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There have been many advances in our understanding of how to promote mental health wellbeing, resilience and recovery. The evidence for this comes from various sources and methodologies, including individuals, communities, health and social care services from many different cultures. These includes individual testimony of service users and families and research findings.
Research and best practice indicates that there are key innovations that we need to further develop and implement to provide effective support, care and treatment for people with mental health issues.
New community mental health practice and systems should be based on these foundations:
- All practices should be provided in non-coercive ways and without the use of force or restraint
- Care, support and treatment should be provided to people in their own local communities,in their homes, wherever possible based on the choices made by the person
- Mental health services should be integrated into primary health care systems
- Services must be accessible and available when and where the person requires them, on a 24 hour / 7 day a week basis
- All people regardless of their status must have equal opportunity and culturally appropriate access and experience of relevant service provision
- Identifying mental health issues at an early stage and providing effective support should be provided as quickly as possible
- Care, support and treatment must be person centred and based on individual need and choice
- Practices should incorporate the means to evaluate service user experiences in their use of treatments and supports
- Improved access to effective modern methods including talking therapies
- Mental Health systems should adopt the latest service user led research evidence for delivering effective support and practice
- Mental Health systems should encourage and support the development of user run services as an essential learning in the development of all services
- Effective recovery care practice should be coordinated through Multi-disciplinary Team Work that promotes access to a range of effective services
- Greater promotion of self-management and peer support techniques and skills by service users and family members
- Increasing access to individual talking or psychological therapies
- Developing support to families
- Promoting in everyday practice, opportunities for employment through vocational training, social enterprises and engagement with local businesses
- Promoting the proper and effective use of medication
It is essential to ensure service users have access to, and the necessary provision of physical health care
Encouraging action research in new ways of working
It is necessary that innovative practices are further researched to demonstrate their effectiveness.
Further, qualitative and participatory research needs to be given equal status to quantitative methodologies. Importantly equal care needs to be taken in determining the validity and applicability of current “scientific methodologies”.
Research must be based on peoples experiences and narratives. It should be co-produced and encompass a diversity of view points and positions and relevant to the priorities identified by people, their lives and needs.
New research centres and networks need to be established and further developed, for example the IMHCN Research Network and the Hearing Voices Movement Research Centres.
People have a responsibility for determining for themselves the lives they lead and their own wellbeing. This is particularly relevant when they are concerns about the persons mental health and well being. The services should encourage and support the important principle of self determination by providing services and practices that support and underpin this.
1. Choice: Service users should be able to determine their own recovery plan in collaboration with their workers, families and significant others. Service providers should accept that recovery is a process requiring every service user to be regarded as a unique individual. Their wishes, needs and hopes should be at the centre of service provision.2. Relationships: The service user should be able to determine the person they want to work with based on the importance of a trusting relationship.
3. Ownership: Service providers should accept that the service users are experts in their own life experience and this should be the foundation of a therapeutic alliance with the expert by profession.
4. Opportunities: The service user should have available the same life opportunities as a person without a mental health problem.
Making Recovery a Reality Geoff Shepherd, Jed Boardman & Mike Slade, Sainsbury Centre for Mental Health, (2008) "The concept of recovery requires further development, but that it provides a framework which, if seriously adopted, will bring a radical transformation of mental health services in this country in the future. This policy paper presents some of the key ideas and examines their implications for the delivery of mental health services. it is not the last word on the topic of recovery; rather it aims to open up debate about how the recovery approach can be put into practice and what services need to do to make it happen." More information here
Whole Life: Cornwall NHS Partnership Trust Whole Life is a common sense approach which accepts people with mental health problems are more than the sum of their symptoms. It started in mental health but because of the local commitment is applied to everyone with whom we work. It acknowledges and encourages their hopes and aspirations. Just like everyone, they want to be well and valued. Whole Life in Cornwall has embedded a set of values and principles that support recovery and enable people to enjoy the full benefits of citizenship. More information here.
Paths to Personalisation in Mental Health : A whole system, whole life framework NDTi has written Paths to Personalisation on behalf of the Department of Health and the National Mental Health Development Unit (NMHDU). This whole system guide has been produced to help all those involved understand how things will need to be done differently to make personalisation a reality for people with mental health needs. Click on the pdf in the right hand column for a copy of Paths to Personalisation. More information here. Download the pdf here.
Moving West Cork Mental Health Service in a Recovery Direction
The West Cork Mental Health Service has been awarded a grant of over €100,000 to move the service in a ‘recovery direction’. This document sets the context for this award, explains what is meant by ‘recovery’, outlines what has already been achieved in West Cork and explains how the service will develop in the next two years.
Download the document as a pdf here
Pillars of Peer Support: Transforming Mental Health Systems of Care
Through Peer Support Services: The Pillars of Peer Support Services Summit The Carter Center Atlanta, GA, USA November 17-18, 2009
The findings of this report demonstrate that peer support has gained an important and effective role in state systems of mental health care. The goals and principles of peer support are consistent with contemporary policy reports including the New Freedom Commission, the Institute of Medicine, and others. The Pillars of Peer Support that are outlined in this report provide a framework for future services to be built upon.
More information here
Whole Life Programme In Cornwall
Michaela Burt describes the principles, aims and objectives of the Cornwall Partnerships in patient services. View the presentation here.
Recovery based services
Presentation by Mary O'Hagan on what a recovery service is.
Together we will find the way Presentation of the Experience of the services in Slotsvænget Lyngby-Taarbæk Kommune, Denmark by Jørn Ditlev Eriksen.
Recovery into Practice for and by Professionals Powerpoint presentation by Social Psychiatrist and chair of INTERVOICE Dirk Corstens.
WRAP A Wellness Recovery Action Plan is a structured plan. It is a system that you devise for yourself that helps you work through mental health challenges or life issues. It is adaptable to any situation. Through careful observation, you identify those things you do to help yourself feel better when you are not feeling well, and those things you do to stay well and enjoy your life (Wellness Tools), and then use these wellness tools to develop personal action plans. People all over the world who are working on their recovery and wellness successfully use this planning process. Mental Health Recovery and WRAP was started in 1989 as Mary Ellen Copeland began her studies of how people help themselves, get well, and stay well. Find out more here