning, and review and monitoring of dietary treatment plans, as well as liaison with families or carers. Nutrition education may also be offered in a group format. The dietician is involved in contributing to the general health and wellbeing of all the young people on the unit through a variety of activities including liaison with the catering department, involvement in the development of policies/procedures relating to nutrition, staff training, health promotional activities and nutritional screening. Page 12 Our Service Junction 17 Journey through Junction 17 REFERRAL PATHWAYS Patients are referred through a number of routes including: Community Child and Adolescent Mental Health Services (CAMHS Tier 3) Accident and Emergency Departments Paediatric Inpatient Wards Young people are only admitted to Junction 17 if they are in crisis or cannot be safely cared for by community services or other alternatives. Junction 17 provides inpatient care and treatment in the least restrictive environment. MODELS OF CARE Our Models of Care are recovery focused and tailored to suit the needs of the young people Junction 17 (CAMHs Tier 4) cares for young people who require assessment and treatment for a range of complex mental health difficulties. Patients are cared for by a clinical team including the Responsible Clinician and the MDT who are responsible for ensuring high quality Recovery based interventions. Individualised care packages are developed collaboratively with the young person, their families and carers and the MDT. Patients can be admitted voluntarily to the service or subject to detention against their wishes. Interventions include mental health nursing interventions, psychological interventions, cognitive therapy and dialectical behavioural therapies, systemic interventions, occupational therapies and pharmacological based treatments. Care and treatment is provided in line with the Care Programme approach ensuring full involvement of the local mental health services responsible for the young person’s care on discharge. Greater Manchester West Mental Health NHS Foundation Trust Page 13 MENTAL HEALTH PATHWAYS Ben Ben is fifteen and has recently been having difficulty with feeling down, low mood, poor sleeping pattern and thoughts of self-harm. He was referred by his GP to Local Community CAHMS Services. Unfortunately he began to deteriorate and a Community Worker referred him to Junction 17 for a period of assessment and treatment. Ben was able to engage with a number of therapeutic approaches including psychological intervention, group work and cognitive behavioural therapy, has his primary nurse and assistance with his motivation as well as medication to help lift his mood. The clinical teams, Ben and his family agreed he had improved so much that he could spend time at home on a period of leave which went well. For a further week Ben remained an inpatient and the local services met with the MDT at junction 17 with Ben and his family. Ben was discharged home with therapeutic support Victoria Victoria is a 16 year old female experiencing anorexia nervosa and low mood. She was admitted to Junction 17 with a body mass index of 17 (underweight). Victoria started dieting six months prior to her admission and had lost 16kg in weight. Her weight loss was due to a reduction of food intake and excessive exercise. Victoria believed that she was overweight and perceived herself as obese; she weighed herself regularly and was persistently looking in the mirror to check her perceived areas of fat. Initially Victoria had ongoing difficulties in engagement with the team, due to her belief that the goal for her admission was to make her fat. Her ability to co-operate with treatment remained very limited and highly fluctuating. Due to the concerns about ongoing risks to herself she was detained against her wishes under section 3 of the Mental Health Act. Victoria was given antidepressant medication which helped with her low mood Victoria’s care and treatment consisted of 1-1 sessions with her key nurse, psychology, occupational therapy, art therapy, family therapy, dietician input and physical health monitoring. The range of therapeutic interventions Victoria accessed included cognitive behaviour therapy; thinking skills therapy and psychosocial interventions. Victoria gradually improved with extensive support from the multidisciplinary team and her family. Victoria’s weight increased and she began to understand how her negative thinking impacted on her wellbeing . Approximately seven weeks into her treatment she became an informal patient and was discharged from hospital (as she was no longer deemed a risk to herself) Following this, Victoria’s care was transferred to the Junction 17 day service. She continued to receive therapy, dietician input and 1-1 sessions with the eating disorder nurse specialist for a period of eight months. Victoria is now in control of the anorexia nervosa and has completed a two year course in health and social care. She has been accepted for a place at university to study children’s nursing. Pseudonyms are used in the case studies and quotes from young people, parents and carers to protect the identity of that person. Page 14 Our Service Junction 17 RECOVERY FOCUSED SERVICES At Junction 17 we focus on recovery through all aspects of our services and emphasis goes on understanding the condition of the young person and learning to manage this through everyday life. “ I was given strategies to cope with difficulties and people listened to my problem and helped ” TOM, YOUNG PERSON We work with the young people to support, identify and work towards their personal goals and ambitions. RECOVERY - BETH’S STORY For 18-year-old Beth, a battle with an eating disorder and depression led to her being sectioned under the Mental Health Act, but being detained against her will marked the start of her road to recovery. “Loads of people just think, ‘Oh get a Big Mac down you and you’ll be fine,’ but yes you might be physically underweight, but it’s more mental. It’s like you’ve got another person that’s got inside your head and they’ve taken over you,” “It’s not you any more. It’s them in charge and they say you’re not allowed to eat, that you’ve got to exercise.” “Anorexics do get hungry, but we just learn to ignore it and fight it off and then food just becomes the enemy.” Beth was put on the Rainbow programme, a structured treatment plan for those suffering from anorexia, with the aim of achieving a healthy weight-to-height ratio. The programme means supervision during and after meal times and if a person is struggling with solid food, they can have a supplement drink instead. Despite the additional supervision, Beth continued to refuse to eat and three months after being admitted to the unit in December 2012 she was detained under section 3 of the 1983 Mental Health Act. After being sectioned she began to comply more with the Rainbow programme and agreed to be weighed for the first time. She made so much progress she was able to eat unsupervised at mealtimes. After spending six months in the unit, Beth’s section was removed and she was discharged in April 2013. She says it was important to seek help, because battling a mental illness is not something you can fight on your own. She is now planning to study to become a physiotherapist and has the energy to take up dancing again, which she enjoyed before she became ill. “My mood is 100% better because I’m on the right medication now, and I’m just so happy now with my life, but food wise it’s still a bit of a struggle sometimes, but I’m getting there.” Greater Manchester West Mental Health NHS Foundation Trust Page 15 Spreading the word about Mental Health At Junction 17, we aim to spread the word about mental health in order to help put an end to stigma as 1 in 10 young people will experience a mental health problem. In 2012, Junction 17 (previously the McGuinness Unit) chose to take part in a three part documentary for the BBC in order to raise awareness of young people experiencing mental health problems. The hit documentary ‘Don’t Call Me Crazy’ was part of the mental health season ‘It’s a Mad World’ on BBC3 which aimed to tackle the stigma often associated with mental health problems and to shed light on various aspects of mental health. The programme gave a voice to the brave young people who took part as they used their own words and experiences to speak frankly and openly about what it is like to receive specialist mental health care. “ Starvation, compulsions, restraint, MH Act - issues of control stood out on #DontCallMeCrazy but patience of staff came through just as much. ” PROFESSOR LOUIS APPLEBY, NATIONAL DIRECTOR FOR HEALTH AND CRIMINAL JUSTICE AND PROFESSOR OF PSYCHIATRY AT THE UNIVERSITY OF MANCHESTER “ We see how important family and their support is to recovery” #DontCallMeCrazy B E A T ED, ” T H E UK’ S N A T I O N A L C H A R I T Y FOR PEOPLE AFFECTED BY EATING DISORDERS AND THEIR FAMILIES Page 16 “ Appearances can be deceiving” & “Anorexia is not a lifestyle choice” lessons to take from #DontCallMeCrazy ” MIND CHARITY Our Service Junction 17 Our Promise to You J unction 17 is part of Greater Manchester West Mental Health NHS Foundation Trust. As part of the Trust’s Values into Action initiative, five values to which the Trust subscribes were developed by service users and staff working together. The Trust’s values were born out of workshops undertaken in the summer of 2012 in which staff and service users came together to define what the essential messages of great care were. “ I always felt my daughter was in the best possible place and that I could trust each and every member with her welfare. Every person that was there is so obviously dedicated to their job “ ” JAMES, PARENT The staff were genuinely concerned about my safety and were very considerate towards my needs. I felt the staff were there for me ” KERRY, YOUNG PERSON OUR VALUES We are welcoming and friendly We show this by smiling and acknowledging others, using open and appropriate body language, giving our full attention, being polite and using your name, being a friendly professional. We are caring and kind We show this by putting ourselves in your shoes, treating others in a manner we would want for our own family and friends, being genuinely concerned for the wellbeing of others, giving hope and inspiring confidence, treating others with warmth and compassion, offering to help – not waiting to be asked. We value and respect We show this by doing what we say we will do, apologising if we are wrong or if we have let you down, seeing the individual in everyone, being honest – we are all human, seeing the person, not the illness. We work together We show this by supporting others to make informed choices, listening and hearing what you are saying, giving support when it is needed – not just when asked for, empowering people to engage in their own care, being interested in others and showing understanding. We go the extra mile We show this by choosing a ‘can do’ attitude, being helpful and exceeding expectation, going out of our way to make a difference to others, not just saying ‘no’ – seeking solutions or alternatives. Greater Manchester West Mental Health NHS Foundation Trust Page 17 Jargon Buster Biopsychosocial - general model or approach positing that biological, psychological, and social factors, all play a significant role in human functioning in the context of disease or illness. Cognitive Behavioural Therapy or CBT - Cognitive Behavioral Therapy (CBT) is a talking therapy that can help you manage your problems by changing the way you think and behave. MDT or Multidisciplinary Team - A team or group consisting of representatives from several different professional backgrounds who all have different areas of expertise. Pathway - The different routes to recovery for young people with mental health issues (See mental health pathways section for different examples) Psychodynamic - is an approach to psychology that emphasises systematic study of the psychological forces that underlie human behavior, feelings, and emotions and how they might relate to early experience. Section 2 - Is a civil section that can last up to 28 days with the purpose of making an initial assessment of the patient in order to see if they may need treatment. Section 3 - A civil section that can last up to six months. It can be renewed for a further period of six months and after that every 12 months. Tier 3 - Provides services for children and young people with severe, complex and persistent mental health conditions, such as obsessive compulsive disorder (OCD), bipolar disorder, and schizophrenia. Tier 4 - Provides specialist services for children and young people with the most serious problems, such as violent behaviour, a serious and lifethreatening eating disorder, or a history of physical and/or sexual abuse. Use of mental health act - For a small number of young people who are particularly distressed and are struggling to accept that they require help, there may be a need for them to be kept in hospital against their wishes and prevented from leaving. This means a young person is detained under a legal order under the Mental Health Act, a ‘Section’. This allows for a young person to remain in hospital for a sufficient period of time, to either assess or treat their mental health difficulty. Detention under the Mental Health Act is undertaken with the consent of the young person’s parents or nearest relative. Page 18 Our Service Junction 17 To M62 to Leeds Map N PRESTWICH A56 Bury New Road To Manchester Junction17 TGI Friday’s Creative Living Centre Information and Finance M60 Occupational Health Social Work * & Other * Depts * * * Contracts Lowry Ward * Kingsley Ward CP * * Personnel Recovery, Health & Well Being Academy Offices * Psychology M60 to Stockport to M61 to Preston and to M62 to Liverpool Main Car Park * * * * * * Pharmacy Trust Library & Knowledge Centre * CP Waterdale Restaurant and Conference Room Car Park Car Park * CP Chapman-Barker Unit * CP Junction CP * National Centre for Mental Health and Deafness: John Denmark Unit Car Park Key Not to scale Main entrance to building: * Car Park: CP Tesco * Finance Trust Management Offices Drive up slowly to the barrier and it will rise Junction17 * Adolescent Forensic Psychiatry: Gardener Unit To Edenfield Centre (0.5 miles) Greater Manchester West Mental Health NHS Foundation Trust Page 19 CONTACT DETAILS: Junction 17 Greater Manchester West Mental Health NHS Foundation Trust Trust Headquarters Bury New Road Prestwich Manchester M25 3BL Junction Tel: 0161 773 3678 www.gmw.nhs.uk www.facebook.com/GreaterManchesterWestNHS www.twitter.com/GMW_NHS www.youtube.com/user/GMWMentalHealthTrust Page 20 Our Service Junction 17