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Building an Action Plan
Change rather than maintenance
In almost every area of life that is valued by the general population, there is an opportunity gap which means that people with mental illness, learning disability or personality disorder miss out 37. It will take a considerable, sustained effort across the whole of society to close the gap and 'promote wellbeing and social development' 38.
While local authorities are charged with this statutory duty, they cannot achieve it on their own. Individual citizens and voluntary, statutory and commercial agencies all have a part to play. Some of the skills that will be needed are not traditionally found in health or social services. This document aims to show how local authorities can discharge their duties by working in partnership with a variety of community organisations. It recommends harnessing the skills and commitment of universal community organisations rather than providing segregated activities for specific client groups.
Lifelong learning
The Skills Training Service in Clackmannanshire used to provide computer training to groups of students with mental health issues. It now works as a flexible support service both within and beyond education. They encourage community organisations and their staff to be welcoming and also provide support to people to move on beyond their service until that support is no longer needed.
Contact: Sylvie Vernis 07811123922
It is important to note that many of the actions needed to fulfil the duty to promote wellbeing and social development under the Mental Health Act will also satisfy other obligations, such as the duty to promote disability equality 39, to tackle poverty and disadvantage, to provide community care and to promote participation in public life.
Making a considered response to Sections 25-31 of the Mental Health Act is a long-term, complex process that will need to be led, co-ordinated and monitored. Local authorities should consider carefully how these functions are to be achieved. For example, asking social work or joint mental health managers to lead may inadvertently suggest to other services that they have little or no part to play. Equally, mental health and learning disability specialists have valuable expertise that will need to be harnessed if all the other services are to make the most of their opportunities. Authorities will want to assign the leadership task within their own organisation to a specific individual employed at a senior level.
Successful co-ordination of actions designed to meet obligations under these Sections of the Mental Health Act will need a plan. Elements of this plan should be incorporated within other published documents 40, but the local authority will need to draw these elements together to make a coherent response to the requirements of the Act. One mark of progress would be the extent to which the agenda is embedded in other plans developed across the community and in the local authority.
Funding
Responding to Sections 25-31 of the Mental Health Act requires a range of actions, many of which are already established requirements. There was funding to help implement the new Mental Health Act and no new funding is being made available to assist in meeting this specific duty.
Monitoring progress as distance travelled
As the scope for change is so broad and local circumstances call for different forms of action from different agencies, progress cannot be satisfactorily monitored by a simple system of benchmarks. Progress will be made where people listen carefully, acknowledge complexity and sponsor creativity 41. Therefore, rather than presenting a rigid action plan and suite of obligatory performance indicators to the local authority, this document seeks to analyse, encourage and inspire. Distance travelled is suggested as a basis for discriminating between local authorities that have addressed the challenges of the Act and those that have avoided them. The key question is 'Have things improved since last year?' and the key people to ask are people with mental illnesses, learning disabilities or personality disorders. Part of the review process should thus include establishing a baseline.
Below, we consider steps to take in building an action plan. The two Appendices provide some ideas and reference materials to assist in the development of an action plan. These are resources to promote ideas and clarify aspirations, rather than a rigid description of how to achieve 'minimum compliance' with the Act or 'pass' an external inspection.
Steps:
- Consider who should be involved. It is vital to achieve a shared ownership of the agenda from the outset, with Community Planning Partnerships playing a key role. All discussions will need representation from people with mental illnesses, learning disabilities or personality disorders using services.
- Review current opportunities in your local area, including whether they are reaching the right people and are of a sufficiently high quality - this will form your baseline. A comprehensive review of progress on removing access barriers will examine such areas of a community as:
Housing
Communities
Employment
Personal finances
Parenting
Statutory education
Lifelong learning
Volunteering
Civic engagement
Arts and cultural activities
Healthy living
Health and social care servicesThe service user-led audit in Appendix 1 will provide insights into the experience of people using the services in question, while the whole-system approach explained in Appendix 2 will provide starting places for this discussion.
- Then, having established a baseline, consider what modifications will be required to meet the statutory duties under Sections 25-31.
- Prioritise 42, by thinking both about which actions would make the most difference, and what other local priorities are already in place.
- Make a plan and submit it for adoption by senior officers and elected members. Engaging support from key individuals (such as Chief Executives) will be vital at this stage of the process.
- Build your actions, review and reporting processes into other routines.
- Incorporate the plan into other duties.
Inspection and accountability
As these are duties under the Mental Health (Care and Treatment) (Scotland) Act 2003 the local authority may be subject to legal challenge on whether it has met its obligations under the Act. The Scottish Government's mental health delivery plan Delivering for Mental Health, published in December 2006, requires local authorities to play their part in helping people with a mental disorder to live a full and meaningful life, thereby contributing to each individual's recovery journey. Monitoring tools are being considered to assist in measuring compliance with the plan.Other monitoring systems that apply across the local authority may take cognisance of With Inclusion in Mind and revise their criteria accordingly. A coherent, sustainable response to the Act by the local authority will include reporting to the public and other interested partners.Local authorities and their partners who aim for continuous improvement will welcome feedback from staff and the public about what is working and will gather, interpret and learn from data about outcomes in people's lives. Local authorities are required to report on progress against their disability equality scheme every year, and demonstrating outcomes of actions to deliver Sections 25-31 of the Mental Health Act will help them to do that.
Reviews
People with a mental illness, learning disability or personality disorder who attempt to access community opportunities may provide exactly the kind of 'mystery shopper' that is needed to identify the barriers to participation. The goal is that people who need support have the same access to opportunities as other citizens 43, and local authorities will wish to monitor this by reviewing the available data for their area. Such data will also be needed for Equality Impact Assessments of all their policies and services to find out how far their services encourage the increased participation of disabled people. Since Equality Impact Assessments cover all equalities they will also identify where policies and services may have different implications for people with mental health problems as a result of their gender, sexual orientation, age, race or religion.
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