Wednesday, 18 January 2012
Mainstream in 2012
The future of the mainstream approach in mental health recovery is bleak. Once pioneered as the most radical yet realistic approach to the care pathway, mainstream has now been side-lined and pushed into a corner.
The thinking behind mainstream in mental health is simple. Linking up individuals with mainstream areas of their own choice as part of recovery. Social domains cover a wide spectrum: the arts, employment, volunteering, sport and healthy living, faith, worship or spirituality, employment, self-employment, education and business.
In 2012, the cuts in mental health provision are going deep and are across the board. Employment is touted as a be-all and end-all yet employment often only happens through a gradual re-introduction to mainstream living . This is especially true for people who are in secondary mental health care with a 'severe and enduring' diagnosis.
The outcomes that have been attained by individuals who have been referred or self-referred to a mainstream service are often formidable. Access to mainstream arts providers such as music recording studios, visual arts courses or creative writing workshops have led to individuals succeeding in employment, self-employment, higher education and collaborative enterprises with their peers.
The mainstream approach goes far beyond therapies and this blog contains many examples of its success.
Mainstream is based on recovery as opposed a 'cure'. It is also based on the individual claiming his or her right to mainstream living along with everyone else.
The opportunity to access mainstream on his or her own terms is not denied to an individual with a 'severe and enduring' mental health diagnosis. Mainstream can be highly supportive of clients' individual aspirations and self-development. Sometimes this encouragement comes directly from the mainstream outlet itself rather than being dictated by carers, statutory services or voluntary agencies. What can be denied and often is, is the opportunity to access the opportunities in the first place.
In many cases, an individual with a 'severe and enduring' mental health diagnosis will only have the chance to access a mainstream activity if it is built in to his or her care pathway and recovery plan. The professionals who can help signpost people to such activities will be skilled in allowing individuals to identify personal goals and aspirations. They will also need skills in knowing exactly where the mainstream sites are where an individual can develop and pursue his or her aspirations. Linking someone up with a mainstream activity of his or her own choice allows that mainstream venue to provide exactly what it is already providing for its clients, users and consumers.
The client with a mental health diagnosis will be treated no differently from anyone else, unless he or she has specificied particular adjustments. That too is part of person-centred planning, with individuals free to disclose or not as they deem fit.
There are sound reasons for mainstream being a lot less discriminatory and stigmatizing than it can be portrayed. Mainstream allows individuals to access services as consumers with consumer rights. If someone with a mental health diagnosis freely chooses to develop his or her aspirations in a mainstream environment, there is no good reason why that person should be denied any of the services that particular venue may provide. The client is accessing mainstream as a consumer of that service, not as a 'diagnosis'.
Once a firm relationship with mainstream has been established, there are multiple ways that mainstream finds to continue to develop individual hopes, dreams and aspirations. I have clients who have found employment through accessing music by rehearsing regularly in a mainstream recording studio. Others have opted to join higher and further education outlets to progress with their dream. Yet others have become volunteers in an environment they enjoy. This has not happened because I have requested the venue to provide employment for my clients Far from it - the venue itself often instigates the process or helps provide the signposting. In many cases this can lead an individual towards a working role in the environment where he or she happens to feel most fulfilled.
This is the viral effect of mainstream