St Columba’s Hospice Care developed its Family Support Team during the COVID-19 pandemic.
Some people who are referred for bereavement support are experiencing an acute reaction to a loved one's illness or death. However, others might have more complex mental health problems including prolonged grief. Some could be at risk of suicide.
To help make sure people get the support they need, when they need it, the hospice developed a new evidence-based care model. This enables staff to assess each individual's mental health needs and refer them to the most appropriate support.
The Family Support Team offers a range of bereavement support services, including adult bereavement support, family and children’s support services, adult counselling, funeral information, spiritual support, and social work.
Previously, these services were provided by different teams all over the hospice, but now they have been integrated under one management structure.
The team aims to:
support patients' friends and family through the normal cycle of grief
assess individuals' needs and refer those who have more complex or enduring mental health issues for more specialist interventions and support
train hospice staff and volunteers to identify grief and mental health issues.
Outcomes
The Family Support Team uses a blended model of in-person, telephone and video-call sessions. This helps them meet the diverse needs of the local community. They are able to reach individuals who might previously have struggled to receive support, for example due to their physical health or living in a remote location.
In 2021, the team delivered 41% more one-to-one sessions to patients and their family members than in 2020. They delivered a further 19% in 2022.
During the pandemic, St Columba's received grants from the Scottish Government’s Wellbeing Fund and from the Tides foundation. This meant the hospice was able to buy secure technology and provide staff with specialist training for remote work.
Online delivery requires different skills to face-to-face therapeutic work. All team members have completed specialist qualifications in online and telephone therapy.
The National Lottery Community Fund and the Arnold Clark Fund provided grants and funding to enhance the Children and Family services. This allowed the team to deliver more support and cover a wider geographical area.
The team conducted extensive research on best practice when they were developing the service. This helped them develop an evidence-based care model that meets the diverse mental health needs of patients and family members.
Challenges
The demand for bereavement and mental health support is vast, and the service has seen an increase in referrals from April 2021. This has put pressure on the team’s capacity to meet everyone's needs.
It can be difficult to distinguish between the normal cycle of grief or adjustment to illness, and chronic, pre-existing medical conditions. Pre-existing conditions may require referral to specialist services.
Referrals for specialist support can be delayed, with patients having to wait months to receive the support they need. The Family Support Team ensures patients have access to 24-hour telephone helplines while they wait for a referral.
From April 2023 they have run support groups to reduce the pressure on the one-to-one bereavement support service.
Tips and Advice
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Train your staff to understand how to identify acute grief, which is a normal part of bereavement, and to recognise when individuals require referral to more specialised mental health services.
Offer services over telephone, video and in-person to widen the net of delivery, and ensure individuals can access care no matter their diverse needs. It is vital for hospices to be flexible when facing changing circumstances and be willing to adapt to the shifting needs of their communities.
Future development
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St Columba’s Family Support Team is planning to enhance its services in a number of ways. This includes:
updating the website to offer more bereavement information for people to download
two new bereavement groups: a “Next Steps” walking group and a time-limited psychoeducational group for adults
a weekly cognitive behavioural therapy (CBT) clinic for depression, panic disorder, post-traumatic stress disorder (PTSD), generalised anxiety disorder, phobias and other relevant mental health problems
an education programme for staff on identifying and treating depression in palliative care.
The team also aims to streamline the referral and carer assessment systems, to simplify the process for patients.
