Recovery
Recovery is a process of hope and aspiration that signals the return to mainstream life for those who have experienced mental health problems. Recovery can take place regardless of whether the individual is symptom-free or not. Hope and recovery are recognised as key parts of the care pathway. Social inclusion bridge builders work with clients on a recovery programme based on the client's own choices and aspirations.
More about Recovery and the work of Dr. Pat Deegan
Friday, 21 May 2010
Wednesday, 19 May 2010
Wednesday, 12 May 2010
Who should take an MHFA England course?
Who should take an MHFA England course?
Anyone can benefit from Mental Health First Aid (MHFA). It is open to members of the general public. Families affected by mental health problems, teachers, health service providers, emergency workers, frontline workers who deal with the public, volunteers, human resources professionals, employers and community groups are just a few of the groups who have benefited from MHFA.
Mental Health First Aid covers a comprehensive range of common mental health conditions and their appropriate first aid interventions. The conditions covered range from psychosis to phobia, from bi-polar to anxiety, from schizophrenia to stress at work. From this point-of-view MHFA is highly intensive, detailed and excellently put together.
It is important to bear in mind that MHFA is more than mental health awareness. A good mental health awareness course may well be a good 'Level I' for those who wish to find out more about general mental health before deciding to go on to MHFA at 'Level II'.
Anyone can benefit from Mental Health First Aid (MHFA). It is open to members of the general public. Families affected by mental health problems, teachers, health service providers, emergency workers, frontline workers who deal with the public, volunteers, human resources professionals, employers and community groups are just a few of the groups who have benefited from MHFA.
Mental Health First Aid covers a comprehensive range of common mental health conditions and their appropriate first aid interventions. The conditions covered range from psychosis to phobia, from bi-polar to anxiety, from schizophrenia to stress at work. From this point-of-view MHFA is highly intensive, detailed and excellently put together.
It is important to bear in mind that MHFA is more than mental health awareness. A good mental health awareness course may well be a good 'Level I' for those who wish to find out more about general mental health before deciding to go on to MHFA at 'Level II'.
Social Inclusion Facebook Group
Social Inclusion facebook group is now up and running. It's open to anyone interested in social inclusion, mainstream living, mental health, aspiration, goals and the arts. So welcome friends!
Tuesday, 4 May 2010
Talking Therapies - are they all they're cracked up to be?
Lord Victor Adebowale, Chief Executive of the charity Turning Point, calls access to psychological therapies as 'the biggest shift in mental health provision in the last 50 years'. (Big Issue April 5th 2010). Lord Victor goes on to state that IAPT (Improved Access to Psychological Therapies) 'gives a lot of people access to psychological treatment who suffer from depression and anxiety, whose relationships may have broken down or who have housing issues. It's the first intervention in that triage, and it's a path for people to get their lives back together'.
It's great that Lord Victor feels so positive about Improved Access to Psychological Therapies (IAPT). Turning Point as an organisation may well be equipped to help deliver therapies to more and more people in an increasingly effective way. It's also the case that psychological therapies are more readily available in some areas, through being delivered in community settings such as family centres and libraries.
However, for many people in the mental health system, particularly those diagnosed as having a 'severe and enduring' condition, psychological therapies can be exceptionally difficult to obtain. Firstly, the IAPT programme is only available to people in primary care who are under a GP. There is no eligibility for IAPT if you happen to be in secondary care or under a community mental health team. The reason for this is that people in secondary care are deemed to have therapeutic provision 'in-house' or within the professional team. If an individual is under section and hospitalised, he or she has the legal right to psychological therapies within 2 or 3 days of their request.
What happens in practice is often very different. A colleague desperate for therapy applied for it from his secondary care team (his legal right). Pushed from pillar to post, he finally received therapeutic treatment only through the intervention of the local MP. In the absence of a therapist being in post at the time, the treatment was delivered by the Head of Clinical Services.
It is great that charities like Turning Point are promoting greater access to psychological therapies. It is also great that therapies are being delivered in some locations through a slimmed-down faster process such as a well-being service. Nonetheless, if you happen to be someone with a 'severe and enduring' mental health diagnosis you will have no access to the IAPT programme. The accessible therapies under secondary care depend entirely on whether there is a suitable professional in post within your community mental health team. Despite rights enshrined in law, service users with a 'severe and enduring' condition are often denied psychological therapies.
It's great that Lord Victor feels so positive about Improved Access to Psychological Therapies (IAPT). Turning Point as an organisation may well be equipped to help deliver therapies to more and more people in an increasingly effective way. It's also the case that psychological therapies are more readily available in some areas, through being delivered in community settings such as family centres and libraries.
However, for many people in the mental health system, particularly those diagnosed as having a 'severe and enduring' condition, psychological therapies can be exceptionally difficult to obtain. Firstly, the IAPT programme is only available to people in primary care who are under a GP. There is no eligibility for IAPT if you happen to be in secondary care or under a community mental health team. The reason for this is that people in secondary care are deemed to have therapeutic provision 'in-house' or within the professional team. If an individual is under section and hospitalised, he or she has the legal right to psychological therapies within 2 or 3 days of their request.
What happens in practice is often very different. A colleague desperate for therapy applied for it from his secondary care team (his legal right). Pushed from pillar to post, he finally received therapeutic treatment only through the intervention of the local MP. In the absence of a therapist being in post at the time, the treatment was delivered by the Head of Clinical Services.
It is great that charities like Turning Point are promoting greater access to psychological therapies. It is also great that therapies are being delivered in some locations through a slimmed-down faster process such as a well-being service. Nonetheless, if you happen to be someone with a 'severe and enduring' mental health diagnosis you will have no access to the IAPT programme. The accessible therapies under secondary care depend entirely on whether there is a suitable professional in post within your community mental health team. Despite rights enshrined in law, service users with a 'severe and enduring' condition are often denied psychological therapies.
Monday, 3 May 2010
How people with mental health conditions enrich the work environment
How people with mental health conditions enrich the work environment.
People with mental health conditions who are returning to employment or even accessing it for the first time can often make exceptional contributions to the workplace. An art tutor who understands mental illness from first-hand experience will apply non-discriminatory and more inclusive practice alongside his or her skills.
Identifying a suppressed aspiration as the cause of stress at work can lead to formidable achievement when previously hidden dreams are pursued and developed in the appropriate mainstream setting. This too creates employment or self-employment alongside increased cashflow and profits for service providers who are helping dreams to become reality.
People with mental health conditions who are returning to employment or even accessing it for the first time can often make exceptional contributions to the workplace. An art tutor who understands mental illness from first-hand experience will apply non-discriminatory and more inclusive practice alongside his or her skills.
Identifying a suppressed aspiration as the cause of stress at work can lead to formidable achievement when previously hidden dreams are pursued and developed in the appropriate mainstream setting. This too creates employment or self-employment alongside increased cashflow and profits for service providers who are helping dreams to become reality.
How businesses profit from mental health
How businesses profits from mental health.
Businesses and services are developing the understanding that informed practice around mental health benefits both service delivery and profits. Staff are happier and more productive when they know that their employers' practices and procedures do not stigmatize or discriminate against illness or experience.
Days lost to absenteeism, sickness or unproductive presenteeism decrease when employees are not anxious about being dismissed should they choose to disclose a mental health condition. The attrition of unexplained job resignations or sudden departures decreases when taboos around mental health are dismantled by enlightened policies and staff trainings.
Business and services profit from individuals who are being signposted to mainstream as part of their recovery plans. Mainstream social inclusion takes place in any outlet where a recovering individual feels he or she can prioritise a personal goal. Venues such as education and training centres, sports facilities, colleges, recording studios, voluntary organisations and arts groups are benefiting substantially and financially from motivated people accessing mainstream. Where individuals are not paying all the costs themselves, there may well be contributions from schemes such as direct payments or from built-in concessions and offers. The increased business generated by mainstream social inclusion is considerable.
Businesses and services are developing the understanding that informed practice around mental health benefits both service delivery and profits. Staff are happier and more productive when they know that their employers' practices and procedures do not stigmatize or discriminate against illness or experience.
Days lost to absenteeism, sickness or unproductive presenteeism decrease when employees are not anxious about being dismissed should they choose to disclose a mental health condition. The attrition of unexplained job resignations or sudden departures decreases when taboos around mental health are dismantled by enlightened policies and staff trainings.
Business and services profit from individuals who are being signposted to mainstream as part of their recovery plans. Mainstream social inclusion takes place in any outlet where a recovering individual feels he or she can prioritise a personal goal. Venues such as education and training centres, sports facilities, colleges, recording studios, voluntary organisations and arts groups are benefiting substantially and financially from motivated people accessing mainstream. Where individuals are not paying all the costs themselves, there may well be contributions from schemes such as direct payments or from built-in concessions and offers. The increased business generated by mainstream social inclusion is considerable.
Social Inclusion - why it makes sense for businesses
The business case for mental health awareness is evidenced by the increasing numbers of employers who are commissioning mental health awareness trainings for their workforce. Employers want trainings which enable their staff to understand more about common mental health conditions. Understanding mental health means that staff can work better with clients and customers. It also allows staff to feel less isolated about personal issues around health and well-being.
Mental health awareness provides the opportunity for employers and employees to find out more about the law as it relates to employment and mental health.
Enlightened employers will seek to develop a workforce team which is happy rather than unhappy, fulfilled rather than excluded. Courses such as MHFA (Mental Health First Aid) show that attendees often feel that one of the benefits of the training in that it allows for a safe space. A safe space where individuals can share feelings about their personal well-being in addition to learning about the broader aspects of mental health conditions and the appropriate interventions.
In addition to mental health, it makes solid sense for businesses to incorporate awareness of social inclusion and mainstream. Returning to or accessing mainstream living is now a key part of the care pathway for those diagnosed with 'severe and enduring' mental health diagnoses. It is equally important for people who may be experiencing conditions such as anxiety, phobia or stress at work.
Both groups - those in primary and secondary care - are being signposted to mainstream life rather than to special settings as a central plank of the recovery process. The implications for any service provider - and that includes businesses - are crucial. Businesses and services are at the receiving end of mainstream.
Clients in recovery are choosing to access their personal goals through a diverse range of outlets. These could range from faith venues to volunteer bureaus, from retail outlets to sports centres, from recording studios to adult education colleges, from libraries to personal counselors, from training venues to department stores.
For businesses, it's not just one in four of their staff who may be experiencing mental health challenges, it's also one in four of their clients, customers and service consumers. Mental health challenges will also have an impact on one in three families. Disclosed or undisclosed, it's clear that mental health and well-being lie at the heart of our transactions and interactions.
Sunday, 2 May 2010
The Business Case for Mental Health Awareness
The Business Case for Mental Health Awareness. The economic and social cost of mental health problems in the United Kingdom is well documented. In 2002/03 the economic and social cost of mental health problems in England was £77 billion. (SCMH, 2003). The economic and social cost of mental health problems is greater than that of crime and larger than the total amount spent on all NHS and social services in the UK (HM Treasury, 2005).
Dame Carol Black's 2008 report 'Working for a Healthier Tomorrow' was a major attempt to address these concerns. Legislative review such as the 2005 amendments to the Disability Discrimination Act (DDA) highlighted the need to address the massive economic and social attrition behind issues of mental ill-health. In 2005 the Confederation of British Industry was concerned enough to commission its own research. Stress, anxiety and depression accounted for a third of the 168 million working days lost in the UK for health and related reasons in 2004, translating to a cost of sickness absence of about £4.1 billion (Confederation of British Industry, 2005).
Dame Carol Black's 2008 report 'Working for a Healthier Tomorrow' was a major attempt to address these concerns. Legislative review such as the 2005 amendments to the Disability Discrimination Act (DDA) highlighted the need to address the massive economic and social attrition behind issues of mental ill-health. In 2005 the Confederation of British Industry was concerned enough to commission its own research. Stress, anxiety and depression accounted for a third of the 168 million working days lost in the UK for health and related reasons in 2004, translating to a cost of sickness absence of about £4.1 billion (Confederation of British Industry, 2005).
As a result of legislation, employees have more rights and employers more responsibilities relating to the incidence of mental health in the workplace. Employees who choose to disclose a mental health condition to their employers are strongly protected by legislation and have the right to 'reasonable adjustments' that they may request their employers to make. In practice, it is still true that people with mental health diagnoses may well feel little confidence in this legislation. Nonetheless, their rights are enshrined in law. Similarly, employers have a legal responsibility not to discriminate against employees who have disclosed a mental health condition and to make any reasonable adjustments that have been requested.
Friday, 23 April 2010
Wednesday, 31 March 2010
MHFA England: Local branch of an international movement
Local branch of an international movement
Mental Health First Aid is now running in sixteen countries around the world. Australia is the birthplace of MHFA.
In 2000, Betty Kitchener and Professor Tony Jorm began writing a MHFA manual and an accompanying course, with the aim to improve the mental health literacy of members of the Australian community. Since then, the MHFA Training and Research Program has been developed, evaluated and disseminated nationally and internationally. This Program includes a 5-day Instructor Training Course to accredit suitable candidates to become MHFA Instructors who deliver the 12-hour MHFA course to their communities. This 12-hour course is designed to give members of the public some skills to help someone developing a mental health problem or in a mental health crisis situation. The philosophy behind the course is that mental health crises, such as suicidal and self-harming actions, may be avoided through early intervention with people developing mental disorders. If crises do arise, then members of the public can take action to reduce the harms that could result.
http://www.mhfa.com.au/
MHFA is revised regularly to keep up-to-date with developments in mental health as well as listening to feedback from course participants and instructors. One key spin-off of the course (and not originally anticipated) is that people have found it to be a safe and confidential space where personal mental health issues can be shared if they so choose.
In 2008 the Royal Society for Public Health (RSPH) announced support for training and qualifications in Mental Health First Aid. Together with NMHDU (National Mental Health Development Unit) RSPH is developing a national qualification in Mental Health First Aid and is also accrediting the national training programme for the MHFA course instructors.
Mental Health First Aid is now running in sixteen countries around the world. Australia is the birthplace of MHFA.
In 2000, Betty Kitchener and Professor Tony Jorm began writing a MHFA manual and an accompanying course, with the aim to improve the mental health literacy of members of the Australian community. Since then, the MHFA Training and Research Program has been developed, evaluated and disseminated nationally and internationally. This Program includes a 5-day Instructor Training Course to accredit suitable candidates to become MHFA Instructors who deliver the 12-hour MHFA course to their communities. This 12-hour course is designed to give members of the public some skills to help someone developing a mental health problem or in a mental health crisis situation. The philosophy behind the course is that mental health crises, such as suicidal and self-harming actions, may be avoided through early intervention with people developing mental disorders. If crises do arise, then members of the public can take action to reduce the harms that could result.
http://www.mhfa.com.au/
MHFA is revised regularly to keep up-to-date with developments in mental health as well as listening to feedback from course participants and instructors. One key spin-off of the course (and not originally anticipated) is that people have found it to be a safe and confidential space where personal mental health issues can be shared if they so choose.
In 2008 the Royal Society for Public Health (RSPH) announced support for training and qualifications in Mental Health First Aid. Together with NMHDU (National Mental Health Development Unit) RSPH is developing a national qualification in Mental Health First Aid and is also accrediting the national training programme for the MHFA course instructors.
Saturday, 27 March 2010
Mainstream isn't Therapy
Mainstream isn't therapy
Mainstream isn't therapy. The road back into mainstream life for someone with a 'severe and enduring' mental health diagnosis does not require a therapeutic relationship. It requires the individual's genuine desire to access the mainstream world based on personal goals, passions and motivation.
People with mental health conditions are taking the road back to mainstream every day. Sometimes they achieve this entirely through their own efforts, sometimes with the skills of a bridge builder. The bridge builder's role is not to set up a therapeutic relationship. It is simply to help the client identify which area or areas of mainstream life he or she wishes to prioritise.
The most effective way to start the conversation about mainstream is by having the conversation in a mainstream setting. If a client wishes to access a place where he or she can record and produce music, the meeting can take place in a mainstream music studio. If a client wishes to access a course in flower arranging, the meeting can be in an adult education venue. If a client wishes to return to their faith, the meeting can take place in a mosque, temple, church or wherever the client's chosen faith venue happens to be.
The journey of recovery into what Dr. Pat Deegan calls 'valued social roles' can only start effectively by setting out from and within a place where social roles cohere and are realised. These can be places situated anywhere in the mainstream community and not in special settings.
The client's relationship with the social inclusion bridge builder lasts for as long as the client requests some support in order to access mainstream goals. As such, it is not an ongoing therapeutic relationship.
Mainstream isn't therapy. The road back into mainstream life for someone with a 'severe and enduring' mental health diagnosis does not require a therapeutic relationship. It requires the individual's genuine desire to access the mainstream world based on personal goals, passions and motivation.
People with mental health conditions are taking the road back to mainstream every day. Sometimes they achieve this entirely through their own efforts, sometimes with the skills of a bridge builder. The bridge builder's role is not to set up a therapeutic relationship. It is simply to help the client identify which area or areas of mainstream life he or she wishes to prioritise.
The most effective way to start the conversation about mainstream is by having the conversation in a mainstream setting. If a client wishes to access a place where he or she can record and produce music, the meeting can take place in a mainstream music studio. If a client wishes to access a course in flower arranging, the meeting can be in an adult education venue. If a client wishes to return to their faith, the meeting can take place in a mosque, temple, church or wherever the client's chosen faith venue happens to be.
The journey of recovery into what Dr. Pat Deegan calls 'valued social roles' can only start effectively by setting out from and within a place where social roles cohere and are realised. These can be places situated anywhere in the mainstream community and not in special settings.
The client's relationship with the social inclusion bridge builder lasts for as long as the client requests some support in order to access mainstream goals. As such, it is not an ongoing therapeutic relationship.
Monday, 22 March 2010
Broken Recovery II
In a previous post I wrote:
'Dr. Pat Deegan visualises recovery and the return to mainstream life as crucial moments in an individual's journey through mental illness. It is a return that can often be blighted by low expectations, both by the service user and by his or her professional team. Even carers and family members can contribute to damaging an individual's recovery.'
The reasons why a recovery might be 'broken', protracted, delayed, postponed or put on hold indefinitely, are many. The return to mainstream is part of a crucial moment in the mental health survivor's journey. The moment is that space where the mental health survivor moves from being a patient into perceiving his or her ability to be a decision-maker. For Deegan the decision was to refuse the health profession's signposting her to 'a career in mental health'. Instead she chose to follow an inner calling to become someone who could learn to develop what she calls 'a valued social role'. The valued social role was to train to become a doctor and to work from the inspirational thought she phrases as 'I am going to become Dr. Deegan and change the mental health system from within so that no-one ever gets hurt in it again.'
'Dr. Pat Deegan visualises recovery and the return to mainstream life as crucial moments in an individual's journey through mental illness. It is a return that can often be blighted by low expectations, both by the service user and by his or her professional team. Even carers and family members can contribute to damaging an individual's recovery.'
The reasons why a recovery might be 'broken', protracted, delayed, postponed or put on hold indefinitely, are many. The return to mainstream is part of a crucial moment in the mental health survivor's journey. The moment is that space where the mental health survivor moves from being a patient into perceiving his or her ability to be a decision-maker. For Deegan the decision was to refuse the health profession's signposting her to 'a career in mental health'. Instead she chose to follow an inner calling to become someone who could learn to develop what she calls 'a valued social role'. The valued social role was to train to become a doctor and to work from the inspirational thought she phrases as 'I am going to become Dr. Deegan and change the mental health system from within so that no-one ever gets hurt in it again.'
Friday, 12 March 2010
Access to Mainstream
Access to Mainstream
In a recent editorial, Big Issue magazine founder John Bird states that the purpose of the Big Issue is to enable homeless people to access the marketplace.
For a homeless person, becoming a Big Issue salesperson creates a position in the marketplace, perhaps for the first time.
John Bird's explanation of the rationale behind the Big Issue is analagous to the reasons for exclusion from mainstream experienced by many people with mental health conditions.
As a person who has not only experienced homelessness but who is also a businessman, Bird's prioritises the activities of selling and distribution. These are methods through which a homeless person can access mainstream. Bird doesn't discuss breaking down barriers, addressing stigma or seeking support. He is keen to stress that the purpose of purchasing a Big Issue is not to give charity or even sympathy. The purpose is commercial empowerment for the individual salesperson.
For people with severe and enduring mental health conditions, a similar disempowering process has taken place which not only denies access to the marketplace but to any kind of mainstream opportunity. Sometimes the process has taken place over many years.
A Big Issue seller is a valued salesperson on the basis of their motivation. He or she becomes a sole trader or franchisee under an umbrella organisation.
For someone with a 'severe and enduring' diagnosis the journey into or back into what Pat Deegan calls a 'valued social role' can be impaired by the same system which has organised support. Access to mainstream can be discouraged by years of grounding in the process that Deegan calls 'a career in mental health'.
A career in mental health can mean a life on benefits, a life in residential support, a life of incapacity, a career of inertia. For people with mental health conditions it can be their clinical diagnosis which become the key determinant of identity. Yet the factors which determine an active social role for someone with a mental health condition are no different from anyone else's. Our identities are determined by the things we are passionate about, our aspirations, our goals, our dreams and our key priorities.
Meaningful involvement in mainstream for people with a mental health diagnosis begins to take place when individuals are allowed to measure themselves in terms of their goals. The world of mainstream does not necessarily discriminate or stigmatise and even where it does, this may not be the main obstacle.
In a recent editorial, Big Issue magazine founder John Bird states that the purpose of the Big Issue is to enable homeless people to access the marketplace.
For a homeless person, becoming a Big Issue salesperson creates a position in the marketplace, perhaps for the first time.
John Bird's explanation of the rationale behind the Big Issue is analagous to the reasons for exclusion from mainstream experienced by many people with mental health conditions.
As a person who has not only experienced homelessness but who is also a businessman, Bird's prioritises the activities of selling and distribution. These are methods through which a homeless person can access mainstream. Bird doesn't discuss breaking down barriers, addressing stigma or seeking support. He is keen to stress that the purpose of purchasing a Big Issue is not to give charity or even sympathy. The purpose is commercial empowerment for the individual salesperson.
For people with severe and enduring mental health conditions, a similar disempowering process has taken place which not only denies access to the marketplace but to any kind of mainstream opportunity. Sometimes the process has taken place over many years.
A Big Issue seller is a valued salesperson on the basis of their motivation. He or she becomes a sole trader or franchisee under an umbrella organisation.
For someone with a 'severe and enduring' diagnosis the journey into or back into what Pat Deegan calls a 'valued social role' can be impaired by the same system which has organised support. Access to mainstream can be discouraged by years of grounding in the process that Deegan calls 'a career in mental health'.
A career in mental health can mean a life on benefits, a life in residential support, a life of incapacity, a career of inertia. For people with mental health conditions it can be their clinical diagnosis which become the key determinant of identity. Yet the factors which determine an active social role for someone with a mental health condition are no different from anyone else's. Our identities are determined by the things we are passionate about, our aspirations, our goals, our dreams and our key priorities.
Meaningful involvement in mainstream for people with a mental health diagnosis begins to take place when individuals are allowed to measure themselves in terms of their goals. The world of mainstream does not necessarily discriminate or stigmatise and even where it does, this may not be the main obstacle.
Wednesday, 3 March 2010
Is anti-stigma the new stigma?
Anti-stigma the new Stigma?
The 'Time to Change' campaign challenges stigma and discrimination against people with mental health conditions. Time to Change is helping groups and individuals organise activities which actively cooperate in challenging discriminatory attitudes and behaviours.
Challenging discrimination is achieved primarily through engaging in mainstream as a contributor, a consumer or a provider. Many people with mental health conditions access mainstream activities, making their own choices as to whether to disclose or not. The greatest impact in challenging mainstream can be achieved by prioritising individual goals and aspirations. Support is also available to access mainstream from mental health organisations and bridge builders or through personalisation and direct payments.
'Time to Change' seems to insist that all people with mental health conditions wish to disclose as part of their eligibility for mainstream life. In a recent campaign video the broadcaster and service user Stephen Fry asserts that stigma and the attitudes of society in general are the main roadblocks that hinder the self-development of people with mental health conditions.
But many individuals with mental health diagnoses are accessing mainstream life without stigma, whether they choose to disclose or not. Disclosure is really up to the individual and far from discouraging service users to use mainstream, many organisations are open to all and are accessed by people with mental health conditions every day of the week. These are not simply voluntary organisations or groups limited to the health or charity sectors. These are consumer providers of all kinds - art galleries, libraries, recording studios, performance venues, gyms, sports centres, retail outlets and many more. To assert these these organisations are discriminating simply isn't fair on these groups, nor is it a realistic assessment.
Where people with mental health conditions may lose out is in having the initial confidence to set on the journey back to mainstream. This is particularly true of those who have been in secondary care and who may have become habituated to the life that Pat Deegan calls 'a career in mental health'. Dr. Deegan is referring to the lack of hope, aspiration and goals that can set in with a long-term condition.
People who play football who happen to have mental health conditions are footballers. They aren't required to be 'positive mental health footballers'. People who play guitar who happen to have mental health conditions are guitarists, not mental health guitarists. People who are arts tutors who have a mental health condition are arts tutors. By continuing to tag mental health on mainstream activities and aspirations there is a danger of recycling stigma and not allowing people to move into valued social roles.
Could anti-stigma be the new stigma?
The 'Time to Change' campaign challenges stigma and discrimination against people with mental health conditions. Time to Change is helping groups and individuals organise activities which actively cooperate in challenging discriminatory attitudes and behaviours.
Challenging discrimination is achieved primarily through engaging in mainstream as a contributor, a consumer or a provider. Many people with mental health conditions access mainstream activities, making their own choices as to whether to disclose or not. The greatest impact in challenging mainstream can be achieved by prioritising individual goals and aspirations. Support is also available to access mainstream from mental health organisations and bridge builders or through personalisation and direct payments.
'Time to Change' seems to insist that all people with mental health conditions wish to disclose as part of their eligibility for mainstream life. In a recent campaign video the broadcaster and service user Stephen Fry asserts that stigma and the attitudes of society in general are the main roadblocks that hinder the self-development of people with mental health conditions.
But many individuals with mental health diagnoses are accessing mainstream life without stigma, whether they choose to disclose or not. Disclosure is really up to the individual and far from discouraging service users to use mainstream, many organisations are open to all and are accessed by people with mental health conditions every day of the week. These are not simply voluntary organisations or groups limited to the health or charity sectors. These are consumer providers of all kinds - art galleries, libraries, recording studios, performance venues, gyms, sports centres, retail outlets and many more. To assert these these organisations are discriminating simply isn't fair on these groups, nor is it a realistic assessment.
Where people with mental health conditions may lose out is in having the initial confidence to set on the journey back to mainstream. This is particularly true of those who have been in secondary care and who may have become habituated to the life that Pat Deegan calls 'a career in mental health'. Dr. Deegan is referring to the lack of hope, aspiration and goals that can set in with a long-term condition.
People who play football who happen to have mental health conditions are footballers. They aren't required to be 'positive mental health footballers'. People who play guitar who happen to have mental health conditions are guitarists, not mental health guitarists. People who are arts tutors who have a mental health condition are arts tutors. By continuing to tag mental health on mainstream activities and aspirations there is a danger of recycling stigma and not allowing people to move into valued social roles.
Could anti-stigma be the new stigma?
Monday, 1 March 2010
Do Care and Support hinder Recovery?
Care and support are not the only models or frameworks for mental health recovery. The establishing or re-establishing of what Dr. Pat Deegan refers to as 'valued social roles' can be held back by a mental health system that often encourages the client to choose 'a career in mental health' (Pat Deegan).
A career in mental health means living longterm on benefits and longterm marginalisation from mainstream life. A career in mental health will identify symptoms, diagnoses, medication and team support but will often leave out aspirations, goals, priorities.
Where access to mainstream is encouraged, it can often be through projects or programmes which take place in special settings or are designed for people with mental health conditions. So the marginalisation continues.
A genuine return to mainstream can only take place in mainstream. This is where the role of the bridge builder comes in. A client who has worked with a mainstream bridge builder identifies goals and priorities for him or herself. It is the bridge builder's job to signpost or link the client up with mainstream venues appropriate to the client's life choices. The amount of support a client may request from there on is determined only by the client not by the bridge builder.
A career in mental health means living longterm on benefits and longterm marginalisation from mainstream life. A career in mental health will identify symptoms, diagnoses, medication and team support but will often leave out aspirations, goals, priorities.
Where access to mainstream is encouraged, it can often be through projects or programmes which take place in special settings or are designed for people with mental health conditions. So the marginalisation continues.
A genuine return to mainstream can only take place in mainstream. This is where the role of the bridge builder comes in. A client who has worked with a mainstream bridge builder identifies goals and priorities for him or herself. It is the bridge builder's job to signpost or link the client up with mainstream venues appropriate to the client's life choices. The amount of support a client may request from there on is determined only by the client not by the bridge builder.
Sunday, 28 February 2010
MHPF - Recovery Star Approach
MHPF - Recovery Star Approach
An excellent site about the Recovery Star for social inclusion appears on the Mental Health Providers Forum website. The link appears on the post header.
Mental Health Providers Forum describes the Recovery Star as:
'a tool for supporting and measuring change when working with adults of working age who are accessing mental health support services. As an outcomes measurement tool it enables organisations to measure and summarise:
the progress being made by service users
the service being delivered through a project.
The Recovery Star is also an effective keyworking tool. It is designed to support individuals in understanding where they are in terms of recovery and the progress they are making, providing both the client and worker a shared language for discussion mental health and wellbeing.
Core dimensions of the Recovery Star
The Recovery Star identifies and measures ten core areas of life:
Managing mental health
Self-care
Living skills
Social networks
Work
Relationships
Addictive behaviour
Responsibilities
Identity and self-esteem
Trust and hope'
An excellent site about the Recovery Star for social inclusion appears on the Mental Health Providers Forum website. The link appears on the post header.
Mental Health Providers Forum describes the Recovery Star as:
'a tool for supporting and measuring change when working with adults of working age who are accessing mental health support services. As an outcomes measurement tool it enables organisations to measure and summarise:
the progress being made by service users
the service being delivered through a project.
The Recovery Star is also an effective keyworking tool. It is designed to support individuals in understanding where they are in terms of recovery and the progress they are making, providing both the client and worker a shared language for discussion mental health and wellbeing.
Core dimensions of the Recovery Star
The Recovery Star identifies and measures ten core areas of life:
Managing mental health
Self-care
Living skills
Social networks
Work
Relationships
Addictive behaviour
Responsibilities
Identity and self-esteem
Trust and hope'
Social Inclusion
Social Inclusion
Two major assessment tools have been developed for social inclusion. One is the social inclusion 'Web' and the other is the 'Star' or 'Recovery Star'. The web can be viewed by clicking on the header link above.
Originally created by the National Development Team (NDT) the web is a simple and effective assessment tool based on five key social domains. The domains were identified as key in the research done in the late 90s and early 2000s around social inclusion.
On the web these domains appear as:
Employment
Education & Training
Arts & Culture
Faith & Cultural Communities
Volunteering & Befriending
Family & Neighbourhood
Services
What makes the web unique for mental health is that it does not record or measure symptoms or diagnoses. A client who wishes to record which services he or she accesses may include the psychiatrist or community mental health team. However, the main purpose of the web is to record the client's involvement in mainstream. More importantly, the web is there to identify client's goals and aspirations in terms of where he or she wishes to be in mainstream.
Next blog posting: The Web and the role of the Bridge Builder.
Two major assessment tools have been developed for social inclusion. One is the social inclusion 'Web' and the other is the 'Star' or 'Recovery Star'. The web can be viewed by clicking on the header link above.
Originally created by the National Development Team (NDT) the web is a simple and effective assessment tool based on five key social domains. The domains were identified as key in the research done in the late 90s and early 2000s around social inclusion.
On the web these domains appear as:
Employment
Education & Training
Arts & Culture
Faith & Cultural Communities
Volunteering & Befriending
Family & Neighbourhood
Services
What makes the web unique for mental health is that it does not record or measure symptoms or diagnoses. A client who wishes to record which services he or she accesses may include the psychiatrist or community mental health team. However, the main purpose of the web is to record the client's involvement in mainstream. More importantly, the web is there to identify client's goals and aspirations in terms of where he or she wishes to be in mainstream.
Next blog posting: The Web and the role of the Bridge Builder.
Monday, 22 February 2010
Equalities in Mental Health Conference February 24th
Look out for the MHFA England stand at the Equalities in Mental Health Conference on February 24th. Queen Elizabeth II Conference Centre Westminster, London.
Tuesday, 16 February 2010
The Broken Recovery
Dr. Pat Deegan visualises recovery and the return to mainstream life as crucial moments in an individual's journey through mental illness. It is a return that can often be blighted by low expectations, both by the service user and by his or her professional team. Even carers and family members can contribute to damaging an individual's recovery.
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