Vicserv hosted an event on the true meaning of control and choice. Simon Duffy explores how control and choice should be seen as a part of building citizenship for all and moving way from institutional responses to need.

1. Heading Upstream
21st Century deinstitutionalisation

2. Acknowledging our
elders past and present

5. Countries where self-directed support is happening

7. Location N Change
England - 6 Sites Phase I Report 60 -18.0%
England - 17 Sites Phase II Report 128 -9.0%
England - 13 Sites IBSEN Report 203 -6.0%
England - Northamptonshire 17 -18.7%
England - City of London 10 -30.0%
England - Worcestershire 73 -17.0%
England - Southwark 85 -29.8%
Scotland - Glasgow 12 -44.0%
USA - Denver - Disabled Children - -34.0%
USA - Florida - Disabled Children - -30.0%

9. We must beware
the drift of ideas
rooted in rights
and citizenship
into the emptiness
of consumerism

12. Upstream
mental health
• Creating a life of citizenship
• Finding places of belonging
• Social justice and income equality
• Connection to nature and the land
• Family, love and relationships
• Work life with meaning

13. Deinstitutionalisation

16. How institutions
closed
• Moral outrage + sense of hope
• Advocacy and campaigning
• Professional leadership
• Offering politicians a new narrative
• Unlocking resources
• Testing out solutions for real

17. Serviceland

20. The new
institutions
• Day centres, not jobs
• Care homes, not homes
• Special buses, not a car
• Respite, not a holiday
• Therapy, not fun
• Befriending, not love

24. Citizenship

28. How we discover our citizenship
1. Finding our sense of purpose
2. Having the freedom to pursue it
3. Having enough money to be free
4. Having a home where we belong
5. Getting help from other people
6. Making life in community
7. Finding, sharing and giving love

30. Personalised
Support
• Flexible funding
• Ordinary housing options
• Shared management
• Creativity & commitment
• Staff matching

31. Family

37. Family
leadership
• Love and spirit at the heart
• The obvious problem is rarely
the problem
• The obvious solution is rarely
the solution
• Families listen to families, peers
listen to peers

38. Community

43. What people
really need
• Each other
• Place to belong
• Opportunities to give
• Integrity of governance

44. Society

48. In total, across England as a
whole, the WCA disability
reassessment process during this
period was associated with an
additional 590 suicides…
279,000 additional cases of self-
reported mental health
problems…
and the prescribing of an
additional 725,000
antidepressant items.
Barr B, et al. J Epidemiol Community
Health 2015;0:1–7. doi:10.1136/
jech-2015-206209

50. …there is reliable evidence that the threshold of grave or
systematic violations of the rights of persons with
disabilities has been met in the State party… The core
elements of the rights to independent living and being
included in the community, an adequate standard of living and
social protection and their right to employment have been
affected… freedom of choice and control over their daily
activities restricted, the extra cost of disability has been set
aside and income protection has been curtailed as a result of
benefit cuts, while the expected policy goal of achieving
decent and stable employment is far from being attained
UN Committee on the Rights of Persons with Disabilities:
Inquiry concerning the United Kingdom of Great Britain and
Northern Ireland carried out by the Committee under article 6 of
the Optional Protocol to the Convention
6th October 2016
UN declares UK Government fails to respect disability rights

52. How to do
social change
• New ideas
• ‘Unionise’
• Breakdown silos
• Create a new narrative

53. What about us?

54. TY Tim Keilty
Service
providers:
coming to
a galaxy
near you
soon

58. We don’t need
to give our
power away

61. Let’s do what citizens do…
work together for a better world

64. For those of us who value citizenship
this beautiful world of diverse people
and complex communities is a
profound source
of strength
and joy