What is the Bipolar Service?
The Bipolar Service is a specialist secondary care service within Birmingham and Solihull Mental Health Foundation Trust (BSMHFT).
The service supports individuals with episodes of high mood and/or fluctuations between high and low mood, irrespective of diagnosis. Individuals with a diagnosis of bipolar disorder (type 1 or 2), cyclothymia, schizoaffective disorder, or a history of clear fluctuations in mood may benefit from being referred to our service.
Referrals are received from all community mental health teams, assertive outreach, perinatal services, acute services and other secondary care teams across the trust.
Mood on Track
The Bipolar Service offers the Mood on Track (MoT) programme, which is a cognitive-behavioural psychological intervention designed specifically for bipolar disorder. It incorporates elements of social rhythm and family therapy framework within this psychoeducation approach. The MoT course aims to improve service user’s understanding of their presenting difficulties and self-management of their mood.
After completing the group sessions, service users are then offered 6-8 individual sessions. These sessions are designed to consolidate and personalise information covered in the group sessions, with a focus on mood management. They allow service users to think about what protective factors help with wellbeing, what they might find stressful, how they can best approach stressors in the future and how to identify and respond to early signs of mood change.
Following this, graduates of the Mood on Track programme are offered a monthly support group. The support group is co-designed with our service users to ensure that it focuses on topics helpful to their wellbeing. Graduates of the Mood on Track programme also receive a monthly newsletter with further information about events, updates and other relevant information regarding staying well with bipolar disorder.
MoT follows the National Institute of Clinical Excellence (NICE) guidelines. These state that all individuals with a bipolar disorder diagnosis should be offered a structured psychological intervention. This can be in the form of group or individual sessions and should have a published evidence base. You can find further information about the NICE guidelines on their website: https://www.nice.org.uk/guidance/cg185
- Appropriate for anyone with episodes of high mood and/or fluctuations between high and low mood, irrespective of diagnosis. Individuals with a diagnosis of bipolar disorder (type 1 or 2), cyclothymia, schizoaffective disorder, or a history of clear fluctuations in mood may benefit from being referred to our service
- The course may benefit individuals where managing mood is a priority
- Must be under a Community Mental Health Team (CMHT) in Solihull and Birmingham Mental Health Foundation Trust.
The ‘mood on track’ course requires that individuals attend most of the group sessions, as well as the individual sessions. This means that they need to be able to concentrate for a period of two hours (with a break) and be able to listen to and use the information provided in sessions. They also need to feel comfortable in a group setting. This will be considered during their collaborative discussion and any adaptations that need to be made to help them benefit from the course can be decided.
Individuals will also need to take part in exercises at home to support the learning from the ‘mood on track’ course.
For service users
Self-referral to the bipolar service is not available, however, if you are interested in being referred, please speak to a clinician within your community mental health team (i.e. community psychiatric nurse, psychiatrist, care coordinator) so they can assist you with this.
Please complete a Bipolar Service Referral form and send this to the Bipolar Service email (firstname.lastname@example.org) or alternatively you can post your referral.
If you have any questions or queries about a referral or would like some advice before making a referral, please contact us via email or call us on 0121 301 3370. We welcome all referral discussions.
Collaborative discussion with prospective service user (previously called Assessment)
This discussion will allow a clinician from the team to build on the information from an individual’s clinical record. The aim is to get an understanding of an individual’s experience of mood changes. As well as what has previously helped with mood changes and what support an individual currently has access to. This will allow the potential service user and the clinician to conclude whether MoT is a suitable programme for the individual’s needs.
Psychoeducation CBT Groups
Groups are made up of approximately 10-15 individuals and facilitated by experienced healthcare professionals. These run once a week for two hours, over a period of 11 (in person)/13 (online) weeks. These allow service users to get a better understanding of bipolar disorder and the associated mood changes as a whole. They also provide coping skills for managing mood. Groups allow service users to meet and support other people who have had similar experiences to themselves. Each week covers a different topic and with session will consist of a combination of psychoeducation content and group activities.
“When I first came to the group] I had no idea what to expect… The thing I took from the first session was that there were other people doing this too, it wasn’t just [my] secret problem… that had quite a major effect. It took me a long time to realise that I was sitting in a room with people like me… it was huge… it was like walking through a door which I had always pretended didn’t exist. Over the course of the weeks, all the pieces started coming together. For me it was exactly what I needed. The pieces fit together now, in as much as they can, in a way that they haven’t and hadn’t in a very long time… it gave me enough understanding to work with a recovery plan”.
“The group helped me to trust other people. I’m still in contact with some of the group now”.
“There were handouts for each week… the fact that you have it all as a resource is really important. In a lot of the weekly sessions we would do activities… things to do with mood monitoring, things to do with how we spent hours of the day, card sort exercises, thinking about things that might be triggers, the way you feel, things that you have done that might help. All of those exercises gave you different things to take away each week”.
Following completion of the group sessions, service users will be offered individual sessions with one of the clinicians who facilitated their group. This is an opportunity to work with the clinician to create a ‘staying well plan’ which covers areas such as high-risk situations, protective factors, and the early, middle, and late warning signs of high/low mood. This is completed collaboratively and will include an action plan for managing these mood changes.
“[The individual sessions helped] to focus me on how to deal with the reality of [living with bipolar] in the day to day and also how to spot when it is going awry. The individual sessions helped me a lot with this because it looked at what actually happens before I’m ill as opposed to what happens when I’m ill… It certainty helped me a great deal to see where it all begins. And also, to accept that I don’t have a prescribed ‘normal’… I discovered that actually by following certain steps, I can stay roughly in that middle band”.
“my wife was able to attend with me which was extremely helpful…she doesn’t understand about this specific type of mental health issue… to be able to come meant everything to her.. she was able to understand what I go through”
“The [staying well] plan was extremely useful for me. At work, I shared a shortened version of this [plan] with three people very close to me for them to be aware”.
Support groups are open to any previous MoT participants and take place once a month. These are either refresher sessions of content covered on the course or talks by guest speakers about useful topic areas. Service users are given the opportunity at the beginning of the year to suggest the kind of topics they would like for these sessions.
“The support group allowed me to talk to others in a safe space where I felt comfortable to share”.
“Monthly meetings are my harbour in the storm. They help me with trying to live day by day”.
“It gives me a refocus and a reminder of what to do to keep myself well. I’d meet every week if I could!”
The Newsletter is sent out once a month to any previous service users who wish to access it. It contains useful information about upcoming support groups and events. It also provides suggestions of activities that are on in Birmingham, and a clinical corner which summarises a topic from the group sessions or that is relevant to the time of year.
“I just wanted to say a quick and massive thank you for your newsletters. I find them really helpful and […] refer to them when I’m in a low or high mood. I find the what’s on bits particularly helpful […] I think recently you published some advice services available in Birmingham which was great and I found the Bipolar and women article really interesting […] Please keep them coming, they are read and they are helpful!”
Meet the Team
Service User Feedback
‘I just wanted to say huge a huge thank you to Liz, Gareth and Jayne for facilitating the group over the past 14 weeks. As you all are aware it’s been a very very difficult time for me since losing dad. There have been a lot of challenges emotionally. I wasn’t keen to start the group at the beginning of back in May and was very apprehensive and resistant about even attempting to try the group. However, I wanted to give it a go for my own mental well-being and actually in my dad’s memory. He would have wanted me to do everything I can to be happy and be well. Each week I came along to the group with an open mind that there were no obligations or pressure to complete the course and I could stop at any time if it became too much. However, as the weeks progressed, I became more and more comfortable with the group and felt valued and listened to. I have learnt a huge amount from the group, confirming things I was already aware of but most importantly giving me different perspectives and ways to look at situations and experiences and ways I can understand my emotions and feelings. It’s given me practical ideas for ways to improve my mental health and well-being that I hadn’t even considered or thought of before – like mood monitoring, questioning how we are things through our 5 senses, ways to relax and unwind and the importance of surrounding yourself with positive people and social networks that will encourage and uplift rather than those that are toxic and detrimental.
It’s been a roller coaster of emotions over the past 14 weeks, but I have enjoyed it immensely. After feeling very insecure, anxious and self-conscious at the beginning of the group, every member of the group and each facilitator made me feel comfortable, listened to, not alone and to be honest – like life is worth living and there is hope that you can be happy with a mental health diagnosis. I have a lot more hope and optimism and am going to utilise all of the resources and coping techniques and strategies that have been taught and explained.
I really like the mood monitoring and sticky dots , the worry tree for finding solutions, the 5 stage model for seeing how situations affect you and how you can change one area ( like thinking to be more positive) which will positively impact on the other areas like feelings and behaviours, the bucket analogy of stress and ways to release the tap to prevent overload, the anger session which we covered today (as that and irritability are particular issues for me) and generally in every session there was something I could take from .
Bipolar doesn’t define you and it most definitely doesn’t mean you cannot live a fulfilled life. And that is one of the biggest things I have taken away from the group.
Attending the group was the best thing I have done for myself ever since I was first entered the mental health system back in 2009! I am so glad I took the chance and gave it a go. It has been invaluable to me! As a direct result of the group I feel more in control, have more understanding of bipolar and a clearer direction of things looking forward.’
‘At first, I thought there was no way of me coping with doing an online course let alone a video zoom course, I’d never used an iPad in this way ever before. With a little bit of help from family they showed me how to get onto the course and do it for myself and from there I learnt so much. I cannot explain how much this course has helped me progress.
I was diagnosed with bipolar in 2019 and I didn’t know much about my condition at all. This course helped me gain knowledge of what I had and how I could deal with it and live a normal life again.
I had support throughout that I could ring for support outside of zoom and if I’m honest the video zoom call was a lot better for me, when my mood was low I didn’t feel like I would have been able to turn up to a face to face appointment but I could do a video call.
The zoom helped me learn and keep an eye on things that triggered me, I now have a care plan and booklet to hand if I need it for support.
I would 100% recommended this kind of treatment and support to anyone who has been diagnosed and needs some support as a new way forward.
The staff who run the Zoom program are excellent in there care towards patients.
Thank you for all your help.’
Research and Future Developments
Improving Access to Psychological Therapies for Severe Mental Illness (IAPT-SMI)
The MoT course was recently evaluated as an Improving Access to Psychological Therapies for Severe Mental Illness (IAPT-SMI) intervention. Service users’ scores of depression and anxiety were significantly reduced, and questionnaires suggested that service users had improved well-being and indicated that mood difficulties were less impactful on their daily functioning following the MoT course (at the six month follow-up).
Patient experience indicated high levels of satisfaction with the treatment and service, as well as a higher sense of personal recovery experienced by those who completed MoT. Service-use data collected during IAPT-SMI demonstration site period demonstrated that people’s use of crisis and inpatient services was significantly reduced during and following the MoT course.
Evaluating the feasibility and acceptability of delivering Mood on Track online
As a service we continually strive to improve, and this includes conducting ongoing research to allow us to adapt with the changes of the world. Some of our most recent work looks at the shift from an in-person to an online delivery style, as a result of the on-going Coronavirus pandemic. This began with two smaller scale service evaluations. One of which conducted interviews with service users who attended a Mood on Track group which began in-person and switched to online part way through in March 2020. This aimed to understand these service users’ unique perspective on the difference between the two delivery styles in the context of the Mood on Track group. The second service evaluation compared the outcomes, which focus on factors such as quality of life, depression, and mania, of a previous in-person cohort to our first remote cohort of service users. Both these evaluations found promising preliminary results which indicated that there was limited difference for service users regardless of delivery style. These have fed into a larger-scale ongoing research project which aims to assess the feasibility and acceptability of delivering Mood on Track online. Following this project we hope to find continually positive outcomes for a remote delivery style, which will allow the service to offer the choice of in-person or remote groups to suit the needs of all service users in the future.
Cognition in Bipolar Disorder
Dr Elizabeth Newton is currently involved in research on Cognitive Remediation Therapy (CRT). CRT is a therapy that focuses on improving cognitive processes (e.g. attention, memory, social cognition) and the research is looking at whether it can improve cognitive impairments faced by some clients recovering from bipolar disorder. CRT has been previously been shown to be successful in improving cognitive impairments in those who have schizophrenia. Currently, this is an ongoing nationwide study involving clients and psychological staff from all corners of the UK and the results are not yet published. As the study progresses keep an eye out on our website or newsletter for the results.
Exploring non-attendance in the Bipolar Service
We have recently commenced a service evaluation to understand why service users do not attend (DNA) their assessment appointments or Mood on Track group sessions. We are also hoping to understand why service users drop out of the MoT course. We are collecting this data using online questionnaires. We hope this research will improve our understanding of non-attendance and help us to remove any potential obstacles in accessing our service.
Our response to COVID-19
Due to the COVID-19 pandemic, we are unable to offer in-person sessions, therefore all group and individual sessions, as well as some support groups, are now offered via Zoom. This will be continuing until further notice, as our staff continues to work remotely whenever possible.
As it is becoming more likely that we will need to use videoconferencing technology to deliver interventions in the future, we are conducting a research project to test this mode of delivery. This will help us to understand how interventions delivered virtually can benefit our service users and help us improve in the future.
The Bipolar Service, Tall Trees, Uffculme Centre, 52 Queensbridge Road, Moseley, Birmingham, B13 8QY.
Tel. 0121 301 3370
Fax: 0121 301 2701
Please note we are not a crisis service. If you are experiencing a mental health crisis or need immediate support, please use the contact details below:
Between the hours of 9am – 5pm
- Please contact your CMHT duty team
Outside of these hours
- Please contact the crisis-out-of-hours team on 0121 301 5500
- Or the urgent mental health helpline on 0800 915 9292 or 0121 262 3555
In an emergency
- Dial 999 or visit A&E
- Samaritans (Call 116 123) / SHOUT (Text ‘SHOUT’ to 85258)