What does a successful move-on look like in our mental health recovery communities?
Making the decision to move on from our mental health recovery communities, especially when it’s a place you’ve called home, is a significant milestone in our residents’ journey.
In this blog post, we explore what makes a transition from care successful, through a conversation with Ryan Burke, the Senior Service Manager at our Therapeutic Recovery Communities.
Ryan discusses how someone might start to feel ready to move on, the importance of collaborative planning, and how our residents’ voice must be central to every transition from our care.
If you are a resident in one of our services, we hope this post provides some insight and reassurance about what moving on from our support might look like for you. And if you are a family member, care team or other healthcare professional, we hope you find it useful for understanding how we support residents on their journey to recovery.
Can you tell us a bit about yourself and describe what life is like in our Therapeutic Recovery Communities?
My name is Ryan, and I’ve been the Senior Service Manager for CHT’s four Therapeutic Recovery Communities since 2022. Our Therapeutic Recovery Communities in Richmond, Southall and Surbiton are homes where our residents have private bedrooms and shared living facilities, and where our team supports them to participate in therapeutic activities and community life. Each provides a supportive, structured environment where residents develop life and social skills through groups and activities, and by taking shared responsibility for running the community. All residents have access to regular, onsite one-to-one psychotherapy, and we support them to develop the skills and confidence to manage difficult emotions, their symptoms and life’s challenges.
Supporting residents to build positive relationships with peers and staff is central to our approach, as is helping residents have a say in how we can improve our services, make informed choices about their care, set goals, and, over time, take on more responsibility.
The journey to recovery takes time, and no two journeys are the same. It’s hard work, and it can take a lot of courage to open yourself up to being part of a community, especially if you haven't had many supportive relationships in the past or if you’ve been let down by services.
That’s why a big part of what we do is to provide time and encouragement to create space to discover what’s possible.
How do you know when someone is ready to leave the community?
Our support is offered for as long as it’s needed, so there isn’t a timeframe that people have to work to in order to be ‘ready’ to leave care. There also isn’t a set definition of what it feels like to be ready either - that’s something that's deeply personal to each resident.
What is important is that the decision of whether and when to leave our care is made collaboratively with the resident, and it’s something that’s grown and negotiated over time. There are lots of things to consider together when planning to move on, like how moving on fits with a resident’s recovery goals, how well they feel able to manage day-to-day life, such as managing medication or their tenancy, accessing support and advocating for themselves; these are all positive indicators of readiness.
How do you plan with residents how to move on from care?
Planning for move-on begins early in a resident's recovery, and forms part of their recovery plan. We’ll start discussions through residents’ quarterly reviews, and that will usually involve bringing in their wider support network, such as their social worker, care coordinator, or community mental health team.
When they feel ready to move on, together with the resident, we set a timeframe to manage the process. We always make it clear that decisions won't get made in just one meeting - it's usually over the course of several reviews. With a planned move-on, we’d usually put together a three - to six-month plan. But sometimes time frames can be shorter due to an urgent or immediate need. Either way, with a timeline in place, it’s then all about making sure the resident feels supported, because change and leaving your home can feel unsettling.
How do you manage the challenges of moving on, and what support do you provide?
Anticipating the challenges of moving on and talking openly about them can provide reassurance. The more information somebody has, the easier it is for them to manage the transition. It also gives our residents more opportunities to share what is happening in their lives. We always reassure residents that their needs might change over time, and that’s completely normal and part of the journey. Wanting more or different support is OK, and it’s something we can plan for together - it’s not a sign of failure but a positive sign that someone is aware of what they need to go forward.
We also emphasise at every step of the way that move-on is about what’s right for them, not what feels right for us, or their key worker or a family member. The purpose of move-on is about the longer-term journey, and success should be for the resident, not anyone else.
How would you define a successful move on?
We could define a successful move-on as being ready and able to transition to lower support or to independent living. But that’s not always the path that a resident’s journey will take. Sometimes a resident might take a sideways step into another service, or even require higher support. But as long as their opinions and needs are heard, they are involved throughout the process, and the best decisions are being made for them, that’s still a success.
Before joining our communities, many residents have not been able to be part of decisions about their care or treatment, or have felt excluded from the process. This can put them at risk of agreeing to a service or placement without feeling it was the right choice for them or fully understanding what was involved.
One resident, before coming to CHT, had extended periods on the streets and had been in and out of homelessness services, often placed in accommodation as an emergency provision. When we first met them, they had given up on having a say over where they went. They often spoke to their key worker about feeling as if “those with mental health challenges are treated as if they don't deserve the nicer things in life”.
This resident has since moved on from our care because their needs changed while with us, and they needed higher support than we could offer.
Although this might not be seen as a ‘successful move on’ in performance metrics, this move on was hugely successful for the resident, who finally had a say in where they went next.
We supported them in visiting and considering multiple services before they made a final decision on moving on. They actually declined two services before settling on a place they felt comfortable in, with a level of autonomy the resident had been denied in previous placements.
So, a successful move-on is not about reaching a ‘perfect’ ending. It's about working alongside our residents on what feels right, supporting them throughout their transition – whatever that looks like – and ensuring they are listened to and have a say in what matters to them.
