Engaging with support services for your relative

The government has recognised that the provision of care should be integrated to ensure that all the persons needs in relation to medical care, social support, housing, occupation and finances can be addressed together and regularly reviewed as the situation changes. It acknowledges that people have varying needs and that support required may become more or less intensive over time.
The move away from institutional care and towards care in the community has meant that increasingly, health and social care is provided jointly by the two services (the local Health Authority and Social Services Department) working together to provide a package of care. In some cases other agencies such as the probation service or local housing department will also be involved.

Who provides Services?

Health and local authorities have developed their joint working relationship through Community Mental Health Teams (CMHTs) These may involve psychiatrists, clinical psychologists, Community Psychiatric Nurses (CPNs), social workers occupational therapists and others who develop a Care Plan for the person using services. The local GP should also be involved.

The care plan should identify the needs of your relative and make arrangements for meeting them. There is a requirement that a key worker / care coordinator should be named in the care plan.

Care Coordinator
This person acts as a link between the team and the person for whom they are caring and where possible for the informal carer.

The care coordinator is therefore likely to be the most effective point of access to the services. It will be important to know who the key worker / care coordinator is and how far it is possible to develop a good working relationship. Ideally this relationship would include your relative, yourself as informal carer and the care coordinator - this is not always easily achieved as the care coordinators professional obligation is to meet the needs of your relative. This means that if your relative prefers not to have you involved, the care coordinator is unlikely to communicate with you about your relative on grounds of confidentiality.

New & recent services

New types of services are being developed to address different problems and situations; for example

  • home treatment should be available as an alternative to hospital admission -this is often suitable for people who might have problems coping in the environment of a hospital ward
  • crisis teams might provide support to people in their own homes, offering a fast response, available around the clock
  • crisis places may be available as an alternative to hospital in-patient care, in 'crisis homes' which can provide a safe and acceptable environment
  • assertive outreach services may offer intensive support to people who are likely to lose contact with the mental health services

Actions you can take

Where a full range of services is not available, you may want to take action to improve the situation. Suggestions include: 

  • being proactive in identifying those needs which your relative has that are not being met by existing services - you should be assertive in alerting the care coordinator to those unmet needs
  • participating in any initiatives your local authority plans for involving people with mental health problems and their informal carers in developing mental health services
  • joining forces with voluntary agencies such as Rethink or MIND where they have support workers or development workers, in order to press for implementation and development of services
  • acting collectively with other informal carers to lobby your MP and/or Councillors to maintain and improve services
  • using the established complaints procedures to seek redress and improve the quality of services.