Choice: a priority for people accessing mental health services?

At Leeds and York Partnership  NHS Foundation Trust we are developing guidance for staff to help ensure that people are offered choice, including choice of worker. What is your view on people being offered a choice of worker? Please complete this quick poll, responses are anonymous.

If you would like to contribute to the development of this guidance or want to share your views to inform its development, then please contact donna.kemp@nhs.net Click here to read the comments from Twitter

Choice is a hot topic in Mental Health at the moment. People will be able to choose where they have their first outpatient appointment under choose and book, providing equal status between physical and mental health services.  This is a welcome move, but is only part of the story; Dr Sean Lennon writes about the broader picture of choice, of collaborating with service users, empowering people to make autonomous decisions about their own care and lives “Mental health service users are no different from anyone else in that they want to be able to exercise choice. They want to be treated with respect and be supported by skilled staff to receive high-quality care. Freedom of choice is absolutely fundamental to these aspirations”. You can read the full story here.

Locally, people attending the Service User Network (SUN) pulled together their views about choice and how they want to be treated within mental health services. The discussions were lively – clearly people had strong views about this and there were many stories highlighting the importance of choice and how it makes a difference to the persons experience and their progress. You can read about ‘Choice and how people want to be treated: key messages from SUN’ here.  There is more information about Leeds SUN here; you can click here for details about a developing service user group in York and there is also the Independent Mental Health Service User Forum, you can read about how to contact them and what they do here.

 

Advance Statements in LYPFT

“When I am ill, I am not quite me, I do not want to speak, I want to be left alone, my carers think I am being difficult but this is how I deal with my illness.  How can I convey this to my carers?” Diane  

Answer: through an Advance Statement

What is an Advance Statement?

It is a contingency plan or a wish list that a service user writes when they are feeling well in the event of them not being well.  It should cover what they would like to happen concerning their wellbeing and lists their choice in care and treatment.  It can let staff know what care needs/medications work for them and which one’s don’t.  It can also let staff know about any physical needs or disabilities they have ensuring these needs are met.  It can help in planning things to run smoothly whilst they are ill e.g. who is taking care of the children, bills, pets etc.

What an Advance Statement cannot do for the service user:

It cannot ensure they get their preferred treatment, as it is not legally binding.  It cannot stop them from being treated against their will if they are sectioned under the mental health act.

It is all about Choice:

It gives the service user more control in their recovery, making sure their choices over childcare, pet care, bills etc are know and so elevating any unnecessary worrying.

Choice is a key reoccurring theme that runs through the discussions we have at the Service User Network (SUN) which meet every month on the first Wednesday afternoon of the month, at St Chads Community Centre, Headingley.  Service users are encouraged to give their observation on services/care and these are addressed at the clinical governance group.  They are given the choice to contribute by having their say on how things are done.  This has resulted in changes in care delivery .e.g. Care Programme Approach.  So choices and using your voice can influence the services you receive which will also directly affect service user’s recovery.

Where can you get an Advance Statement? 

Easy, there is a template at: www.leedsandyorkpft.nhs.uk/service_users/Advancedstatements with guidance notes.

The service user’s psychiatrist, care co-ordinator, health support worker, or occupational therapist can help them fill in the form.   It is a good idea to discuss it with their friends and family as they might have advice which could help their plan. It doesn’t have to be written on an official Advanced Statement document for it to be valid but you need your family, friends and care worker to know about it and the Trust can hold a copy which should be reviewed every year.

How many advance statements are we aware of within the Trust? 

There are 57, which is not enough when you consider that approximately 20,000 people use Trust services.

What can we do to help promote advance statements? 

Make sure people are aware of them and encourage the use of them throughout the Trust.

If YOU were given a choice in care, wouldn’t you want to take up that choice?  

Of course you would, so please help promote Advanced Statements now.

Written by Anne Perry, Recovery & Social Inclusion Team

If you require further information about Advance Statements, then please contact Beverley Thornton on 0113 3056755/58  or email beverley.thornton1@nhs.net

Choice & how people want to be treated: key messages from SUN

At the March Service User Network (SUN) meeting there was a discussion carried forward from the previous meeting. The SUN members wanted to explore areas that they would like choice in. The following two questions were addressed at tabletop discussions, and the responses are condensed:

1. What would you like choice in?

• Which service I am involved with
• Choice of worker and who I work with – gender, CPN/Support worker/care coordinator, access to different professions, seeing the same worker
• Appointments – flexibility in where we meet
• Involvement in planning care – reviews: how often, who attends, what is discussed; involved in agreeing care plans;
• Medication – the different options, including not taking any medication, easy access to a second opinion
• Treatment and therapy options – CBT, DBT, TC; what we do not want and what we do want, including ECT; access to complementary therapies; mindfulness
• Access to peer support – including courses (Mind), easy access
• Personal independence budgets
• Where I live and the things I do – like cooking, what I eat, and watching sport
• To have the right to make my own choices

2. How would you like to be treated as an individual within Mental Health and Learning Disability services?

• Treated as a person, not an illness
• As an equal – regardless of my characteristics
• Non-judgementally – with respect, compassion and understanding
• As an intelligent person – just because I have a mental health problem doesn’t mean I’m stupid – people can talk down to you!
• As an expert in my own issues and life
• As a customer – eye contact, honesty, humane, respect my sense of urgency in crisis
• To be talked to, listened to and liked – to be seen as worth getting to know and be with
• That my feedback is accepted – that what I say has value

These points will be discussed at the April SUN meeting and next steps in moving this forward decided. How would you like to see this – as a charter? a ‘best practice’ support? All ideas welcomed!

What is your view from a mental health professional, carer or partner agency  perpective? Feel free to comment…..

Please leave a comment if you have anything to add to these suggestions…….

The next SUN meeting is on Wednesday 2^nd April at St Chad’s Community Hall in Headingley; the guest speaker will be Dr Jim Isherwood, LYPFT’s Medical Director – click here to see the flyer. All are welcome to attend, but if you can’t get there, please feel free to post any comments or questions you may have for him here or email donna.kemp@nhs.net