When Dr. Pat Deegan coined the phrase 'a career in mental health' she was referring to endemic features of the mental health system prevailing at the time when she was first clinically diagnosed. A 'career in mental health' was the path that her specialists advised would become her future. It would mean a life on benefits, no chance of employment and massively limited access to opportunities. It would mean an end to her aspirations, and end to her hopes. Effectively, the end of a career.
For people who have been through secondary mental health experiences in the UK, a 'career in mental health' can still be the norm. Huge inroads have been made nonetheless. The recovery programmes that have been set up by many clinical teams all around the country. The user-led services that are widely encouraged and supported. The involvement in recruiting people who have experienced mental health conditions for employment within services. The movement from supported accommodation to independent living. The emphasis on mainstream by third-sector organisations working alongside the NHS and statutory services. The 'paths to personalisation' programme and the independence-based use of direct payments and personal budgets.
All of these initiatives and more are continuing to help enable people with severe and enduring diagnoses to find personal autonomy and make a break from the pitifully bleak reality of Deegan's appositely-described 'career in mental health'.
But what of the future?
In the UK we are witnessing the root-and-branch dismantling of mental health services as they currently stand. There will be no more primary care teams and more and more people are being discharged from CMHTs (Community Mental Health Teams). Within two years consortia of GPs and general practice surgeries will become the budget-holders both for primary and secondary mental health care.
At this stage there is no way of telling whether these changes will be for the better or for the worse. The only implacable fact is change itself and that changes are going to be massive and across the board.
The fallout from the first tremors of change is already with us. The much-vaunted personalisation programme was due to be rolled out universally throughout the UK within 18 months. Now I feel it is unlikely to happen at all. Personal budgets could well be forgotten in the midst of the general upheaval of services. Certainly, direct payments for mental health have become a thing of the past, at least in the south-west London borough where I work as a bridge builder. This is despite service users having a legal right to direct payments where these can be shown to be a strong factor in their recoveries.
The experience of personalisation in other parts of the UK may well be different and could paint a much more hopeful picture. Unfortunately, it won't last.
Showing posts with label mental health. Show all posts
Showing posts with label mental health. Show all posts
Friday, 4 March 2011
Saturday, 5 February 2011
Obliquity in Mental Health
Formulated by economic theorist and author John Kay, obliquity is the notion that complex goals are often best achieved indirectly. As Kay puts it 'happiness is the product of fulfilment in work and private life, not the repetition of pleasurable actions, so happiness is not achieved by pursuing it'.
Kay is hailed widely as a perceptive business and organisational guru, but his ideas have a great deal of relevance in the mental health field.
Kay is very strong on the question of goals and defining business and personal objectives. However his take is interesting as he does not have a straightforward linear viewpoint.
'We find out about the real nature of our goals in the process of accomplishing them, and our understanding of the complex structures of personal relationships or business organisations is necessarily incomplete', Kay writes.
John Kay underlines the importance of goals and goal-setting, which is commonplace in most business and personal development thinking. But he emphasises that even when we set clear goals, we only 'find out about the real nature of our goals in the process of accomplishing them'.
Nothing could be more true when this perception is applied to mental health, recovery and mainstream.
As a social inclusion bridge builder, I am employed to help enable clients set clear goals and prioritise a personal route into and through the mainstream environment. But even when a client has prioritised one specific pathway, it can sometimes be the case that this will not be the area of mainstream that he or she will end up pursuing.
I have clients who have prioritised music or the arts but who soon find a place elsewhere - in sports, volunteering or employment, for example.
It used to be somewhat discouraging to find that clients were not engaging in their originally prioritised mainstream domains. Now I check with other members of the bridge building team and find that many of my original referrals are now active in other areas.
Obliquity in action!
As John Kay puts it: 'the paradox of obliquity is all around us'.
Kay is hailed widely as a perceptive business and organisational guru, but his ideas have a great deal of relevance in the mental health field.
Kay is very strong on the question of goals and defining business and personal objectives. However his take is interesting as he does not have a straightforward linear viewpoint.
'We find out about the real nature of our goals in the process of accomplishing them, and our understanding of the complex structures of personal relationships or business organisations is necessarily incomplete', Kay writes.
John Kay underlines the importance of goals and goal-setting, which is commonplace in most business and personal development thinking. But he emphasises that even when we set clear goals, we only 'find out about the real nature of our goals in the process of accomplishing them'.
Nothing could be more true when this perception is applied to mental health, recovery and mainstream.
As a social inclusion bridge builder, I am employed to help enable clients set clear goals and prioritise a personal route into and through the mainstream environment. But even when a client has prioritised one specific pathway, it can sometimes be the case that this will not be the area of mainstream that he or she will end up pursuing.
I have clients who have prioritised music or the arts but who soon find a place elsewhere - in sports, volunteering or employment, for example.
It used to be somewhat discouraging to find that clients were not engaging in their originally prioritised mainstream domains. Now I check with other members of the bridge building team and find that many of my original referrals are now active in other areas.
Obliquity in action!
As John Kay puts it: 'the paradox of obliquity is all around us'.
Wednesday, 14 July 2010
Mainstream and the law
The Disability Discrimination Act (DDA 2005) makes it unlawful for a service provider to discriminate against a disabled person by refusing to provide any service which it provides to members of the public.”
'Service provider' refers to public and commercial sectors alike. A service provider may be a retail outlet, an NHS service, an employment bureau, a police station, a dating agency....the list is endless.
The implications for mainstream are highly significant. Clients referred from backgrounds of mental ill-health to mainstream life will encounter a new range of service providers. It is a social inclusion bridge builder's role to ensure that clients accessing mainstream are introduced to any service providers the client may have identified as key. Once a client is engaging with the services or products of that provider, he or she will be a beneficiary of the policies, procedures, insurance and legal obligations of that provider. The service user becomes equal with all the other consumers who are accessing mainstream as a matter of course. Consumers' rights are considerable.
Another result of the mainstream process is that it puts the responsibility for provision onto the mainstream provider. A client accessing a mainstream service such as a recording studio, for example, is a beneficiary of all that the studio provides. Provides not merely in terms of the studio service and products, but also in terms of the studio's policies, procedures, insurance and legal obligations. Equality with every other consumer creates an equal opportunities situation for the person now accessing mainstream.
Mainstream is not required to provide 'special settings' and nor should it. Mainstream should not stigmatize because of its awareness or unawareness of mental health issues. It should not stigmatize because stigma is not part of any reasonable access to a mainstream product or service.
'Service provider' refers to public and commercial sectors alike. A service provider may be a retail outlet, an NHS service, an employment bureau, a police station, a dating agency....the list is endless.
The implications for mainstream are highly significant. Clients referred from backgrounds of mental ill-health to mainstream life will encounter a new range of service providers. It is a social inclusion bridge builder's role to ensure that clients accessing mainstream are introduced to any service providers the client may have identified as key. Once a client is engaging with the services or products of that provider, he or she will be a beneficiary of the policies, procedures, insurance and legal obligations of that provider. The service user becomes equal with all the other consumers who are accessing mainstream as a matter of course. Consumers' rights are considerable.
Another result of the mainstream process is that it puts the responsibility for provision onto the mainstream provider. A client accessing a mainstream service such as a recording studio, for example, is a beneficiary of all that the studio provides. Provides not merely in terms of the studio service and products, but also in terms of the studio's policies, procedures, insurance and legal obligations. Equality with every other consumer creates an equal opportunities situation for the person now accessing mainstream.
Mainstream is not required to provide 'special settings' and nor should it. Mainstream should not stigmatize because of its awareness or unawareness of mental health issues. It should not stigmatize because stigma is not part of any reasonable access to a mainstream product or service.
Sunday, 30 May 2010
The Business Case for Mental Health Awareness
The economic and social cost of mental health problems in the United Kingdom is well documented. In 2002/03 the economic and social cost of mental health problems in England was £77 billion. (SCMH, 2003). The economic and social cost of mental health problems is greater than that of crime and larger than the total amount spent on all NHS and social services in the UK (HM Treasury, 2005).
Dame Carol Black's 2008 report 'Working for a Healthier Tomorrow' was a major attempt to address these concerns. Legislative review such as the 2005 amendments to the Disability Discrimination Act (DDA) highlighted the need to address the massive economic and social attrition behind issues of mental ill-health. In 2005 the Confederation of British Industry was concerned enough to commission its own research. Stress, anxiety and depression accounted for a third of the 168 million working days lost in the UK for health and related reasons in 2004, translating to a cost of sickness absence of about £4.1 billion (Confederation of British Industry, 2005).
As a result of legislation, employees have more rights and employers more responsibilities relating to the incidence of mental health in the workplace. Employees who choose to disclose a mental health condition to their employers are strongly protected by legislation and have the right to 'reasonable adjustments' that they may request their employers to make. In practice, it is still true that people with mental health diagnoses may well feel little confidence in this legislation. Nonetheless, their rights are enshrined in law. Similarly, employers have a legal responsibility not to discriminate against employees who have disclosed a mental health condition and to make any reasonable adjustments that have been requested.
Dame Carol Black's 2008 report 'Working for a Healthier Tomorrow' was a major attempt to address these concerns. Legislative review such as the 2005 amendments to the Disability Discrimination Act (DDA) highlighted the need to address the massive economic and social attrition behind issues of mental ill-health. In 2005 the Confederation of British Industry was concerned enough to commission its own research. Stress, anxiety and depression accounted for a third of the 168 million working days lost in the UK for health and related reasons in 2004, translating to a cost of sickness absence of about £4.1 billion (Confederation of British Industry, 2005).
As a result of legislation, employees have more rights and employers more responsibilities relating to the incidence of mental health in the workplace. Employees who choose to disclose a mental health condition to their employers are strongly protected by legislation and have the right to 'reasonable adjustments' that they may request their employers to make. In practice, it is still true that people with mental health diagnoses may well feel little confidence in this legislation. Nonetheless, their rights are enshrined in law. Similarly, employers have a legal responsibility not to discriminate against employees who have disclosed a mental health condition and to make any reasonable adjustments that have been requested.
Sunday, 9 May 2010
How businesses profit from mental health
How businesses profits from mental health.
Businesses and services are developing the understanding that informed practice around mental health benefits both service delivery and profits. Staff are happier and more productive when they know that their employers' practices and procedures do not stigmatize or discriminate against illness or experience.
Days lost to absenteeism, sickness or unproductive presenteeism decrease when employees are not anxious about being dismissed should they choose to disclose a mental health condition. The attrition of unexplained job resignations or sudden departures decreases when taboos around mental health are dismantled by enlightened policies and staff trainings.
Business and services profit from individuals who are being signposted to mainstream as part of their recovery plans. Mainstream social inclusion takes place in any outlet where a recovering individual feels he or she can prioritise a personal goal. Venues such as education and training centres, sports facilities, colleges, recording studios, voluntary organisations and arts groups are benefiting substantially and financially from motivated people accessing mainstream. Where individuals are not paying all the costs themselves, there may well be contributions from schemes such as direct payments or from built-in concessions and offers. The increased business generated by mainstream social inclusion is considerable.
Businesses and services are developing the understanding that informed practice around mental health benefits both service delivery and profits. Staff are happier and more productive when they know that their employers' practices and procedures do not stigmatize or discriminate against illness or experience.
Days lost to absenteeism, sickness or unproductive presenteeism decrease when employees are not anxious about being dismissed should they choose to disclose a mental health condition. The attrition of unexplained job resignations or sudden departures decreases when taboos around mental health are dismantled by enlightened policies and staff trainings.
Business and services profit from individuals who are being signposted to mainstream as part of their recovery plans. Mainstream social inclusion takes place in any outlet where a recovering individual feels he or she can prioritise a personal goal. Venues such as education and training centres, sports facilities, colleges, recording studios, voluntary organisations and arts groups are benefiting substantially and financially from motivated people accessing mainstream. Where individuals are not paying all the costs themselves, there may well be contributions from schemes such as direct payments or from built-in concessions and offers. The increased business generated by mainstream social inclusion is considerable.
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