As a social inclusion bridge builder I work with clients with severe and enduring mental health diagnoses. They are referred or they self-refer with the desire to access mainstream life domains.
Clients aspire to a variety of mainstream choices. It might be volunteering or befriending, it may be arts activities, it might be employment or running your own business. Client aspirations may include sports, faith, education, training or a selection from any or all of these.
Enabling individuals with a 'severe and enduring' background is not always a straightforward process although it certainly can be sometimes. A client can be introduced to a mainstream outlet and it can work for him or her almost immediately. Other clients may be unready for mainstream for a variety of reasons. They may suffer a relapse before accessing the mainstream environment. They may visualise mainstream as another form of day service or statutory support system, which it isn't.
Equally, clients can sometimes express a wish to access mainstream out of a misplaced fear that not accessing it might in some way affect their payments and benefits. It can be a long process before the value and rewards of mainstream are understood.
What is true is that clients who successfully access or re-access mainstream in turn become examples of mainstream's effectiveness. Signposting to mainstream as part of the mental health recovery pathway is undoubtedly effective, even if it does not work for everyone straight away.
Mainstream also helps to sustain recovery in the individual and even better, it can propagate more success and recovery out of its own resources. An example of this would be the musician who successfully links up with a mainstream recording studio. After months of regular rehearsal the musician is invited by the studio manager to contribute to a recording session. I witness this kind of beautiful outcome and its benefits for the client in my work as an arts bridge builder.
Another example - again from music bridge building - is the guitarist client who uses a studio regularly and invites a friend to join him during the session. The friend may well be another mental health service user who has never successfully engaged with mainstream despite the best efforts of the bridge building service. Where services have been unsuccessful a friendship and peer network can do the job far more effectively.
Mainstream reaches the places other services cannot reach and in the process it is able to create a cascade effect - a continuing path of development, recovery and individual growth.
JVT
Sunday, 25 July 2010
Sunday, 18 July 2010
Incredible Stories
Click on Incredible Stories for some incredible and inspiring stories about personalisation, human growth, direct payments and social inclusion.
Friday, 16 July 2010
Social Health
From www.answers.com by Ian McDowell:
"The concept of social health is less intuitively familiar than that of physical or mental health, and yet, along with physical and mental health, it forms one of the three pillars of most definitions of health. This is partly because social health can refer both to a characteristic of a society, and of individuals. "A society is healthy when there is equal opportunity for all and access by all to the goods and services essential to full functioning as a citizen" (Russell 1973, p. 75). Indicators of the health of a society might include the existence of the rule of law, equality in the distribution of wealth, public accessibility of the decision-making process, and the level of social capital.
The social health of individuals refers to "that dimension of an individual's well-being that concerns how he gets along with other people, how other people react to him, and how he interacts with social institutions and societal mores" (Russell 1973, p. 75). This definition is broad—it incorporates elements of personality and social skills, reflects social norms, and bears a close relationship to concepts such as "well-being," "adjustment," and "social functioning."
Formal consideration of social health was stimulated in 1947 by its inclusion in the World Health Organization's definition of health, and by the resulting emphasis on treating patients as social beings who live in a complex social context. Social health has also become relevant with the increasing evidence that those who are well integrated into their communities tend to live longer and recover faster from disease. Conversely, social isolation has been shown to be a risk factor for illness. Hence, social health may be defined in terms of social adjustment and social support—or the ability to perform normal roles in society.
Definitions of social health in terms of adjustment derive from sociology and psychiatry. Poor social adjustment forms a common indicator of neurotic illness, and adjustment may be used to record the outcome of care, especially for psychotherapy. Adjustment may be rated subjectively, or it may be judged in terms of a person's fulfillment of social roles—how adequately a person is functioning compared to normal social expectations. Role performance can also indicate the impact of disability, bringing the concept of social health close to that of handicap, which refers to the social disadvantage resulting from impairments or disabilities (World Health Organization, 1980). As norms vary greatly between cultures, however, a challenge lies in selecting an appropriate standard against which to evaluate roles.
Mutual social support is also commonly viewed as an aspect of social health. Support attenuates the effects of stress and reduces the incidence of disease. Social support also contributes to positive adjustment in children and adults, and encourages personal growth. The concept of support underlines the theme of social health as an attribute of a society: a sense of community—or the currently fashionable concept of social capital, which refers to the extent to which there is a feeling of mutual trust and reciprocity in a community—is an important indicator of social health".
Bibliography
Hawe, P., and Shiell, A. (2000). "Social Capital and Health Promotion: A Review." Social Science and Medicine 51:871–885.
Russell, R. D. (1973). "Social Health: An Attempt to Clarify This Dimension of Well-Being." International Journal of Health Education 16:74–82.
World Health Organization (1980). International Classification of Impairments, Disabilities, and Handicaps. Geneva: Author.
— IAN MCDOWELL
"The concept of social health is less intuitively familiar than that of physical or mental health, and yet, along with physical and mental health, it forms one of the three pillars of most definitions of health. This is partly because social health can refer both to a characteristic of a society, and of individuals. "A society is healthy when there is equal opportunity for all and access by all to the goods and services essential to full functioning as a citizen" (Russell 1973, p. 75). Indicators of the health of a society might include the existence of the rule of law, equality in the distribution of wealth, public accessibility of the decision-making process, and the level of social capital.
The social health of individuals refers to "that dimension of an individual's well-being that concerns how he gets along with other people, how other people react to him, and how he interacts with social institutions and societal mores" (Russell 1973, p. 75). This definition is broad—it incorporates elements of personality and social skills, reflects social norms, and bears a close relationship to concepts such as "well-being," "adjustment," and "social functioning."
Formal consideration of social health was stimulated in 1947 by its inclusion in the World Health Organization's definition of health, and by the resulting emphasis on treating patients as social beings who live in a complex social context. Social health has also become relevant with the increasing evidence that those who are well integrated into their communities tend to live longer and recover faster from disease. Conversely, social isolation has been shown to be a risk factor for illness. Hence, social health may be defined in terms of social adjustment and social support—or the ability to perform normal roles in society.
Definitions of social health in terms of adjustment derive from sociology and psychiatry. Poor social adjustment forms a common indicator of neurotic illness, and adjustment may be used to record the outcome of care, especially for psychotherapy. Adjustment may be rated subjectively, or it may be judged in terms of a person's fulfillment of social roles—how adequately a person is functioning compared to normal social expectations. Role performance can also indicate the impact of disability, bringing the concept of social health close to that of handicap, which refers to the social disadvantage resulting from impairments or disabilities (World Health Organization, 1980). As norms vary greatly between cultures, however, a challenge lies in selecting an appropriate standard against which to evaluate roles.
Mutual social support is also commonly viewed as an aspect of social health. Support attenuates the effects of stress and reduces the incidence of disease. Social support also contributes to positive adjustment in children and adults, and encourages personal growth. The concept of support underlines the theme of social health as an attribute of a society: a sense of community—or the currently fashionable concept of social capital, which refers to the extent to which there is a feeling of mutual trust and reciprocity in a community—is an important indicator of social health".
Bibliography
Hawe, P., and Shiell, A. (2000). "Social Capital and Health Promotion: A Review." Social Science and Medicine 51:871–885.
Russell, R. D. (1973). "Social Health: An Attempt to Clarify This Dimension of Well-Being." International Journal of Health Education 16:74–82.
World Health Organization (1980). International Classification of Impairments, Disabilities, and Handicaps. Geneva: Author.
— IAN MCDOWELL
Thursday, 15 July 2010
Wednesday, 14 July 2010
Disability and the law
The Disability Discrimination Act (DDA 2005) makes it "unlawful for a service provider to discriminate against a disabled person by refusing to provide any service which it provides to members of the public.”
'Service provider' refers to public and commercial sectors alike. A service provider may be a retail outlet, an NHS service, an employment bureau, a police station, a dating agency....the list is endless.
The implications for mainstream are highly significant. Clients referred from backgrounds of mental ill-health to mainstream life will encounter a new range of service providers. It is a social inclusion bridge builder's role to ensure that clients accessing mainstream are introduced to any service providers the client may have identified as key. Once a client is engaging with the services or products of that provider, he or she will be a beneficiary of the policies, procedures, insurance and legal obligations of that provider. The service user becomes equal with all the other consumers who are accessing mainstream as a matter of course. Consumers' rights are considerable.
Another result of the mainstream process is that it puts the responsibility for provision onto the mainstream provider. A client accessing a mainstream service such as a recording studio, for example, is a beneficiary of all that the studio provides. Provides not merely in terms of the studio service and products, but also in terms of the studio's policies, procedures, insurance and legal obligations. Equality with every other consumer creates an equal opportunities situation for the person now accessing mainstream.
Mainstream is not required to provide 'special settings' and nor should it. Mainstream should not stigmatize because of its awareness or unawareness of mental health issues. It should not stigmatize because stigma is not part of any reasonable access to a mainstream product or service.
'Service provider' refers to public and commercial sectors alike. A service provider may be a retail outlet, an NHS service, an employment bureau, a police station, a dating agency....the list is endless.
The implications for mainstream are highly significant. Clients referred from backgrounds of mental ill-health to mainstream life will encounter a new range of service providers. It is a social inclusion bridge builder's role to ensure that clients accessing mainstream are introduced to any service providers the client may have identified as key. Once a client is engaging with the services or products of that provider, he or she will be a beneficiary of the policies, procedures, insurance and legal obligations of that provider. The service user becomes equal with all the other consumers who are accessing mainstream as a matter of course. Consumers' rights are considerable.
Another result of the mainstream process is that it puts the responsibility for provision onto the mainstream provider. A client accessing a mainstream service such as a recording studio, for example, is a beneficiary of all that the studio provides. Provides not merely in terms of the studio service and products, but also in terms of the studio's policies, procedures, insurance and legal obligations. Equality with every other consumer creates an equal opportunities situation for the person now accessing mainstream.
Mainstream is not required to provide 'special settings' and nor should it. Mainstream should not stigmatize because of its awareness or unawareness of mental health issues. It should not stigmatize because stigma is not part of any reasonable access to a mainstream product or service.
Discussing mainstream
Bridge building for mainstream is now incorporated into the care pathway for people recovering from mental health conditions.
Community mental health teams, occupational therapies, psychiatrists are all aware of the value of mainstream bridge building. Many community mental health teams actively promote mainstream as part of their in-house practice with clients. Service-user led initiatives are also widely encouraged.
Where mental health teams may not always the time and resources to promote mainstream fully, there are many outside organisations working alongside the teams. The benefits of referral to an outside non-clinical team can be considerable.
Mental health teams can often discuss mainstream with clients in a clinical or home setting. An outside organisation has more time and capacity to draw clients out into mainstream settings where a conversation can begin. This may well be and should be - a conversation about the client's hopes, dreams, goals and aspirations.
One of the bridge builder's roles is to help facilitate this conversation. Another role is to be clued-in with what mainstream has to offer. For example, a bridge builder specialising in arts and culture needs to know what outlets there are both locally and further afield. A client who wishes to develop skills in music production should be introduced to the mainstream venue or venues where this opportunity takes place.
Community mental health teams, occupational therapies, psychiatrists are all aware of the value of mainstream bridge building. Many community mental health teams actively promote mainstream as part of their in-house practice with clients. Service-user led initiatives are also widely encouraged.
Where mental health teams may not always the time and resources to promote mainstream fully, there are many outside organisations working alongside the teams. The benefits of referral to an outside non-clinical team can be considerable.
Mental health teams can often discuss mainstream with clients in a clinical or home setting. An outside organisation has more time and capacity to draw clients out into mainstream settings where a conversation can begin. This may well be and should be - a conversation about the client's hopes, dreams, goals and aspirations.
One of the bridge builder's roles is to help facilitate this conversation. Another role is to be clued-in with what mainstream has to offer. For example, a bridge builder specialising in arts and culture needs to know what outlets there are both locally and further afield. A client who wishes to develop skills in music production should be introduced to the mainstream venue or venues where this opportunity takes place.
Bridge Building for Mainstream living
Bridge building for Social Inclusion is a way to enable people to connect or re-connect with mainstream life.
Bridge building to mainstream is widely practiced as part of the care pathway for people in recovery from severe and enduring mental health conditions.
Bridge building is based on key 'social domains' or life domains. Each domain represents an area that may be important or relevant to a person's development.
Life domains include:
Healthy Living
Arts & Culture
Education & Training
Faith & Cultural Communities
Volunteering & Befriending
Employment
Bridge builders work with clients to help them identify key areas they may wish to access in one or more life domains.
Bridge building to mainstream is widely practiced as part of the care pathway for people in recovery from severe and enduring mental health conditions.
Bridge building is based on key 'social domains' or life domains. Each domain represents an area that may be important or relevant to a person's development.
Life domains include:
Healthy Living
Arts & Culture
Education & Training
Faith & Cultural Communities
Volunteering & Befriending
Employment
Bridge builders work with clients to help them identify key areas they may wish to access in one or more life domains.
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