Core Unit 1: What service users want from care and treatment planning

7/27/2019 Core Unit 1: What service users want from care and treatment planning

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Uned Graidd 1: Beth mae defnyddwyr

gwasanaeth yn dymuno ei gael o

gynllunio gofal a thriniaeth

Core Unit 1: What service users want

from care and treatment planning


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Core Unit 1: What service users want rom care and treatment planning

Write your notes here:


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Uned Graidd 1: Beth mae defnyddwyr gwasanaeth yn dymuno ei gael o gynllunio gofal a thriniaeth

Uned Graidd 1: Beth mae denyddwyr gwasanaeth yn dymuno ei

gael o gynllunio goal a thriniaeth

Oriau hyorddi yn gysylltiedig r uned hon = 2 awr a 30 munud.

Nodaur uned hon:Maer uned ddysgu hon yn rhoi persbecti denyddwyr gwasanaeth a goalwyr am y gwerthoedd

craidd syn sail i waith ansawdd uchel wrth gynllunio goal a thriniaeth. Nod yr uned yw nid yn

unig atgoa cyranogwyr am werthoedd craidd a disgwyliadau, ond heyd hybu yrdd i wella

cynllunio goal a thriniaeth yn barhaus.

Pri negeseuon i hwyluswyr:

Yn yr uned hon, dylair hwylusydd bwysleisio:

Beth maer denyddiwr gwasanaeth yn ei ddymuno ac nid o anghenraid yr hyn y maer

gwasanaeth yn ei gynnig.

Bod Mesur Iechyd Meddwl (Cymru) 2010 yn seiliedig ar werthoedd gwellhad.

Cyfwyniad a chendir

Yn yr uned hon edrychir ar yr hyn y mae pobl yn dymuno ei gael or broses Cynllunio Goal a

Thriniaeth. Dangosir hynny trwy ddenydd helaeth o straeon personol a gywynir yn benna trwy

gywyniad PowerPoint.

Yn amlwg, maen bwysig i wasanaethau o bob math ddeall beth mae pobl yn chwilio amdano

wrth ddenyddio eu gwasanaethau. Mae Mesur Iechyd Meddwl (Cymru) 2010 yn gosod

goynion statudol ar ddatblygu a darparu cynlluniau goal a thriniaeth a chydlynu goal. Nod yr

uned hon yw sicrhau bod cyranogwyr yn gallu edrych yn eirniadol ar yr egwyddorion sylaenolsyn sail i gynllunio goal a thriniaeth.

Adnoddau dysgu angenrheidiol:

DVD o straeon/hanesion

Taunydd data a chyrifadur neu beiriant chwarae DVD Siart ip

Taenni ymarer

Canlyniadau dysgu

Ar l cwblhaur uned hon bydd y cyranogwyr yn gallu:

1 Cydnabod pri rannau Mesur Iechyd Meddwl (Cymru) 2010

2Nodi gwerthoedd craidd a disgwyliadau denyddwyr gwasanaeth mewn perthynas

Chynllunio Goal a Thriniaeth

3Meddwl yn eirniadol am gysyniad gwellhad ar ystyriaeth a roddir i hynny mewn ymarerpresennol

4Nodi unrhyw gamddealltwriaeth posibl ynglyn gwellhad a sut mae hynny yn berthnasol ardraws grwpiau oed a phroblemau iechyd meddwl.


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Core Unit 1: What service users want from care and treatment planning

Core Unit 1: What service users want rom care and

treatment planning

Training hours associated with this unit = 2 hours and 30 mins.

Aims o the unit:

This learning unit presents a service users and carer perspective on the core values which

underpin high quality work in care and treatment planning. The unit is designed to not only

remind participants o core values and expectations, but also to promote ways in which care

and treatment planning can be continuously improved.

Key messages or acilitators

In this unit, the acilitator should emphasise:

What the service user wants not necessarily what the service oers.

That the Mental Health (Wales) Measure 2010 is underpinned by the values o recovery.

Introduction

This unit examines what people want and needs rom the care and treatment planning process

and this is expressed through the extensive use o personal accounts and delivered largely

through a PowerPoint presentation.

Clearly it is important or mental health workers to understand what people are looking or

when they use their services. The Mental Health (Wales) Measure 2010 places statutory

requirements on the development and delivery o care and treatment plans and care

coordination. This unit seeks to ensure that participants can reect and critically examine the

undamental principles on which high quality care and treatment planning is based.

Required teaching resources:

DVD/audio o narratives

Data projector and PC or DVD player

Flip chart

Handouts or exercises

Learning outcomes

On completion o this unit the participants will be able to:

1 Acknowledge the key aspects o the Mental Health (Wales) Measure 2010

2 Identiy the core values and expectations o service users

3 Critically reect on the concept and components o recovery and its place incurrent practice

4Identiy potential misunderstandings about recovery and how it applies across age groupsand mental health problems.


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Amser

(munudau)Focws

Canlyniadau

dysgu

cysylltiedig

Dull dysgu/

adnoddauCynnwys

15 munud Cywyniad 1 Sleidiau 1, 2 a 3

40 munudRhan 1:Cywyno Dave Smith 1,2,3, a 4 Traodaeth grwp

Ymarer 1

Sleid 4 a 5

DVD/Clip sain:

mynd am ddiod

gyda Dave Smith

(rhan 1)

Taen 1

25 munudRhan 2:Elennau Gwellhad 1

2,3,4, a 5Sleid 6 a 7Ymarer 2Taen 2

30 munud Elennau Gwellhad 2 1,3 a 4Sleid 8Clip DVD

30 munud Elennau Gwellhad 3 1,3 a 4

Sleid 9 a 10Clip DVD

mynd am ddiodgyda Dave Smith(rhan 2)Taen 3

10 munud CrynhoiCrynodeb athraodaeth grwpcyan

Sleidiau 11, 12a 13

Cynllun y wers

Cynllun gwers manwl

Gweithio trwyr uned

Gallech ddangos y sleid PowerPoint cynta wrth ir cyranogwyr gyrraedd.

Yn dibynnu ar y seylla, gallech anteisio ar y cye i gywyno eich hun ar cyranogwyr

iw gilydd. Peidiwch threulio gormod o amser yn gwneud hynny.

Sleidiau 2 a 3: Nodau a chanlyniadau dysgu disgwyliedig ar l cwblhaur uned hon


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Time

(minutes)Focus

Related

learning

outcomes

Teaching method /

resourcesContent

15 mins Introduction 1 Slides 1, 2 & 3

40 minsSection 1:Introducing Dave Smith 1,2,3, & 4 Group discussion

Exercise 1

Slide 5

DVD/Audio clip:

Going or a drink

with Dave Smith

(part 1)

Handout 1

25 minsSection 2:The components orecovery 1

2,3,4, & 5Slide 6 & 7Exercise 2Handout 2

30 minsThe components orecovery 2

1,3 & 4Slide 8DVD clip

30 minsThe components orecovery 3

1,3 & 4

Slide 10

DVD clipGoing or a drinkwith Dave Smith(part 2)Handout 3

10 mins Review and conclusionSummary and wholegroup

Slides 11, 12 &13

Lesson plan

Detailed lesson plan

Orientation

You might like to have the frst PowerPoint slide showing when participants arrive.

Depending on the situation, you might like to introduce yoursel and participants to

each other. This should be kept airly brie.

Slides 2 & 3: Aims and expected learning outcomes on completion o this unit


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Rhan 1: (40 munud)

Sleid 4: Pri rannau Mesur Iechyd Meddwl (Cymru) 2010.

Nodiadau ir hwylusydd: Nid oes angen edrych yn anwl ar y ddeddwriaeth ei hun (gwneir hynny

mewn unedau eraill). Maen bwysig bod cyranogwyr yn deall bod y materion hyn yn oynion

cyreithiol o sabwynt gwasanaethau iechyd meddwl eilaidd.

Sleid 5: Cywyno Dave Smith

Audio/DVD Clip sain 1:

(Dafen 1)

Ymarer 1: Mynd am ddiod gyda Dave Smith (Rhan 1; 12 munud)

Mae Dave Smith yn Hyorddwr Cleifon Arbenigol gyda Haal. Yn y darn hwn bydd Dave yn

esbonio pam ei od yn credun gry bod gwellhad yn bwysig a sut mae pobl wedi ei helpu.

Goynnwch i gyranogwyr ysgriennur pri themu yn y rhan hon o hanes Dave a thynnu sylwat yr elennau gwellhad oi bersbecti e. Yn unigol, gwrandewch/gwyliwch a chonodwch eich

ymateb i gynnwys y DVD/clip sain o Dave yn siarad am ei wellhad. Mewn grwpiau bach

cymharwch eich ymateb ir clip a nodwch beth oedd yn ddenyddiol yn ei wellhad.

Nodiadau ir hwylusydd: Nodiadau ir hwylusydd: Ar sail yr adborth, cysylltwch ag egwyddorion a

gwerthoedd gwellhad gan ddenyddior cywyniad PowerPoint i ddilyn. Meddyliwch am y

rhwystrau ar atebion i hybu ymarer syn seiliedig ar wellhad. Cyeiriwch yn benodol at CAMHS,

pobl ag anabledd dysgu a phobl hwn wrth ystyried ym mha ordd y maer ymarer ar

egwyddorion gwellhad hyn yn berthnasol.

DVD


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Section 1: (40 mins)

Slide 4: Key elements o the Mental Health (Wales) Measure 2010.

Notes or acilitator: There is no requirement to delve deeply into the actual legislation (this

will be done in other units). However it is important that participants understand that these

issues are legal requirements o secondary mental health services.

Slide 5: Introducing Dave Smith

Audio/DVD clip 1:

(Handout 1)

Exercise 1: Going or a drink with Dave Smith (Part 1: 12 minutes)

Dave Smith is an Expert Patient Trainer with Haal. In this extract Dave will explain why he is

passionate about the importance o recovery and how people helped him. Ask participants

to write the key themes in this part o Daves narrative and highlight the elements o recovery

rom his perspective. Individually, listen/watch and record your reactions to the content o the

audio/DVD clip o Dave talking about his recovery. In small groups compare your reactions to

the clip and identiy what was helpul in his recovery.

Notes or acilitator: From the eedback, make links to the principles and values o recovery

using the PowerPoint presentation to ollow. Think about the obstacles and solutions to

promoting recovery orientated practice. Make particular reerence to CAMHS, people with

a learning disability and older people when considering how these recovery principles and

practices apply.

DVD


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Rhan 2: (85 munud)

Sleid 6: Elennau gwellhad

Nodiadau ir hwylusydd: Denyddiwch y sleid hon i sicrhau bod y grwp cyan yn deall beth yw

gwellhad a sut gellir ei ddenyddio.

Sleid 7: Elennau gwellhad 1: grymuso a hunan reolaeth

Goynnwch ir grwp cyan eddwl am ystyr y sleid hon i ymarer iechyd meddwl wrth gynllunio

goal a thriniaeth. Pa weithredoedd a gwerthoedd yddai eu hangen i sicrhau bod hyn yn

digwydd yn ymarerol?Nod y sleid hon ar ymarer canlynol yw annog pobl i eddwl sut mae grymuso ac ymarer

hunan reolaeth yn gallu bod o gymorth sylaenol wrth hybu gwellhad. Dylid diogelu pobl ond

dylid heyd eu hannog i gymryd risgiau positi. Am nad ydym yn byw heb risgiau, rydym i gyd yn

prof cyyngiadau ar ein gallu drwyr amser. Weithiau rydym yn methu ac mae honno yn gallu

bod yn wers bwysig i ni i gyd.

Nodiadau ir hwylusydd: Os oes gennych gyranogwyr o wahanol rannau or gwasanaeth

(oedolion hyn/CAMHS/gwasanaethau orensig) goynnwch iddynt ystyried beth yw ystyr

grymuso a hunan reolaeth i bobl syn denyddio eu gwasanaethau. Denyddiwch y nodiadau

cychwynnol yn y cywyniad yn llawlyr yr hwylusydd i helpu ddechraur draodaeth.

Ymarer 2: Beth yw ystyr grymuso a hunan reolaeth yng nghyd-destun cynllunio goal

a thriniaeth?

Mewn grwpiau bach lluniwch restr ar siart ip or holl yrdd y gall pobl ddangos eu bod wedi

eu grymuso. Lluniwch restr arall i ddangos Hunan Reolaeth. Goynnwch ir grwpiau rannu eu

rhestrau gydag eraill. Ar ddiwedd yr ymarer gallwch rannu taen 2 ymysg y cyranogwyr.

Sleid 8: Elennau Gwellhad 2: y dull holistaidd

Goynnwch ir grwp cyan eddwl am ystyr y sleid hon i ymarer iechyd meddwl yng nghyd-destun

Cynllunio Goal a Thriniaeth. Pa weithredoedd a gwerthoedd yddai eu hangen i sicrhau bod

hyn yn digwydd yn ymarerol? Nod y sleid, DVD/clip sain hwn yw galluogi pobl i ddeall yn well y

dull holistaidd o oal iechyd meddwl. Mae yna bobl syn rhieni; syn oalwyr; syn weithwyr; yn

ysbrydol ac yn chwilio am ystyr yn eu bywydau. Mae yna bobl sydd dyheadau o ran gwaith;

addysg a sicrwydd ariannol. Mae yna bobl heyd sydd phroblemau goal iechyd cororol ac

maer rhain yn ystyriaethau pwysig wrth hybu gwellhad. Gallai heyd od yn ddenyddiol ystyried

sut yddai dull holistaidd yn gweithio wrth ymwneud phlant a phobl ianc. Mae meddwl amy system deuluol yn agwedd bwysig o waith CAMHS ac maen rhoi darlun pwysig wrth eddwl

mewn ordd holistaidd.


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Slide 6: The components o recovery.

Notes or acilitator: Use this slide to ensure understanding o the whole group on what

recovery is and how it can be applied.

Slide 7: Components o recovery 1: empowerment and sel management

Ask the whole group to reect on what this slide means or mental health practice in care and

treatment planning? What are the actions and values that would be required to make this

happen in practice?

This slide and ollowing exercise is designed to encourage reection and action on how

empowerment and sel management can undamentally enable recovery to happen. There are

issues o keeping people sae but acilitating positive risk taking. Not everyone lives in a risk

ree environment because we need to explore the limits o our abilities all the time.

Sometimes we ail and this can be an important lesson or us to learn.

Notes or acilitator: I you have participants rom dierent parts o services (older adults/

Learning Disability CAMHS/orensic services) ask them to consider what empowerment and

sel management may mean or people who use their services. Use the initial notes in the

introduction to the acilitators handbook to help start the discussions.

Exercise 2: What does empowerment and sel management mean in the context o

care and treatment planning?

In small groups list on a ip chart all the ways in which people can demonstrate they are

empowered Make another list or a demonstration o Sel Managing Facilitate the groups

to share their lists with others. At the end o the exercise you can provide participants with

Handout 2.

Slide 8: Components o recovery 2: the holistic approach

Ask the whole group to reect on what this slide means or mental health practice? What are

the actions and values that would be required to make this happen in practice? This slide,

DVD clip and exercise is designed to enable greater understanding o the whole person

approach to mental health care. They are people who are parents; are carers; are workers; are

spiritual and seeking meaning in their lives. They are people with aspirations or work; or

education and fnancial security. They are people who may also have physical health care

problems and these are important issues in enabling recovery. It may also be useul to

consider how a holistic approach would operate when working with children and young people.Thinking about the amily system is an important aspect o CAMHS work and oers some

important insights to holistic thinking.


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Clip DVD: Byddai cywyno siaradwr Cymraeg syn siarad am oal holistaidd ac yn cydna

bod ymateb positi iw hangen am wasanaeth Cymraeg yn uddiol yma.

Sleid 9: Cenogwyr ar cynllun goal a thriniaeth

Maen werth nodi bod dewis o rwydweithiau cenogi posibl ar gael i ddenyddwyr gwasanaeth

yn ystod eu bywyd. Gallai unrhyw un or rhai a enwir yn y sleid wneud cyraniad pwysig i gynllun

goal. Goynnir i gyranogwyr ystyried sut y gallair bobl hyn od yn rhan o gynllunio goal a

thriniaeth.

Nodiadau ir hwylusydd: Maer Mesur yn datgan yn glir y goynion o ran cymryd rhan,

ymgynghori a rhannu cynlluniau goal a thriniaeth gyda chenogwyr. Maen hanodol bod

cyranogwyr yn ymwybodol y bydd y deunyddiaun rhoi sylw manylach i hyn, ond yn y lle cynta

dylen nhw wybod bod ymgynghori a rhannun seiliedig ar gytundeb y denyddiwr gwasanaeth.

Sleid 10: Elennau gwellhad: ymrwymiad i gynnydd

Maer sleid hon yn cael ei denyddio i ddangos bod ymrwymo i wellhad yn broses

gydweithredol. Rhaid i ddenyddwyr gwasanaeth au goalwyr (ac mae hyn yn cynnwys gweithwyr

iechyd a goal cymdeithasol) greu (gwerthawrogi) a gweithredu (ymddwyn) mewn yrdd syn

cenogi cynnydd tuag at wellhad.

Ymarer 3: Mynd am ddiod gyda Dave (Rhan 2: 9.06 munud)

Rhannwch daen 3 a chwaraewch ail hanner y draodaeth gyda Dave Smith. Sylwch ar ei arn

na ellir gorodi gwellhad ar bobl ai arn ynglyn chyrioldebau denyddwyr gwasanaeth yn rhan

or dull gwellhad. Heyd sylwch ar ei arn ynglyn hunan reolaeth a grymuso.

Heyd mae ystyriaethau pwysig ynglyn ag ystyr gwellhad ar draws y sbectrwm oed ac yn

arbennig i bobl syn diodde o ddementia. Maer cywyniad ir llyr gwaith hwn yn cynnig rhai

syniadau ynglyn gwellhad i bobl syn diodde o ddementia.

DVD


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DVD clip: Introducing a Welsh speaker talking about holistic care and acknowledging a

positive response to their Welsh language need.

Slide 9: Supporters and the care and treatment plan

It is worth noting that or service users there may be an array o possible support networks

in their lie. Any o these named in the slide may make an important contribution to a plan o

care. Participants are asked to consider how such people could be involved in care and

treatment planning.

Notes or acilitator: The Measure makes explicit statements about involvement, consultation

and sharing o care and treatment plans with supporters. It is essential that participants are

aware that the materials will cover this in more detail, but in the frst instance they should

know that consultation and sharing has to take account o the views o the service user.

Slide 10: Components o recovery 3: commitment to progress

This slide is used to illustrate that commitment to recovery is a shared commitment.

Service users and their carers (and this includes health and social care personnel) must

believe (value) and act (behave) in ways which support progress to recovery.

Exercise 3: Going or a drink with Dave (Part 2: 9.06 minutes)

Distribute handout 3 and play the second part o the discussion with Dave Smith.

Note his view that recovery cannot be imposed on people and his views on the responsibilities

o service users within an approach to recovery. Also note his views on sel management and

empowerment.

Please note, there are also important considerations on what recovery means across the age

spectrum and particularly or people suering with a dementia. The introduction to this

workbook oers some thoughts on recovery or people with a dementia.

DVD


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Rhan 3: (10 munud)

Sleid 11: Adolygu

Sleid 12: Crynhoi

Nod yr uned ddysgu yw herio cyranogwyr i adolygu sut maen nhw yn ystyried ac yn

gweithio wrth gynllunio goal a thriniaeth, a lle bon briodol, annog newid o ran ymarer neu

ddisgwyliadaur broses. Os ywr cysyniad yn newydd iddynt, yna e yddant yn cael eu cywyno i

broses cynllunio goal syn gyson r ddeddwriaeth ar polisi newydd yng Nghymru.

Cweatiynau a beth ydych chi am ei wneud yn wahanol nawr?

Maer rhan hon yn rhoi cye i gyranogwyr gael eglurhad ynglyn ag unrhyw bwyntiau a godwyd yn

y sesiwn. Mae heyd yn gye pwysig i oyn i gyranogwyr ystyried camau ymarerol y gallant eu

cymryd iw helpu i weithredur Mesur a goal iechyd meddwl syn rhoi pwyslais ar wellhad.

Goynnwch ir cyranogwyr nodi yn eu llyrau gwaith o leia un cam y bydden nhwn gallu ei

gymryd i wellar broses o gynllunio goal a thriniaeth syn rhoi pwyslais ar wellhad.

Negeseuon a ddysgwyd

mae cynllunio goal a thriniaeth yn llawer mwy na mater o lenwi dogen

mae cynllunio goal a thriniaeth yn seiliedig ar werthoedd a ddylai ddylanwadu ar ymarer

mae credu mewn gwellhad wrth galon Mesur Iechyd Meddwl (Cymru) 2010.


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Slide 11: Review

Slide 12: Conclusion

The learning unit is designed to challenge participants to review how they perceive and work

with care and treatment planning and, where appropriate to prompt a change in practice or

expectations o the process. I they are new to the concept then they will be introduced to a

care planning process that is consistent with new legislation and policy in Wales.

Questions and what are you going to do dierently now?

This section oers participants and opportunity to clariy any points raised in the session.

It is also an important juncture to ask participants to explore practical actions they can take to

support implementation o the Measure and recovery orientated mental health care.

Ask participants in their workbooks to note at least one action they eel they can take to

improve recovery orientated care and treatment planning.

Take home messages

care and treatment planning is much more than a document flling exercise

care and treatment planning is underpinned with values which should inuence practice.

a belie in recovery is at the heart o the Mental Health (Wales) Measure 2010.


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Darllen pellach

Elias, E. & Singer, L. (2009) Review o the Care Programme Approach in Wales. Uned Cyenwi a

Chymorth / Asiantaeth Genedlaethol Arwain ac Arloesi mewn Goal Iechyd.

Haal (2006) Arweiniad i ddenyddwyr: yr hyn mae pobl gydag afechyd meddwl yng Nghymruangen ei wybod am Gynllunio Goal a Thriniaeth.

Haal (2009) Fy aderiad: cynllun gam wrth gam ar gyer pobl ag afechyd meddwl diriol.

Llywodraeth Cynulliad Cymru (2005) Gwasanaethau Iechyd Meddwl Oedolion. Codir Saon:

Gwasanaeth Cenedlaethol Diwygiedig a Chynllun Gweithredu i Ddarparu Gwasanaethau Iechyd

Meddwl ar gyer Oedolion yng Nghymru. Caerdydd. Llywodraeth y Cynulliad.

Llywodraeth Cynulliad Cymru (2010) Cyawnir Dull Rhaglen Oal yng Nghymru.

Canllawiau Interim ar gyer Rhoir Polisi ar Waith. Caerdydd. Llywodraeth y Cynulliad.

Llywodraeth Cynulliad Cymru (2010) Dedd Iechyd Meddwl (Cymru) 2010.


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Further reading

Elias, E. & Singer, L. (2009) Review o the Care Programme Approach in Wales. Delivery and

Support Unit/ National Leadership and Innovation Agency or Healthcare.

Haal (2006)CPA A users guide: what people with a mental illness in Wales need to know

about the Care Programme Approach.

Haal (2009)My recovery: a step by step plan or people with serious Illness.

Welsh Government (2005)Adult Mental Health Services. Raising the Standard. The Revised

Adult Mental Health National Service Framework and an Action Plan or Wales. Cardi.

Welsh Government.

Welsh Government (2010) Delivering the Care Programme Approach in Wales Interim Policy

Implementation Guidance. Cardi. Welsh Government.

Welsh Government (2010) Mental Health (Wales) Measure 2010.


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Tafen 1 / Handout 1:

Mynad am ddiod gyda Dave (Rhan 1) / Going or a drink with Dave (Part 1)

I I come back to the question on receiving mental health services and a belie in recovery,the driver or me is, the bottom line that we are all born with whether youve got an illness or

not you can think o it as a bag o potential, yknow we have skills we have experience we have

talents that we add on to that we can chose that thats our currency i you like. We can chose

to spend it and reach our potential or drive orward to our potential or we can chose to let it

lie dormant people. Whether you are ill or not, people chose to leave it dormant and stumble

through lie not having too many goals or plans that bag, perhaps you lose it or a while,

perhaps it is not a matter o it lying dormant you cant even fnd it it takes that

recovery process to it dawns on you and sometimes you have the pleasure o meeting

people who inspire you who help you fnd your potential again certainly i they dont help you

fnd your potential, they bring it to light again and say you do still have potential its thosepeople and that knowledge o a recovery ethos is one o those moments when you discover,

this isnt the be all and end all o lie its not that you have been struck down with mental

illnessyou know things have changed and certainly or a period you believe that change is so

drastic you will never be able to have a amily, youll never be able to have those nice

relationships that we all love and enjoy with your riends you will become an outcast because

you have lost your marbles, thats what it eels like that long dark tea time o the soul when

you ponder on your situation i you can because your mind is so uid and plastic and jelly-like

in those times when you are alone more and more than not you are in your loneliness and

thats being lonely in a crowd and youre thinking o some o the true deeper things that

anyone can think about what is the point? What is the purpose o this now? Why has this

happened to me? beore I was on target to be a mechanical engineer or an electrical

engineer or those aspirations be it a carpenter or a plumber, shopkeeper, whatever those

aspirations are the illness strikes and everything that was beore changes it is as i the sand

in the box is thrown up in the air and it has got to settle again and it settles in disorder and

you think, wow, what will ever become o me? Thats what its like. and yet we now are in a

position where we have recovery enshrined in law, which gives it real orce and teeth, which as

ar as I know no other country in Europe, no other country in the world has the type o

environment, the ramework by law to develop recovery, not just a model but a way o

working a way in which our systems adhere to the way in which relationships between

proessionals work it is the whole gamut yknow and its in some sensesor those who have

been involved in mental health or 10, 20, 30 years. I dont think they realise the position weare in and you think wow that is big, it is something to be celebrated it is something to be

seized uponand what I think is it is but a start but boy what a start weve got yknow.

Numerous people have told me that i you went in to see a psychiatristand they were told in no

uncertain terms that you will never work you will never have the normality that other

people can expect because you are, a service user. It was i they stopped being part o

the human race and became a totally dierent species a species with no hope with no

aspiration o lie, with no choice.

So they took their medication they went to day services they went to the drop-in centre and

drank coee with other service users, that other species that could only use drop incentres they didnt mix in the normal circle, they didnt meet the normal people because they

were sub-human that was the category that was almost imposed upon them.


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Yeah, well OK, or me right at the start it was some o the things that I couldnt carry or

mysel, so Im not talking necessarily about burdens, like fnances or things like that, but real

core things such as belie. When youve got mental illness and youre in that real pea-souper

o not having that clarity o thought and chaoticness, its that ability to have someone there

someone who is rooting or you. Lets use simple language, someone who is able to

encourage you and to give you hope. Now you cant hold that hope or yoursel and you mightnot be able to hold that or a long period o time, be it several months, it might be a year, it

might be several years where you are incapable o hope. Ive been there, Ive been suicidal, I

wanted to end it all and Ive been totally beret o hope and I think one o the key

characteristics o proessionals who have worked in my lie and not just proessionals but

amily, riends and latterly, work colleagues. At times when I have been beret o hope, they

have become carriers o hope or me. Sometimes you need to learn starting to walk again as

someone with a resh diagnosis, sometimes you need to learn how to walk, but its no good i

someone is going to hold your hand all the timetheyve got to let you go and try it out.

So dependence is bad, but reliance, having that someone there, waiting catching you i you do

all a bit or helping you back up, thats another thing and its a very important dierence.Support workers Ive worked with, proessionals that Ive seen dont always get we talk about

empowerment its a massive buzz word in our proession and yet so many people dont quite

get what empowerment is its unny rom the eminist movement, I can think o a woman

called Gloria Steinem, her quote about empowerment is brilliant, what she says is let me get

this right, what she says is power can never be given but power can be taken ysee and thats

what empowerment is. People think we have empowering practice, cos we try to give people

the opportunity to have choice and things like that. Empowerment can never take place just

because that exists empowerment happens when a person says I recognise the

conditions are right or choice and I have those things laid beore me but its not about the

practitioner handing over power empowerment only truly happens when the client, the service

user, says I see the choices now Im gonna take up those choices, Im gonna make a choiceand take the power to do it, Im gonna be responsible, Im gonna take that power.

So empowerment doesnt take place those conditions are there, thats only part o it.

What you can have is conditions an environment which allows a service user to be

empowered, so he takes up those things so thats something o a allacy and a real bug-bear

or me because or me in that journey o recovery, its about realising what responsibilities I

have or mysel yknow we talked about we talked earlier in the day about that journey you

become the RP the relevant patient. Once that designations is stamped upon you what that

says is that you are not ully capable, youre not ullyan adult i you like you cannot really be

treated as an adult yet. So once youve been given a label as a relevant patient and I dont

argue against it what I say is once youve got that your responsibility as a service user andyour responsibility as a practitioner is to try to remove that relevant patient tag so thats your

goal. Under Part 2 youre a Relevant Patient to goal o the service user and practitioner is

to go back to the consultant and say thanks or the tag o relevant patient, but Im gonna

hand it back, cos I dont need it anymore, Im now a responsible personso you are saying

the goal is to go rom Part 2 o the Measure into Part 3 hopeully Part 3 gets let behind, but

thats another story. The goal though is to become a responsible person again, ok and that is

it in a nutshell. Thats what recovery is about.


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Tafen 2

Rhestrau Grymuso a Hunan Reolaeth

Dyma ddwy restr ond mae llawer mwy o enghreitiau! Mae pobl wedi eu grymuso osydyn nhw:

yn deall bod ganddynt yr un hawliau a chyrioldebau ag eraill

yn teimlo eu bod yn gallu gwneud eu penderyniadau au dewisiadau eu hunain

yn ganolog ir broses o wneud penderyniadau am eu bywyd

yn gallu cael mynediad at wybodaeth angenrheidiol er mwyn gwneud dewisiadau

yn gallu dewis o blith nier o opsiynau

yn gweld bod eu hawl i ddewis yn cael ei barchu

yn cael y gair cynta ar ola mewn unrhyw draodaeth amdanyn nhw eu hunain

yn teimlon gyartal ag eraill a chael eu trin yn gyartal gan eraill

yn rhoi cyarwyddyd ymlaen llaw - dweud wrth bobl sut maent yn dymuno cael eu trin

pan maent yn wael.

Mae gan bobl hunan reolaeth os ydyn nhw:

yn gwneud cynlluniau yn eu hiaith eu hunain ac yn denyddio eu geiriau eu hunain

yn gwneud galwadau n, ysgriennu llythyrau a llenwi urenni eu hunain i odloni eu

hanghenion

yn datrys eu problemau eu hunain

yn negydu phobl er mwyn bodloni eu hanghenion

yn derbyn cymorth eraill ar eu telerau eu hunain a dal i od yn gyriol

yn goalu amdanynt eu hunain, cynnal iechyd cororol ac ymdopi phroblemau

iechyd meddwl

yn cymryd eu meddyginiaeth eu hunain

yn hunanymwybodol ac yn gweithredu ar hynny - yn cynnwys rhagweld os bydd argywng

yn dechrau.


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Handout 2

Empowerment and Sel Management lists

Here are two lists but there can be many more examples! A person is empoweredwhen they:

recognise that they have the same rights and responsibilities as others

eel a strong sense o autonomy

are at the centre o decision making processes concerning their lie

are able to access inormation necessary to make choices

are able to choose rom a range o options

see their right to choice respected

have the frst and last word in any discussion about them

eel equal to others and are treated equally by others

make advance directives telling people how they want to be treated when they

are unwell.

A person is sel-managing when they:

make plans in their own language and using their own words

make phone calls, write letters and fll in orms themselves to address their needs

sort out their own problems

negotiate with people to get their needs met

accept the support o others on their own terms and without resigning responsibility

look ater themselves, maintaining physical health and addressing mental health problems

administer their own medication

exercise sel-awareness and act on this including anticipating the onset o a crisis.


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Tafen 3 / Handout 3

Mynad am ddiod gyda Dave (Rhan 2) / Going or a drink with Dave (Part 2)

I you become a mental health service user suddenly your lie is surrounded by mental healthservices. Its a very specialist, niche market in one sense and its one that service

users struggle to get beyond and the creation that needs to happen are avenues, or

doorways out o those services, so you are not just hemmed in by those services, but you see

beyond those services. Now what seems to happen and the danger, even in care and

treatment planning is that you are defned by your illness ok, so in trying to do good, by

providing you with a care and treatment plan, you start being defned by your issues, by the

act that you have got a mental health issue so the danger in concentrating on that and giving

you a plan, that again starts to disenranchise you its not a bad thing, certainly in the initial

stages o an illness, but every encouragement has got to be made to move rom a lie which

has guidance and direction and support at its oreront which is really desperatelyneeded, Im not advocating against it but as you piece back your lie, as you take up more

reins o responsibility, every eort must be made by practitioner and service user alike to

extricate themselves as quickly and as efciently and as expeditiously or whatever right as

possible because the longer you are in that system as a mental health service user, the

longer your lie is gonna be that o a mental health service user, rather than being a

human being.

In act, Im encouraged to do the things that service users do my care and treatment plan

doesnt say maybe you should join the job club..or you should join a local photography

society or the gym or things like that it says things like Dave should go to the local MIND

association and spend two hours there and when you go to the local MIND association whatdo you fnd? You fnd people whose only thing in common with you is mental illness.

You make a choice at that point you go in through the door and you either think ok num the

only thing Ive got in common with these people is mental illness I walked into a MIND

association and I saw lots o people with similar mental health conditions to mysel there were

people with bi-polar, people with schizophrenia, people with depression and the one thing that

saved me was the act that I was 22. When I walked through that door it was ull o

people who were 50, maybe 40 , maybe 60 and that saved me because when I walked through

that door, what I saw was old people. I didnt see people with a mental health condition,

what I saw was people who didnt have anything in common with me whatever and I got out

o there..I spent two minutes assessing it and I told my CPN who told me to go there, whydid you tell me to go there? And he said, I thought it would help you to meet other people

with your condition. So the intent was good, his core value was right yknow, but the outcome

could have been disastrous. I I had embedded mysel i I as a service user had taken that on

as my identity the results could have been disastrous, I could have spend 10, 20, 30 years in

my new ound role, as a service user doing the service user things.

Now I put it to you that i you were to change services ok you may still need to have your tea/

coee and sympathy group where people can come along and do a bit o that. I you adopt

a more structured approach and once they get through the initial shock, once they get into it

and rather than give them medication, which does play its part, but just leave it, rather than

give them a timetable o activities at the day centre o art work, o which does have its valuei we trained a whole host o proessionals who normally do just a baby-sitting role alright, who

make sure the darts arent going in the wrong place, or that everyone puts the game away at


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the end and rather give them some real skills, training people in sel management,

acilitation o sel management skills now then that would be something that people could

aspire to go to. I always remember someone telling me o how sick they were o scoring

a treble 20 on a magnetic darts board only to see it end up on the 3, ok and to spend a

lie doing that, cos they couldnt have the real thing anyway so dont oer them the ake,oer them that thing that will hold them in stasis give them real opportunity, give them sel

management skills so they can learn how to cope, how to look at their illness, measure their

mood, how to cope with the voices, how to give the voices time now I dont like saying it but

Im tempted to say its not rocket science, this is evidence thats out there.

With bi-polar, the whole model o looking at mood maps, we are looking at mood diaries, were

monitoring known eects, its no dierent to Diabetes i someone has diabetes, they can learn

to take their own blood sugar levels, to learn to recognise when their energy levels are low,

when they start eeling a bit hyper, they can monitor and adjust their sugar. I tell you what, in

my experience Bi-polar is no dierent yes sometimes I get it a little bit wrong, I dont tweak

enough when I should..but the wealth o knowledge that is out there that could be brought tobear on those situations.

So recovery in a nutshell is tapping into the potential you have, that little bag o currency that

we carry around with us and allowing ourselves to spend it, invest it and do with it, and allow

ourselves to become more and more, become better and better. And surely i thats recovery,

then we all need it, not just the mentally ill, but we all need it. Talk about 5 year plans, people

who are on care and treatment plans would have a 5 year plan. They might be able to say in

10 years time to say my lie is better ordered than your chaotic living, despite me having a

mental illness, who knows.

Core Unit 1: What service users want from care and treatment planning

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Transcript of Core Unit 1: What service users want from care and treatment planning