Self-Directed Support in mental health: what can you do differently?

Permission to DreamBelow is a post written for Outside the Box in Scotland, ahead of their Permission to Dream event next month on how people across Scotland have been getting on over the first year of Self-Directed Support.

Last year, Outside the Box ran a series of great events on what the new Self-Directed Support Act (2014) might mean for mental health in Scotland. The events brought together a range of people from across the mental health system: people who use services, families, carers and representative organisations; social workers; team managers; commissioners and providers. As a result, the conversations were rich and engaging.

One thing that struck me during people’s discussions was that very few people thought the health and social care system was working for people with mental health problems as it was. This feeling wasn’t limited to just social care outcomes and people’s mental health themselves: it included what opportunities people with mental health problems had in areas of life like housing, employment and fairly accessing welfare support.

The question before everyone was clear: how do we make things better? The Self-Directed Support Act 2014 is a major part of the answer. The Act aims to empower people to have control and responsibility over how their care and support is arranged, including offering people different choices for organising their care. (You can find out more information about the Act on the Getting There website.)

Henry Ford famously said: “If you always do what you’ve always done, you’ll always get what you’ve always got.” The Act is therefore a really good chance to do something differently. A really interesting question for everyone with an interest in the mental health system to ask themselves is: what can they do differently as a result of the new SDS Act?

Here are a few suggestions (you can find more in this practice paper on the Getting There website):

  • For people who use services, this could mean finding out more about the Self-Directed Support Act so you know what your rights are and how to access the support available to live the life you want.
  • For a frontline practitioner, this could mean working in partnership with a person rather than thinking of them as someone to assess and put in place a package for. This could include thinking together beyond the usual menu of ‘traditional’ services people might access.
  • For team managers, it could mean creating regular opportunities for their team members to talk about the good things they’ve done as a result of self-directed support, or to talk about the challenges this new way of working brings and enabling people to support each other to address those challenges.
  • For people who commission services, it could mean knowing how much money was spent on what types of mental health support and then explicitly aiming to change this over the next 3 years, responding to the different choices that people make.

The pressure and constraints that currently exist in the mental health system sometimes lead people to think they can’t do anything themselves to make things better – it’s “beyond their control”. The places that make the most progress are those where as many people as possible take the opportunity to do something different in their part of the system and give it a go – no matter how small a change they personally make. Let’s all of us use the opportunity of the Self-Directed Support Act to help improve the lives of people with mental health problems.

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More disabled groups set to benefit from £3m fund

Below is a copy of some exciting news about the Strengthening DPULOs Programme, which is being extended into Scotland and Wales from today. Great news!

From today, disabled grassroots organisations in Scotland and Wales – which can make a real difference to the everyday lives of disabled people on the ground – will be able to access a £3 million fund.

Disabled People’s User-Led Organisations (DPULOs) run by and for disabled people, often provide support and services alongside those provided by the public sector.  Drawing on their own first hand experience of disability, they have clear ideas about what works and what doesn’t.

Now these organisations in Scotland and Wales will be able to bid for pots of money to fund individual projects that will help them to become more sustainable.  More than half a million has already been paid out by the ‘Strengthening DPULO Programme’ in England since it was launched a year ago.

Minister for Disabled People, Maria Miller said:

“Back in July last year I launched a £3m fund to help strengthen grassroots organisations by giving out pots of money to fund individual projects on the ground.

“The idea was based on feedback I received from these organisations that a little funding at the right time can make all the difference to the support they are able to provide to disabled people.

“We have millions of pounds to invest, so I would urge people who are part of DPULOs in Scotland and Wales to apply to the fund and take this is an opportunity build on the successes they have already achieved.”

As well as offering financial support, the Strengthening DPULOs Programme will provide Scottish and Welsh DPULOs with support and advice on how to strengthen and make their organisations more sustainable through two new Ambassadors.

Rhian Davies, Chief Executive of Disability Wales, said:

“The extension of the Strengthening DPULOs Programme into Wales means that Welsh DPOs can now access specific funding aimed at supporting their growth as well as their ability to advocate and deliver even more effectively on behalf of disabled people.”

Jim Elder Woodward OBE, Convenor of Independent Living in Scotland Steering Group, said:

“It has never been more important to grow and strengthen the capacity of this influence. That is why the Independent Living in Scotland project (ILiS) welcomes the ODI’s plans to support disabled people and their organisations to grow in strength and influence, and we look forward to working with the Strengthening DPULOs Programme to build on work here in Scotland.”

Examples of how the Strengthening DPULO programme is making a difference to the lives of disabled people in the local community include:

  • Communication for Blind People based in North London which is using the funding they have received to develop a smartphone app for blind travellers.  The app will help blind people to explain where to get off public transport and when they arrive at their destination.
  • My Life My Choice in Oxford is using its grant to help it realise the dream of running the StingRadio show.  This not only plays music from people with learning disabilities, it also gives its listeners key information and a voice on the airwaves.
  • The Personalisation Forum Group in the North East is just one of many organisations which are using the money to give invaluable day to day support to its users.  They are ‘over the moon’ with their grant which will contribute toward setting up a service user group in for disabled people in Doncaster.
  • DASH, a DPULO in Hillingdon supports disabled people in the local community through a ‘one stop shop’ service. The service will mean disabled people who are being assessed for equipment by an occupational therapist can have their prescription redeemed a few doors down the corridor in the organisation’s office.

People can find out more about the Strengthening DPULOs scheme and Facilitation Fund by visiting www.odi.gov.uk/dpuloprogramme or www.facebook.com/dpulos

I would walk 500 miles… Visiting #dpulo in Scotland

After my visit to Wales, I made the enjoyable 12-hour round trip to Edinburgh to meet with a range of Scottish Disabled People’s User-Led Organisations.

(I say it was an “enjoyable” trip because I had some excellent books to keep me company, alongside the usual work stuff. I’d recommend Justice by Michael Sandel and The Righteous Mind by Jonathan Haidt. Ill Fares the  by Tony Judt was fine and, though I agree with its diagnosis, I’m not so sure about the symptoms it identifies nor the remedies it recommends.)

It has been some 5 years since I last worked in the disability scene in Scotland through the Scottish office of the Disability Rights Commission, so I was looking forward to hearing about the current set of issues DPULOs face.

And there are certainly lots that gave me food for thought. Alongside the ones we might normally associate with disabled people’s organisations and the voluntary sector (funding, governance, communications, impairment “versus” pan-impairment, infrastructure) there were some issues specific to Scotland, too.

The ones I was particularly left with were:

  • The significant rurality of Scotland. I heard tales of three-day roundtrips for a 2-hour meeting and the associated complexities of working across 32 local authorities
  • The challenge of two significant pieces of legislation traveling through the Scottish parliament at the same time – one on Self-Directed Support in social care and another on Health and Social Care integration – and how they do (or don’t) join up and what this means for DPULOs looking to develop services for commissioners and individuals to buy
  • The particular relevance of big “P” Politics and its more pronounced impact on decision making, particularly in commissioning and procurement.

At the same time, though, I came away from a meeting with around 20 disabled people’s organisations feeling inspired and optimistic about the future in Scotland. There are some fantastic people there doing some great stuff, and the Scottish Government feels to have acknowledged some of the more pressing issues. (This includes, for example, through the work of Independent Living in Scotland and Self-Directed Support Scotland to name but two of very many excellent organisations).

As with Wales, so it will be fascinating to see how Scottish DPULOs individually and collectively respond to the challenges and opportunities that exist at the moment and over the coming years.

Thanks to Lothian CIL for hosting the visit and for the contributions of everyone who was involved. I shall look forward to a chance to learn more on a further visit towards the end of July.

Man walks into a column, no.20: Britain

Some of my friends are Scottish. One of my best friends is Scottish. Over the years he and I have almost come to blows on a number of occasions about the topic of Scottish independence. That’s not strictly true: what actually happens is that he is provoked to the verge of hitting me by my point of view. With friends like that, eh?

What annoys my tartan chum so much is that I would be perfectly content for the Scots to go their own way. This causes waves of William Wallace-esque rage to course through the veins of my usually emollient pal because, primarily, he thinks I am showing lack of regard for our shared cultural, political, military etc. heritage (he seems to be missing the point that for every battle our respective countrymen fought together, there are at least two or three we waged against each other).

The problem is I do not feel ‘British’, whatever that means. To be honest I don’t feel particularly ‘English’ either. I guess if anything I feel like a Londoner: it’s this wonderful city where I now live that most frequently provokes a sense of pride and belonging. First and foremost I feel like a Swindoner, thanks to the town I (have no choice but to) call my own.

I suppose it changes a bit depending on the context, although even during a football match I wouldn’t say I felt particularly ‘English’. Unlike David Mitchell (writing in The Observer) I never, ever feel British. Perhaps it’s because my family is exclusively south and east of the borders, and my holidays as a child were invariably in Devon. I also think, along with Billy Bragg, that the whole concept of Britain is past its sell-by-date:

As we experience it now, Britishness is fundamentally a 19th-century concept based on an imperial world view. The British among us are a people who believe that there is only one culture in our society, a sense of tradition which can be summed up in the phrase Queen and Country.

Maintaining a sense of history, of tradition, is absolutely vital; sure. But historic ties shouldn’t be a straightjacket either. Given how far devolution has already gone, the sensible thing would be to turn Westminster into an English parliament. Of course this is unlikely to happen any time soon: as the AV referendum showed, we are not a people (peoples?) prone to hasty decisions.

You’re unlikely to find me actively agitating for change, either: there are bigger fish to fry. But given the choice I would opt for separation. Apart from anything else I think a smaller state would be more befitting of our status in the world, dramatically shrunk since the age of empire and the world wars. It would stop us from always trying to punch above our weight and then feeling impotent when we fail.

The trove that is openDemocracy – ten years old! – is running a series on ‘The Scottish Spring’ which is worth following, I think. A recent piece, in response to David Mitchell, has Gareth Young arguing that:

If the way to a new understanding of British identity is to forge a Little England nationalism that replaces the Anglo-British nationalism of a faded imperial power, then yes, let’s reimagine Britain as a multinational, consensual, union of partner nations with an English nationalism that complements the nationalisms of Scotland and Wales.

I agree right up until the bit about ‘union of partner nations’. What, I ask, is the point in preserving a union that belongs to another age?