To celebrate World Mental Health Day, ARC EoE researchers Prof Morag Farquhar, Dr Carole Gardener and Community Psychiatric Nurse, Dawn Stewart, share how they adapted Support Needs Approach for Patients (SNAP) to help people using mental health services. This approach is used in community healthcare to support people with long-term conditions and has been adapted for use in other care settings.
Health care should be driven by patients’ needs, and the NHS recommends provision of person-centred care. The Support Needs Approach for Patients (SNAP) was developed as an approach to aid this using a tool (the ‘How are you?’ booklet) which has a set of questions to help patients think about areas where they may need more support. The tool enables a focused conversation between the patient and clinician to help address those needs.
SNAP was first developed for patients with chronic lung disease and is now being used to enable person-centred conversations for patients with a range of chronic physical conditions. Clinicians wanted to use SNAP in mental health, but we needed to adapt it for this care setting. We worked with service users who had lived experience of mental health services and mental health clinicians to adapt SNAP, including the booklet and process, to use in mental health (SNAP-MH).
Professor Morag Farquhar explains the background to the SNAP Study:
Policy documents often ask clinicians to deliver person-centred care, but rarely advise them on how they could do that – by working with mental health service users and clinicians to adapt SNAP for mental health we have provided an evidence-based intervention (SNAP-MH) to enable mental health clinicians to deliver person-centred care.
Professor Morag Farquhar
Principal Investigator of the SNAP-MH Study
We worked with patients through a series of focus groups, workshops, and a survey, as well as a NHS media studio and service user group at Cambridgeshire and Peterborough NHS Foundation Trust (CPFT). The original idea to adapt SNAP for mental health came from Dawn and the project was funded by ARC East of England and delivered within CPFT.
SNAP-MH directly links to CPFT’s strategy to improve NHS service delivery and care, by supporting people-centred care that is co-produced and tailored to individual needs. SNAP-MH is designed to put mental health service users in the centre, improving how their support needs are identified and addressed through collaboration. It also has the potential to bridge gaps between mental health services and wider social support systems. By identifying housing, education, and social connectivity needs, it has the potential to bridge gaps between mental health services and wider social support systems.
SNAP-MH can also help to standardise high-quality, evidence-based care improve the confidence of clinicians in identifying and addressing complex support needs that might otherwise be missed in a standard psychiatric assessment. By identifying social or practical stressors early on such as housing instability, clinicians can refer patients to appropriate social support services. SNAP-MH also enables CPFT to gather better data on the population it serves through systematic assessment of what they really need, so resources can be better allocated.
Ultimately supporting empowerment and shared decision making in mental health care, SNAP-MH fosters a more collaborative relationship between the clinician and the service user. When service users feel their holistic needs related to housing, finances and employment are being acknowledged, engagement with their treatment plans increases to improve recovery and quality of life.
Dawn Stewart
Community Psychiatric Nurse at Cambridgeshire and Peterborough NHS Foundation Trust
The SNAP-MH research project has now completed and an academic paper for publication has been submitted for publication, co-produced with service users. Participants have been provided with brief reports, and the project will be collating feedback from service users and clinicians as services start to apply the tool in practice.
The benefits of using SNAP-MH include transforming care into a collaborative partnership, empowering individuals to manage their mental health and restoring personal agency as well as improving treatment adherence. The evidence base highlights several core reasons for this approach:
- Improved clinical outcomes: Systematic reviews of self-management and recovery programs show significant reductions in depressive symptoms, shorter hospital admissions, and improved overall functioning.
- Increased self-efficacy and autonomy: Active participation in treatment increases the confidence an individual has in their ability to manage their condition. Evidence shows that when patients are actively involved in designing their treatment, they report higher subjective measures of recovery, including hope and empowerment.
- Better healthcare navigation: Patients with high health literacy and self-management skills are better equipped to navigate the care system. Studies indicate that confident, activated patients utilise emergency services less frequently and engage more with the right services.
- Enhanced trust and communication: Engaging in self-management helps to improve honest and open health professional-patient interactions. Research indicates that this empowerment mediates a stronger, trusting relationship with healthcare providers, which helps people stick to recommended treatments.
ARC East of England (EoE) funded and supported this study – SNAP-MH exists primarily as a clinician asked us to adapt SNAP for mental health, but this was only possible because of ARC EoE’s flexible responsive funding model. In addition to funding the study, ARC EoE has facilitated highly valuable PPI work and dissemination of the findings.
Professor Morag Farquhar
Principal Investigator of the SNAP-MH Study
The adapted SNAP-MH Tool is available under licence and is accessible via the SNAP website, free of charge to not-for-profit organisations. Guidance developed to help deliver SNAP within mental health is available to clinicians via the SNAP website. Any clinical teams who are interested in introducing SNAP-MH to their practice and implementing in their service are welcome to get in touch at Dawn Stewart at Dawn.Stewart@cpft.nhs.uk.
