This is an update after the recent post about personal health budgets in mental health. I met with both my care coordinator and woman from the health budgets department and it was decided that we should have a meeting with them as well as my therapist as my support was to be psychologically driven and so needed her input.
When we all met the following week, we discussed how better my needs could be met based upon my health goals:
1) better crisis support to reduce a&e visits
2) support network around therapy as this was going to get difficult over the coming months when we start trauma work.
3) help to get back to a fitness regime which was a big part of my life before everything happened.
4) psychological help.
In order to meet these goals we tried to think outside what the current NHS provides and so came up with the following:
1) Crisis support similar to a residential setting but without actually staying anywhere else – so having access to a service 24 hours a day as nighttime is my worst time and at the moment, I am advised to go to a&e at these times.
2) A support worker twice a week to try and integrate me back to a standard of living and not just existing. Hopefully this will allow me to start getting out and doing things like shopping – simple tasks that just aren’t doable right now.
3) A personal trainer twice a week to help me with my health and fitness goal to lose weight and hopefully reverse a recent type 2 diabetes diagnosis.
4) Psychological trauma work to overcome my ptsd symptoms and move forwards.
I must admit, I’ve found the whole process rather stressful which I know is because I’m the first in the area to do this and so a lot of questions are being asked for the first time and I’ve not really had anywhere to turn for advice on what others have done in my situation or similar. The good thing though is that I’ve realised my care coordinator and therapist both totally understand what I need in order to move forward and this has given me some renewed hope that I can get through this and maybe have a chance of a ‘normal’ life. I’ve definitely learnt however, that there is no way you can try and do this process alone, you need the help of professionals who know your situation.
I think when I was first told about this new way of working, I was worried that it essentially meant stripping away everything I was currently receiving and then buying in services. It really stressed me out thinking I would be losing relationships that I’d spent time and effort building and could I really go through all that again. I’ve since learnt that I can keep these things, like therapy, and the additional support is to help reduce costs elsewhere (like the use of a&e). I think this needs to be made more known at the outset to relieve any potential worry.
The actual process seems a bit in the air right now, with some parts seemingly a bit backwards. For example, once you receive an indicative budget, you are able to meet with a broker to help fulfill the goals in the support plan. However, the support plan asks for information that would seemingly come from a broker so that bit had to be left unanswered. There was a lot of repetition as well in the forms and I’m not sure they are right as they currently are.
The process though has been well communicated to me throughout and I can’t fault the people involved (my cc, therapist and woman from personal health budget department), it just feels like everyone is on a learning curve right now. Hopefully this is the start of things changing for me.
Moving forward now, I’m not 100% how things will actually work out as I don’t know if there is anything out there that can be commissioned to meet the crisis care goal. I guess this is where the broker will come in and be able to help find anything out there. It’s quite a slow process so far, we started in back in August and so I’m not sure when these things will be actually put in place. The only downside I think is that I feel under pressure not to use a&e, like I’m wasting resources. To be honest, like most people with mental health issues, the last place they want to go in a crisis is a busy a&e department, but what other option is there? It’s where we are told to go repeatedly when out of hours. I’m hoping that this will provide me with an alternative, but what if I’m incredibly suicidal, will the crisis place not also just tell me to go to a&e? Will this actually work? I guess time will tell, but my personal concern is that I won’t speak up in crisis because I don’t want to use resources that are above and beyond the budget. Will this end up in me just being actively suicidal and in a lot of danger? I guess only time will answer these questions.