Direct Payments
Direct Payments are assisting people to achieve both greater independence and also greater inclusion in their local communities. They do this by offering people increased choice and control over how some or all of their social care needs are met. It means that people with mental health problems and their carers can have greater flexibility around their support arrangement. However, despite their potential for facilitating individual and culturally sensitive support, few people from ethnic minority groups with mental health problems are accessing direct payments.
Studies have shown that inadequate leadership, a lack of awareness about and promotion of direct payments, and staff concerns about people’s ability to manage payments have hindered greater take-up.
Service users, carers, statutory and voluntary sector staff, all have a role to play in making direct payments a standard option within mental health services.
One of the key actions of the National Social Inclusion Programme was the publication and dissemination of a guide, Direct Payments: A Guide to Action to promote direct payments within mental health services as a means of facilitating greater social participation. Accompanying this guide to action was a document specifically written for service users and carers. An introduction to Direct Payments in mental health services for people eligable to use mental health services and carers.
Towards Independent Living: promoting recovery and inclusion
Government policy on direct payments is clear:
- Improving the Life Chances of Disabled People People describes direct payments as “The most successful public policy in the area of social care in recent years”. The report prepares the way for individual budgets for disabled people, to bring together the services to which they are entitled and give them greater choice over the mix of support they receive in the form of cash and/or direct provision of services.
- Independence, Well-being and choice sets the direction for increased access to direct payments for groups where take up has been low, such as people with mental health problems, in the context of positive risk-taking, adequate information, individually tailored assessment (including self-assessment), and a move towards individual budgets.
- The Direct Payments Guidance provides local authorities with the means to carry out their duty to make direct payments to those people who are eligible and are willing and able (alone or with assistance) to use them. This guidance and subsequent ministerial statements confirm the government’s intention that all authorities must be making direct payments routinely available to people with mental health problems.
- Within the Health and Social Care Standards and Planning Framework 05/06 – 07/08 there is reference to mental health services addressing social exclusion through tackling unemployment and social isolation. Direct payments is one approach to achieving this.
Implementing direct payments within mental health services
The Department of Health Guidance on direct payments requires every local authority to set up a direct payments scheme to make the payments available. This should include the lead officer for implementing direct payments, the scheme manager (where this is a different person), finance staff who administer direct payments, and arrangements by the local authority to train and support users and potential users of direct payments and all staff who are involved in the offering and making of direct payments.
The direct payments support service is the part of this scheme which provides advice, support, and sometimes training to users and potential users of direct payments. It can be provided directly by the local authority, but is generally provided under contract by one or more voluntary organisations or organisations of disabled people. Support provided through voluntary/recipient-run organisations has been shown to be particularly effective and valued by recipients.
A Voice and a Choice
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