Carolyn Lochhead explains why SDS isn't working for people with mental health issues and what needs to be done to change that
There are good policy ideas and there are bad policy ideas. But more often, there are good policy ideas not implemented as well as they should be: like Self Directed Support, usually known as SDS.
SDS is a good idea. As most TFN readers will know, it’s a way of giving people who need social care more control over how the money spent on their care is used. People can choose from a menu of options, ranging from managing a budget themselves to the more traditional route of receiving a service chosen by the local authority.
SDS is clearly working well for some people, but it isn’t for people with mental health problems, who make up just 5% of those receiving SDS. It’s a figure that hasn’t shifted much in recent years: relatively few people with mental health problems have ever been well served by this policy.
Last week, a report by Audit Scotland found while many people have benefited from SDS, integration authorities still have a lot to do provide this for everyone. In particular, it reported that people with mental health problems may experience less choice and control over the way they receive social care services, and noted that this group often requires more flexible support.
And that’s certainly the view of SAMH. In our experience, social care is still mostly based on providing a certain number of hours of support per week; not on helping people achieve their goals. People with mental health problems can be well for weeks then extremely unwell for a while. So it makes no sense to tie people into weekly hours of support.
What we want to see is care packages focusing on outcomes, not hours, so people whose mental health fluctuates can have more support when they need it and less when they don’t.
Ahead of this year’s local elections, SAMH called on councils to make self-directed support work for people with mental health problems.
We asked councils to:
- focus on achieving outcomes with people, not carrying out tasks
- allow annualised contracts so that people with mental health problems can receive support when they needs it, not when the council says they should
- find ways to involve third sector providers or primary care staff in assessments
Audit Scotland’s report has generated a fresh wave of discussion about SDS, so we hope government and policymakers will take the opportunity to look again at these ideas. There is a real chance here to give people experiencing mental health problems a better, more personalised, more effective and in some cases less costly service. Being able to access the support you need, when and only when you need it, would be a real step forward.
SDS is a good idea. Let’s make it work in practice as well as on paper.
Carolyn Locchead is public affairs manager at SAMH