How We HelpIn-Reach
  • In-Reach

  • Our In-Reach service is designed to help adults (17+) make the transition from a mental health hospital ward to their home and to support their wellbeing during that process.

  • What is In-Reach?

    In-Reach exists to help people successfully transition from a hospital ward to their home environment. We work with the individual as well as their family and carers in a holistic way to provide the most effective support.

    Our In-Reach Workers engage with people up to two weeks before their discharge to help them plan practically for their move home. They also help people to identify and reach out to services and support groups in the community as well as provide a listening and caring presence to help them adjust to their new surroundings.

    Our In-Reach Workers will continue to support the individual for up to three weeks after their hospital discharge. They do not, however, offer clinical support or any type of clinical intervention.

    In-Reach is provided by third sector providers such as Catalyst, Mary Frances Trust and Richmond Fellowship and is commissioned by Surrey and Borders Partnership NHS Foundation Trust.

    Download our In-Reach poster

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  • Who is In-Reach for?

    Anyone aged 17+ who is being discharged from a mental health hospital ward to go back home can be supported by the In-Reach team. Once a referral to the service has been received, an assessment will be carried out to identify if a person is suitable.

    People who are most likely to benefit are those who:

    • have no or limited support networks
    • have a history of hospital re-admission
    • require support for social and emotional wellbeing needs

    While all people will be considered on an individual basis, the service may not be suitable for:

    • those who are a high risk to other people
    • those who have been diagnosed with dementia
    • those who have learning difficulties where mental health is not their primary need.
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  • Where is In-Reach available?

    In-Reach is available in the following hospital wards:

    Farnham Road Hospital, Guilford:

    • Magnolia Ward
    • Juniper Ward
    • Mulberry Ward

    Farmfield Hospital, Horley:

    • Faygate Ward

    Cygnet Hospital, Woking:

    • Frieda Kalo Ward
    • Picasso Ward
    • George Willard Ward
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  • What can YOU expect?

    This information is for people being referred to In-Reach.

    During your time with us, we aim to offer a service which can support you as you prepare for your move back into the community and help you to identify other opportunities and services which may benefit you.

    Prior to discharge, our In-Reach Workers will work with you, your family/carers for up to two weeks, to create a personalised discharge support plan including:

    • Practical arrangements to ready your home, including help with utilities and food
    • Help with attending and booking health appointments following discharge
    • Advice and support in identifying and accessing community services
    • Be someone you can talk to and build trust with
    • Work in collaboration with those professionals involved in your discharge
    • Work to support carers and family members

    Our supportive and understanding team will work with you to help you to transition from being cared for on a psychiatric ward to re-engage with and be supported by your local community.

    Our team will also work to support your carers and/or family members as part of your support plan. Our support workers can offer encouragement and advice during this process. We offer a person-centred approach and will be led by you when setting personal goals and making decisions.

    Download our Welcome Pack

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  • How to make a referral

    Please note In-Reach isn’t a self-referral service which means people cannot refer themselves to it. Only professionals working on the hospital wards can refer people onto In-Reach. However, if you are a patient on a hospital ward and would like to be referred to the service prior to your discharge, please do speak to the ward staff.

    Below is information for hospital ward staff:

    People identified as being suitable for In-Reach (scroll up to see our section called “Who is In-Reach for?”) should be provided with a leaflet about the service. If they would like to be referred to the In-Reach service, ward staff should complete the referral form with them. They must verbally give the staff member their consent to submit a referral form on their behalf.

    Ward staff will have an electronic copy of the referral from which should be sent to: along with the most recent risk assessment. Once these have been received the service will then assess the referral. Only ward staff working on one of the participating wards can make a referral to the In-Reach Service.

    Personal Information
    To be successfully referred onto In-Reach, a person will be required to consent to the sharing of their personal data and risks. This will be covered in the above mentioned referral form that is to be completed by the ward staff.

    Download our In-Reach leaflet for professionals

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