The 10 Essential Shared Capabilities for Mental Health Practice

1. The 10 Essential Shared Capabilities for Mental Health Practice Welcome!

2. What are the 10 Essential Shared Capabilities (ESCs)? • Working in partnership. • Respecting diversity. • Practising ethically. • Challenging inequality. • Promoting recovery. • Identifying people’s needs and strengths. • Providing service user-centre care. • Making a difference. • Promoting safety and positive risk taking. • Personal development and learning.

3. Why Are We Here? • To support cultural change. • To promote rights-based, recovery focused practice. • To become action focused. • To develop knowledge, skills & attitude.

4. Rights, Relationships and RecoveryCulture and Values - All MH nurses have access to values based training. - Embed values based practice in personal development plans. - Use recovery audit tools. - Train in Recovery methods. - Help maximise contact time.

5. Rights, Relationships and Recovery Practice and Services • Create national CPD Programme. • Develop recovery models for inpatient units. • Promote continuity of Care. • Develop practice networks. • Develop competency based framework. • Support nurses to deliver therapies. • Create nurse consultants.

6. Rights, Relationships and Recovery Education and development • Attract the right people. • Opportunities to develop and learn. • Involve users and carers in programme design. • Develop role of Health care Support Workers. • Nursing leaders. • More research and Evaluation. • Develop robust learning climate.

7. Delivering for Mental Health • Improve patient and carer experience of mental health services. • Respond better to depression, anxiety and stress. • Improving the physical health of people with mental illness. • Better management of long-term mental health conditions.

8. Delivering for Mental Health • Early detection and intervention in self-harm and suicide prevention. • Manage better admission to, and discharge from, hospital. • Child and Adolescent services. • Enhancing specialist services.

9. Legislation • Regulation of Care (Scotland) Act 2001 • Code of practice for Social Services Workers 2005 • Data Protection Act 1998 • Access to Medical Reports Act 1985 • Human Rights Act 1998 • Adults with Incapacity (Scotland) Act 2000 • Mental Health Care and Treatment (Scotland) Act 2003 • Social Work Scotland Act 1976 • Sex Discrimination Act 1975 • Disability Discrimination Act 1995 • Race Relations Act 1976 • Race Relations Amendments Act

10. MODULE2 10 Essential Shared Capabilities (ESCs)

11. 10 Essential Shared Capabilities (ESCs) • Working in partnership. • Respecting diversity. • Practising ethically. • Challenging inequality. • Promoting recovery. • Identifying people’s needs and strengths. • Providing service user-centre care. • Making a difference. • Promoting safety and positive risk taking. • Personal development and learning.

12. Learning outcomes • Describe the 10 ESCs and how they relate to mental health. • Reflect on yourself and your practice in relation to the ESCs. • Understand how the ESCs relate to and support the delivery of mental health policy and legislation in mental health practice in Scotland. • Start to think about further developing your practice in line with the ESCs and recognise how they can help you to improve your experience of mental health work and the experiences of the people you work with.

13. Working in Partnership • Value service users as equal in their care and treatment. • Acknowledge the positive part families, friends and carers can play in the service user’s support network. • Engage people as partners in care in a way that maximises their role in decision making and making choices.

14. Respecting Diversity Practice and Services Respecting diversity is about working in partnership with service users, carers, families and colleagues to provide care and interventions that not only make a positive difference, but also do so in ways that respect and value diversity, including age, race, culture, disability, gender, spirituality and sexuality.

15. Practising Ethically Practising ethically involves the rights and aspirations of service users and their families and carers, acknowledging power differentials and minimising them whenever possible. It also focuses on providing care and treatment that is accountable to service users and carers within the boundaries prescribed by law and professional, national and local codes of ethical practice.

16. Challenging Inequality Challenging inequality involves addressing the causes and consequences of stigma, discrimination, social inequality and exclusion on service users, carers and mental health services. It also focuses on creating, developing or maintaining valued social roles for people in the communities in which they live.

17. A Scottish Government survey (SEHD, 2006) showed that: • Half of the respondents said they would not want anybody to know if they developed a mental health problem. • Most people in the survey said they thought the media portrayed people with mental health problems negatively.

18. More research findings • 41% of people with mental health problems living in Scottish communities have experienced harassment, compared with 15% of the general public. • A 2001 study found that only 37% of employers said they would in future take on people with mental illness, compared to 62% who would take on physically disabled people, 78% who would employ long-term unemployed people, and 88% who would appoint lone parents. • 64% of young people say they would be embarrassed to disclose a mental health problem to a prospective employer.

19. Promoting Recovery • Promoting recovery involves 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 lifestyle within and beyond the limits of any mental health problem.

20. It’s Important to note what recovery doesn’t mean. It is not: • Cure. • Something mental health workers ‘do’ to people. • A new word for ‘rehabilitation’. • A model. • ‘Something we have always been doing anyway.’

21. The keys to working in a recovery-focused way include: • HOPE, one of the most important factors in recovery. • A belief in recovery. • Holding and demonstrating values and practices that reflect this belief. • Taking what people can do and want (their strengths) as a starting point. • Developing care so that service users can increase their role in directing their own care and treatment. • Creativity and positive risk taking. • The use of tools such as person-centred planning, strengths-based approaches and wellness recovery action planning.

22. Identifying Peoples Needs and Strengths • Identifying people’s needs and strengths involves working in partnership to gather information to agree health and social care needs in the context of the preferred lifestyles and aspirations of service users, their families, carers and friends.

23. Providing Service User-Centred Care • Providing service user-centred care involves negotiating achievable and meaningful goals, primarily from the perspective of service users and their families and carers. It also involves influencing and seeking the means to achieve these goals and clarifying the responsibilities of people who will provide help, including systematically evaluating outcomes and achievements.

24. ‘Most helpful strategies and supports’ • Friends, partners, family. • Other service users/people with similar problems. • Mental health professionals. • Counsellors/therapists. • People encountered in day centres, drop-ins, voluntary sector projects.

25. Strategies Personal strategies • Peace of mind. • Thinking positively, taking control. • Medication. • Physical exercise. • Religious and spiritual beliefs. • Money. Other activities • Hobbies and interests. • Information. • Home. • Creative expression.

26. Making a Difference Making a difference involves facilitating access to and delivering the best quality, evidence-based, values-based health and social care interventions to meet the needs and aspirations of service users and their families and carers.

27. Promoting Safety and Positive Risk Taking Promoting safety and positive risk taking involves working with people to decide the level of risk they are prepared to take with their health and safety. It encompasses working with the tension between promoting safety and supporting positive risk taking, including assessing and dealing with possible risks for service users, carers, family members and the wider public.

28. Perkins (2007) points out that often mental health professionals feel that their job is to protect the people they work with – protect them not only from physical harm, but also from failure. But if any of us are to do the things we want to do, we have to risk the possibility of being unsuccessful.

29. The Factors that need to be in place for Positive Risk Taking to Take place • Having enough information to exercise choices and make decisions. • Holding some control over the direction of your destiny. • Having a degree of power and control. • Being able to work with others positively to inform your decisions. • Having options to make constructive use of opportunities.

30. It should become part of the culture of training • Adequate resources to enable creative work. • Limiting the duration of the decision. • Having team and service mechanisms. • Individual and collective accountability and responsibility is clearly defined. • The ‘organisation’ also holds responsibilities.

31. Personal development and learning • Personal development and learning involves keeping up to date with changes in practice and participating in lifelong learning and personal and professional development opportunities for self and colleagues through supervision, appraisal and reflective practice.

32. MODULE 3 Involving service users and carers

33. Learning OutcomesAfter completing the module you will be able to: • Describe the links between service user involvement, carer involvement and the 10 ESCs. • Discuss service user and carer involvement at individual, organisational and strategic levels. • Explore local approaches to increasing service user and carer involvement. • Present ideas on how this improved approach can be achieved

34. Policy, Legislation and local strategies related to service user and carer involvement  • Changing Lives Implementation Plan (SEHD, 2006) • Framework for Mental Health Services (Scottish Office, 1997) • Delivering for Mental Health (SEHD, 2006) • Community Care and Health (Scotland) Act 2003 • The Mental Health (Care and Treatment) (Scotland Act 2003) • Voices of experience (VOX)

35. Levels of Involvement • Individual • Organisational • Strategic

36. Developing People’s Confidences • Listening to their needs and aspirations. • Providing information. • Working to develop constructive relationships with people. • Basing assessments and plans on individuals’ strengths. • Including people in planning.

37. “ Writing an advance statement has made me feel that I have taken control of my care and treatment. I feel more empowered and the whole process has given me an opportunity to think through my mental health history and what works for me”

38. Core components of effective service-user involvement • It is essential to involve people in assessment, reviews and discussion making around their care, support and treatment. • Having the information they need to be involved. • Knowing what options and choices are available to them. • Feeling free to express views and wishes. • Being listened to and understood and having their views respected. • Being able to influence what happens and make decisions that matter.

39. Barriers to Service User and Carer Involvement • Individual • Serviced-related • Societal

40. Actions that can contribute to developing people’s confidence include: • Listening to their needs and aspirations • Providing information • Working to develop constructive relationships with people • Basing assessments and plans on individuals’ strengths • Including people in planning

41. “ Power is the ability to influence and control people, events and processes …. it is an ever-present phenomenon

42. Good Practice in Strategic Involvement • Support organisations that help individuals to be involved. • Set up meetings at convenient times and locations. • Acknowledge individuals’ backgrounds and circumstances, including diversity of age, culture, race, disability, gender, sexuality and spirituality, and take these into account when asking for involvement. • Find out about training and development opportunities that will facilitate greater involvement • Be aware of and use person-centred approaches to commissioning services.

43. Good Practice in Strategic Involvement - cont. • Provide information in a timely and accessible manner. • Set out tasks clearly. • Run meetings and events in ways that promote participation. • Allow enough time meetings for debate and consultation. • Involve service users in decision-making processes from the beginning and make it clear how, where and when decisions are made. • Have a jointly agreed approach to involving service users and carers which covers practical aspects, such as payments and expenses, and difficult points such as ways of resolving differences of opinion.

44. MODULE 4 Values-based practice

45. Learning outcomesAfter completing the module you will be able to:Explain what values-based practice (VBP) means in mental health and social care by: • Describing the 10 pointers to good process in VBP. • Explaining the relationship of VBP to the 10 Essential Shared Capabilities (ESC’s). • Beginning to apply VBP in your work.

46. The values base for mental health nursing • Relationships • Rights • Respect • Recovery • Reaching out • Responsibility

47. Changing Lives – Core Values of Social Work in Scotland • Respecting the right to self determination • Promoting partnership • Taking a whole-person approach • Understanding each individual in the context of family and community • Identifying and building on strengths

48. Values- based practice • The theory and capabilities for effective decision making in health and social care builds in a positive way on differences and diversity of values

49. The 10 Pointers to Good Process in VBP (Woodbridge and Fulford) Practice Skills • Awareness • Reasoning • Knowledge • Communication

50. The 10 Pointers to Good Process in VBP Models of Service Delivery • User Centred • Multidisciplinary