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'.
Saturday, 5 February 2011
Tuesday, 21 December 2010
Review of the Year part II
Questions
What was the mental health scene like in 2010 for those at the grittier end of the stick? What was 2010 like for people in secondary care? For people under community mental health teams?
Was there more recovery in 2010? Were people in secondary care able to access mainstream in 2010? Were they less doomed to what Dr. Pat Deegan calls 'a career in mental health'?
Did people with severe and enduring mental health conditions receive enough support from services? Did they receive the right support? Did the support help them or hinder them?
Some answers
Throughout 2010, statutory and voluntary services responded to the health challenge of independence and mainstream in several key ways. Firstly, mental health teams set up some important initiatives. These were geared towards client independence and recovery. Many predominantly service-user led.
Recovery University in the south-west London borough of Merton enables secondary care clients to access a wide spectrum of trainings and skillsets. These include preparing for work, independence and life skills, confidence building, anger management and many more. Recovery University also trains service users as trainers for forthcoming courses.
Other community initiatives are also up and running, including wellbeing programmes and access to psychological therapies. However, pyschological therapies in non-clinical settings are still not available should you happen to have a severe and enduring mental health condition.
Training the trainers often draws upon experiences and qualifications which service users have already gained within their life journeys. Mainstream groups have also utilised service user skills as part of their own training programmes in areas such as visual arts, music and creative writing. This has taken the recovery university one stage further, providing paid employment and access to mainstream.
Statutory services continued to have success in keeping people out of hospital or limiting hospital stays to a minimum. The downside of this is that more and more people are being discharged from statutory services altogether. In 2011 this will inevitably result in more pressure on GP services, as it is these practitioners who will become responsible under the latest government directives.
The rolling-out of the personalisation programme should mean more access to direct payments for many clients under mental health care plans. It should also mean more and more creative uses of direct payments, as DP is being promoted for any activity or outcome that a client deems relevant to his or her recovery. The Personal Stories videos on the NMHDU site bears witness to some of these outcomes. With more and more people being discharged from mental health services, it is crucial that personalisation is a success in the new year.
What was the mental health scene like in 2010 for those at the grittier end of the stick? What was 2010 like for people in secondary care? For people under community mental health teams?
Was there more recovery in 2010? Were people in secondary care able to access mainstream in 2010? Were they less doomed to what Dr. Pat Deegan calls 'a career in mental health'?
Did people with severe and enduring mental health conditions receive enough support from services? Did they receive the right support? Did the support help them or hinder them?
Some answers
Throughout 2010, statutory and voluntary services responded to the health challenge of independence and mainstream in several key ways. Firstly, mental health teams set up some important initiatives. These were geared towards client independence and recovery. Many predominantly service-user led.
Recovery University in the south-west London borough of Merton enables secondary care clients to access a wide spectrum of trainings and skillsets. These include preparing for work, independence and life skills, confidence building, anger management and many more. Recovery University also trains service users as trainers for forthcoming courses.
Other community initiatives are also up and running, including wellbeing programmes and access to psychological therapies. However, pyschological therapies in non-clinical settings are still not available should you happen to have a severe and enduring mental health condition.
Training the trainers often draws upon experiences and qualifications which service users have already gained within their life journeys. Mainstream groups have also utilised service user skills as part of their own training programmes in areas such as visual arts, music and creative writing. This has taken the recovery university one stage further, providing paid employment and access to mainstream.
Statutory services continued to have success in keeping people out of hospital or limiting hospital stays to a minimum. The downside of this is that more and more people are being discharged from statutory services altogether. In 2011 this will inevitably result in more pressure on GP services, as it is these practitioners who will become responsible under the latest government directives.
The rolling-out of the personalisation programme should mean more access to direct payments for many clients under mental health care plans. It should also mean more and more creative uses of direct payments, as DP is being promoted for any activity or outcome that a client deems relevant to his or her recovery. The Personal Stories videos on the NMHDU site bears witness to some of these outcomes. With more and more people being discharged from mental health services, it is crucial that personalisation is a success in the new year.
Friday, 10 December 2010
UK Mental Health Review of the Year 2010 - part 1
The background
Most years are momentous for mental health and 2010 has been no exception.
Momentous for individuals experiencing mental health conditions or their onset. Momentous for their family, friends and carers. Momentous for the way that society, the legislature and the populace have chosen to respond to the challenge of mental health.
There has been a clear road, a visible highway. The 2005 amendments to the Disability Discrimination Act (DDA) have been taken further with the Equality Act that came into force on October 1st 2010. Carol Black's 2008 report 'Working for a Healthier Tomorrow' was a round-up and reinforcement of the initiatives embodied in DDA, designed to address key concerns of health and legal rights in the workplace.
The year 2010
Major businesses and business organisations have also addressed the massive loss to the economy and to human happiness that can be caused by mental ill-health. In 2005 the Confederation of British Industry was concerned enough to commission its own research. Business owners and directors have not been slow to follow their confederation's lead.
Supported by business ‘dragon’ Duncan Bannatyne, Mind’s ‘Taking care of Business’ campaign continues to highlight the initiatives being taken by many employers around issues of mental health at work. Some of the companies who signed up to support the Mind campaign include EDF energy, BT, Hewitt Consultancy, AXA and police and security services. Hewitt Associates helped set up an Employee Assistance programme allowing staff access to counselling services where appropriate.
Anti-stigma group Shift is also 'high visibility' in its tireless campaigning for an end to mental health discrimination and in its promotion of understanding the need to support good mental health in the workplace.
Equality Act
The increasing awareness of how mental health affects culminated in 2010 with the Equality Act. The Act reinforces all the implementations of the Disability Discrimination Act (DDA) and in particular, the rights of employees who have disclosed a mental health condition. Before the act came into force, employees had the legal right to reasonable adjustments in their working conditions where appropriate. With the Equality Act, the burden of proof now lies with the employer to show that adjustments have been made rather than with the employee to prove they haven't. It is a highly significant rights-based change.
Most years are momentous for mental health and 2010 has been no exception.
Momentous for individuals experiencing mental health conditions or their onset. Momentous for their family, friends and carers. Momentous for the way that society, the legislature and the populace have chosen to respond to the challenge of mental health.
There has been a clear road, a visible highway. The 2005 amendments to the Disability Discrimination Act (DDA) have been taken further with the Equality Act that came into force on October 1st 2010. Carol Black's 2008 report 'Working for a Healthier Tomorrow' was a round-up and reinforcement of the initiatives embodied in DDA, designed to address key concerns of health and legal rights in the workplace.
The year 2010
Major businesses and business organisations have also addressed the massive loss to the economy and to human happiness that can be caused by mental ill-health. In 2005 the Confederation of British Industry was concerned enough to commission its own research. Business owners and directors have not been slow to follow their confederation's lead.
Supported by business ‘dragon’ Duncan Bannatyne, Mind’s ‘Taking care of Business’ campaign continues to highlight the initiatives being taken by many employers around issues of mental health at work. Some of the companies who signed up to support the Mind campaign include EDF energy, BT, Hewitt Consultancy, AXA and police and security services. Hewitt Associates helped set up an Employee Assistance programme allowing staff access to counselling services where appropriate.
Anti-stigma group Shift is also 'high visibility' in its tireless campaigning for an end to mental health discrimination and in its promotion of understanding the need to support good mental health in the workplace.
Equality Act
The increasing awareness of how mental health affects culminated in 2010 with the Equality Act. The Act reinforces all the implementations of the Disability Discrimination Act (DDA) and in particular, the rights of employees who have disclosed a mental health condition. Before the act came into force, employees had the legal right to reasonable adjustments in their working conditions where appropriate. With the Equality Act, the burden of proof now lies with the employer to show that adjustments have been made rather than with the employee to prove they haven't. It is a highly significant rights-based change.
Friday, 26 November 2010
Wednesday, 17 November 2010
Are UK services ready for the personalisation programme?
Within two years, by 2013, the Personalisation Programme is set to be rolled out across UK health and mental health services.
In June 2010 Eight Primary Care Trusts began roadtesting direct payments for personal health budgets.
'Patients will be offered more choice and control over their healthcare' announced Care Services minister Paul Burstow. 'The launch of the first direct payment scheme is an important step towards putting patients at the heart of everything the NHS does' he added .
The Coalition government has pledged its 'commitment to extend access' to direct payments. As Paul Burstow reasons, direct payments 'is a step away from the rigidity of the Primary Care Trusts deciding what services a patient will receive'.
Quite how the PCTs are going to be less rigid with their budgets is still unclear. Some formidable outcomes have already been achieved in some of the areas where the scheme is being piloted ( testimonial videos at NMHDU). Nonetheless, the PCTs are still holding the budgets for direct payments. Where direct payments is not being piloted or simply not understood, patients and carers are still being denied their rights. The 'rigid' approach is still being applied and clients wishing to access mainstream activities of their own choice are being turned down.
The Care Services minister has announced that direct payments 'will stop healthcare from slipping back to the days of one-dimensional, like-it-or-lump-it services'.
It is a great pity and possibly a legal scandal that clients wishing to determine their own recovery journeys are still being turned down by PCTs for direct payments.
'One-dimensional, like-it-or-lump-it services' are still around.
In June 2010 Eight Primary Care Trusts began roadtesting direct payments for personal health budgets.
'Patients will be offered more choice and control over their healthcare' announced Care Services minister Paul Burstow. 'The launch of the first direct payment scheme is an important step towards putting patients at the heart of everything the NHS does' he added .
The Coalition government has pledged its 'commitment to extend access' to direct payments. As Paul Burstow reasons, direct payments 'is a step away from the rigidity of the Primary Care Trusts deciding what services a patient will receive'.
Quite how the PCTs are going to be less rigid with their budgets is still unclear. Some formidable outcomes have already been achieved in some of the areas where the scheme is being piloted ( testimonial videos at NMHDU). Nonetheless, the PCTs are still holding the budgets for direct payments. Where direct payments is not being piloted or simply not understood, patients and carers are still being denied their rights. The 'rigid' approach is still being applied and clients wishing to access mainstream activities of their own choice are being turned down.
The Care Services minister has announced that direct payments 'will stop healthcare from slipping back to the days of one-dimensional, like-it-or-lump-it services'.
It is a great pity and possibly a legal scandal that clients wishing to determine their own recovery journeys are still being turned down by PCTs for direct payments.
'One-dimensional, like-it-or-lump-it services' are still around.
Care and Support - can they hinder recovery?
Care and support are not the only models or frameworks for mental health recovery. The establishing or re-establishing of what Dr. Pat Deegan refers to as 'valued social roles' can be held back by a mental health system that often encourages the client to choose 'a career in mental health' (Pat Deegan).
A career in mental health means living longterm on benefits and longterm marginalisation from mainstream life. A career in mental health will identify symptoms, diagnoses, medication and team support but will often leave out aspirations, goals, priorities.
Where access to mainstream is encouraged, it can often be through projects or programmes which take place in special settings or are designed for people with mental health conditions. So the marginalisation continues.
A genuine return to mainstream can only take place in mainstream. This is where the role of the bridge builder comes in. A client who has worked with a mainstream bridge builder identifies goals and priorities for him or herself. It is the bridge builder's job to signpost or link the client up with mainstream venues appropriate to the client's life choices. The amount of support a client may request from there on is determined only by the client.
A career in mental health means living longterm on benefits and longterm marginalisation from mainstream life. A career in mental health will identify symptoms, diagnoses, medication and team support but will often leave out aspirations, goals, priorities.
Where access to mainstream is encouraged, it can often be through projects or programmes which take place in special settings or are designed for people with mental health conditions. So the marginalisation continues.
A genuine return to mainstream can only take place in mainstream. This is where the role of the bridge builder comes in. A client who has worked with a mainstream bridge builder identifies goals and priorities for him or herself. It is the bridge builder's job to signpost or link the client up with mainstream venues appropriate to the client's life choices. The amount of support a client may request from there on is determined only by the client.
Wednesday, 10 November 2010
Equalities Act 2010
During the parliamentary stages of the Equality Bill, mental health organisation Mind lobbied with other mental health and disability charities to get a ban on pre-employment questionnaires included in the Act. After securing cross-party support for the principle of a ban on questions that ask about a candidate's medical history and putting considerable pressure on Ministers, the last Government introduced a new clause to the Equality Bill making these questions unlawful.
The Equality Act came into force on October 1st 2010. The act bans companies from finding out whether potential employees are healthy enough to work for them prior to an offer of employment. Candidates will no longer be expected to declare medical issues during the recruitment stage unless it is specifically related to their job role.
Equality campaigners have long argued that employers discriminate against prospective employees with mental health issues, disabilities or a long history of illness, putting people off applying for a job.
However, 65pc of employers still ask a candidate about their health prior to a job offer, and 48pc ask potential employees to fill out a questionnaire detailing medical conditions and sickness records, according to a poll of 100 companies by law firm Pannone.
Jim Lister, head of employment law at Pannone, said: "The penalties for employers include investigation by the Equality and Human Rights Commission and the reversal of the burden of proof, meaning that the employer will be assumed to have discriminated, unless it can show there was another reason for non-selection.
Organisations that learn of a person's health issue after the job offer but fail to make reasonable adjustments and are forced to withdraw the offer face litigation, lawyers have said.
The reversal of the burden of proof is highly significant. Effectively this means that an employee who feels discriminated against on the grounds of mental ill-health, for example, is not required to prove that this is the case. It becomes the employer's responsibility to prove that this is not the case. If proved otherwise, the employer will be required by law to comply with equalities legislation and where necessary, to make reasonable adjustments on behalf of the employee.
The Equality Act came into force on October 1st 2010. The act bans companies from finding out whether potential employees are healthy enough to work for them prior to an offer of employment. Candidates will no longer be expected to declare medical issues during the recruitment stage unless it is specifically related to their job role.
Equality campaigners have long argued that employers discriminate against prospective employees with mental health issues, disabilities or a long history of illness, putting people off applying for a job.
However, 65pc of employers still ask a candidate about their health prior to a job offer, and 48pc ask potential employees to fill out a questionnaire detailing medical conditions and sickness records, according to a poll of 100 companies by law firm Pannone.
Jim Lister, head of employment law at Pannone, said: "The penalties for employers include investigation by the Equality and Human Rights Commission and the reversal of the burden of proof, meaning that the employer will be assumed to have discriminated, unless it can show there was another reason for non-selection.
Organisations that learn of a person's health issue after the job offer but fail to make reasonable adjustments and are forced to withdraw the offer face litigation, lawyers have said.
The reversal of the burden of proof is highly significant. Effectively this means that an employee who feels discriminated against on the grounds of mental ill-health, for example, is not required to prove that this is the case. It becomes the employer's responsibility to prove that this is not the case. If proved otherwise, the employer will be required by law to comply with equalities legislation and where necessary, to make reasonable adjustments on behalf of the employee.
Subscribe to:
Posts (Atom)