Transcript Slide 1

Personalisation & Integration
Cambridge
January 2011
© Simon Duffy. Rights Reserved. Full copyright details at www.centreforwelfarereform.org
Four Questions
1. What is personalisation?
2. What does it mean for people with mental health
problems?
3. Is integration important?
4. How should we fund mental health supports?
1. Personalisation
Personalisation Model from Personalisation in Mental Health by Simon Duffy
•
A positive focus on the person - their real wealth
•
An equal and productive relationship with the
professional - coproduction
•
A commitment to positive outcomes and
citizenship
Real Wealth from A Fair Start by Pippa Murray
Coproduction by Simon Duffy cited in A Fair Start by Pippa Murray
Community Support & Health Care From Personalisation in Mental Health by Simon Duffy
From Keys to Citizenship by Simon Duffy
2. Mental Health
These findings [better long-term outcomes for
schizophrenia in developing countries] still generate some
professional contention and disbelief, as they challenge
outdated assumptions that generally people do not recover
from schizophrenia and that outcomes for western
treatments and rehabilitation must be superior. However,
these results have proven to be remarkably robust, on the
basis of international replications and 15-25 year follow-up
studies. Explanations for this phenomenon are still at the
hypothesis level, but include:
1. greater inclusion or retained social integration in the
community in developing countries, so that the person
retains a role or status in the society;
2. involvement in traditional healing rituals, reaffirming
community inclusion and solidarity;
3. availability of a valued work role that can be adapted to a
lower level of functioning;
4. availability of an extended kinship or communal network,
so that family tension and burden are diffused, and there is
often less negatively 'expressed emotion' in the family.
Quote from Alan Rosen cited in Turning the World Upside Down by Nigel Crisp
Type of Purchase
Amount (£)
% of Total
Transportation
7526.72
13%
Computers and accessories
6899.95
12%
Dental services
6662.59
11%
Medication management services
4897.87
8%
Psychotropic medications
4890.33
8%
Mental health counselling
4864.18
8%
Housing
4133.59
7%
Massage, weight control, smoking cessation
3017.13
5%
Utilities
1968.77
3%
Travel
1721.13
3%
Equipment
1615.88
3%
Clothing
1423.27
2%
Food
1390.25
2%
Crafts
1361.35
2%
Licenses/ certification
1253.35
2%
Entertainment (movies, eating out)
1216.12
2%
Vision services
1127.47
2%
Furniture
640.44
1%
Non-mental health medical
515.24
1%
Camera and supplies
477.47
1%
Education, training, materials
394.22
1%
Haircut, manicure, make up lessons
336.43
1%
Pet ownership
330.93
1%
Supplies and storage
282.12
<1%
Other
8.26
<1%
Total
58,965.40
100%
Research cited in Active Patient by Vidhya Alakeson
Tapered Control in Personalisation in Mental Health by Simon Duffy
Organisational Structures from Personalised Support by Julia Fitzpatrick
3. Integration
From Women at the Centre (forthcoming) by Simon Duffy & Clare Hyde
From Women at the Centre (forthcoming) by Simon Duffy & Clare Hyde
From Women at the Centre (forthcoming) by Simon Duffy & Clare Hyde
From Women at the Centre (forthcoming) by Simon Duffy & Clare Hyde
Personalised Pathway from A Fair Start by Pippa Murray
4. Funding
Total Place Commissioning from Personalisation in Mental Health by Simon Duffy
Local Authority
Resources
NHS Resources
Welfare funding
‘Social Care’
Well-being or
Independence
Medical services
Improved clinical
outcomes
‘what works’
Improved mental
health
From Women at the Centre (forthcoming) by Simon Duffy & Clare Hyde
Different Funding Systems in Health Care from Personalisation in Mental Health by Simon Duffy
Individual Budget from Personalisation in Mental Health by Simon Duffy
From Resource Allocation in Mental Health by Simon Duffy
1. Status quo - 2 systems
2. Tidy up & rationalise, but 2
systems
3. One system - but with two
funding streams
4. Just one system, with real
joint funding
•
Health-social care distinction will not hold when people
seek solutions that work
• Mental health is sufficiently coherent to have its own
system - but not coherent enough to have two!
•
Political situation creates interesting opportunities creative havoc in local government and PCTs
•
Risk of increased tension and incoherence - the
imperative to personalise will fail without greater rigour
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© Simon Duffy. Rights Reserved. Full copyright details at www.centreforwelfarereform.org