Improve patient and carer experience of mental health services
Though much of the focus of the work on this plan was on the improvement of services, the strongest message we heard was that service users and carers still had experiences of the mental health system that did not match their expectations and the commitments of public and other bodies.
This is not a new problem, but it is disappointing that more progress has not been made. We need to address this issue more directly, not simply restate existing principles or develop new ones. Change is possible, but we need better levers to produce change and clarity about the changes that we expect to see. By addressing cultures and behaviours in our services we will improve the experience of all those who work in the system and those who come into contact with it.
Commitment 1: We will develop a tool to assess the degree to which organisations and programmes meet our expectations in respect of equality, social inclusion, recovery and rights. The tool will be piloted in 2007 and be in general use by 2010.
Work has already begun on the tool and is being led by the Scottish Recovery Network, drawing on the Recovery-Orientated Practices Index methodology developed in the United States. The key areas the tool will cover are:
- Equality, non-discrimination and respect for diversity
- Social inclusion, particularly in relation to the new duties under sections 25 to 31 of the Mental Health (Care and Treatment) (Scotland) Act 2003
- Recovery, the degree to which services are structured to deliver better outcomes across a range of domains, including employment, housing, education and training opportunities, family and social life
- Rights, in particular the Millan Principles, notably reciprocity, benefit, and participation
The tool will establish expectations and support local assessment of structures and services and enable the identification of where change is required. This will complement the work that we are doing on benchmarking, in order that we can start to gather information and start to measure 'like with like' and see where we are making improvements or where more work is needed.
In addition, we will work with NHS Education for Scotland and other professional bodies to develop a common set of behavioural expectations for those working in mental health services, which in turn should influence practice and service delivery.
We believe that we can also support change in cultures and behaviours by embedding peer support workers in mental health services. Peer support workers are an example of expert patients, being trained staff who themselves have direct experience of mental illness who are part of the care team.
Commitment 2: We will have in place a training programme for peer support workers by 2008 with peer support workers being employed in three board areas later that year.
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