achieving meaningful integration in mental health services

1. Personalisation &
Integration
Cambridge
January 2011
© Simon Duffy. Rights Reserved. Full copyright details at www.centreforwelfarereform.org

2. Four Questions
1. What is personalisation?
2. What does it mean for people with mental health
problems?
3. Is integration important?
4. How should we fund mental health supports?

3. 1. Personalisation

5. Personalisation Model from Personalisation in Mental Health by Simon Duffy

6. 1. A positive focus on the person - their real
wealth
2. An equal and productive relationship with
the professional - coproduction
3. A commitment to positive outcomes and
citizenship

7. Real Wealth from A Fair Start by Pippa Murray

8. Coproduction by Simon Duffy cited in A Fair Start by Pippa Murray

9. Community Support & Health Care From Personalisation in Mental Health by Simon Duffy

10. From Keys to Citizenship by Simon Duffy

11. 2. Mental Health

12. These findings [better long-term outcomes for
schizophrenia in developing countries] still
generate some professional contention and disbelief,
as they challenge outdated assumptions that
generally people do not recover from schizophrenia
and that outcomes for western treatments and
rehabilitation must be superior. However, these
results have proven to be remarkably robust, on the
basis of international replications and 15-25 year
follow-up studies. Explanations for this phenomenon
are still at the hypothesis level, but include:
1. greater inclusion or retained social integration in
the community in developing countries, so that the
person retains a role or status in the society;
2. involvement in traditional healing rituals,
reaffirming community inclusion and solidarity;
3. availability of a valued work role that can be
adapted to a lower level of functioning;
4. availability of an extended kinship or communal
network, so that family tension and burden are
diffused, and there is often less negatively 'expressed
emotion' in the family.
Quote from Alan Rosen cited in Turning the World Upside Down by Nigel Crisp

13. Type of Purchase Amount % of
Transportation 7526.72
(£) 13%
Total
Computers and accessories 6899.95 12%
Dental services 6662.59 11%
Medication management services 4897.87 8%
Psychotropic medications 4890.33 8%
Mental health counselling 4864.18 8%
Housing 4133.59 7%
Massage, weight control, smoking 3017.13 5%
Utilities
cessation 1968.77 3%
Travel 1721.13 3%
Equipment 1615.88 3%
Clothing 1423.27 2%
Food 1390.25 2%
Crafts 1361.35 2%
Licenses/ certification 1253.35 2%
Entertainment (movies, eating out) 1216.12 2%
Vision services 1127.47 2%
Furniture 640.44 1%
Non-mental health medical 515.24 1%
Camera and supplies 477.47 1%
Education, training, materials 394.22 1%
Haircut, manicure, make up lessons 336.43 1%
Pet ownership 330.93 1%
Supplies and storage 282.12 <1%
Other 8.26 <1%
Total 58,965.40 100%
Research cited in Active Patient by Vidhya Alakeson

14. Tapered Control in Personalisation in Mental Health by Simon Duffy

15. Organisational Structures from Personalised Support by Julia Fitzpatrick

16. 3. Integration

17. From Women at the Centre (forthcoming) by Simon Duffy & Clare Hyde

18. From Women at the Centre (forthcoming) by Simon Duffy & Clare Hyde

19. From Women at the Centre (forthcoming) by Simon Duffy & Clare Hyde

20. From Women at the Centre (forthcoming) by Simon Duffy & Clare Hyde

21. Personalised Pathway from A Fair Start by Pippa Murray

22. 4. Funding

23. Total Place Commissioning from Personalisation in Mental Health by Simon Duffy

24. Local Authority Well-being or
‘Social Care’
Resources Independence
Improved clinical
NHS Resources Medical services
outcomes
Welfare Improved mental
‘what works’
funding health

25. From Women at the Centre (forthcoming) by Simon Duffy & Clare Hyde

26. Different Funding Systems in Health Care from Personalisation in Mental Health by Simon Duffy

27. Individual Budget from Personalisation in Mental Health by Simon Duffy

28. From Resource Allocation in Mental Health by Simon Duffy

29. 1. Status quo - 2 systems
2. Tidy up & rationalise,
but 2 systems
3. One system - but with
two funding streams
4. Just one system, with
real joint funding

30. • Health-social care distinction will not hold when
people seek solutions that work
• Mental health is sufficiently coherent to have its
own system - but not coherent enough to have
two!
• Political situation creates interesting opportunities
- creative havoc in local government and PCTs
• Risk of increased tension and incoherence - the
imperative to personalise will fail without greater
rigour

31. Contact Details
The Centre for Welfare Reform
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Sheffield, S9 4WG
T +44 114 251 1790
M +44 7729 7729 41
admin@centreforwelfarereform.org
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© Simon Duffy. Rights Reserved. Full copyright details at www.centreforwelfarereform.org