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Presidential Address. Consultant Rehabilitation Psychiatrist at Guild Lodge Past Chair of Faculty of Rehabilitation Rehabilitation and Recovery Services for the 21 st Century The Recovery Movement and the Social Inclusion Agenda. Presidential Address. Sarah Davenport. Current situation .

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Presidential Address

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Presidential Address

  • Consultant Rehabilitation Psychiatrist at Guild Lodge

  • Past Chair of Faculty of Rehabilitation

  • Rehabilitation and Recovery Services for the 21st Century

  • The Recovery Movement and the

  • Social Inclusion Agenda


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Presidential Address

Sarah Davenport


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Current situation

  • Post de-institutionalisation

  • Post NSFMH and NHS Plan

  • Pre next cycle of “New Long Stay”

  • Up to the neck in the “Virtual Asylum”

  • Too many “OATS”


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Too many deficits and not enough strengths

  • Lack of a substantial evidence base since the TAPS Studies

  • Lack of Policy support (3 Functional teams but no rehab team)

  • The Forgotten Generation (RETHINK 2004)

  • The OATS scandal (Ryan 2004)


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Rehab services are strength based NOT deficits driven!

  • Optimism

  • Resist asset stripping

  • Resist closures

  • Become more political, now a Faculty

  • Champion recovery and social inclusion

  • Advocate on the evidence we do have


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Comparison of Ohio Recovery Outcomes and NICE

  • Encourage my independent thinking

  • “Discuss preferences, record advance directives.”

  • Treat me in a way that helps my recovery

  • “in an atmosphere of hope and optimism”


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Comparison 2

  • Treat me as an equal in planning my services

  • Collaborative working relationship

  • Give me the freedom to make my own mistakes

  • Service User preferences are central


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Comparison 3

  • Treat me like they believe I can shape my own future

  • The right to be fully informed and share in decision making

  • Listen to me and believe what I say

  • Write account in the notes and say what else is important


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Comparison 4

  • Look at and recognise my abilities

  • Include assessment of occupation status and potential

  • Work with me to find the resources or services I need

  • Comprehensive care co-ordination


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Comparison 5

  • Are available to talk to me when I need to talk to someone

  • Should be engaging and kind, in constructive partnership

  • Teach me about the medications I am taking

  • Clear and intelligible information,full discussion, choice


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Political Context for change

  • Social Inclusion (Mental Health and Social Exclusion Report 2004)

  • Respecting Diversity,BME Communities (NIMHE 2003)

  • The Recovery Movement


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A socially inclusive recovery based rehab service should…

  • Promote self management

  • Empower the expert patient

  • Value ethnicity and diversity

  • Value employment and activities to recover for…leisure, creativity, friendship networks and spirituality


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How should we do this?

  • 10 Essential Shared Capabilities (DH 2004)

  • Framework for workforce development

  • New Ways of Working (DH 2005) should be included in training and CPD

  • Skills sets for recovery and social inclusion


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Working in Partnership ESC 1

  • Develop and maintain constructive working relationships with lay people and the wider community networks


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Respecting Diversity ESC 2

  • Work in ways that respect and value diversity including age, race, culture, disability, gender, spirituality and sexuality

  • Understand the impact of prejudice on mental health services


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Practising ethically ESC 3

  • Recognise the rights and aspirations of service users and their families, acknowledging power differentials and minimising them wherever possible.

  • Demonstrating an understanding of the service user’s wider social networks and the contribution made by carers, family and friends to the recovery process


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Promoting Recovery ESC 5

  • Recovery is what people experience themselves as they become empowered to achieve a meaningful life and a positive sense of belonging to the community

  • Facilitate access to community groups and networks that enable service users to participate in community activities


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Questions about Service Structures

  • Is a specific rehab service necessary?

  • Should it be part of a CMHT?

  • Or should there be a specific rehab team?

  • Who should work with the “virtual asylum”

  • NHS v Private v Voluntary Sector ?


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A Family of Psychosis Services

  • AOTs

  • EITs

  • Rehab and Recovery Teams

  • Continuing Care Teams

  • Dedicated In-patient resources


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An inspirational story to close

  • Fiona’s Recovery


  • Login