More Social Inclusion For People With Mental Health Problems, UK

New guidance will help re-integration and provide a safe environment
for rehabilitation


A new drive to help people with mental health problems get back on
their feet and back into work was launched today by Health Minister
Rosie Winterton.


She published four sets of new guidance for commissioners of services
designed to better re-integrate people that have suffered with mental
health problems into society.


The guidance covers:


- vocational services - providing commissioners of mental health
services with a framework to provide services enabling people with
mental health problems to gain employment;


- day services - to refocus day services for adults with mental
health problems from traditional day centre-based activities to
community resources that promote social inclusion;


- direct payments - about one third of local authorities in England
are not making make direct payments in lieu of mental health
services; the guidance aims to ensure that such payments become the
norm where appropriate; and


- women's only day services - providing a safe space to help women
engage in mainstream opportunities and offering women an opportunity
to talk about issues that they may find difficult to discuss in a
mixed environment.


The guidance has been drawn up following the report of the Social
Exclusion Unit (SEU) Social Exclusion and Mental Health, published in
June 2004. The report sought to reduce the barriers to employment and
community participation experienced by people with mental health
problems. It identified further development of vocational services,
day service modernisation and improved provision of direct payments
for as key to reducing such barriers.


Rosie Winterton launched the documents during a visit to Churchview
Rehabilitation Unit, an inpatient rehabilitation service for people
with severe and enduring mental health problems in south Essex.


Launching the guidance, she said:


"People who suffer from mental health problems remain one of the most
excluded groups in society. Tackling inequalities and providing
opportunities is a key objective for the government and these
guidance documents will be a tool to help commissioners of mental
health services provide better quality care so that people who have
suffered from such problems are integrated more successfully.


"These sets of guidance will help patients through different stages
of the patient journey. Direct payments can give people with mental
health problems control over their own lives by providing an
alternative to social care services provided by a local council. They
give the person flexibility to find 'off the peg' solutions, leading
to increased opportunities for independence and social inclusion.


"The guidance on day services and vocational services complement this
by refocusing efforts on providing opportunities for people with
mental health problems to access more community services and also
gain employment."















The new guidance on vocational services for people with mental health
problems recognises that being in employment improves mental health
outcomes, prevents suicide and reduces reliance on mental health
services. It refocuses guidance on helping people back to work being
a key part of their recovery and rehabilitation, rather than waiting
for them to be fully recovered.


The Labour Force Survey (2003) showed that 24 per cent of people with
mental health problems were in employment - with only 8 per cent of
those with severe mental health problems in work.


The vocational services guidance outlines measures to place people in
employment settings consistent with their abilities and interests.
It has been written in conjunction with the Department for Work and
Pensions and Jobcentre Plus.


Employment minister Margaret Hodge said:


"Work is an important part of rehabilitation. And people with mental
health conditions have a right to share in the benefits a job can
bring. In close partnership with the Department of Health, we are
increasing the opportunities and support available for people on
incapacity benefits to realise their potential."


Angela Greatley, chief executive of the Sainsbury Centre for Mental
Health, an independent charity, said:


"Too many people with mental health problems are barred from
opportunities in life everyone else takes for granted. Having a job,
a home and a social life are often made unnecessarily difficult. It
is vital that public services work together to offer people with
mental health problems greater equality of opportunity. They need to
provide good quality advice and support for people who want to take
up work, education or training. They need to offer genuine choices
over what kind of care people get, where possible through direct
payments and individual budgets. And they need to step up the fight
against stigma and discrimination in society as a fundamental part of
their work.


"Most people with mental health problems want to work but find the
way barred. If health and social services follow the evidence of what
is proven to work they could make a dramatic difference to the lives
of many people."


1. The report of the Social Exclusion Unit (SEU) Social Exclusion and
Mental Health can be accessed at socialexclusion.uk


2. According to the SEU, 70 per cent of people with mental health
problems want much better help and support to return to work. The
Healthcare Commission Patients Survey (2004) also found that the
majority of people with mental health problems were not in work. Of
those that needed help finding work, 53 per cent said they had not
received any help, but would have liked some.


3. The National Social Inclusion Programme (NSIP) has been
co-ordinating the delivery of the action points set out by the Social
Exclusion Unit's report.


4. Direct Payments are cash payments made in lieu of social service
provisions, to individuals who have been assessed as needing
services. They can be made to disabled people aged 16 or over, to
people with parental responsibility for disabled children, and to
carers aged 16 or over in respect of carer services. The aim of a
direct payment is to give more flexibility in how services are
provided to many individuals who are assessed eligible for social
services support. By giving individuals money in lieu of social care
services people have greater choice and control over their lives, and
are able to make their own decisions about how their care is
delivered.


5. Since April 2003, regulations have been in force that require
councils to make direct payments to those people who are able to
choose to have them. According to the Commission for Social Care
Inspection, at September 2004, one third of local authorities in
England were not making direct payments in lieu of mental health
services. A further 51 per cent were making between one and five,
three authorities were making between 21 and 25, and two over 50
each.


6. All three sets of guidance support and promote well the seven
outcomes proposed in the Green Paper Independence, Well-being and
Choice, in particular those of improved health, making a positive
contribution, economic well-being, personal dignity and exercise of
choice and control. The Green Paper proposes a shift of the pattern
of services that will ensure greater social inclusion and improved
quality of life. This will involve the commissioners of services
thinking more imaginatively and in a more person-centred way,
offering more choice and self-determination for people in receipt of
services.


7 The guidance can be found at dh.uk