Direct payments increase the choice and control that people have over the support they receive. The take-up of direct payments by people experiencing mental health problems has been extremely low in most parts of the country. This project, New Directions, was undertaken by the Health and Social Care Advisory Service and draws on a range of discussions with over 250 service users and staff in order to identify what needs to happen for direct payments to be successfully implemented. Service users, carers and professionals require straightforward, accurate and accessible information about direct payments which is specific to mental health. Both service users and professionals can be confused about the distinction to access to an assessment for receipt of direct payments and access to services, where the threshold may be much higher and based largely on clinical considerations. This can affect take-up. Mental health users require specific advocacy and practical support to facilitate access to and use of direct payments. The absence of a streamlined process integrated with the Care Programme Approach adds to the sense of direct payments being a burden rather than an opportunity. Ways to increase take-up by people from black and minority ethnic communities include developing resources and approaches, including outreach and direct support services specific to those communities.
Direct payments increase the choice and control that people have over the support they receive. The take-up of direct payments by people experiencing mental health problems has been extremely low in most parts of the country. This project, New Directions, was undertaken by the Health and Social Care Advisory Service and draws on a range of discussions with over 250 service users and staff in order to identify what needs to happen for direct payments to be successfully implemented. Service users, carers and professionals require straightforward, accurate and accessible information about direct payments which is specific to mental health. Both service users and professionals can be confused about the distinction to access to an assessment for receipt of direct payments and access to services, where the threshold may be much higher and based largely on clinical considerations. This can affect take-up. Mental health users require specific advocacy and practical support to facilitate access to and use of direct payments. The absence of a streamlined process integrated with the Care Programme Approach adds to the sense of direct payments being a burden rather than an opportunity. Ways to increase take-up by people from black and minority ethnic communities include developing resources and approaches, including outreach and direct support services specific to those communities.
Subject terms:
mental health problems, social care provision, user views, access to information, access to services, advocacy, black and minority ethnic people, decision making, direct payments;
The Shaping Our Lives project, working in partnership with Black User Group (London), Service User Action Group (Wakefield), Ethnic Disabled Group Emerged (Manchester) and an alliance of user groups in Waltham Forest (London), looked at the application in practice of on-going work about what service users meant by 'user-defined outcomes'. Both the research and the development projects covered a range of experiences - including those of older people, mental health users, minority ethnic communities and disabled people and involving 66 users in all.
The Shaping Our Lives project, working in partnership with Black User Group (London), Service User Action Group (Wakefield), Ethnic Disabled Group Emerged (Manchester) and an alliance of user groups in Waltham Forest (London), looked at the application in practice of on-going work about what service users meant by 'user-defined outcomes'. Both the research and the development projects covered a range of experiences - including those of older people, mental health users, minority ethnic communities and disabled people and involving 66 users in all.
Subject terms:
mental health problems, older people, outcomes, physical disabilities, service users, user participation, user views, advocacy, black and minority ethnic people;
The Disability Discrimination Act 1995 has focused the attention of health and social care employers on the issue of discrimination within the workforce. Describes a small exploratory study which asked a range of mental health professionals, who have also used mental health services, about their experiences as members of this workforce and their recommendations for change.
The Disability Discrimination Act 1995 has focused the attention of health and social care employers on the issue of discrimination within the workforce. Describes a small exploratory study which asked a range of mental health professionals, who have also used mental health services, about their experiences as members of this workforce and their recommendations for change.
Subject terms:
mental health problems, mental health professionals, mental health services, service users, staff, user views, community mental health services, disability discrimination, discrimination;
This research is about the involvement in risk assessment and management of mental health service users considered by professionals to pose a potential risk to other people. The research was carried out due to concerns that the voices of these service users are not being heard in research, policy or practice. Many service users were aware that they could pose a risk to other people when experiencing psychosis and they wanted help to reduce the chances of this happening. Full and frank discussion of risk to others was difficult for many professionals. Some people could not be asked to participate in the study because they did not know they were considered to be a risk to other people. Reasons for talking about risk to others included the user's right to know what is written about them, and increased trust between user and professional, with the potential for collaborative risk management. Reasons against talking about risk to others included increasing stigma and distress; this prompted disengagement from services, and fears for personal safety. Levels of agreement between service users and professionals about risk and how to respond to it ranged from full agreement to very little or none. Service user involvement in risk assessment and management was variable and depended upon individual professional initiative. Few professionals were undertaking systematic risk assessment or risk management plans. Some service users influenced the support they received but, generally, users' main role was to accept or reject what was offered. Professionals had less room to accommodate user views where the risks were considered too high. Little use was made of advocates, and users were not provided with a full picture of the different supports available. Medication and supported housing emerged as key issues for potential tension and disagreement between service users and professionals. Serious gaps and inaccuracies were sometimes found in information held about service users that potentially put themselves and others at risk.
This research is about the involvement in risk assessment and management of mental health service users considered by professionals to pose a potential risk to other people. The research was carried out due to concerns that the voices of these service users are not being heard in research, policy or practice. Many service users were aware that they could pose a risk to other people when experiencing psychosis and they wanted help to reduce the chances of this happening. Full and frank discussion of risk to others was difficult for many professionals. Some people could not be asked to participate in the study because they did not know they were considered to be a risk to other people. Reasons for talking about risk to others included the user's right to know what is written about them, and increased trust between user and professional, with the potential for collaborative risk management. Reasons against talking about risk to others included increasing stigma and distress; this prompted disengagement from services, and fears for personal safety. Levels of agreement between service users and professionals about risk and how to respond to it ranged from full agreement to very little or none. Service user involvement in risk assessment and management was variable and depended upon individual professional initiative. Few professionals were undertaking systematic risk assessment or risk management plans. Some service users influenced the support they received but, generally, users' main role was to accept or reject what was offered. Professionals had less room to accommodate user views where the risks were considered too high. Little use was made of advocates, and users were not provided with a full picture of the different supports available. Medication and supported housing emerged as key issues for potential tension and disagreement between service users and professionals. Serious gaps and inaccuracies were sometimes found in information held about service users that potentially put themselves and others at risk.
Subject terms:
medication, mental health problems, mental health services, management, risk, risk assessment, risk management, severe mental health problems, stereotyped attitudes, stress, supported housing, user participation, user views, assessment;