Self-Directed Support: will it promote mental health recovery in services?

9th January 2014

The way that social care is provided in Scotland is changing. Here, SRN’s Louise Christie takes a look at self-directed support (SDS) and how this new way of working could promote and encourage recovery in mental health services.

Quote graphicFrom April 2014, when the new Self-Directed Support Act comes into force, people receiving social care support will be entitled to have more say over who provides it, how it is provided and what type they get.

Many councils have been working to bring about these changes, but from April all will have to implement SDS.

SDS was long fought for and has been welcomed and used by many people. However, we know that very few people with lived experience of mental health problems are using SDS.

What is SDS?

SDS is where a person decides what they want to achieve through support (their outcomes or goals) and then works with services and an agreed individual budget to meet those goals.

The new SDS Act gives people four options to choose from. This means they can decide how much control over their support they want and the type of support they believe will help them meet their goals in life.

SDS is coming into play at a busy, and changing, time for health and social care. All of this is underpinned by a growing body of opinion that believes there needs to be a radical shift in the design and delivery of health and social care in Scotland.

SDS, mental health and recovery

This is good news for those promoting recovery focused services. Key to recovery is empowerment — where people are enabled and supported to take responsibility for their life and recovery. Placing the person and their rights at the centre of decisions about their social care support, and providing them with options to choose how much control they want, will promote and support recovery.

However, while this all sounds very positive there are some concerns about SDS in mental health and the way it is being implemented. SRN have been working with others including Penumbra and Mental Health Foundation to find out more about SDS from the people who have been using it.

As demonstrated by the quotes below, we have learned that SDS can help people to feel more in control of their support and also to be more creative and flexible about the type of support provided.Quote graphic

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Nevertheless, all of those sharing their stories emphasised the need for good information and support to go through the process. It is very early days for SDS in mental health but there is already evidence of what works. Working with people in a way that understands their lived experience and involves them and others in their life (such as family or support providers) fully in the process can enable them to take more control and focus on what they need to live a fulfilling and satisfying life.

So implemented appropriately, SDS can contribute to recovery in services. But it may be that a lot of effort and energy is going into a process that will only affect a small proportion of people with mental health problems in Scotland.

Quote graphicSRN believes that some new thinking about how best to realise the objectives of SDS and other similar policies may be needed in mental health. If we are agreed that mental health recovery is a reality for all and that our services should be designed and delivered in a way that promotes and enables this; then we must look at it from the perspective of the person with mental health problems. From such a viewpoint, having one system for social care and another for healthcare starts to make less sense. Is it time to take the ambitions of SDS to give people more choice and control and a real say in the support they receive to reach their self-set goals and apply them more widely?

If we are to realise the ambitions of SDS in mental health then we need to carefully consider how best to do that. Starting from the perspective and life of the person with mental health problems, rather than our institutional structures, may be a good place to start.

SRN want to hear from people using SDS and also from those who are interested in how these principles of choice and control can be realised in mental health services. Ensuring the voices of those with lived experience of mental health problems and support services are heard can only improve understanding of how our mental health services can promote recovery more effectively by being strengths and rights based, personalised and empowering.

Tell us what you think! Have you experience of SDS? How do you think choice and control can best be realised in mental health services? Email us at info@scottishrecovery.net.