Name: Louise Lingwood.
Job: Community services manager, Hillingdon PCT, on secondment to the Mental Health Foundation as project manager of the fast-track change programme.
Qualifications: BA applied social studies, CQSW.
Last job: Adult services manager.
First job: Photographer’s assistant
Day services have not enjoyed the best of presses of late; largely thought to be outmoded (people sitting around all day smoking and drinking tea), lacking a focus on social inclusion, offering little or no contact with people outside the client group and providing few chances to learn new skills.
But they have a crucial role to play: service users and carers greatly value day services. They provide somewhere to go, the chance to meet people and to do something meaningful during the day. The challenge, however, hinges on defining and delivering the “meaningful” aspect.
Mental health day services are being revitalised by placing social inclusion and recovery at their heart. This means seeing beyond “problems” and not simply helping people survive but rather moving people forward through activities, learning and relationships that can restore purpose to their lives. Forget survival, think aspiration.
A day services review in Hillingdon, west London, in 2002 provided the impetus for an aspirational rethink. “Our day services were thought to be quite progressive for the 1990s,” says community services manager Louise Lingwood, who is on secondment to the Mental Health Foundation from Hillingdon Primary Care Trust. “But there was a feeling that they didn’t go far enough. They weren’t really promoting social inclusion and moving people on; people were getting very stuck in day services.”
There was a desire to develop employment opportunities. Lingwood says: “We had a job club where people developed CVs or learned new computer skills. It was a good start but we didn’t have the resources or expertise to provide the kind of support people with longer-term mental health problems needed to access mainstream employment.”
Lingwood says the secondment of a day service development manager – “to take forward the change agenda” – and the creation of a day services focus group – “to explore what day services might look in the future” – were crucial early victories in helping her manage the redesign.
Equally crucial was engaging the commitment of the trust’s chief executive, commissioning manager and human resources manager, the latter not least in terms of thinking how the trust as an employer can help service users into employment.
A visit to an employment scheme in Birmingham run by the voluntary agency Mental Health Matters also inspired Lingwood, and she began to explore what they might be able to achieve together in Hillingdon.
This partnership with a provider from outside was a difficult but positive step to take. Lingwood says “While we didn’t feel that our local not-for-profit provider had the necessary expertise and experience required to directly provide the new service, we did invite them to be part of the working group. Nonetheless, this caused tensions but we just had to be as transparent and inclusive as possible. But there were times when that was uncomfortable.”
As ever, it was important to convince staff of the need to change. Lingwood adds: “The pressure on existing services became more intense with the same workload but fewer staff – as vacant posts transferred over to the new scheme. But we had to keep up morale by convincing people it was the right way forward and supporting people through that. They had to see the value.”
The new service, Employment Link, now has a project co-ordinator and two employment workers. Having a partnership with a voluntary organisation opened up access to alternative streams of funding; it made a successful bid for section 64 funding – discretionary government grants – to employ a job retention worker for three years.
The service is now established with positive early signs. Lingwood says: “We have got people not only into work but into full-time posts within the PCT; we’re very engaged with Jobcentre Plus; and there are now more people going into training, education and volunteering schemes.”
Importantly, Employment Link has been a catalyst for other services to start thinking about vocational assessment. Lingwood says: “When we do care plans with people we should be asking what their aspirations are; it has encouraged our care co-ordinators to think more about how we work with individuals and what we can help them achieve.”