On October 23rd, 2014, we updated our
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Sue attends the day centre and the clinic. She has 5 friends she sees at outpatients or the day centre. Employment Education Volunteering Arts and Culture Faith communities Family & neighbourhood Sport & exercise Services People can become very isolated
How can adults with mental health problems secure the same opportunities for social participation and access to services as the general population ?
What more can be done to enable adults with mental health problems to enter and engage within community life ?
and so on …,
Recovery What does ‘recovery’ mean for an individual? “… of changing one’s orientation and behaviour from a negative focus on a troubling event, condition or circumstance to the positive restoration, rebuilding, reclaiming or taking control of one’s life .” NIMHE Guiding Statement on Recovery (January 2005)
What does recovery mean for a system designed to provide support to people? Focus on people rather than services. Monitoring outcomes rather than performance. Emphasising strengths rather than deficits or dysfunction. Educating people who provide services, schools, employers, the media and the public to combat stigma. Fostering collaboration between those who need support and those who support them as an alternative to coercion. Enabling and supporting self-management, promoting autonomy and, as a result, decreasing the need for people to rely on formal services and professional supports. NIMHE Guiding Statement on Recovery (January 2005)
Direct Payments are …,
Money given directly to people to meet their assessed social care needs
The result of campaigning by Disabled People for greater choice and control in their lives
Improving the life chances of disabled people Prime Minister’s Strategy Unit, DWP, DH, DfES, ODPM (2005) Improving the Life Chances of Disabled People – January London: Cabinet Office
A means to an end:
Recovery and Independent Living or
Enabling people to live their life as they would want
“ Ultimately every locality should have a single community based support system focussed on the health and well being of the local population. Binding together local Government, primary care, community based health provision, public health, social care and the wider issues of housing, employment, benefits advice and education/training. This will not require structural changes, but organisations coming together to re-design local systems around the needs of citizens.” (“ Putting People First 10th Dec 2007 Local Government Association, NHS, ADASS
Individual Budget Continuing Health Care funding Pooled Budgets Virtual Individual Budgets for health & therapy services - Use of non-recurring budgets and grants Environmental adaptations Tax, income solutions for families NHS State funded... Payment by results Increased focus on electives Early clarification of community entitlements (including Individual Budgets) Practice-based commissioning Local Area Coordination Some people with Individual Budgets already LEVERS Support planning to stay well Professional help to train family, friends and supporters working with family and housing environment crisis emergency planning MH capacity plan District Nursing Virtual budget Construct a person-centred approach Information on efficacy Therapy services link to friends, neighbours environmental assessment Maximise recovery from shock - regain confidence and prepare for return to control Maximise control - ward routine - mealtimes - patient participation - self-medication Maximise relative contribution Planning changes to home and support Develop ‘passports’ Involve family and friends Making plans transparent Share good information on health and risk STRATEGIES Reduce risk of re-admission Maximise health & well-being Reduce risk of re-admission to hospital or care home Increase rate of return to home Maximise focus on return to home Maximise dignity & self-respect Reduce risk of admission Increase planning for admission GOAL Home + support Intermediate Hospital Home Environment
The Challenge Ahead
Some areas for Action!
A standard option within CPA
Commissioning that facilitates this
Pro-active approach from managers, based on the guidance, research and ministerial statements
Well informed and well supported Care Co-ordinators
Adequate Payments support services
Information and support to people eligible to use mental health services and carers