Case Studies
One of the best ways of finding out the truth about direct payments is to hear from people who how have already experienced the process.
Below are a number of case studies from service users who have experienced direct payments. Hear if these service users have found direct payments to be a positive thing or indeed if they choose to get there care from a more traditional route.
Case Study One
I have been living with Rapid Cycling Bipolar Disorder for fourteen years. This had meant regular spells in hospital, most of which have been under a section of the mental health act. From the first time I was sectioned I never could bring myself to trust my workers enough to tell then what I was thinking for fear of being hospitalised again, unfortunately this resulted in the admissions being more regular because I quite often missed the warning sighs and with my illness being so fast acting unmanageable symptoms soon followed.
Seven years ago I was heavily involved in the service user movement and attended lots of meetings with both mental health service users and professionals as high up as chief executives. Although still regularly unwell, I found that after an episode or admission I could return to work quite quickly, which gave my life some quality. I was a very confident and articulate person. I devised and carried out a survey into the quality of the Care Programme Approach, which became nationally recognised as an excellent monitoring tool and even had two pieces of work published in psychiatric journals. Unfortunately this all stopped when four years ago I had a major episode that resulted in yet another admission to hospital under a section 3.
This time when I came out things were very different. I lost all confidence. I had to stand down from the work I was doing. I found I couldn't even write because of a fear that someone might recognise me in my writing and I certainly couldn't go to meetings. I felt that I had failed in my work and more importantly in my life. I didn't leave the house for more than two years, other than even more hospital admissions.
Somehow I knew that the old me was still inside me somewhere, but I didn't have a clue where to find her. I spent many sessions with my workers trying to regain my confidence but never came close to managing. One day I told my CPN that being with my friend was the only time I came anywhere close to feeling safe or even OK, but how I felt guilty for taking up so much of her time and interrupting her life. We worked out together that if I could pay my friend and turn her time with me into some kind of job I would feel less guilty.
Together my CPN and I looked into Direct Payments, at the time these were new to Mental Health services. My CPN carried out the necessary assessment, filled in the paperwork and I was given 12 hours a week to pay my friend, now my Personal Assistant. Getting Direct Payments has completely changed my life and in my opinion saved it. I spend my time with my PA in many different ways. On bad days, which I still have, we simply stay in the house, but instead of sitting in front of the telly or staring into space we play games or make cards, things I have always enjoyed in the past but lost all motivation for. On better days we go out, sometimes carrying out mundane but essential tasks like shopping and sometimes for pure pleasure like walking the dog or popping to a garden centre. I have been able to go back to church again something I had to stop when I isolated myself in the house. More recently I have even managed with the support of my PA to carry out some tasks that two years ago would have been impossible. I have been on a course and learnt how to build websites, which I now built and manage four of them. Also with my PA at my side I have even managed to speak publicly at two mental heath training events. Finally last year with an additional Direct Payment for respite, taking my PA with me, I was able to go on a short holiday, something it has not felt safe to do for over ten years. But to me the most important and dramatic change has been the management of my illness. My PA was and is still foremost my friend and therefore posses no threat in my mind when it comes to being sectioned, therefore when I am becoming unwell I am able to tell her what I am thinking, she also knows me well enough to spot the warning signs well before I can. Having her to talk to in a natural, run of the mill way had illuminated the stress caused a structured session with a worker. My PA and I then talk to my workers together again causing me less stress. Less stress means that instead of escalating my condition, it can be dealt with in a more manageable way. During the last couple of years I have had two relatively major episodes, but my PA's hours have simply been increased to cover these periods and I have been able to stay at home.
The quality of my life is the best it has been for the fourteen years of having this illness, and as I speak now I have not been in hospital for coming up to two years, compared with admissions of up to three times a year this has been an amazing achievement, largely down to the benefits of receiving Direct Payments.
Case Study Two
Living alone in a rural area with depression I realised I needed some support as the feeling of isolation was making my depression worse. I was referred to the Community Mental Health Team where I was assessed as needing social support to help me reduce my feelings of isolation, lack of confidence and self worth. It was agreed that a Community support worker would visit me at home for 2 hours per week. Unfortunately this didn't work well and within a few months I became more anxious when the Community support worker was visiting because I felt overwhelmed with someone I didn't know and they were also inflexible and unreliable. After a meeting with my care co-ordinator the service stopped on my request and I was then informed about Direct Payments. I became very interested and realised that I could have choices about how I could use my Direct Payment as long as it met my requirements. I thought long and hard about what I felt would help me to reduce my feelings of isolation and get me out to socialise even if this meant passing someone in the street to say ‘hello' or talk about the weather. I discussed this with my care co-ordinator and I came up the idea of owning a dog
It was discussed with the direct payments Team and it was agreed that I would receive a direct payment in order for me to buy a dog. I know where I wanted to go to purchase the dog, from the RSPCA and got as much information as I could about my responsibility and the RSPCA were very informative. I chose (dogs name and breed)and we have been together for some time and it's working out great. I feel less isolated I go out for walks and it encourages me to speak to people he gives me confidence and of course is a great companion. I have started to improve and I'm on my way to recovery. Direct Payments gave me the opportunity to buy my social care needs that I could never have received through in-house services.
Case Study Three
I've suffered from mental health problems for some time now…..I just couldn't be bothered about myself…. Or anything else for that matter
I didn't want to know about mental health service and day centres…. Its just not me !!!!
Then one day my care co-ordinator told me about Direct Payments. I liked the idea because it would let me do more everyday things… and I definitely needed something to get me out of there… In the real world…and get me fit again. I also wanted to learn about computers…but I didn't have the confidence to go to a class and learn. So I had a word with my care Co-ordinator… and with a direct payment…I bought a bike and a computer.
Now I go cycling…. Meet lots of people and feel a lot healthier. Along with this my confidence in my own abilities is increasing all the time and I can see a job in the computer world being a real possibility in the future
I suppose direct payments is part of the mental health service.. But I see it as a positive way for me to become a normal person… able to do Normal things again. enjoying life again.
