Personalisation, individual budgets, direct payments have all been around for some time. The particular significance for mental health and recovery is highlighted by some of the action that has been taken by service users.
Tony Martin has been speaking up for people with mental health problems since he started using services 15 years ago. In 2006 he took up a direct payment and became a convert to personalisation.
When the Department of Health started piloting individual budgets in 2005, he was appointed as a citizen leader tasked with promoting self-directed support.
Becoming a Mind personalisation champion was an extension of what he was doing already, though the cachet of saying he was working for Mind helped open more doors.
Martin aimed to increase the number of mental health service users with a direct payment in Derbyshire. As champion, he used his established links with the local primary care trust, the county council, government and with service users and service user forums.
He even held a conference on personal budgets to disseminate thinking. Attended by 140 people, including professionals, carers and service users, all groups felt they had learned a great deal.
Tackling professionals' attitudes and levels of knowledge about personalisation was key.
Martin says: "The real crux of it is ignorance in the service teams about how a direct payment can be used differently in mental health compared with in other groups, such as people with disabilities.
"It's no good thinking about how you can get people out of bed. It's about being able to give us new focuses and new interests in life and improving our quality of life."
Martin's analysis of 'ignorance in the service teams' is probably no longer as relevant as it was when he made the original comment. Mental health teams are very clued-in with the importance of direct payments as a potential route to mainstream above and beyond simple arrangements for care provision.
Service users like Martin and user groups are also pioneering creative uses for direct payments. Also, independent brokers working alongside mental health teams can help to ensure that direct payments and personalisation go hand-in-hand. Ultimately, personalisation can only exist for the sole purpose of enabling individuals' dreams, hopes and aspirations in the mainstream world.
Tony Martin's championing of direct payments for mental health led to a dramatic increase in take-up. By March 2010 there were 52 mental health service users with a direct payment in Derbyshire, up from 16 in September 2009, when Martin started his work as a champion.
Friday, 30 July 2010
Tuesday, 27 July 2010
Bridge Building for Mainstream
Bridge building for mainstream is now incorporated into the care pathway for people recovering from mental health conditions.
Community mental health teams, occupational therapies, psychiatrists are all aware of the value of mainstream bridge building. Many community mental health teams actively promote mainstream as part of their in-house practice with clients. Service-user led initiatives are also widely encouraged.
Where mental health teams may not always the time and resources to promote mainstream fully, there are many outside organisations working alongside the teams. The benefits of referral to an outside non-clinical team can be considerable.
Mental health teams can often discuss mainstream with clients in a clinical or home setting. An outside organisation has more time and capacity to draw clients out into mainstream settings where a conversation can begin. This may well be and should be - a conversation about the client's hopes, dreams, goals and aspirations.
One of the bridge builder's roles is to help facilitate this conversation. Another role is to be clued-in with what mainstream has to offer. For example, a bridge builder specialising in arts and culture needs to know what outlets there are both locally and further afield. A client who wishes to develop skills in music production should be introduced to the mainstream venue or venues where this opportunity takes place.
Community mental health teams, occupational therapies, psychiatrists are all aware of the value of mainstream bridge building. Many community mental health teams actively promote mainstream as part of their in-house practice with clients. Service-user led initiatives are also widely encouraged.
Where mental health teams may not always the time and resources to promote mainstream fully, there are many outside organisations working alongside the teams. The benefits of referral to an outside non-clinical team can be considerable.
Mental health teams can often discuss mainstream with clients in a clinical or home setting. An outside organisation has more time and capacity to draw clients out into mainstream settings where a conversation can begin. This may well be and should be - a conversation about the client's hopes, dreams, goals and aspirations.
One of the bridge builder's roles is to help facilitate this conversation. Another role is to be clued-in with what mainstream has to offer. For example, a bridge builder specialising in arts and culture needs to know what outlets there are both locally and further afield. A client who wishes to develop skills in music production should be introduced to the mainstream venue or venues where this opportunity takes place.
Sunday, 25 July 2010
Mainstream - the Cascade Effect
As a social inclusion bridge builder I work with clients with severe and enduring mental health diagnoses. They are referred or they self-refer with the desire to access mainstream life domains.
Clients aspire to a variety of mainstream choices. It might be volunteering or befriending, it may be arts activities, it might be employment or running your own business. Client aspirations may include sports, faith, education, training or a selection from any or all of these.
Enabling individuals with a 'severe and enduring' background is not always a straightforward process although it certainly can be sometimes. A client can be introduced to a mainstream outlet and it can work for him or her almost immediately. Other clients may be unready for mainstream for a variety of reasons. They may suffer a relapse before accessing the mainstream environment. They may visualise mainstream as another form of day service or statutory support system, which it isn't.
Equally, clients can sometimes express a wish to access mainstream out of a misplaced fear that not accessing it might in some way affect their payments and benefits. It can be a long process before the value and rewards of mainstream are understood.
What is true is that clients who successfully access or re-access mainstream in turn become examples of mainstream's effectiveness. Signposting to mainstream as part of the mental health recovery pathway is undoubtedly effective, even if it does not work for everyone straight away.
Mainstream also helps to sustain recovery in the individual and even better, it can propagate more success and recovery out of its own resources. An example of this would be the musician who successfully links up with a mainstream recording studio. After months of regular rehearsal the musician is invited by the studio manager to contribute to a recording session. I witness this kind of beautiful outcome and its benefits for the client in my work as an arts bridge builder.
Another example - again from music bridge building - is the guitarist client who uses a studio regularly and invites a friend to join him during the session. The friend may well be another mental health service user who has never successfully engaged with mainstream despite the best efforts of the bridge building service. Where services have been unsuccessful a friendship and peer network can do the job far more effectively.
Mainstream reaches the places other services cannot reach and in the process it is able to create a cascade effect - a continuing path of development, recovery and individual growth.
Clients aspire to a variety of mainstream choices. It might be volunteering or befriending, it may be arts activities, it might be employment or running your own business. Client aspirations may include sports, faith, education, training or a selection from any or all of these.
Enabling individuals with a 'severe and enduring' background is not always a straightforward process although it certainly can be sometimes. A client can be introduced to a mainstream outlet and it can work for him or her almost immediately. Other clients may be unready for mainstream for a variety of reasons. They may suffer a relapse before accessing the mainstream environment. They may visualise mainstream as another form of day service or statutory support system, which it isn't.
Equally, clients can sometimes express a wish to access mainstream out of a misplaced fear that not accessing it might in some way affect their payments and benefits. It can be a long process before the value and rewards of mainstream are understood.
What is true is that clients who successfully access or re-access mainstream in turn become examples of mainstream's effectiveness. Signposting to mainstream as part of the mental health recovery pathway is undoubtedly effective, even if it does not work for everyone straight away.
Mainstream also helps to sustain recovery in the individual and even better, it can propagate more success and recovery out of its own resources. An example of this would be the musician who successfully links up with a mainstream recording studio. After months of regular rehearsal the musician is invited by the studio manager to contribute to a recording session. I witness this kind of beautiful outcome and its benefits for the client in my work as an arts bridge builder.
Another example - again from music bridge building - is the guitarist client who uses a studio regularly and invites a friend to join him during the session. The friend may well be another mental health service user who has never successfully engaged with mainstream despite the best efforts of the bridge building service. Where services have been unsuccessful a friendship and peer network can do the job far more effectively.
Mainstream reaches the places other services cannot reach and in the process it is able to create a cascade effect - a continuing path of development, recovery and individual growth.
Thursday, 22 July 2010
Traditional cohorts
Service providers, staff, service users and carers are often perceived as the main groups comprising the traditional cohort of secondary mental health care provision. All this changes when mainstream practice is incorporated into care pathways. The effect of mainstreaming is that it introduces new stakeholders into the equation. Stakeholders chosen by the client as part of his or her recovery. Person-centred practice is designed to enable the person in recovery to access activities and outlets of their own choice in the mainstream environment. These outlets can be anywhere and everywhere, depending on the client's personal goals, hopes and aspirations.
Mainstream effectively destroys the stigma attached to recovery as it is longer attached to special settings, wherever this is the individual's preferred choice.
Mainstream effectively destroys the stigma attached to recovery as it is longer attached to special settings, wherever this is the individual's preferred choice.
Monday, 19 July 2010
Thursday, 15 July 2010
Discussing Mainstream
Bridge building for mainstream is now incorporated into the care pathway for people recovering from mental health conditions.
Community mental health teams, occupational therapies, psychiatrists are all aware of the value of mainstream bridge building. Many community mental health teams actively promote mainstream as part of their in-house practice with clients. Service-user led initiatives are also widely encouraged.
Where mental health teams may not always the time and resources to promote mainstream fully, there are many outside organisations working alongside the teams. The benefits of referral to an outside non-clinical team can be considerable.
Mental health teams can often discuss mainstream with clients in a clinical or home setting. An outside organisation has more time and capacity to draw clients out into mainstream settings where a conversation can begin. This may well be and should be - a conversation about the client's hopes, dreams, goals and aspirations.
One of the bridge builder's roles is to help facilitate this conversation. Another role is to be clued-in with what mainstream has to offer. For example, a bridge builder specialising in arts and culture needs to know what outlets there are both locally and further afield. A client who wishes to develop skills in music production should be introduced to the mainstream venue or venues where this opportunity takes place.
Community mental health teams, occupational therapies, psychiatrists are all aware of the value of mainstream bridge building. Many community mental health teams actively promote mainstream as part of their in-house practice with clients. Service-user led initiatives are also widely encouraged.
Where mental health teams may not always the time and resources to promote mainstream fully, there are many outside organisations working alongside the teams. The benefits of referral to an outside non-clinical team can be considerable.
Mental health teams can often discuss mainstream with clients in a clinical or home setting. An outside organisation has more time and capacity to draw clients out into mainstream settings where a conversation can begin. This may well be and should be - a conversation about the client's hopes, dreams, goals and aspirations.
One of the bridge builder's roles is to help facilitate this conversation. Another role is to be clued-in with what mainstream has to offer. For example, a bridge builder specialising in arts and culture needs to know what outlets there are both locally and further afield. A client who wishes to develop skills in music production should be introduced to the mainstream venue or venues where this opportunity takes place.
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