Gill Stewart at Norfolk Council talks about individual budgets for mental health service users

Early indications from the individual budgets pilot in Norfolk suggest people with mental health problems go beyond the traditional models of social care when it comes to spending their money.

The county’s individual budgets lead Gill Stewart says in the past service users would have been offered day, respite or domiciliary care but the pilot has opened a whole new world of opportunities.

Norfolk is the only one of the 13 pilot sites in England to focus solely on people with mental health problems and Stewart says different models were needed from the previous In Control pilots, which focused on people with learning disabilities.

“Most of their models were aimed at people who had fairly constant levels of need that were predictable whereas when you’re talking about people with mental health problems that’s not necessarily so. They may be very able in some areas but have real difficulties in others.”

Norfolk used an approach based on life coaching, which has been developed by the Department of Health, where people are helped to consider what is working in their lives and what they would like to change.

Following a simple assessment that covers only a person’s eligibility to receive an individual budget, they are encouraged to think about how they might use the resources, drawn from previous social care and Supporting People budgets, to improve their lives. They can be supported through the process by a care co-ordinator, family member, friend or local voluntary organisation paid to help people with support planning. Support plans are then signed off by the local community mental health team.

Although it is still early days – the project was not fully up and running until December 2006 despite launching a year earlier and only a handful have received their budgets – Stewart says it has struck her that many recipients want to use the money to develop skills to gain employment.

She cites the example of one man who had been attending day centres or day hospitals five days a week and wrote most of his support plan himself, with input from his care co-ordinator. The plan identifies a strong interest in becoming a professional photographer and allocates resources to a photography training course, digital camera and tent so he can get out into the countryside to take photographs.

“I doubt the normal care planning process would have identified that,” says Stewart.

Another man spent a small part of his budget on a dating agency and met a woman whom he made aware of his mental health history. Now the pair are set to go on holiday together (using their own money).

Stewart believes the process has also been supported by staff despite initial misgivings. The duty to maintain people’s safety under the mental health care programme approach remains and users have still been building money into their budgets for support workers if things do not work out as planned.

But Stewart says the possibility of elements of the press criticising the idea of social care money being spent on dating agencies and cameras has been considered.

“It’s almost as if the medicine has to taste bad in order for it to be doing good,” she says. “If people are not using or benefiting from services as much as they could then are we really saying that we want to spend money on those services?”

Stewart recognises there is a tension in society with many people on low incomes who would also like to access the opportunities offered by individual budgets. But she stresses that people need to recognise that those with disabilities have extra needs on top of their social disadvantage.

Stewart on Stewart

● Favourite book: The Poisonwood Bible by Barbara Kingsolver
● Favourite film: As Good as it Gets starring Jack Nicholson and Helen Hunt

Further information
A Life Like Any Other for more on individual budgets
Mental Health 

Contact the author
 Simeon Brody