Are Service Users Feeling the Difference?

1. Are Service Users Feeling the Difference? Shaun McNeil Managing Director-Advocacy Matters (Greater Glasgow)

2. …but also Secretary VOX-Voices Of eXperience

3. 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

4. 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

5. 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 Scotland”Lewis Macdonald MSP, Deputy Health Minister

6. 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?

7. 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.

8. 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

9. 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.

10. 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!

11. 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 can’t get off of observations or paperwork or servicing the ward rounds to do so.

12. 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.

13. 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

14. 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!

15. 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 community…I’m afraid the data isn’t yet available…it may be early days, the wind of change may be blowing from the mountain top-but it doesn’t seem to be perceptible in the valleys quite yet!

16. Are Service Users Feeling the Change? VOX-Voices Of eXperience c/o Mental Health Foundation (Scotland) 30 George Square, Glasgow, G2 1EG. voxscotland@yahoo.co.uk www.voxscotland.org.uk Advocacy Matters (Greater Glasgow) 30 George Square, Glasgow, G2 1EG 0141 572 2850 advocacymatters@yahoo.co.uk THANK YOU FOR YOUR INTEREST!

17. ‘Rights, Relationships and Recovery’One Year On • Meeting the Educational Challenges and Opportunities

18. 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/

19. 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

20. 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

21. The Challenge ?

22. Remembering the context of the actions

23. 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)

24. A values base for Mental Health Nursing

25. A support service for mental health professionals • A frequently asked question: • “Can I get advise and support without being treated like a patient” ?

26. The 10 Essential Shared Capabilities for Mental Health • Working in Partnership • Respecting Diversity • Practicing Ethically • Challenging inequality • Promoting recovery • Identifying people’s needs • and strengths • Providing service user centred care. • Making a Difference. • Promoting safety and positive • risk taking • Personal development and learning.

27. 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

28. 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

29. 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)

30. 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

31. Last word • Thank you