Earlier this year I was commissioned by the Putting People First Team to find out some of the best ways to develop support plans with people who use mental health services. One of the inspiring stories I heard was Kevin's: a man who loves the great outdoors, but who for 17 years also experienced major episodes of paranoia and was diagnosed with schizo-affective disorder. This obviously had a big impact on his working life, leading to cycles of joblessness, homelessness and hospital stays. He would make a full recovery and return to work, but things would spiral, either from something going wrong in his job or stress in his personal life, and the cycle would start again.
Following the end of his marriage last year, Kevin found himself at the start of another cycle and his employment ended a few months later. At that point, his community mental health nurse spoke with him about applying for a personal budget.
How they wrote Kevin's support plan
Together with a representative from the local Independent Living support planning service, they started working on a support plan. Kevin attended three interviews and said he didn't feel like he had to do very much except "tell his story." As a group, they talked about what was important to him: keeping well and only using mental health services if he is unwell, and managing his wellbeing through his social and work life.
They looked at what was working in Kevin's life - so things like his relationship with his care coordinator and his family - and what wasn't working. He described his love of cycling and making people aware of mental health issues. He also said that social interaction, occupation and routine from work helped to stabilise his mood. They talked about what could be achieved with his personal budget and explored the idea of self-employment - providing mental health and cycling mechanics training - and the things Kevin would need to make that happen.
Kevin's personal budget now covers some of his business costs and allows him to do a trade qualification as a cycle mechanic. There is also money set aside for respite if things get too much (it has been agreed he will stay with a friend who owns a farm) and a contingency fund for emergencies and other needs.
Keeping safe and managing risks
A "keeping safe plan" was written, which considered all the risks of implementing the activities described in his support plan including:
· Whether the planned activities could result in an increased risk of mental health problems or additional stress.
· Whether Kevin would be able to spend his personal budget in the way they agreed.
· Whether there were triggers to recognise when he needed help and how he would stay in control if his mental health got worse.
At the final interview, Kevin met with "a chap at the council" who assessed his financial situation and that was where he found out his personal budget would be approved. The whole process took less than a month.
Helen Sanderson is the Department of Health's expert adviser on person centred approaches. For more information on support planning, visit www.supportplanning.org
Leave a comment