Paul Lefever

Paul Lefever

Adult Mental Health Nurse & International Executive Mental Health Case Manager

Adults up to 60 years, Adolescents over 16 years

I'm Paul Lefever, a Mental Health Nurse Coach and International Executive Mental Health Case Manager with over two decades of experience specialising in depression, anxiety, substance misuse, and psychosis.

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Substance (drug) addiction
Depression in Adults
Anxiety in Adults

Paul Lefever

Adult Mental Health Nurse & International Executive Mental Health Case Manager

I am an accomplished Mental Health Nurse Coach and International Executive Mental Health Case Manager, with a career spanning over two decades in the mental health sector. I have a proven track record of making a tangible difference in the lives of adolescents and adults grappling with a spectrum of mental health conditions since 2003, including depression, anxiety, substance misuse, psychosis, and complex trauma-related disorders. As an award-winning Registered Mental Health Nurse, my dedicated service has touched lives across the globe, such as in the UK, the Middle East, Southeast Asia, Central America, and Europe.

I work towards fostering improved mental health awareness for my patients, their families and the wider community. My role extends beyond devising comprehensive solutions to mental health challenges; it's about empowering individuals to achieve their full potential and foster personal development, spiritual growth, and recovery. I believe my dedication to my role as a Mental Health Case Manager is evident in my expertise in handling complex mental health issues. I provide bespoke care packages that seamlessly integrate case management, conventional treatments, and comprehensive live-in support. My approach is holistic, incorporating outdoor environments that lead to healthier outcomes and improved wellbeing. Activities range from simple nature walks to integrating elements of philosophical questioning and Buddhism, aimed at helping my patients reach the deeper meaning of their experiences and thoughts.

Central to my practice are my core values of compassion, trust, respect, and openness. I take a compassionate and considerate approach to ensure that I can provide the highest level of care to aid my patients with self-awareness, acceptance, and strategies for building resilience. I believe the first and most important step in any treatment programme is to create a space where you the patient feel safe and supported. Building a mutual relationship based on trust and respect is crucial before any therapy or coaching can begin. My commitment extends to aiding individuals experiencing acute or chronic psychological difficulties and self-injurious behaviours. I aims to ensure that everyone I work with has the opportunity to live a happy, healthy, and fulfilling life, and I continuously seek out new and innovative ways to help my patients on their journey to achieving their mental health goals.

Areas of Expertise

Individual and Coordinated Support

My holistic approach to mental health extends to you and the coordination of your care among various healthcare professionals. As an International Executive Mental Health Case Manager, I work closely with you to understand your unique needs and circumstances. This one-on-one attention allows me to tailor therapy and treatments to you, empowering you in your journey towards recovery and personal growth.

Recognising that mental health care often requires a team approach, I take on a coordination role when working with other professionals involved in your care. This includes general practitioners, psychiatrists, psychologists, social workers, and others as needed. My role as a case manager ensures a cohesive and integrated approach to your mental health care. I coordinate with other professionals, ensuring everyone involved in your care is informed and aligned with the treatment goals. My case management approach also includes crisis intervention, providing timely and effective support during critical moments. I understand the importance of immediate response and coordination in such situations, ensuring that you and your family receive the appropriate resources and support during challenging times. This comprehensive approach to individual and coordinated care ensures that you receive a tailored and integrated treatment plan. It also fosters open communication between you, your family, and your healthcare team, contributing to more effective and sustainable mental health outcomes.

Family Support

I understand that mental health conditions do not only affect the individual but also their families and loved ones. My commitment to providing comprehensive support extends to those around you, recognising that their understanding, involvement, and wellbeing are integral to your recovery process. In my role, I offer tailored support for families. This includes education about your condition, advising on best communication practices, and guidance on how to support you effectively without compromising their own wellbeing. My bespoke care packages can incorporate family consultations and therapy sessions, facilitating open dialogues that foster understanding, empathy, and resilience within your family unit.

I also provide support for families in crisis, coordinating with other healthcare providers and social services as needed. My case management approach ensures that both you and your family receive the appropriate resources and support during challenging times. In addition, I believe in empowering families to become advocates for mental health awareness. Through education and guidance, I can enable your family to navigate mental health systems, advocate for your rights, and contribute to a broader understanding and acceptance of mental health conditions in your community. By encompassing your support network in my approach to therapy and case management, I ensure that my care extends beyond you as an individual, fostering a healthier, more resilient family and community.

Outdoor Adventure Therapy & Coaching

In 2006, I pioneered a new type of nature-based therapy programme that goes one step further than nature-based therapy. In my programme, I utilise wide, open spaces in the countryside or wilderness, in the UK or internationally depending on my patient’s location. I find that these settings help to instil a sense of freedom and peace, allowing people to find themselves again.

I also encourage my patients to learn a new outdoor activity as part of their therapy or coaching programme. Over the years, I’ve enjoyed outdoor activities with my patients like walking, orienteering, mountain biking, horse riding, climbing, swimming, diving, bushcraft, camping, and even simple activities such as making a fire together. The choice of activity is completely up to you, but I can suggest specific activities and settings according to your preferences and goals for therapy, while ensuring activities are appropriate and safe for your current fitness level and physical health.

I’ve witnessed dramatic and life-changing improvements in my people’s psychological and physical health by taking therapy and coaching outdoors. Many people simply want to try this style of coaching as an opportunity to explore their goals and sense of purpose in life. I’ve also taken many patients with acute and severe psychological difficulties on my outdoor adventure programmes, helping them to overcome their fears, build resilience and reconnect with themselves in nature. Often these experiences are a powerful catalyst for change in my patients, and they leave with higher self-esteem, better communication skills and a sense of personal achievement.

Psychosis, Schizophrenia & Self-Injury

I’m passionate about helping people with acute or severe psychological difficulties, such as people in psychotic states and those suffering from self-injury behaviours. Being in the wilderness allows patients suffering from severe symptoms to freely express themselves in a safe and supported environment. Building this human-to-human connection in beautiful outdoor spaces allows people to reconnect and regain their confidence in themselves.

I find therapy in the outdoors is incredibly beneficial for people suffering from psychosis or schizophrenia. By walking together and teaching them outdoor survival skills this enables us to create a genuine connection with one another, without creating fears of judgement, anxiety, or suspicion.

I find it incredibly beneficial to connect with patients suffering from self-injury behaviour patterns while in the outdoors. Integrating activities such as climbing, can have a profound effect on rebuilding confidence, self-esteem and overcoming trauma. By using a harness and relying on one another, this enables us to build a mutual relationship based on trust and safety, allowing patients to let go of their fears and regain control.

I believe the first and most important step in any treatment programme is to create a space where my patient will feel safe and supported. Building a mutual relationship based on trust and respect is crucial before any therapy or coaching can begin. I encourage patients to ask as many questions as they like to make sure they feel comfortable with my approach and allow them to judge if it works for them before starting treatment. As a mental health nurse and coach, I always try to gain a deep understanding of my patients and understand their journey so that I can share suffering with gentleness and empathy, rather than adopting a fixed approach or style. I also believe it’s crucial to be honest and transparent about actions and outcomes during the course of therapy or coaching to avoid creating any unrealistic expectations. I aim to put my patients in control of the therapeutic process where possible, so that they feel involved and honoured throughout their journey.

Personalised treatment plans

My approach is truly holistic, encompassing a broad range of knowledge and integrating outdoor environments that lead to healthier outcomes and improved wellbeing. Being in nature and the environment forms a large component of therapy, and I incorporate many activities that range from collecting materials gathered in nature, to building trust and self-esteem through adventure sports, or simply walking and talking. My coaching integrates elements of philosophical questioning and Buddhism to help my patient’s reach the deeper meaning of their experiences and thoughts. I also find that practicing non-attachment and recognising transience helps my patients to let go of negative thinking patterns and focus on what’s truly important to them. Ultimately, every aspect of my approach to therapy is formulated to help people become the best version of themselves, and find the knowledge they have within them to lead a happier, more connected and fulfilled life.

Training and education

I’m an accredited and registered Mental Health Nurse, specialising in providing bespoke case management and crisis support interventions. I’ve been working in mental health for over 18 years, within the NHS, charities, and research teams, alongside my private practice. In 2006, I pioneered the world’s first nature-based walking therapy programme, Discovery Quest, which helped people with severe, long-term mental health conditions and was awarded the Eileen Skellern Mental Health Practice Innovation Award for my work.

I’ve also worked on two programmes helping serving and ex-military personnel as the Lead Mental Health Advisor for The Royal British Legion and Activities Coach and Managing Director, running mental health programmes helping wounded, sick and injured military personnel. I have extensive experience in designing and implementing mental health and related policies and procedures and strategic business plans in the UK and internationally.

I completed my BSC in Mental Health Nursing at the University of East Anglia in 2006. After finishing my studies, I collaborated with academic psychiatrists working on research projects and clinical studies. The University of Essex published reports with our findings showing the beneficial effects of outdoor therapy on mental health and I was interviewed by the Guardian about the mental health benefits of mountain climbing.

Personal Interests

I was brought up on a small farm in Pembrokeshire, Wales, surrounded by open countryside. My childhood was intrinsically connected to nature. As a young teen, I moved to a large city in England, immediately feeling somewhat discombobulated and yearning for a closer connection with nature. I initially found this through mountain biking and, in later life, through mountaineering. After completing formal education, I joined the British Army. I served in a range of locations across the world and, when time allowed, would explore the wild and mountainous spaces. Upon leaving the British Army, I spent five years exploring different continents, living with various indigenous communities and immersing myself as much as possible in multicultural environments. Such experiences broadened my understandings of others and provided a greater context to my own human condition.

As a young man I experienced a period of considerable emotional difficulty, which led me to explore what it means to be human and the conditions attached to mental torment and liberation. After much deliberation, I moved into a Buddhist monastery in the UK and eventually moved to Asia, where I studied vipassana meditation and absorbed the Buddhist writings or ‘dhamma’.

In more recent years I have spent the majority of my professional career in mountainous environments with clients both here in the UK and abroad. After many years of training, I obtained various outdoor qualifications that have enabled me to take clients safely on bespoke ‘Quests’ to find or relocate a sense of equilibrium.

I currently live in North Norfolk, where I can often be found walking the coastal footpaths, cycling the quiet country lanes, or enjoying the stunning wildlife that North Norfolk offers. When not being active, I enjoy cooking and reading non-fiction.

Patient Stories

Paul, I just wanted to thank you from the very bottom of my heart. Your involvement, advice and encouragement has been transformational.
Wow, Paul has this way about him. He was able to put me at ease and got where I was coming from...
Dear Paul, thank you so much for the compassion and kindness you showed my son and my whole family...

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