esc module 3
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TheTenEssentialSharedCapabilities
Module3:
Involvingserviceusersandcarers
Welcome to this module that explores the link between the Ten Essential Shared Capabilities
and service user and carer involvement.
After completing this module you will be able to:
Describe the link between service user involvement, carer involvement and the
Ten Essential Shared Capabilities.
Answer the question: what is service user and carer involvement?
Present evidence about how you are promoting service user and carer
involvement.
Contents
.Startingpoints .................................................................................................. 2
2.Serviceuserandcarerinvolvement ................................................................. 5
3.Recovery............................................................................................................ 15
4.Overcomingbarrierstoserviceuserandcarerinvolvement........................... 26
5.Evaluation.......................................................................................................... 32
6.Linkstourtherlearning .................................................................................. 34
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How to get the best out of this module:
Complete learning activities as honestly as you can.
Recognise what you do know, and what you dont know Identify small goals that will help to change the way you do things
.Startingpoints
Activity3.
Here are some questions to get you started:
What does service user involvement mean to you?
Do you need convincing about the value of service user involvement?
Mark where you are on this scale:
No YesUnsure
Where is service user involvement in your list of priorities?
Mark where you are on this scale:
Low HighMedium
Give some reasons for this:
What would help you to move further up this scale?
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Where do you place carer involvement in your list of priorities?
Mark where you think you are on this scale:
Low HighMedium
What would help you to move further up this scale?
Is your attitude to service user and carer involvement the same or different - why do you
think this is?
How can involving carers help service users to recover?
Read the denitions below which show the challenges of nding the right language to talk
about mental distress.
Mentalillness,mentalhealthproblemsormentaldistress?
romtheStrategiesorLivingreport(FaulknerandLayzell2000):
Wehaverequentlyusedthetermmentaldistresswhereotherpeoplemay
preersuchtermsasmentalillnessormentalhealthproblemswerecognise
thatnotallexperiencesorbehavioursassociatedwithadiagnosisomentalillness
arenecessarilyexperiencedasdistressing.Wedobelievethereisacontinuumo
distressandthateveryoneisonthatcontinuum.
Manypeoplendtheconceptomentalillnessauseulwayothinkingabout
theirexperiences.
Othersbelievethatusingthetermmentalillnessencouragesproessionalsto
labelpeoplewithinarestrictedsetocategoriesandtreatthemaccordingly.
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Patient,Client,User,ServiceUser,Survivor,allthesetermsandmanyotherso
amorenegativenatureareusedtodescribepeoplewithmentaldistresswhohave
orareusingmentalhealthservices.Workersneedtobesensitivetotheimplications
otheirlanguage.Serviceuseristhemostcommonlyacceptedtermatthistimealthoughitisnotalwaysliked.Userorsomepeoplemeansdruguserandisseen
asinsulting.Survivormaysuggestpersonalpowerandchallenge,whichisvery
demanding(andperhapseventhreatening)toserviceusersandtomentalheath
workers.Patientplacesmentalhealthcarermlywithinthemedicalworld/model.
Manylearningprogrammesnowpresentabio-psycho-socialmodel,whichoersa
holisticviewocare,recognisingthatapersonssocialworldisasimportantastheir
psychologicalandphysicalworld.Whileeachothetermsusedhasitsvaluethe
constantcryotheserviceuseristobeacknowledgedasauniqueandindividual
humanbeing.
Carer,Signicantother,Lovedone,Relative,Friend,Child,Describingsomeoneasa
carermaybeproblematic.Thewordcarermayimplybeingpaid.Manypeoplewho
providesupportdonotrecognisethistermandpreertoseethemselvesinterms
otheirrelationship-orexampleasapartner,mother,brotherorriend.Acarer
hasbeendescribedassomeonewhoprovidesorintendstoprovidepracticaland
emotionalsupporttosomeonewithamentalhealthproblem.Theymayormay
notlivewiththepersontheycareor.A Commitment to Carers Leaet Rethink/
Department of Health
To demonstrate capability in relation to the ESC you need to:
understand what is meant by service user and carer involvement
actively promote service user and carer involvement yourself
develop skills to involve service users and carers effectively
use strategies to overcome barriers to involvement
The need to involve service users and carers in planning services is a policy requirement.
Good practice also requires mental health workers to Work in Partnership (ESC 1) with
service users and carers.
Allmentalhealthservicesmustbeplannedandimplementedinpartnership
withlocalcommunities,andinvolveserviceusersandcarers. National Service
Framework for Mental Health - Department of Health 1999
Planningresourcesandcareinpartnershipwithusersomentalhealthservices
isnowrecognisedasbeingthemosteectivewayoensuringservicesmeet
needseectively.Philpot 1994
Truepartnershipshouldalsoresultinusersbeingactiveparticipantsintheir
treatmentandprovidersdoingtheirjobsinamorecollaborativeandmutuallysupportiveway.Trivedi 1996
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2.Serviceuserandcarerinvolvement
Service user and carer involvement can happen at different levels and in different ways.
Evidence that real involvement exists might include:
Service users and carers being actively and effectively involved as equal partners in care
planning and the Care Programme Approach (CPA). CPA is a framework for assessment,
care planning and review in mental health servces.
Try to think of some more examples of how service users can be involved and record them
below:
Where real involvement exists service users should be able to:
Give formal and informal feedback to individual workers
Have access to user-friendly advocacy and complaints services
Design and carry out surveys and audits on services
Join self help, service user or campaigning organisations
Be members of management, clinical governance and PPI (Patient and Public
Involvement) groups
Take part in planning, delivering and evaluating learning
Get jobs in mental health services
Interview and help to appoint staff
Run services themselves
Rethink (2003) recommends that carers should:
Be recognised and listened to as a partner in providing care
Be valued
Be treated with courtesy and respect
Be able to talk to a mental health or social care professional on request
Receive information as early as possibleReceive prompt and positive responses to requests for help
Be able to get immediate help in a crisis
Have their own needs assessed and met
Be able to have breaks from caring
Be given help in communicating with staff, when needed, for example through
an advocate, interpreter or signer
Be given an explanation of the mental health problem affecting the person they
care for
Be told what treatments the person is receiving, what other treatments are
available, how they work and the potential side-effects
Be given information about what support will be provided when the carer can nolonger care.
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Activity3.2
Looking through the lists above, note some things that you think both service users and
carers are likely to nd helpful:
Your list may include some of these things:
Being listened to and respected
Being given an explanation of the mental health problem
Being told about a choice of treatments and having the opportunity to discuss
this
Being involved in planning the way services are delivered
Being given expenses or payment for consultation activities
Service user and carer involvement exists at the personal, local, regional and national level.
Some examples are:
Memberofacarersgrou
pIn
volvedw
ithRethink
andtheMentalHealthFou
ndat
ion
I
nvo
lvedinCPAofpersonthe
ysuppo
rt
OnCountyCPAgroup
Invo
lvedinownC
PA
Membe
rofloca
lserviceusergroup
Work
ingforN
IMHEregionaldevelopm
entcentre
Attendi
ngMIND
nationalconferences
Service user:
Carer:
Key
Personal:
Local
Regional:
National
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Activity3.3
Using the resources available to you (contact list, telephone directory, information from the
Internet or a colleague) identify a local service user or carer group you are not already in
touch with that may be useful to the people you work with. Make a list of things you needto nd out about this group below. Get in touch with them as soon as possible to ask for
information and make a link.
CarePlanning/TheCareProgrammeApproach(CPA)
The Care Programme Approach was introduced to help provide a good standard of
assessment, care planning and review for adults with mental health problems. The way in
which CPA is delivered varies a great deal.
MyCPN(CommunityPsychiatricNurse)isasoundingboard
Iamlistenedtomyviewsandopinionsaretakenintoaccount
Theworkersaidthatwehadameetingyoudontneedtobeseen
Iwasinastatewhenithappeneddidntknowwhatwasgoingon
IwastoldtheCPNiscarryingitout
DierentexperiencesoCPAromaserviceuserconsultationevent-
CAPITALWestSussex-2005
ThisreportoundthatthemajorityoserviceusersdonotknowwhatCPA
isor.Governmentpolicyisthatusersshouldbeinvolvedindrawinguptheir
careplan.ButoallthesitesvisitedbyUFM(UserFocussedMonitoring)
interviewers,onlyserviceusersinHuntingdonevenknewwhotheirCPAkeyworkerswereorthattheyhadacareplan.Evenewerserviceusersknewthe
dateotheirnextCPAreview.Rose200
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It is essential to involve service users in the Care Programme Approach. Here are some
important points to keep in mind:
Service users need to be encouraged and allowed to express an opinion. Service
users and carers are entitled to hold an opinion that is different to the workers.Service users need to identify their own strengths, resources and goals.
The workers role is to assist people to reach their full potential.
The service user should be able to give feedback about the care they receive,
without fear.
Service users should receive explanations and information.
The service user should be at the centre of the process, actively involved in any
changes in care.
Service users should receive written copies of care plans, and be offered support
and advocacy to help them to express concerns and unmet needs.
This process should be responsive, exible and part of regular on going
partnership working.
Activity3.4
In your recent experience of care planning are these things happening? (if you are not
involved in care planning think about other activities where service users/carers are or could
be involved in a meaningful way)
Place a mark on the scale below that reects your experience:
No YesUnsure
Which important elements tend to be missing from care planning?
Which of the Ten ESCs are most important when care planning?
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You have probably identied at least six of the capabilities. These are:
Working in partnership. Developing and maintaining constructive working
relationships.
Practising ethically. Recognising the rights and aspirations of service users and theirfamilies.
Promoting recovery. Working in partnership to provide care and treatment that
enables service users and cares to tackle mental health problems with hope and
optimism.
Identifying peoples needs and strengths. Working in partnership to gather
information to agree health and social care needs in the context of the preferred
lifestyle and aspirations of service users, their families, carers and friends.
Providing service user centred care. Negotiating achievable and meaningful goals.
Promoting Safety and Positive Risk Taking which includes Empowering the
person to decide the level of risk they are prepared to take with their health and
safety.
Activity3.5
Now, think about the skills you already have. Concentrate on ESC 7 (providing service user
centred care), as this is central to care planning.
Describe a skill which helps you to provide service user centred care planning:
Describe a skill which you need to develop further:
Set a small achievable goal that will help you to develop this skill:
1.
3.
5.
6.
7.
9.
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Identify someone or something that can help you to achieve this:
Set a timescale for achieving this goal:
It is important to involve carers in care planning too, and to remember that they are often
entitled to assessment and services in their own right.
Carersneedsandstrengths
In supporting carers, services should aim to:
Recognise the valuable role carers have and the stresses that caring can
bring;
Provide timely support for them in this role and help if they can no longer carry
this out all or part of this role;
Ensure participation of carers in planning and developing services so that they
can be more effective and suited to carers needs;
And thus ultimately aim to ensure better outcomes for carers and service users.
The outcomes of a carers assessment should be the production of a focused support
plan outlining who will take responsibility for particular services and what outcomes
will be achieved
The respective views of carers and the person supported are sometimes perceived
by agencies as being divergent or in conict. This may be an accurate perception,
although perceptions can be distorted because mental health professionals may have
more contact with carers at the point of crisis when tensions and emotions are running
high. This may not always be an accurate reection of relationships.
From Developing services for carers and families of people with mental illness
Department of Health - 2002
The role of carers in treatment adherence was not always acknowledged. Carers and
families reported that they were viewed with hostility and suspicion by professionals,
who felt their involvement and interventions were unhelpful. This is likely to be
particularly offensive to carers who provide the majority of care.
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Recommendation 7 - Creating Sensitive Services Carers and advocates must be
identied, invited to care planning meetings as far as is possible in advance, and given
copies of all paperwork unless the service user disagrees... ...Families and carers
should have access to training on mental illness to increase their knowledge and
understanding about symptoms and ways of dealing with it.
From Breaking the Circles of Fear - a review of the relationship between mental health
services and African and Caribbean communities - 2002 - Sainsbury Centre for Mental
Health
Thinkoonepracticalthingyoucandotoinvolvecarersmoreeectivelyandrecord
itbelow:
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Involvementandthewiderpicture
Activity3.6
Now were going to return to thinking about different ways in which service user and carerinvolvement can happen. What is your experience in your current role or setting? Rate the
items below using trafc lights Green = good practice Amber = reasonable practice
Red = poor practice.
Towhatextentareserviceusersableto:G
ood
practice
Reasonablepractice
Poorp
ractice
Offer informal or formal feedback to workers
Access user friendly advocacy and complaints procedures
Design and take part in surveys/audits/research on care issues
Join self help, service user or campaigning groups
Become representatives on management, clinical governance or PPI
(Patient and Public Involvement) groups
Take part in learning events for people from across the mental health
community
Find employment in mental health services
Interview and help to appoint staff
Run services
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Use the same trafc lights to assess how carers experience your service:
Rethink(2003)recommendsthatcarersshould:G
ood
practice
Reasonableprac
tice
Poorpractice
Be recognised and listened to as a partner in providing care
Be valued
Be treated with courtesy and respect
Be able to talk to a mental health or social care professional on requestReceive information as early as possible
Receive prompt and positive responses to requests for help
Be able to get immediate help in a crisis
Have their own needs assessed and met
Be able to have breaks from caring
Be given help in communicating with staff, when needed, for example
through an advocate, interpreter or signer
Be given an explanation of the mental health problem affecting the
person they care for
Be told what treatments the person is receiving, what other treatments
are available, how they work and the potential side-effects
Be given information about what support will be provided when the
carer can no longer care
Taking part in activities can be a daunting experience for service users and carers and you
need to be aware of this. It is important to provide for:
service users and carers working in pairs
realistic timing and length of meetings/learning sessionsproper introductions
availability of written material in advance of meetings/learning sessions, regular
breaks and a clear agenda
feedback, support and development opportunities
It is important that there are several means of service user involvement to suit as wide
a range of people as possible Mental health supported housing manager
Service users can gain a great deal from involvement with service user-led groups:
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Whatitmeanstobepartoaserviceuserorganisation:
(Quotations from a service user consultation event - CAPITAL West Sussex - 2005)
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3.Recovery
In this section of the module there are statements relating to three of the Ten ESC to help
you make a link with service user and carer involvement. There are also some learning
activities to help you to consider the skills that you have in these areas.
Statement 1: The old fashioned view was the doctor knows best, some of them still
think that, but some service users believe they know whats best. It is my life, does
getting help mean Im not in charge any more? Service user
This statement relates to ESC 1 Working in partnership. Developing and maintaining
constructive working relationships with service users, carers, families, colleagues, lay people
and wider community networks. Working positively with any tensions created by conicts of
interest or aspiration that arise between the partners in care.
Activity3.
Give an example of an effective partnership between a worker and a service user or carer
(based on your own experience or that of someone else):
Identify fourspecic things that were being done that made this a partnership:
1.
2.
3.
4.
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Think of a situation you are involved in at the moment where there isnt an effective
partnership between a service user and an individual worker, or an organisation.
What fourspecic steps could you take to make a better partnership?
Set a goal, which might lead to a better partnership:
What is your timescale for achieving this goal?
Statement 2: For too long the mental health system has fostered exclusion, stigma
and inequality Service user
This statement relates to ESC 4 Challenging inequality. Addressing the cause and
consequences of stigma, discrimination, social inequality and exclusion on service users,
carers and mental health services. Creating, developing or maintaining valued social roles
for people in the communities they come from.
1.
2.
3.
4.
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Activity3.
Where do you feel that exclusion, stigma and inequality exist in relation to mental health?
Give three examples from your own work or experience:
Think of an occasion when you saw someone with mental health problems experiencing
negative attitudes or comments or some kind of inequality or exclusion.
Were any other factors involved such as race, culture, ethnicity, disability, gender, age or
sexual orientation?
How did this incident make you feel?
What did you do when this happened?
1.
2.
3.
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Would you do anything differently now youve thought about it?
Statementsaboutrecovery
Recovery is a journey as much as a destination. For some people with mental illness,
recovery is a road they travel on only once or twice, to a destination that is relatively
easy to nd. For others, recovery is a maze with an elusive destination, a maze that
takes a lifetime to navigate.
Recovery does not always mean that people will return to full health or retrieve all their
losses, but it does mean that people can live well in spite of them
Allott 2003
The recovery model of mental health care allows for a wide variety of approaches
to living with and overcoming the problems of mental distress. It does not have as
its goal a cure, nor does it refer to an end product. Rather than thinking in terms of
interventions, medication and services, it asks the mental health worker to consider to
what extent any action works towards or hinders the personal journey and process of
recovery. Adapted from Repper and Perkins - 2003
Trying to get the right information for me and my family about my health and
resources has been like being on the slow train to London without any stops. Half the
time the mental health services didnt want to tell me what I wanted to know and half
the time I was too scared to ask. Service user
These statements relate to ESC 5 Promoting recovery. Working in partnership to provide care
and treatment that enables service users and carers to tackle mental health problems with
hope and optimism and to work towards a valued life style within and beyond the limits of any
mental health problem.
To move towards recovery a person has to nd new ways of living either by seeing the world
differently or accessing different resources. Having information about a range of choices is
essential.
Workers have information about the service user, their own organisation and other
community resources. The service user or their carer may not have any of this information.
Activity3.
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FrankisaBlackArican-CaribbeanBritishmaninhismid-thirties.Hekeepsinclose
contactwithhisolderbrotherPaulwhohasusedmentalhealthservicesormany
years.HesupportsPaulasmuchasheisableinhisday-to-daylieandalways
visitshimwhenheisinhospital.Franksaysthathisbrothergetsverydownromtimetotimeandbecomesunnyinhishead.Pauleelshistroublesarespiritual
innatureandalthoughhehasbeentoldhehasschizophreniahedoesntagree
withthisdiagnosis.BothPaulandFrankagreethatPaulneedsmorethanjust
medicationandwouldbenetromsomeormoemployment.Bothareverywary
omainstreammentalhealthservices.Frankhasneverspokentoamentalhealth
workeralthoughhecouldbedescribedasPaulsmaincarer.
What do you think Paul needs to know?
What do you think Frank needs to know?
Why did you decide on these things?
How could Paul and Frank access this information? Think of as many ways as you can.
What might stand in the way of them accessing this information?
In this powerful poem from the Open Up Training Pack (Mental Health Media 2004) LloydLindsay communicates how excluded and powerless someone with a mental health problem
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from a Black and Minority Ethnic community can feel:
Lithium to control my condition
To prevent me, the master did prevent me.
To call a ban to where I can go, Cordoning no go areas within my soul
Where mind guards are on patrol
Saying who are you
Who are you, you
And me and them who them are in between me and them who are them
A mental slavery
Internalise lies, lies
Everybody Run
Another broken black man
With ants in his pants
You got ants in you pants mateAnd his tapping feet, tapping a Rasta man chant
Look back at him from the way you are facing
Is it you who look though him or him through you
Or is the feeling mutual
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Identify three things you could do to improve service user and carer access to information
and support generally:
Identify three things you could do to promote access to information where disability, gender,
race, ethnicity or culture is an issue:
1.
2.
3.
1.
2.
3.
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Activity3.0
Now youve seen how hopelessness can spiral downhill design a realistic cycle of hope for a
service user, carer or worker you are involved with at. Start by thinking about an activity that
would offer this person something positive and build up from this.
Acycleohope:
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Once you have completed your cycle of hope, compare it with the example below.
Cycleohopeoraserviceuser:
A CycleOf Hope
Creativeexpression
Growing a senseof self, success and
acceptance
Wanting todo more
Thinking aboutmoney, spending, work
and relationshipsThe worker
believes in changeand is hopeful
Being referred tothe pathways to
work project
Being a volunteerat a theatre
Looking at priorities leisure and work
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Although each cycle of hope is unique as the diagram below shows the same process
applies with each positive action building towards the next.
Communityresources develop an
inclusive capacity
Decreasing Discrimination/Climate of hope enhanced
Hopeful workers who believein people and empowerment
Service users feelencouraged and hopeful
about the future
Recovery seemspossible
Support networks(staff/family/carers)
feel encouraged
Services are moreinclusive and reach
out into their communities
Service users usetheir strengths to work
towards their goals
A CycleOf Hope
Basset, Repper, Tooth, Wilson (2004)
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4.Overcomingbarrierstoserviceuserandcarerinvolvement
Being mentally ill I lost my power. I didnt believe I had any skills of any sort any more
I was useless Service user
For some of us an episode of mental distress will disrupt our lives so that we are
pushed out of the society in which we were fully participating. For others we live with
this sense of hopelessness Repeatedly when we become ill we lose our homes, we
lose our jobs and we lose our sense of identity. We lose sight of our potential. Social
Exclusion Unit - 2004
The Ten Essential Shared Capabilities highlight things you can do to overcome barriers to
service user and carer involvement.
ESC 3 Practising Ethically by acknowledging power differentials and minimising
them whenever possible.
ESC 9 Promoting Safety and Positive Risk Taking by empowering the person to
decide the level of risk they are prepared to take with their health and safety.
Activity3.
Keep these in mind as you read through the case study below:
Alices admission
Alice is a white British woman in her mid-forties. She is admitted to the Accident and
Emergency department (A & E) after taking a small overdose. This is the rst time she
has taken an overdose in 25 years. The staff at A & E are generally helpful. In the early
evening, Alice is interviewed by a mental health nurse. The nurse seems to be intent on
discharging Alice from the start of the interview. The nurse offers no help and she says
on a number of occasions I am empowering you by letting you go home. Alice is not
keen to go home, where she lives alone. After the interview with the nurse one of Alices
friends arrives and in discussion with Alice decides to stay and try to get Alice admittedto the psychiatric unit. Alice is eventually admitted around midnight and remains in the
psychiatric unit for two weeks before being discharged and going home.
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Here are some questions to consider.
What do you think was inuencing the nurse?
How do you think Alice and her carer/friend felt?
What did the nurse do that was unhelpful?
Suggest something helpful the nurse could have said or done:
Power is an important issue in involving service users and carers. Misuse of power by
workers leads to poor outcomes for service users:
Power is the ability to inuence and control people events and processes... It is an
ever present phenomenon Thomson 1998
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Activity3.2
Think of times when you have power, or lack power, in your current role in mental health
services:
I have power when:
I lack power when:
Suggest ways in which you could use your power to empower others:
1.
2.
3.
1.
2.
3.
1.
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Another way of overcoming barriers to promoting service user and carer involvement is
linked to:
ESC 6 - Identifying Peoples Needs and Strengths.
Activity3.3
How strengths-led (rather than problem-led) is the way you work with people?
Mark this scale to show how strengths-led you are:
Notvery Unsure Very
In the last interview/discussion you had with a service user what percentage of the time did
you spend encouraging them to talk about things that they do well and enjoy?
Was this usual or exceptional?
Name one thing you could do differently to draw out service users interests, skills and
positive experiences?
2.
3.
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Identify a specic occasion when you will try this approach:
Now read this account from a service user:
Mymentalhealthworkershavebeenverygood;IstillsaythatmyrstCPN
probablysavedmylie.ButIworryaboutthesystem;Ihaveoundmywaytoa
placeorecoverybytravellinglongdistancesliterallymilestoaskorinormation
aboutmentalhealthandemploymentopportunities.Noonesaidhereiswhereyou
gotondout.Mostoall,myhusbandandchildrenlostoutbecausenoneous
understoodwhatweweredealingwithandnoonesatdownandtalkedwithus
aboutaplantondawayolivingbetter.Therewassomuchheartbreak.
Itsmadeadierencebeingtoldthattheemploymentprojectwasavailable.The
peoplewhoworkwithmeknowIneedfexibilityandextrasupporttostaywell;
Ivaluenotbeingregardedasapersonwithaproblem.Ivemetprejudiceand
judgementromthepsychiatristandellowworkersbutIhavealsoreceivedthe
bestpossiblecareandconcern.Mostimportanttomeisbeingseenassome
onewithvaluewhocanactivelydosomethinguseul.Findingaplacetoreceive
supportoutsidethestatutoryserviceshasbeenbetter.Idontwanttobeontheendobeingdonetoagain.Itmakesmeeellikedirt.Serviceuser
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Activity3.4
Identify specic things you could have done to make sure this service user (and family) felt
involved:
Below are some things that organisations can do to promote involvement:
Information services / advice lines
Advertised opportunities to get involved
Support and Training for involvement
Giving service users inuence and power at Board level
Funding to promote and support involvement
Flexible approaches to getting people involved
Service user and carer involvement champions
Service users and carers working within the organisation to involve others
Now think about your own recent experience of involving service users.
Identify something that you are already strong in:
Identify something that your organisation is already strong in:
Identify something you need to develop further:
Identify something your organisation needs to develop further:
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5.Evaluation
Evaluatingeectivenessoserviceuserandcarerinvolvement
Making sure that service users and carers are involved is a requirement if you work in mental
health services. This includes helping people to make effective links to organisations outside
health and social care services.
Its important to remember that service users have a right to decide how involved they want
to be. They may be anywhere along this scale:
Disengaged Indierent Active
An important part of good practice is making sure that people who have disengaged are
listened to and given a voice.
And its not enough for service user involvement simply to be present, it must be effective.
Service user involvement may be anywhere along this scale:
Absent Present Eective
Effective service user involvement is:
empowering,
moves people towards health and inclusion,
makes a difference to policy and practice.
To judge whether this is the experience of the service users and carers you work with you
can draw on ESC 7 Providing Service User Centred Care, which includes: Systematically
evaluating outcomes and achievements.
The effectiveness of service user and carer involvement can be assessed in a number of
ways:
Asking questions on involvement in CPA assessments / reviews / meetingsService user / carer led satisfaction surveys
Audit
Research studies
Internal inspections / reviews
External inspections / reviews
Organisational development projects
Tick the list to indicate which of these are already being used in your organisation. Now think
of something practical you can do to check that the service users and carers you work with
are involved more effectively.
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I could involve service users more effectively by:
I could involve carers more effectively by:
Now that you have completed the module here are Three key questions to assist you in
further learning:
What are the main qualities required for involving service users and carers in
effective care planning?
How can you overcome conicts that arise when you offer service user and carer
involvement?
What are some practical ways of involving service users and carers in planning
and consultation?
1.
2.
3.
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Websites
Commission for Patient and Public Involvement, see www.cppih.org
Department of Health, see www.dh.gov.uk
Mental Health Foundations website: www.mentalhealth.org.uk. Spend some time looking at
the resources available at this website including the one in four forum.
Mental Health Media, www.mhmedia.com - contact them for the Open Up training pack
(2004)
Mental Health Trainers Network, see www.mhtn.org
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