Are Service Users Feeling the Difference

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Are Service Users Feeling the Difference?

• Shaun McNeil
• Managing Director-Advocacy Matters (Greater
  Glasgow)

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but also

• Secretary
• VOX-Voices Of eXperience

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Are Service Users Feeling the Difference?

• (In Scotland), a consumer revolution is required
  in Mental Health Services with a louder, clearer
  voice for those on the receiving end of those
  services.
• Maddy Halliday 2000

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Are Service Users Feeling the Difference?

• We need to get to a point in Scotland where
  those who have real experience of the stigma and
  exclusion which comes hand in hand with living
  with mental health problems are in a position to
  help shape services.
• Isabella Goldie 2006

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Are Service Users Feeling the Difference?

• We will continue to work with VOX to deliver
  their ambition to help as many people as possible
  to contribute to the design and development of
  mental health services, care and policy in
  ScotlandLewis Macdonald MSP, Deputy Health
  Minister

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Are Service Users Feeling the Difference?

• Cultural change-how much can be achieved in a
  year?
• The liberation of Mental Health nurses-is this
  happening at the sharp end of service delivery?
• Are the nurses caring about us more?
• Do they have more time to be with us?
• Are they inspiring a hope for recovery?
• Are they acquiring leadership roles?

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Are Service Users Feeling the Difference?

• For us to feel the difference we would suggest
  there needs to be
• Leadership at all levels-experienced, realistic,
  skilful leaders who are practical and decisive
  and who have political savvy-to mobilise
  others, develop their values and will to overcome
  resistance, and turn the vision into reality,
  through considered work and change.

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Are Service Users Feeling the Difference?

• We would also suggest there needs to be
• Meaningful involvement of all involved which will
  make the change process
  easier to reach a consensus,
  easier to develop a vision,
  easier to carry out collective action, easier
  to make everyone feel equal, united and enjoying
  a forward momentum

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Are Service Users Feeling the Difference?

• Coming into a programme everyone has different
  levels of knowledge and different abilities,
  Knowledge is Power so we would suggest there
  needs to be-an equalisation of knowledge. This
  avoids exclusion (which can be unintentional) and
  promotes mutual education in any group, as all
  involved give and receive a variety of
  perspectives and experiences.
  

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Are Service Users Feeling the Difference?

• Finally, when considering cultural and service
  change, we need to think about sustainability!
  What is the point of positive change if it is not
  sustained? People need to be able to work across
  boundaries-spreading the vision, collect the
  data, celebrate the successes and actions, use
  print/media to publicise and spread good
  practice, change the policy, the procedures, the
  regulations for good!

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Are Service Users Feeling the Difference?

• We believe that many mental health nurses are
  feeling liberated in the head, but just not in
  the workplace! There appears to a
  missing link between the Senior NHS Staff who
  have been tasked to implement the Delivery Action
  Plan and the D grade staff nurse who wants to
  spend more time with people, but cant get off of
  observations or paperwork or servicing the ward
  rounds to do so.

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Are Service Users Feeling the Difference?

• Are nurses caring about us more? We believe the
  Scottish Recovery Indicator may assess if the
  ward is a caring environment and hope that the
  Ten Essential Shared Capabilities Training will
  help to ensure that nurses will know what we mean
  when we ask to be cared about, as well as being
  cared for.

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Are Service Users Feeling the Difference?

• Do nurses have more time to be with us? See the
  slide about psychological liberation as compared
  to practical liberation.
• Are nurses inspiring a hope for recovery? We
  believe that the true messages of what recovery
  means are getting through and there is some
  optimism in nurses ability to move nearer to a
  role where they want to be-that of enabler,
  rather than custodian

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Are Service Users Feeing the Difference?

• Are nurses acquiring leadership roles? There
  certainly seems to be more mental health nurse
  consultants but more rank and file staff nurses
  need to get access to leadership development
  opportunities. Leadership needs to be at all
  levels in Nursing, not the preserve of the few!

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Are Service Users Feeling the Difference?

• So are Service Users feeling the difference?
• Well, this one is in policy terms, but
  practically, I have not had the need to sample
  nursing services over the past year!
• Locally we may be, because we some service users
  have opportunities to become involved in
  implementation of the Action Plans,
• But on the wards and in the communityIm afraid
  the data isnt yet availableit may be early
  days, the wind of change may be blowing from the
  mountain top-but it doesnt seem to be
  perceptible in the valleys quite yet!

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Are Service Users Feeling the Change?

• VOX-Voices Of eXperience
• c/o Mental Health Foundation (Scotland)
• 30 George Square, Glasgow, G2 1EG.
• voxscotland_at_yahoo.co.uk
• www.voxscotland.org.uk
• Advocacy Matters (Greater Glasgow)
• 30 George Square, Glasgow, G2 1EG
• 0141 572 2850
• advocacymatters_at_yahoo.co.uk
• THANK YOU FOR YOUR INTEREST!

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Rights, Relationships and RecoveryOne Year On

• Meeting the Educational Challenges and
  Opportunities

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NES actions from the review

• Progressing activity to support 12 of the review
  actions
• Some actions now also being progressed as part of
  Delivering for Mental Health and Delivering Care,
  Enabling Health agendas
• Find out more, contact us, get involved and
  involve us by going to
• http//www.nes.scot.nhs.uk/mentalhealth/

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Underpinning principles for our work

• All projects sourced in and informed by the lived
  experiences of people who use mental health
  services and their families/carers
• Joining up the various policy initiatives
• Multi agency/multi-disciplinary approach while
  maintaining the integrity of the review
• Not just about producing resources and putting
  them out there
• Support for implementation infrastructure
  issues
• What's happening nationally is about
  supporting/enhancing/learning from innovation
  already happening locally not inhibiting or
  stalling it

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Presentation overview

• Focus on the values based practice agenda
• Reflecting back on the context
• Exploring the challenges and the opportunities
• Looking at the next stages

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The Challenge ?
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Remembering the context of the actions
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Values Based Practice ?

• Before you get any ideas of expanding roles make
  sure you get what is important right first
  (Service user and carer reference group)
•  
• From Shaun McNeil  Karen Robertson (on behalf
  of their groups)
• For too long, mental health nurses have known
  what they would like to do to improve service
  users lives, but have often felt constrained.
  The review of mental health nursing in Scotland
  now gives us the instrument to support, develop
  and liberate mental health nurses undoubted
  skills and talents. (SEHD, 2006)

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A values base for Mental Health Nursing
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A support service for mental health professionals

• A frequently asked question
• Can I get advise and support without being
  treated like a patient ?

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The 10 Essential Shared Capabilities for Mental
Health

• Working in Partnership
• Respecting Diversity
• Practicing Ethically
• Challenging inequality
• Promoting recovery
• Identifying peoples needs
• and strengths
• Providing service user centred care.
• Making a Difference.
• Promoting safety and positive
• risk taking
• Personal development and learning.

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10 ESCs learning materials

• Developed and piloted in England 2004/2005
• Extensively revised for Scotland
• Launched April 2007
• Introduction
• The 10 ESC
• Involving service users and carers
• Values based practice
• Equality and diversity respecting difference
• Developing socially inclusive practice

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Ideal ESC learning ?

• Closely linked to exploring own practice and
  services
• Linked to personal and practice/service
  development
• Whole team learning multi professional/agency
• Facilitated
• Opportunities to discuss with others
• Service users and carers involved as learners and
  as trainers/facilitators
• Used as part of supervision (group or individual)
• Used to look at real issues in practice

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Education and training is just one of the
components that will contribute to development

• Opportunities for joining up The ESC (Action 1)
  learning and other actions
• Essential building blocks for recovery focussed
  practice (Action 3)
• SRI (Action 2)
• Reviewing assessment and care planning frameworks
  to reflect the values base and key messages of
  the review (action 4)
• Models of care informed by the principles and
  recovery focussed
• (Action 6)
• Competency frameworks for acute care and older
  peoples health (Action 10)
• National framework for pre registration
  preparation and the meaningful involvement of
  users and carers in education (Action 16)
• Clinical supervision opportunities (Action 22)

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Next stages

• Supporting roll out- training for trainers -
  regional infrastructure for values based practice
  and recovery training (2 phases)
• Evaluation/impact assessment
• International activity
• ESCs influence out with mental health
• Share what's happening locally so we can learn
  from each other

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Last word

• Thank you