A good deal of discussion is taking place around the idea of peer support workers in mental health practice. A recent Guardian article entitled 'Putting the lunatics in charge of the asylum' has highlighted the debate.
It's not just the 'asylum', hospital, day centre or residential setting where peer support working can take place. Nor does a peer support or recovery worker have to be an official post, paid or voluntary within the NHS or any clinical setting.
Peer support in mental health is taking place informally all over the place. Many peer supporters would not even give themselves such a title. In many cases they are simply spending time with the friends they already know or with the peers who have accessed a setting or venue which attracts them too.
As a bridge builder who has signposted people with severe and enduring mental health diagnoses to mainstream settings of their own choice, I have witnessed this peer support happen over and again.
Four years ago I signposted a client to a mainstream recording studio. With the help of direct payments he has been accessing this venue weekly ever since, practising guitar and collaborating with others in the studio. He has also secured part-time employment as a studio assistant, getting the rehearsal rooms ready for bands and bookings.
What has happened as a result of this client's involvement is an informal cascading of peer support and group participation. Again, this has occurred with very little prompting from the bridge builder. As my client relishes working with other musicians, he is happy to have peers who also wish to participate i.e. start a band during his weekly studio sessions. This has resulted in a drummer peer and a singer peer rehearsing regularly together with Bernie (not his real name). Another peer also attends regularly - a long-term friend of Bernie who is learning guitar from him and who has previously been impossible to place by the bridge building team in any mainstream setting.
This is informal and highly effective peer support. Above all, it is taking place in mainstream not in any clinical, residential or daycare setting. Recovery that takes place in mainstream allows for hope, confidence, friendship, group projects and routes to employment.
Showing posts with label arts. Show all posts
Showing posts with label arts. Show all posts
Sunday, 4 March 2012
Wednesday, 13 July 2011
The viral effect of mainstream
Things can happen when a client with a mental health condition is allowed the opportunity to access mainstream on his or her own terms. Mainstream can be highly supportive of clients' individual aspirations and self-development. Sometimes this encouragement comes directly from the mainstream outlet itself rather than being dictated by carers, statutory services or voluntary agencies.
There are sound reasons for this. Mainstream allows individuals to access services as consumers with consumer rights. If someone with a mental health diagnosis freely chooses to develop his or her aspirations in a mainstream environment, there is no good reason why that person should be denied any of the services that particular venue may provide. The client is accessing mainstream as a consumer of that service, not as a 'diagnosis'.
Once a firm relationship with mainstream has been established, there are multiple ways that mainstream finds to continue to develop individual hopes, dreams and aspirations. I have clients who have found employment through accessing music by rehearsing regularly in a mainstream recording studio. This has not happened because I have requested the venue to provide employment for my clients. Far from it, the venue itself has instigated the process that can lead an individual towards a working role in the environment where he or she happens to feel most fulfilled.
This is the viral effect of mainstream
There are sound reasons for this. Mainstream allows individuals to access services as consumers with consumer rights. If someone with a mental health diagnosis freely chooses to develop his or her aspirations in a mainstream environment, there is no good reason why that person should be denied any of the services that particular venue may provide. The client is accessing mainstream as a consumer of that service, not as a 'diagnosis'.
Once a firm relationship with mainstream has been established, there are multiple ways that mainstream finds to continue to develop individual hopes, dreams and aspirations. I have clients who have found employment through accessing music by rehearsing regularly in a mainstream recording studio. This has not happened because I have requested the venue to provide employment for my clients. Far from it, the venue itself has instigated the process that can lead an individual towards a working role in the environment where he or she happens to feel most fulfilled.
This is the viral effect of mainstream
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.
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.
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.
Monday, 12 July 2010
Tools for Social Inclusion
Two major assessment tools have been developed for social inclusion. One is the social inclusion 'Web' and the other is the 'Star' or 'Recovery Star'.
Originally created by the National Development Team (NDT) the web is a simple and effective assessment tool based on five key social domains. The domains were identified as key in the research done in the late 90s and early 2000s around social inclusion.
On the web these domains appear as:
Employment
Education & Training
Arts & Culture
Faith & Cultural Communities
Volunteering & Befriending
Family & Neighbourhood
Services
What makes the web unique for mental health is that it does not record or measure symptoms or diagnoses. A client who wishes to record which services he or she accesses may include the psychiatrist or community mental health team. However, the main purpose of the web is to record the client's involvement in mainstream. More importantly, the web is there to identify client's goals and aspirations in terms of where he or she wishes to be in mainstream.
Originally created by the National Development Team (NDT) the web is a simple and effective assessment tool based on five key social domains. The domains were identified as key in the research done in the late 90s and early 2000s around social inclusion.
On the web these domains appear as:
Employment
Education & Training
Arts & Culture
Faith & Cultural Communities
Volunteering & Befriending
Family & Neighbourhood
Services
What makes the web unique for mental health is that it does not record or measure symptoms or diagnoses. A client who wishes to record which services he or she accesses may include the psychiatrist or community mental health team. However, the main purpose of the web is to record the client's involvement in mainstream. More importantly, the web is there to identify client's goals and aspirations in terms of where he or she wishes to be in mainstream.
Sunday, 11 July 2010
Social Inclusion - the mantra and the tantra
Social Inclusion - Does it exist?
Social Inclusion has long been a mantra for organisations representing clients who may be isolated or marginalised for one reason or another. Government think-tanks in the early 2000s identified key areas or social domains relevant to people's lives and development in the mainstream world. These are: employment, the arts, spirituality & cultural identity, volunteering, sports & healthy living, family and neighbourhood.
As a social inclusion bridge builder for mental health, I work with clients who wish to access Arts & Culture . The social inclusion approach will ask a client to identify which social domains they would like to prioritise for inclusion in mainstream. The bridge builder's role is then to signpost the client to the mainstream domain which has been prioritised. In order to facilitate this, bridge builders must have a wide network of local and regional contacts in his or her field of expertise. Further support relates only to how much or how little the client requests.
As Arts bridge builder for example, I need to know what is out there for clients who may wish to do arts courses or rehearse and record their music. Other clients may be seeking self-employment through tutoring, performing or composing. All of these aspirational goals have had successful outcomes, some of them quite outstanding. All the clients referred to mainstream come from a background of 'severe and enduring' mental health conditions.
The bridge building service is not a clinical or diagnostic one, although we work closely with Community Mental Health Teams. It is designed to enable clients to participate in mainstream, based on their own preferences, choices, skills and dreams. Clients are free to choose whether to disclose their illnesses or not.
When the arts bridge builder meets with a client, the key questions are 'what do you wish to see happen for yourself' or 'what would you like to do'. Bridge building focuses on aspiration, goals and innate gifts and talents. And that's it.
Social Inclusion has long been a mantra for organisations representing clients who may be isolated or marginalised for one reason or another. Government think-tanks in the early 2000s identified key areas or social domains relevant to people's lives and development in the mainstream world. These are: employment, the arts, spirituality & cultural identity, volunteering, sports & healthy living, family and neighbourhood.
As a social inclusion bridge builder for mental health, I work with clients who wish to access Arts & Culture . The social inclusion approach will ask a client to identify which social domains they would like to prioritise for inclusion in mainstream. The bridge builder's role is then to signpost the client to the mainstream domain which has been prioritised. In order to facilitate this, bridge builders must have a wide network of local and regional contacts in his or her field of expertise. Further support relates only to how much or how little the client requests.
As Arts bridge builder for example, I need to know what is out there for clients who may wish to do arts courses or rehearse and record their music. Other clients may be seeking self-employment through tutoring, performing or composing. All of these aspirational goals have had successful outcomes, some of them quite outstanding. All the clients referred to mainstream come from a background of 'severe and enduring' mental health conditions.
The bridge building service is not a clinical or diagnostic one, although we work closely with Community Mental Health Teams. It is designed to enable clients to participate in mainstream, based on their own preferences, choices, skills and dreams. Clients are free to choose whether to disclose their illnesses or not.
When the arts bridge builder meets with a client, the key questions are 'what do you wish to see happen for yourself' or 'what would you like to do'. Bridge building focuses on aspiration, goals and innate gifts and talents. And that's it.
How Social Inclusion is good for business
Social Inclusion - so good for business
The business case for mental health awareness is evidenced by the increasing numbers of employers who are commissioning mental health awareness trainings for their workforce. Employers want trainings which enable their staff to understand more about common mental health conditions. Understanding mental health means that staff can work better with clients and customers. It also allows staff to feel less isolated about personal issues around health and well-being.
Mental health awareness provides the opportunity for employers and employees to find out more about the law as it relates to employment and mental health.
Enlightened employers will seek to develop a workforce team which is happy rather than unhappy, fulfilled rather than excluded. Courses such as MHFA (Mental Health First Aid) show that attendees often feel that one of the benefits of the training in that it allows for a safe space. A safe space where individuals can share feelings about their personal well-being in addition to learning about the broader aspects of mental health conditions and the appropriate interventions.
In addition to mental health, it makes solid sense for businesses to incorporate awareness of social inclusion and mainstream. Returning to or accessing mainstream living is now a key part of the care pathway for those diagnosed with 'severe and enduring' mental health diagnoses. It is equally important for people who may be experiencing conditions such as anxiety, phobia or stress at work.
Both groups - those in primary and secondary care - are being signposted to mainstream life rather than to special settings as a central plank of the recovery process. The implications for any service provider - and that includes businesses - are crucial. Businesses and services are at the receiving end of mainstream.
Clients in recovery are choosing to access their personal goals through a diverse range of outlets. These could range from faith venues to volunteer bureaus, from retail outlets to sports centres, from recording studios to adult education colleges, from libraries to personal counselors, from training venues to department stores.
For businesses, it's not just one in four of their staff who may be experiencing mental health challenges, it's also one in four of their clients, customers and service consumers. Mental health challenges will also have an impact on one in three families. Disclosed or undisclosed, it's clear that mental health and well-being lie at the heart of our transactions and interactions.
The business case for mental health awareness is evidenced by the increasing numbers of employers who are commissioning mental health awareness trainings for their workforce. Employers want trainings which enable their staff to understand more about common mental health conditions. Understanding mental health means that staff can work better with clients and customers. It also allows staff to feel less isolated about personal issues around health and well-being.
Mental health awareness provides the opportunity for employers and employees to find out more about the law as it relates to employment and mental health.
Enlightened employers will seek to develop a workforce team which is happy rather than unhappy, fulfilled rather than excluded. Courses such as MHFA (Mental Health First Aid) show that attendees often feel that one of the benefits of the training in that it allows for a safe space. A safe space where individuals can share feelings about their personal well-being in addition to learning about the broader aspects of mental health conditions and the appropriate interventions.
In addition to mental health, it makes solid sense for businesses to incorporate awareness of social inclusion and mainstream. Returning to or accessing mainstream living is now a key part of the care pathway for those diagnosed with 'severe and enduring' mental health diagnoses. It is equally important for people who may be experiencing conditions such as anxiety, phobia or stress at work.
Both groups - those in primary and secondary care - are being signposted to mainstream life rather than to special settings as a central plank of the recovery process. The implications for any service provider - and that includes businesses - are crucial. Businesses and services are at the receiving end of mainstream.
Clients in recovery are choosing to access their personal goals through a diverse range of outlets. These could range from faith venues to volunteer bureaus, from retail outlets to sports centres, from recording studios to adult education colleges, from libraries to personal counselors, from training venues to department stores.
For businesses, it's not just one in four of their staff who may be experiencing mental health challenges, it's also one in four of their clients, customers and service consumers. Mental health challenges will also have an impact on one in three families. Disclosed or undisclosed, it's clear that mental health and well-being lie at the heart of our transactions and interactions.
Wednesday, 7 July 2010
Is anti-stigma the new stigma?
Is anti-stigma the new stigma?
The 'Time to Change' campaign challenges stigma and discrimination against people with mental health conditions. For the next phase of the campaign Time to Change is helping groups and individuals organise activities which actively cooperate in challenging discriminatory attitudes and behaviours.
Time to Change advises that 'at Get Moving events it is ideal if there is a 50/50 mix of individuals with experience of mental health problems and those without in order to maximise the amount of stigma broken down and the number of stereotypes challenged.' Events suggested are football games, group walks or 'a dance routine which is then performed'.
The campaign promotes 'social contact' and 'social contact theory' put into practice' to challenge stigma and discrimination'.
Why should people with mental health conditions have to access mainstream activities as part of a campaign?
Challenging discrimination is achieved primarily through engaging in mainstream as a contributor, a consumer or a provider. Many people with mental health conditions access mainstream activities, making their own choices as to whether to disclose or not. The most impact in challenging mainstream can be achieved by prioritising individual goals and aspirations. Support is also available to access mainstream from mental health organisations and bridge builders or through direct payments.
People who play football who happen to have mental health conditions are footballers. They aren't required to be 'positive mental health footballers'. People who play guitar who happen to have mental health conditions are guitarists, not mental health guitarists. People who are arts tutors who have a mental health condition are arts tutors. By continuing to tag mental health on mainstream activities and aspirations there is a danger of recycling stigma and not allowing people to move into valued social roles.
Could anti-stigma be the new stigma?
The 'Time to Change' campaign challenges stigma and discrimination against people with mental health conditions. For the next phase of the campaign Time to Change is helping groups and individuals organise activities which actively cooperate in challenging discriminatory attitudes and behaviours.
Time to Change advises that 'at Get Moving events it is ideal if there is a 50/50 mix of individuals with experience of mental health problems and those without in order to maximise the amount of stigma broken down and the number of stereotypes challenged.' Events suggested are football games, group walks or 'a dance routine which is then performed'.
The campaign promotes 'social contact' and 'social contact theory' put into practice' to challenge stigma and discrimination'.
Why should people with mental health conditions have to access mainstream activities as part of a campaign?
Challenging discrimination is achieved primarily through engaging in mainstream as a contributor, a consumer or a provider. Many people with mental health conditions access mainstream activities, making their own choices as to whether to disclose or not. The most impact in challenging mainstream can be achieved by prioritising individual goals and aspirations. Support is also available to access mainstream from mental health organisations and bridge builders or through direct payments.
People who play football who happen to have mental health conditions are footballers. They aren't required to be 'positive mental health footballers'. People who play guitar who happen to have mental health conditions are guitarists, not mental health guitarists. People who are arts tutors who have a mental health condition are arts tutors. By continuing to tag mental health on mainstream activities and aspirations there is a danger of recycling stigma and not allowing people to move into valued social roles.
Could anti-stigma be the new stigma?
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