Glasgow Tidal Model project

The Glasgow Tidal Model Project

The formal development of the Tidal Model project within Greater Glasgow's Mental Health Division began in 2001, when the executive management group invited presentations to over two hundred staff, representing the full range of the representative clinical and managerial groups.

Over the succeeding two years, the lead nurses for the different Sectors in the City, led the introduction of training for all staff, and the implementation of the Tidal Model, within key pilot sites.

These pages provide a profile of this important project - not only the first Scottish Tidal Model pilot site, but also one of the most ambitious and well-organised projects in the whole UK. Meet some of the staff team members and see examples of their work in developing the implementation and evaluation of the Tidal Model.

Sector Nurse Robert Davidson, Vice Chair of the mental Health Nurses Forum, Scotland, writes:

" an essential skill of mental health nursing is being able to recognise difference. The Tidal model supports the development of this skill because it is an approach based upon uniqueness.

When we meet a person (patient) for the first time we should listen intently to their story. What is that makes this person different from all the other people we have met? This is the first question the nurse should address. Even if the person has an illness which many other people also have, the nurse should be seeking to establish what it is that is different about the person from all of the other people they have dealt with who have the same illness. To be able to work in partnership with the person and to determine effective recovery strategies together it is crucial to be able to recognize these differences".

"By introducing Tidal into our services we have witnessed:

	Reduced incidence of aggression and self -harm
	Reduced levels of clinical observation
	Increased user satisfaction
	Increased therapeutic engagement between nurses and users
	Greater emphasis on positive risk taking
	Greater compliance with Millan principles e.g. user participation and minimum restriction
	Greater clarity to nursing role
	Enhanced the role of the nurse in the eyes of other professionals
	A new focus for supervision

"As an ongoing development within mental health nursing, I believe that we:

Cannot over-emphasise the significance of Tidal– it provides a flexible and adaptable 'off the shelf' framework which is compliant with all of the principal political drivers and helps nurses realise in practice some of the concepts they have been struggling with for many years e.g. meaningful involvement of users in the care process. It is not rigid and can be adapted to local circumstances enabling local sense of ownership.

It provides the second tier of a practice and skills development framework which has as the foundation tier a rights and values based professional ethic. A very rough graphic explanation of what I mean in a Glasgow context below.

"Moreover, Tidal helps advance the recovery agenda in mental health, as it:

	Promotes a less parental approach to care
	Clarifies what the person can do to manage their own vulnerabilities
	The simplicity of the model and the small steps approach instils hope
	The Holistic assessment model ensures that needs in care-plans reflect what the person feels is important as well as the professional perspective
	Emphasis on engagement rather than containment – supports the management of risks - rather then the elimination of risks which is stifling for everyone involved.
	Can be adapted to so many different circumstances – e.g. palliative care

The Glasgow service has generously offered to share copies of some of the materials, which they have developed as part of their work. Click below to obtain free downloads of these materials.

	Pictures of the Struan Ward Team
	Double Award winning team from the Adolescent Service
	Rutherford House Team
	Meet some of the team from the Adolescent Unit
	Information for Service Users and Carers - Leaflet
	Tidal Model leaflet for staff (PDF)
	Tidal Model Solutions Group leaflet (PDF)
	Tidal Model Evaluation - Pre implementation (PDF)
	Tidal Model Evaluation - Post implementation (PDF)