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Skills ethos helps find work for mentally ill

Perched on a hillside overlooking Bristol, Colston Fort looks like just another modern office building. But this is an assessment and training unit for the mentally ill.

Carpeted corridors lead to well-equipped offices and workshops. The atmosphere is more business-like than clinical and the people who pass through here are not referred to as psychiatric patients - they are trainees.

The aim is not just to provide rehabilitation for the mentally ill, but to give a grounding in basic skills, and proper accreditat ion which can be used outside.

And the training ethos does not only affect those going though the rehabilitation process. Healthcare staff at Colston Fort are also taking a nationally-recognised qualifi-cation to train and assess former patients in-house in a variety of vocational areas.

Thanks to a partnership between owners United Bristol Healthcare NHS Trust and City of Bristol College's Accredited Training Centre, the work at Colston Fort is now attracting considerable interest from other trusts, says Roger Butterworth, the trust's work development officer.

He said: "Staff have background experience in mental health, but in the foreground is their capacity to deliver effective training to NVQ standards - and at a stroke we change our health culture, marrying it with a culture of the college.

"I think we are on the way to becoming a centre of excellence. We have looked at best practice in the rest of the country and we sought to build on it."

In April 1996, Mr Butterworth produced a report called Getting Back to Work, based on a survey of the occupational needs of psychiatric patients in Bristol.

Of those interviewed, 78 per cent had previously been employed and in most cases deterioration of mental health caused them to lose their jobs. A third had had more than five employers in the past 10 years, illustrating their difficulty in holding down a job. And 87 per cent wished to return to work.

"Essentially we were setting up people for failure because there was no cohesion between the employment service and between health and vocational guidance provision," said Mr Butterworth.

Colston Fort's training ethos is part of the solution, he believes. "This place is geared up to assisting people with enduring serious mental health problems, like schizophrenic conditions, major psychosis.

"The common thing with this client group is that they all had a bad experience educationally - lots of bullying, and through that demoralising decline in their mental health, low self-esteem has also come in. That's even with people who before their illness might have been high achievers.

"It is a slight contradiction - we have people whose mental health broke down while they were in the middle of university courses, but in the succeeding years they have lost all confidence in their own abilities.

"What we have done here is to create a centre where we work intensively with people over an 18-month period and we carry out assessments in terms of their mental health, their personal effectiveness, their occupational skills and their domestic skills.

"People have been living in the main disorganised and fragmented lives. Our aim is to create a pattern, and a sense of daily routine and occupation. Supporting that, we have the usual battery of psychiatri c support, and we also have areas where people can practise and develop work skills in a working environment."

The building includes an IT and office skills department, a carpentry workshop, kitchens and a cafe run by trainees, and craft workshops.

Everyone who works in the kitchen gets a basic qualification in food and hygiene. And in the carpentry shop, trainees may soon be able to take NVQ level one.

"We'll become like an accredited centre," says Mr Butterworth. "It's important that wherever possible, people can go and use the colleges. But we want to start people off because otherwise we'll just create a mental health ghetto."

Jane Beckinsale is a speech and language therapist at Colston Fort. She has found her job shifting from therapy towards education, as she tackles literacy problems and runs creative writing groups.

"There are some trainees who have quite specific speech and language problems who I might do therapy with at the beginning of their time. The majority might have difficulty in general communication and that's much more at the training end of the continuum."

In another part of the building, the staff are having their own tutorial on group dynamics. Four staff members have already completed their City and Guilds further education teacher's certificate, and another four are taking it.

Their tutor, Carol Haynes, says: "We're giving them general teaching skills. Communication - that's what we're working on at the moment. Evaluating their own work, their teaching methods and getting feedback from their clients, managing their resources and planning.

"I think one of the main things is to bring more structure into their working areas. The foundation training is a good way for them to do that, and for their clients to get accredited."

Sandra Leach, a technical instructor in office skills, agrees: "It's quite important because we are surrounded by professionals in other branches of this unit. If we can be seen as having some relevant qualification ourselves, we can be taken more seriously - it adds credibility."

Pivotal to all of this has been the partnership with City of Bristol College's Accredited Training Centre and the use of the ASDAN (Award Scheme Development and Accreditation Network) foundation training award, a qualification which recognises achievement of a range of basic employability skills.

Ian McIlvaney, who helped to set up the award scheme at Colston Fort, says: "I'm a firm believer in this qualification. What I like about it is that you can do it with anybody, of any age, of any ability, doing anything.

"I've done preparatory level here with a semi-literate grave-digger. And I've done exactly the same thing, but at a higher level, with somebody who's been working for a Government think tank."

Dave Brockington, head of the Accredited Training Centre and also research and development director of ASDAN, believes the foundation training award will become much more widely used under Labour's New Deal.

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