In 2001, the Workforce Action Team [WAT], set up to consider the workforce implications of the Mental Health National Health Service Framework, [MHNSF] and the NHS Plan [NHSP], commissioned and received two pieces of work: the Capable Practitioner Framework [CPF] and the Mapping of Mental Health Education and Training in England.
The shift in culture in services towards Choice, person-centeredness and mental health promotion is a key imperative. People who use services and their families continue to report not being listened to, being marginal to assessment and care planning and being rendered helpless rather than helped by service use. Tragic events, evidenced by the Bennett inquiry, illustrate that there is a significant need to ensure that all staff have training in what is described here as the Essential Shared Capabilities [ESC].
The Aim of the ESC is to set out the shared or common capabilities that all staff working in mental health services should achieve as a minimum as part of their pre-qualifying training. Thus the ESC should form part of the basic building blocks for all mental health staff whether they be professionally qualified or not and whether they work in the NHS or social care field or the statutory and private and voluntary sector.
In 2003, a national steering group was established to guide the development of the ESC (see Appendix C). The ESC were developed through consultation with service users, carers, managers, academics and practitioners. To facilitate this process, a number of focus groups were held across England in order to sample opinion and seek feedback. In the main, they have what might be termed an "outward focus" and are explicitly and deliberately centred upon the needs of service users and carers.
The Ten Essential Shared Capabilities for Mental Health Practice.
1.Working in Partnership. Developing and maintaining constructive working relationships with service users, carers, families, colleagues, lay people and wider community networks. Working positively with any tensions created by conflicts of interest or aspiration that may arise between the partners in care.
2.Respecting Diversity. Working in partnership with service users, carers, families and colleagues toprovide care and interventions that not only make a positive difference but also do so in ways thatrespect and value diversity including age, race, culture, disability, gender, spirituality and sexuality.
3.Practising Ethically. Recognising the rights and aspirations of service users and their families,acknowledging power differentials and minimising them whenever possible. Providing treatment andcare that is accountable to service users and carers within the boundaries prescribed by national(professional), legal and local codes of ethical practice.
4.Challenging Inequality. Addressing the causes and consequences of stigma, discrimination, social inequality and exclusion on service users, carers and mental health services. Creating, developing or maintaining valued social roles for people in the communities they come from.
5.Promoting Recovery. Working in partnership to provide care and treatment that enables service users and carers to tackle mental health problems with hope and optimism and to work towards a valued lifestyle within and beyond the limits of any mental health problem.
6.Identifying People’s Needs and Strengths. Working in partnership to gather information to agreehealth and social care needs in the context of the preferred lifestyle and aspirations of service userstheir families, carers and friends.
7.Providing Service User Centred Care. Negotiating achievable and meaningful goals; primarily from the perspective of service users and their families. Influencing and seeking the means to achieve these goals and clarifying the responsibilities of the people who will provide any help that is needed, including systematically evaluating outcomes and achievements.
8.Making a Difference. Facilitating access to and delivering the best quality, evidence-based, values-based health and social care interventions to meet the needs and aspirations of service users and their families and carers.
9.Promoting Safety and Positive Risk Taking. Empowering the person to decide the level of risk they are prepared to take with their health and safety. This includes working with the tension between promoting safety and positive risk taking, including assessing and dealing with possible risks for service users, carers, family members, and the wider public.
10.Personal Development and Learning. Keeping up-to-date with changes in practice and participating in life-long learning, personal and professional development for one’s self and colleagues through supervision, appraisal and reflective practice.
* 'Focusing on the core significane of hope and optimism. Being met with hope and optimism, especially at the initial contact, is of central significance in many people’s accounts of recovery, and ‘offering help, treatment and care in an atmosphere of hope and optimism’ is the first and overarching principle in the NICE clinical guidelines (National Institute for Clinical Excellence, 2002: 1.1.1.1). This has implications for staff selection and training to enable them to foster hope-inspiring relationships (Box 3) and exhibit recovery competencies (see Box 5).
Box 3 Dimensions of hope-inspiring relationships
(from Repper & Perkins, 2003)
1 Valuing people as human beings
2 Acceptance and understanding
3 Believing in the person’s abilities and
potential
4 Attending to people’s priorities and
interests
5 Accepting failures and setbacks as part of
the recovery process
6 Accepting that the future is uncertain
7 Finding ways of sustaining our own hope
and guarding against despair
8 Accepting that we must learn and benefit
from experience
Box 5 New Zealand guidelines on recovery competencies for mental health workers (adapted from
O’Hagan, 2001, with permission)
A competent mental health worker:
1 understands recovery principles and experiences in the national and international contexts
2 recognises and supports the personal resourcefulness of people with mental illness
3 understands and accommodates the diverse views on mental illness, treatments, services and recovery
4 has the self-awareness and skills to communicate respectfully and develop good relationships with
service users
5 understands and actively protects service users’ rights
6 understands discrimination and social exclusion, its impact on service users and how to reduce it
7 acknowledges different cultures and knows how to provide a service in partnership with them
8 has comprehensive knowledge of community services and resources and actively supports service
users in accessing them
9 has knowledge of the service-user movement and is able to support its participation in services
10 has knowledge of family perspectives and is able to support the family’s participation in services. `*
Box 3 Dimensions of hope-inspiring relationships
(from Repper & Perkins, 2003)
1 Valuing people as human beings
2 Acceptance and understanding
3 Believing in the person’s abilities and
potential
4 Attending to people’s priorities and
interests
5 Accepting failures and setbacks as part of
the recovery process
6 Accepting that the future is uncertain
7 Finding ways of sustaining our own hope
and guarding against despair
8 Accepting that we must learn and benefit
from experience
Box 5 New Zealand guidelines on recovery competencies for mental health workers (adapted from
O’Hagan, 2001, with permission)
A competent mental health worker:
1 understands recovery principles and experiences in the national and international contexts
2 recognises and supports the personal resourcefulness of people with mental illness
3 understands and accommodates the diverse views on mental illness, treatments, services and recovery
4 has the self-awareness and skills to communicate respectfully and develop good relationships with
service users
5 understands and actively protects service users’ rights
6 understands discrimination and social exclusion, its impact on service users and how to reduce it
7 acknowledges different cultures and knows how to provide a service in partnership with them
8 has comprehensive knowledge of community services and resources and actively supports service
users in accessing them
9 has knowledge of the service-user movement and is able to support its participation in services
10 has knowledge of family perspectives and is able to support the family’s participation in services. `*
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