Four perspectives on implementing mental health personalisation

Today I’ve published a piece on how Stockport has implemented personalisation in its mental health services. Here, four different people involved in the personalisation process talk about specific elements of it that have impacted them.

On going through the self-directed support process

Karen, uses self-directed support: “It wasn’t all a bed of roses. I found the application process quite hard but I think they’ve changed it since to make it less daunting.

“It was good to be in charge of my support plan. I’m quite a creative person so I saw it as an opportunity to put my heart and soul into it. Everything’s in there – it has all the information people need but it’s very visual. It has what’s important to me: my family, my partner, pets and things like that but it’s also got the darker side of things too.

“I know people knock the overuse of the word journey but this really has been a positive journey not just for me, but for other people I know too. I know it might not work for some people but from my experience I’d recommend it.”

On the culture shift for professionals

Barry Tildsley, personalisation coordinator: “This is a huge culture shift for professionals. For example, they’re no longer in control of writing the support plan so there’s a difference in power. Look at Karen’s support plan. We had nothing to do with that whatsoever. She did that her way and in her time and it’s amazing.

“Sometimes you have to hold back. It’s very easy for professionals to say ‘you need to get this done in the next two weeks if you don’t then I’ll do it for you’. It’s a skill to be able to wait for someone to do it in their own time. It’s about people discovering the resilience and skills that they have.

“Working in a caring profession, it can actually feel really difficult to sit back. You want to be able to give people the answers, you want to find solutions so it’s a real culture shift to step back and give people the space to work out a solution for themselves.”

On the risk of personalisation becoming professionalised

Carmel Bailey, social care lead: “That’s something I really worry about. It was so important that when we first started there was input from people completely separate to statutory services – independent providers, service users and carers.

“They challenged us. It led to antagonism at points but without their help we would have been further down the line of prescribing what people could have and couldn’t, especially in terms of big spends on things like holidays.

“I think there’s a real concern that we could slip back in to prescribing what people can and can’t have based on our past knowledge of working with them in traditional ways. We need to be wary of that.”

On why personalisation in mental health is lagging behind nationally

Nick Dixon, commissioning manager: “There’s not a lot of sign-up to innovation and risk-taking in mental health. It’s all very cautious. Everybody is terrified about overspending and won’t take that risk. But that’s when you get into a position of managing decline, where you tighten your referral criteria, top-slice your budgets, withdraw into silos and cut where you can.

“We felt with that approach we would just implode. We wanted to do something different. To make personalisation work you have to get the right people, the right place and the senior backing for it. You need a strong service user voice and you need a strong carers input. And then you have to work and work and work at the culture and win hearts and minds.”