SERVICE USER PARTICIPATION AND LEADERSHIP

IN SERVICES

Mary O’Hagan, St Andrews, 2011

INTRODUCTIONS

Mary O’Hagan

Name and organisation of participants

PURPOSE OF MORNING

To provide a helicopter view of service user leadership and participation

To scan the internal and external contexts that help or hinder service user participation and leadership in Fife

DEFINITIONS

Tables

What do we mean by:•Service user•Participation•Leadership•SUPL?

(3 mins)

SUPL LEVELS

Individual•Own recovery•Client-staff relationship

Service•Service user run initiatives•Mainstream services

System•Local•National

DEGREES OF POWER

Neglect

Professional Power Shared Power User Power

Institutional era Transitional era

Recovery era

Paternalism

Tokenism Participation Leadership

LOW HIGH

SUPL ORIGINS

Human rightsCustomer rights

User/survivor movement (40 yrs) Government policy (20 yrs)

WHY IS SUPL IMPORTANT?

Tables

Why does SUPL in services:• Improve services?• Improve recovery?

(5 mins)

SUPL TODAY?

Discussion

How well is Fife implementing SUPL today at all levels:• Individual – Own recovery, client-staff relationship• Service – Service user run and mainstream services• System – Local to national

SEISMIC SHIFTS NEEDED

The four ‘P’s:• Philosophical• Psychological• Power• Practical

PHILOSOPHICAL SHIFTS

Beliefs about madness – a challenging but legitimate human experience.

Responses to madness – support people to lead own recovery, according to values of:•Hope•Self-determination over life•Choices of services•Valued place in world.

PSYCHOLOGICAL SHIFTS

New identities and roles:• Service users – active agents• Workforce – expert resource• Families – supporters of recovery• Communities – unfearful and inclusive

POWER SHIFTS

Transfer decisions & resources to service users

Individuals• Collaboration, personalisation• Prevent coercion

Collective• Independent systemic advocacy• Service users as leaders in services

PRACTICAL SHIFTS - INDIVIDUAL

Prevent legal and extra-legal coercion.

Practice collaboration eg strengths assessment/ personal planning, shared medication management, shared risk management, self-directed care, personal budgets.

Improve access to peer support & recovery education.

PRACTCIAL SHIFTS – PEER SERVICES

Plan, fund and develop peer run services:• Support groups and networks• Support in housing, education and employment.• Support in crisis• Artistic, cultural and social activities.• Recovery education for peers.• Mentoring, counseling and befriending.• Systemic and individual advocacy.• Information development and distribution.

PRACTICAL SHIFTS – MAINSTREAM SERVICES

Employ people with lived experience in:• Generic roles eg professionals, managers.• SU Specific roles eg advisors, peer support workers.

Support staff with lived experience• To ‘come out’.• workplace adjustments.

Create transparent, responsive feedback loops for service users as individuals and as a collective.

PRACTICAL SHIFTS – SYSTEM

Community governance – user led stakeholder boards to oversee local inter-sectoral service development:•Investigate the needs/strengths of local communities •Investigate outcomes for people using services. •Evaluate services.•Advise funders and providers. •Provide information on services and their quality.

BREAK

15 mins

SUPL CONTEXT IN FIFE

Small groups1. PEST analysis – Political, economic, social &

technological environment (looking out)2. SWOT analysis – Strengths, weaknesses, opportunities

& threats (looking in)

(30 mins)

POLITICAL ENVIRONMENTAL

SOCIAL TECHNOLOGICAL

STRENGTHS WEAKNESSES

OPPORTUNITIES THREATS

LEARNING FROM THE MORNING

Take a blank sheet of paper• Write the three most memorable things you have

learnt• No more than a sentence for each• Write clearly• Put paper in middle

LUNCH

Back at 1.30

INTRODUCTIONS

Mary O’Hagan

Name and organisation of participants

SUMMARY OF MORNING

What was learnt.

Other comments.

See handout.

PURPOSE OF AFTERNOON

To map current service user participation and leadership in Fife – good, poor and non-existent.

To design and agree on new and improved service user participation and leadership processes.

MAPPING SUPL IN FIFE

Small groupsNHS, Council, Voluntary sector, Interagency

Draw up the points where important decisions are made at the service or system level and plot where service user participation/leadership is:

• Good• Poor• Not happening

INTERAGENCY GOOD NHS GOOD

COUNCIL GOOD VOLUNTARY SECTOR GOOD

INTERAGENCY POOR NHS POOR

COUNCIL POOR VOLUNTARY SECTOR POOR

INTERAGENCY NONE NHS NONE

COUNCIL NONE VOLUNTARY SECTOR NONE

BREAK

15 mins

FILLING THE GAPS IN SUPL IN FIFE

Small groupsNHS, Council, Voluntary sector, Interagency

Design new or improved processes for service user participation/leadership where it is poor or not happening.

INTERAGENCY NEW OR IMPROVED NHS NEW OR IMPROVED

COUNCIL NEW OR IMPROVED VOLUNTARY SECTOR NEW OR IMPROVED

QUOTE

The best way to predict the future is to invent it.