Users caught in the ‘service trap’

While considerable attention has been paid to the perils of the
“benefits trap”, there is less acknowledgement of the “service
trap” for mental health users who are trying to hold down jobs or
gain employment.

Why a service trap? Well, if as a mental health service user you
work and try to use services simultaneously life becomes difficult.
At the point when you may need support most, access to services
becomes much harder.

Not only are services inflexible and geared mainly to office hours,
but if you have therapy sessions, psychiatrist appointments and
care programme approach meetings, it can be difficult to return to
the workplace. Also, there is little opportunity to take part in
user-involvement initiatives. The only chance to participate is
through the management committee of a user-controlled organisation
– but that will have a different role and emphasis. It is as though
someone who works is not entitled to have an input into service
development initiatives other than through surveys.

Part-time work may seem the obvious answer but, apart from the
financial implications, even the most supportive flexible employers
need to know when you are likely to be in and establish some
pattern of working hours during the week. For me, mental health
services tend to be on different days of the week and it is
difficult to obtain a schedule of appointments a long time in

Direct payments can provide part of the solution but they take
organisation, time and energy. They are not a replacement for
contact with professionals. The service trap needs to be tackled
urgently if employment rates are to increase. Some of the things
that would help include scheduling appointments and user
involvement initiatives well in advance; having mental health teams
work one day a fortnight till early evening at GP practices if
necessary; having a telephone number or e-mail address where users
can leave messages; and out-of-hours services that are not focused
on crisis management.

Employment is often wrongly seen as a cure. As long as someone is
going to work all must be well. For many of us, the end of the
working day is when your demons catch up with you. The fact that
places of work are just a more valued form of day centre is not
widely acknowledged. Perhaps if more professionals had direct
experience of juggling with mental health services, employment
support and the service trap may change.

Kalisha Parton is a mental health service user.

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