9. Tools and support

9. Tools and support

The Royal College of Psychiatrists and the Money Advice Trust have developed a series of drills, set out below, to help advisers identify and support clients in vulnerable circumstances. Public Health Scotland runs Scotland’s Mental Health First Aid (SMHFA) courses – see smhfa.com/find-a-course.aspx for details.

Advisers should prioritise their wellbeing alongside their clients’, and seek support from colleagues, line managers or appropriate external agencies if they feel overwhelmed or ill-equipped to handle a situation.

TEXAS	When your client tells you about themselves
Thank	Thank the client.
Explain	Explain how the information gathered from the client will be used.
EXplicit	Obtain explicit consent.
Ask	Ask the client questions to get a better understanding of their circumstances.
Signpost	Signpost or refer to internal or external specialist help when appropriate.

 

 

BRUCE	For clients experiencing a mental capacity limitation
Behaviour	Look for clues of a limitation in the client’s behaviour and speech.
Remembering	If they are struggling to remember the advice, ask what might help, write it down or see if someone can help them.
Understanding	Ask them to summarise their understanding. Fill any gaps by repeating advice or using different explanations by simplifying or rephrasing.
Communication	How would they prefer to communicate? Try to accommodate this. Allow enough time and pause regularly.
Evaluation	Discuss each option simply, writing down any pros and cons.

IDEA	This technique is useful when talking to a client about their vulnerability
Impact	How does it impact on your personal and financial situation?
Duration	How long have you been living with this?
Experience	Have you experienced this before, does it fluctuate?
Assistance	Is there anything we should know about the support you are receiving which could help us support you better?

BLAKE	This technique is to help advisers when dealing with a suicidal client
Breathe (to focus)	To help deal with the shock and fear when dealing with a suicidal client, take a moment to breathe and focus your thoughts.
Listen (to understand)	Listen carefully and assess the risk of harm to the client.
Ask (to discover)	If you need more information, ask questions.
Keep safe (from harm)	If the client is at risk of imminent harm, the emergency services should be contacted.
End (with summary)	Everything that has been discussed and agreed should be summarised when suitable.

 

 

 

SPIDER	This technique can be useful for causing minimal distress when you have to deliver bad news to a client
Set the scene	Thank you for calling, we need to talk about…
Perspective	How are you feeling and what are you planning to do next?
Invitation	Invite questions: Can you talk through this today or would you like to talk another time?
Deliver	Use simple, clear language. I’m sorry this news is disappointing. I’ll explain it, and we can go through the options.
Empathise	Listen carefully and give the client space to express their feelings.
Recap	Summarise the information and check understanding. If they are not ready to make a decision, rearrange the meeting and offer reassurance.

 

 

 

RED FLAGS	Vulnerability indicators to look out for
Potentially vulnerable	Signs include difficulty, distress, or life events that might lead to a vulnerable situation.
Vulnerable	More likely to experience harm, loss or disadvantage compared to others.
Particularly vulnerable	Heightened or imminent risk of detriment (a more serious or negative impact). Offer support quickly to avoid significant harm.
Individual factors	Illness, disability, contact with health or social care workers and getting certain benefits (like personal independence payment).
Wider circumstances	Excessive or unusual expenditure, life events (eg, bereavement) or income shocks (eg, unemployment).
Organisational actions	Something ’has been done’ causing difficulty (eg, a change in communication method) or things that ’haven’t been done’ (like no consideration of a third party trying to help).

 

 

 

CRISIS	Ways to support a client in crisis, and yourself
Calm	Be calm and take appropriate action.
Listen	To a concerned third party. Check if the client is available. If not, don’t share data, note their observations, explain your plan and take action.
Acknowledge	Refer to BRUCE, SPIDER or BLAKE cards for support.
Ask	For support, debrief and take time out if you feel upset or worried.
Protect	Anyone in an abusive situation must be taken seriously, given support and referred to those who can protect them.
Signpost	Or refer to those who can help – eg, Samaritans (telephone 116 123) for suicidal or despairing people, 24 hours a day.