Direct payments not reaching mental health service users

People with mental health problems are being denied the benefits of direct payments because of a lack of staff knowledge and inadequate information from councils, a Rethink Mental Illness report has warned.

One hundred per cent of direct payment users surveyed by Rethink recently said that having a cash payment to fund their care needs had had a positive benefit on their lives. However, direct payment take-up rates for the client group remain low.

Just 15% of staff working for Rethink services felt their local authority has a good system in place to ensure people with mental health problems and their carers were able to access personalised social care.

Barriers included a lack of information from councils on direct payments, long waiting times for needs assessments and payments to be made, over-prescription from councils on how payments could be used and a lack of staff knowledge.

It said outcomes were generally better when:

• Information about direct payments was provided at an early stage and people were offered them rather than having to ask for them.

• People had a good relationship with their care co-ordinator, who helped them pro-actively through the process.

• Councils could safely manage issues of risk and capacity while maximising people’s control over their support.

Rethink called for greater training for care co-ordinators in supporting people through the direct payments process and for councils to provide clear and independent information on personalisation and direct payments and to signpost users and carers to local support groups.

Case study

Sue Toms suffers from bi-polar disorder. She has been on direct payments through West Berkshire Council for five years.

“I use my payments for respite care and it’s kept me out of hospital for the past four years, no doubt about it. I live with my husband and adult children and life at home can get incredibly stressful. With the payments, I can get away, just take a break and get out of the house. I don’t do anything luxurious – I go to a local inn for three nights and chill out, listen to music, have some peace and quiet.

“I’ve been really happy with the direct payments system – it’s a relief not to have to negotiate with the local authority. I can go where I like when I like and do what I want.

“One of the problems I’ve had recently is that my payments haven’t gone up for the past two years, but the cost of my respite stays have. I’ve been told to do something cheaper, but I honestly can’t find anything cheaper than the inn.

“So I would highly recommend direct payments to other service users, but with the warning that the cuts are hurting the system right now.”

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