Research

Jill Manthorpe evaluates a study of users’ views of direct
payments while Richard Powell looks at material on how the mental
health needs of prison inmates are being met.

The pay gap

A study of users’ views of a local direct payments scheme.

This study of a pilot project from Staffordshire social services
provides new evidence about the implementation of direct payments.
The project took 18 months and finished in September 2000.

Researchers obtained questionnaire responses from people
receiving direct payments. Information was sought about the ways in
which disabled people heard about the scheme, and from this the
author concluded that schemes for direct payments should be widely
advertised to both disabled people and social workers. It was found
that:

– The social services department should consider whether limits
for direct payments were fair.

– Some potential users of direct payments were of the view that
start-up payments were at too low a level.

– Some disabled people knew of the scheme but did not wish to
participate; individuals could be put off by tight criteria for
entry, and some lacked confidence or the support of their friends
or social support networks.

The scheme revealed other practical difficulties as well as
wider criticisms, such as the ban on employing relatives.

The research also points to a number of possible improvements in
policy and practice, particularly the need to build on the valuable
experience of the Independent Living Fund, and that practitioners
should receive training or education to feel confident enough to
recommend such schemes.

This is another useful piece of early research pointing out
social work’s attempts to learn from pilot or innovative
schemes.

Source: J Leece, It’s a matter of choice: making direct
payments work in Staffordshire, Practice, 12(4), 2000.

Jill Manthorpe is senior lecturer, social work
department, at the University of Hull.

Early warning signs

A study of the mental health needs of those on remand or serving
short sentences.

For organisations serving people with mental health needs
entering prison, identifying mental health needs early is
imperative.

Between 1999-2000, the Revolving Doors Agency sought to identify
need and improve interagency treatment for this client group. For
five weeks, all new inmates at Pentonville prison were screened
using a brief questionnaire intended to assist prison staff
identify people needing referral for a detailed psychiatric
assessment.

This was augmented by a search of inmate medical records for
mental health need. Among the 339 people received into the prison
for the first time:

– At least one in five male prisoners had mental health needs, a
figure based on self-disclosure that may underestimate need.

– Only one in 16 were identified in need by prison health
assessments.

– About 95 per cent of the 3,500 or so new receptions each year
are on short sentences or remand. Despite having higher levels of
mental health need than those on longer sentences, they have less
chance of having that need assessed.

– The mental health needs of prisoners from ethnic minority
groups remain poorly understood and thus inadequately served.

– 40 per cent of people with a psychiatric history did not have
or did not know who their GP was.

The agency then held focus groups to discuss the challenges to
interagency co-operation. Identified needs included:

– Formalised and routine communication arrangements between
community-based and criminal justice agencies.

– Challenging the barriers to co-ordinated care by
community/prison, either via the probation service or via GPs, the
latter acting as information recipients and providers upon clients’
entry and release from prison.

– Training that is multi-agency based, and effective joint
working.

– Clear confidentiality policies and procedures between
agencies.

This succinct report contains a surprising amount of information
and offers a constructive agenda for the future.

Source: J Hyslop, In and Out: people with mental health
and multiple needs on short sentences and remand, Revolving Doors
Agency, 2001.

Richard A Powell is a research associate at the
Sainsbury Centre for Mental Health.