Derwent Clinic



|[pic] |3rd Annual |

| |EPIC Mental Health |

| |Update Conference |

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| |Engaging as |

| |Partners in Care |

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Thursday 22nd November 2018

9.30am- 4.30pm

(Registration and refreshments from 8.45am)

Principal York Hotel

YO24 1AA

Workshop Synopses and Presenter Biographies

Workshop 1: 11.00am to 12.30pm

|GENDER DYSPHORIA |

|Dr Helen Marie Greener. Consultant in Gender Dysphoria, Northern Region Gender Dysphoria Service. Northumberland, Tyne and Wear NHS Foundation Trust |

|Professor Marios Adamou. Consultant Psychiatrist in Neurodevelopmental Psychiatry (ADHD and ASD), South West Yorkshire Partnership NHS Foundation Trust. |

|Workshop synopsis |

|This workshop will enable delegates to develop an understanding of gender dysphoria. There will be a focus on how to support individuals experiencing gender |

|dysphoria, the challenges they face, the services currently available and what is delivered by those services. A significant proportion of patients with gender|

|dysphoria are found to have high Autistic Spectrum Quotient scores. Marios will explore current thinking in this area. |

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|Biographies |

|Dr Helen Greener is a Consultant in Gender Dysphoria and Clinical Lead at the Northern Region Gender Dysphoria Service, at Northumberland Tyne and Wear NHS |

|Foundation Trust, based in Newcastle. The service is one of England’s seven national clinics for the assessment and treatment of gender dysphoria in adults. |

|She has been a member of NHS England’s Gender Identity Clinical Reference Group for 5 years and is Secretary-General of the British Association of Gender |

|Identity Specialists.  She originally trained in Old Age Psychiatry and has a specialist interest in mental capacity.  |

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|Email: HelenMarie.Greener@ntw.nhs.uk Telephone: 07917 557501 |

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|Professor Adamou is a Consultant Psychiatrist in neurodevelopmental psychiatry (ADHD and ASD) at South West Yorkshire Partnership NHS Foundation Trust. He is a |

|Visiting Professor at the University of Huddersfield, Board member of the East Ridings Clinical Commissioning Group and Regional Advisor for the Yorkshire and |

|Humber Region. Professor Adamou heads one of the largest services in the country providing assessments and interventions for people with ADHD and ASD. His |

|research focuses mainly on service provision in ADHD and ASD. |

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|He has academic qualifications in a number of disciplines. He completed postgraduate degrees (MSc) in Mental Health Studies, MA (History), LL.M (Medical Law), |

|MBA (Business Administration) and PGCE (Medical Education). He earned a postgraduate diploma in Occupational Medicine (DOccMed) awarded by the Faculty of |

|Occupational Medicine of the Royal College of Physicians. He completed a PhD by research. |

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|He is a Fellow of the Higher Education Academy (FHEA), the Royal Society of Arts (FRSA), the Royal Society of Public Health (FRSPH) and the Society of Biology |

|(FRSB). He is a Chartered Fellow of the Chartered Management Institute (CMgr MCMI) and Chartered Fellow of the Institute of Directors (CDir FIOD). |

|Email: Marios.Adamou@swyt.nhs.uk Telephone: 01924 31649 Twitter: @DrMariosAdamou |

|MANAGING TREATMENT RESISTANT ANXIETY AND DEPRESSION |

|Dr Baxi Sinha. Consultant Psychiatrist (Stockton Access and Affective Disorders), and Associate Clinical Director (Adult Mental Health Teesside) |

|Workshop synopsis |

|This workshop aims to provide delegates with the knowledge and skills necessary to: |

|Recognise and evaluate treatment resistance in management of anxiety and depression (and differentiate from some closely related conditions) |

|Be more confident in using strategies for managing treatment resistance in primary care |

|Know which medications to use, and when |

|Know how to refer to the appropriate service if secondary care intervention is required |

|Biography |

|Dr Baxi Sinha completed his training at Central Institute of Psychiatry (CIP) in India and has been working as a Consultant in the TEWV Trust for about 10 |

|years. His clinical role is in the Stockton Access and Affective Disorders Teams; he is also the Associate Clinical Director of Adult Mental Health in |

|Teesside. He takes an active interest in teaching and training and contributes regularly to post graduate teaching sessions, he is currently the Senior FP & GP|

|Tutor for the TEWV Trust. He has contributed to research and development, published some research papers, has helped on editorial boards of journals, does peer|

|reviews; he was involved as a Principal Investigator in the ADD Study [Antiglucocorticoid augmentation (metyrapone) of antidepressants in Depression (ADD |

|Study)] and has also helped in the LABILE trial (Lamotrigine And Borderline personality disorder: Investigating Long-term Effectiveness trial). His areas of |

|special interests include treatment of depression, and Personality Disorders and its co-morbidities. |

|Email: baxi.sinha@ Telephone: 01642 368636 / 368600 |

|PERINATAL MENTAL HEALTH |

|Dr Natalie Smith. Consultant in Perinatal Psychiatry. Tees Perinatal Mental Health Team. |

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|Workshop Synopsis |

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|This workshop recognises the importance of perinatal mental health and the challenges for GPs, and includes information and advice on postpartum disorders and |

|prescribing during pregnancy and breast feeding. There will be some brief information on the Perinatal Psychiatry Service delivered by TEWV. |

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|Biography |

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|Appointed as general adult consultant in TEWV in 2012, Natalie has had a special interest in perinatal psychiatry for many years. She developed the perinatal |

|service in Teesside, initially as a non-commissioned service and now as part of a commissioned team across Tees. Natalie hopes to support the Trust in |

|developing perinatal services across other areas of TEWV also. |

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|Email: natalie.smith13@ Telephone: 01642 368303 |

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|UNDERSTANDING AND MANAGING TRAUMA |

|Dr Rachael Hall. Consultant Psychiatrist (Inpatients). Lanchester Road Hospital, Durham. |

|Workshop synopsis |

|This workshop will cover: |

|an overview of why trauma is relevant, how it is defined, and the related facts and figures |

|the physiology of trauma and how it affects the brain |

|clinical presentations such as PTSD, complex PTSD and dissociation |

|management principles and trauma informed care |

|interactive case examples |

|top tips for GPs and their teams |

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|Biography |

|Dr Hall is an inpatient consultant psychiatrist based at Lanchester Road Hospital in Durham. She graduated from the Hull York Medical School in 2008 and |

|completed her foundation programme training at James Cook University Hospital in Middlesbrough. She went on to complete the majority of her core and higher |

|training in psychiatry in TEWV. She achieved her CCT in General Adult Psychiatry with an endorsement in Liaison Psychiatry in July 2016. |

|Dr Hall has a keen interest in quality improvement and the development of acute mental health services, improving the physical health care of people with severe|

|mental illness, and medical education. As she settles into her new role she hopes to build on existing partnerships between local inpatient/crisis services and |

|primary care and third sector organisations. |

|Email: rachael.hall6@ Telephone: 01642 837398 Twitter: @RDoyleHall |

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|Workshop 2: 13.30pm to 2.45pm |

|BEHAVIOURAL ACTIVATION FOR THE TREATMENT OF DEPRESSION |

|Professor David Ekers. Nurse Consultant and Honorary Visiting Professor. Tees Esk & Wear Valleys NHS Trust / University of York (Mental Health and Addictions |

|Research Group) |

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|Workshop synopsis |

|This workshop will provide delegates with a solid overview of the use of behavioural activation for the treatment of depression. In summary, it will cover the |

|following: |

|Theoretical background and the latest research findings in behavioural activation |

|Delivery of behavioural activation for depression across TEWV and beyond |

|An introduction to the relevant techniques that can be used by GPs and practice nurses |

|Secondary care services available, who they are for, and how to refer |

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|Biography |

|Professor David Ekers is a Nurse Consultant at TEWV NHS FT and Honorary Visiting Professor at the Mental Health and Addictions Research Group (MHARG) at The |

|University of York. He has led or collaborated in a range of studies exploring the utility of behavioural activation (BA) across a range of health settings. He |

|is the Chief Investigator on the Community Pharmacy Mood Intervention Study exploring BA focussed health promotion to adults with sub threshold depression and |

|long term physical health problems and  a 6 year NIHR Programme Grant, Multi-Morbidity in Older Adults  (MODS).  He is an international collaborator on the |

|Australian BAN-Dep Study. |

|David is the North East North Cumbria Mental Health Speciality Lead for the Clinical Research Network, a committee member for NICE and the NIHR HTA funding |

|panel. David is a strong advocate for nursing research, the potential nurses hold to lead large, innovative and pragmatic research studies. |

|Email: david.ekers@ Telephone: 0191 3740068 Twitter: @DavidEkers |

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|EATING DISORDERS: WHAT A GP NEEDS TO KNOW |

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|Nicola Birkin. Specialist Practitioner in Eating Disorders, South West Community Mental Health Team |

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|Workshop synopsis |

|The workshop will support you to be confident in: |

|understanding who may be at risk of developing an eating disorder and what places them at risk |

|how to recognise a patient with an eating disorder within general practice |

|how to engage a patient with an eating disorder, key tips and what not to say |

|what might help carers/families cope |

|what physical investigations are useful and how to interpret them |

|when to refer, and what help should be available |

|what community teams deliver and what specialist teams deliver |

|what interventions/treatments are valuable |

|how to recognise an emergency |

|when to use the MHA |

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|Biography |

|Nicola Birkin – biography to follow |

|Email: nicola.birkin@ Telephone: Tel: 01904 736100 |

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|ADULT ADHD FOR GPs |

|Maria Mazfari. Associate Nurse Consultant Adult ADHD. |

|Tina Profitt. Clinical Nurse Specialist Adult ADHD. |

|Specialist Adult ADHD Service in the North East of England, based in Stockton-On-Tees. |

|Workshop synopsis |

|Using presentation and group discussion, clinical management and resources will be explored, this workshop will provide information for GPs around: |

|what adult ADHD is |

|assessment, diagnosis, and management of ADHD |

|NICE guidance for ADHD in adults. |

|tips and resources on how to support patients, carers and families within the general practice |

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|Biographies |

|Maria Mazfari is a Registered Nurse in Mental Health (RN/MH) she has a Diploma in Mental Health Nursing, a BSc Hons Degree in Mental Health Nursing, an MSc |

|Specialist Field Nursing Degree and is a Non-Medical Prescriber. |

|Maria is an Associate Nurse Consultant within a Specialist Adult ADHD Service. Previous roles have involved; Staff Nurse on a psychiatric acute admissions ward,|

|Community Psychiatric Nurse within a Community Mental Health Team, Intensive Home Treatment Worker, Crisis Resolution Team Caseworker (10 years) and Clinical |

|Nurse Specialist within an Adult ADHD service (6 years). |

|Email: maria.mazfari@ Telephone: 01642 368355 |

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|Tina Profitt is a Registered Nurse in Mental Health (RMN). She is a Clinical Nurse Specialist within a Specialist Adult ADHD Service in the North East of |

|England, based in Stockton-On-Tees. Previous roles have involved; Staff Nurse on Psychiatric Acute Admissions Wards and Day Unit running Clozaril/Lithium |

|Clinics and managing the ECT suite at Winterton Hospital (10 years). Community Psychiatric Nurse in a CMHT (10 years) Community Psychiatric Nurse in Eating |

|Disorders and Older Peoples Services (8 years) and Clinical Nurse Specialist within Adult ADHD service (5 years). “I consider myself to be a bread and butter |

|nurse and not a specialist as my title states; I enjoy working with people, I find them an endless source of fascination and sometimes frustration but mostly, |

|generally, a pleasure”. |

|Email: tina.profitt@ Telephone: 01642 368355 |

|A GPs GUIDE TO MANAGING CHALLENGING BEHAVIOUR IN THOSE WITH LEARNING DISABILITIES |

|Dr Neelakandan Murugesan. Psychiatrist and Clinical Director in Adult Learning Disability Services, Durham and Darlington. |

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|Workshop synopsis |

|This workshop will cover: |

|What GPs can do practically when patients with learning disabilities present with challenging behaviour |

|How to support and manage them within primary care, with an emphasis on STOMP - Stopping Over Medication of People with a learning disability, autism, or |

|both. |

|It is estimated that on an average day in England between 30,000 and 35,000 people with a learning disability, autism or both are taking prescribed |

|psychotropic medication. Long-term use of these medicines puts people at unnecessary risk of a wide range of side effects including weight gain, organ |

|failure and even premature death. Psychotropic medication should only be prescribed for managing behaviour which challenges when it is used in combination |

|with psychology or other therapies. Psychotropic medication is often prescribed for people with a learning disability, autism or both with serious mental |

|illness such as psychosis or bipolar disorder. STOMP also aims to ensure that medication used in this way are also reviewed and monitored appropriately. |

|How to refer to appropriate secondary care services. |

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|Biography |

|Dr Neelakandan Murugesan is a Consultant Psychiatrist and Clinical Director in Adult Learning Disability services within Durham and Darlington. |

|Email: neelakandan.murugesan@ Tel: 0191 4415834 |

Workshop 3: 3.15pm to 4.30pm

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|A POSITIVE APPROACH TO OLDER PEOPLE’S CARE FOR GPs: A TASTER OF AN INNOVATIVE EDUCATION PROGRAMME FOR THOS SUPPORTING PEOPLE LIVING WITH DEMENTIA |

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|Susannah Thwaites. Clinical Specialist Occupational Therapist. |

|Amy Smith. Clinical Lead Occupational Therapist |

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|Workshop synopsis |

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|This workshop aims to provide GPs and other practice staff who have direct contact with dementia patients with practical knowledge and skills to actively engage |

|with these individuals, ensuring they receive the best quality care possible, and enhancing their quality of life. It will also cover working with other family |

|members and caregivers, as well as care homes and care home staff, to deliver care on a variety of levels. |

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|Teepa Snow has developed the Positive Approach to Care™ concept to support people living with dementia by equipping both formal and informal carers with specific |

|skills aimed at increasing understanding of what it is like to live with dementia. Her approach is focused on care delivery, rather than theories. This session |

|will include the ‘Positive Approach to Care™: A taster of an innovative education programme for those supporting people living with dementia.’ |

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|Biographies |

|Susannah Thwaites is a Clinical Specialist Occupational Therapist with Tees, Esk & Wear Valleys NHS Foundation Trust, who works within the Care Home Liaison |

|team.  She works predominantly with people living with dementia who are in the later stages of dementia and are presenting with behaviours that care home staff |

|are experiencing as challenging. Susannah has been an occupational therapist for 25 years and has worked with people living with dementia in a variety of settings|

|and has been an accredited Positive Approach to Care™ (PAC™) trainer since 2015. |

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|Email: susannah.thwaites@ Telephone: 01388 645300 |

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|Amy Smith is the Clinical Lead Occupational Therapist for mental health services for older people in Durham and Darlington. She works regularly with clients with |

|functional and organic conditions (early through to late in the condition) within their own home and care homes. |

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|In January 2017 Amy began working at Newcastle University as part of their Developing an intervention for people with dementia with fall-related injuries (DIFRID)|

|study. Amy has been an accredited Positive Approach to Care™ (PAC™) trainer since 2017 delivering training to family members of people with dementia and staff |

|within TEWV. |

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|Email: amy.smith16@ Telephone: 0191 5549000 Twitter: @AmySmithOT |

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|MANAGING ANXIETY, DEPRESSION AND SELF-HARM IN TEENAGERS |

|Dr Anthea Prosser. Consultant Child and Adolescent Psychiatrist. CAMHS York & Selby. |

|Sarah Forrester. CAMHS Practitioner, CAMHS York & Selby. |

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|Workshop synopsis |

|This interactive workshop will provide: |

|A brief reminder of diagnostic criteria for depression and anxiety disorders in children and adolescents |

|How to assess risk and when to refer young people with emotional disorders and self-harm. |

|An update on risk factors, prevalence and prognosis. |

|An overview of up to date assessment and treatment both in the primary care setting as well as specialist CAMHS |

|The workshop will include some interactive Children and Young People’s IAPT based case examples. |

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|Biographies |

|Dr Anthea Prosser is a Consultant Child and Adolescent Psychiatrist working for York and Selby CAMHS, she is the lead psychiatrist for the service and has many |

|years’ experience of working with young people with depression, anxiety and other mood disorders, she regularly delivers training on CAMHS risk assessment and |

|CAMHS assessments of mood disorders to junior doctors, Hull and York Medical School students as well as being the lead for CPA and risk training in CAMHS. |

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|Email: a.prosser@ Telephone: 01904 294200 |

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|Sarah Forrester leads the emotional pathway for York CAMHS Teams, she is an experienced CAMHS Practitioner who has undertaken the CYIAPT CBT programme for CAMHS. |

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|Email: sarah.forrester1@ Telephone: 01904 615300 |

|PERSONALITY DISORDER: WHAT A GP NEEDS TO KNOW |

|Jane Bradley. Advanced Practitioner / CAT Practitioner, Tees Personality Disorders Service |

|Dr Lindsay Jones. Consultant Clinical Psychologist / Lead for Personality and Relational Disorders, North Yorkshire Adult Mental Health. |

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|Workshop synopsis |

|This workshop aims to equip GPs to feel as confident as possible in their understanding, knowledge and care within their practice setting of working with patients|

|with personality disorder/difficulties. The session will: |

|Increase awareness and understanding of Personality Disorder |

|Outline the causes of this disorder including attachment difficulties |

|Make 10 minute appointments therapeutic |

|Help GPs manage chaotic interactions that can be created in the surgery |

|Help GPs build therapeutic relationships with their patients with personality disorder/difficulties |

|Update GPs on where services are up to in their work with clients with personality disorder/difficulties |

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|Biographies |

|Jane is an Advanced Practitioner and works in the Tees Personality Disorder Service for Tees, Esk & Wear Valleys NHS Foundation Trust where she has worked for the|

|past 7 years. Jane is an accredited Cognitive Analytic Therapy (CAT) Practitioner and an accredited Mentalisation Based Therapy (MBT) Practitioner, both of which|

|are relational models of psychological therapies. Whilst Jane continues to do some 1.1 clinical work, the focus of the Personality Disorder Service is to offer |

|consultation, supervision, teaching and training for staff working with clients who struggle with personality disorder/difficulties. Jane’s particular area of |

|interest is helping staff to develop their understanding of the difficult dynamics that clinicians and services can be pulled into when working with this client |

|group and how making sense of this using CAT & MBT can improve our working relationships and thus outcomes. |

|Email: jane.bradley5@ Telephone: 01642 368711 |

|Dr Lindsay Jones is a Consultant Applied Psychologist and currently works as Lead for Personality and Relational Services for North Yorkshire Adult Mental Health |

|Services (Tees, Esk and Wear Valleys NHS Trust). She is also an accredited Cognitive Analytic Therapy (CAT) practitioner and supervisor. She has a longstanding |

|interest in trauma, personality disorder and gender sensitive approaches. She has presented at conferences and published articles in the areas of Cognitive |

|Analytic Therapy, personality disorder and working with women.  |

|Email: lindsay.jones1@ Telephone: 07917 557501 |

|ADULT AUTISM – WHAT A GP NEEDS TO KNOW |

|Dr Conor Davidson. Consultant Psychiatrist. TEWV Autism Clinical Lead, NE CMHT, York. |

|Workshop synopsis |

|Autism is more common than you might think, affecting 1 in 100 people. (For a practice list size of 3000 patients this means a possible 30+ patients with |

|autism.) It persists through the lifespan, and in adulthood is associated with a range of adverse mental and physical health outcomes. A recent well-publicised |

|study found that people with autism have on average 16 fewer years life expectancy than the general population. The issue of health in autism is gaining national|

|prominence and will without doubt be an increasingly important part of general practice in the future. |

|This workshop will provide you with key facts about autism, its impact on individuals, and learn about common mental and physical health co-morbidities in autism |

|and how to effectively manage them. |

|A useful source of information for GPs is provided by the National Autistic Society here: .uk/professionals/health-workers/gp-info.aspx |

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|Biography |

|Dr Conor Davidson is a CMHT consultant psychiatrist based in York. He has an interest in autism spectrum disorders, in particular comorbidity of autism and |

|psychiatric disorders. In the past Conor has worked in the Sheffield Asperger service, and he is now part of the Leeds Autism Diagnostic Service. He has |

|published several papers on autism including on Asperger syndrome and First Episode Psychosis. In April 2017, Conor was appointed trust wide autism lead for |

|Tees, Esk and Wear Valley Foundation Trust. Unfortunately for him, Conor is a lifelong Leeds United supporter. |

|Email: conor.davidson@ Telephone: 01904 556718 Twitter: @conor_davidson |

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