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 LOW HIGH Neglect Paternalism Tokenism Professional Power Institutional era Participation Leadership Shared Power User Power Transitional era Recovery era SUPL ORIGINS Human rights Customer 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 groups 1. 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 groups NHS, 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 groups NHS, 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.