[Robin Murray-Neill]

"My view? Income will drop with DLA cuts, & healthcare will increase with Direct Payments. You'll get care, you'll lose petty cash.With the loss of petty cash everything will have to be hugely pre-planned. You'd lose freedom, spontaneity & independent choice."

I understand those concerns, there is evidence of some local councils appearing to want to take a step back from mental health services and leave it to the NHS. However there are some very encouraging examples of creative thinking about introducing peronal health budgets alongside direct payments for social care and whilst direct payments for personal health budgets can only be made by a very limited number of trusts presently (whilst the personal health budget pilots are running) it is quite clear from the recent mental health strategy 'No Health without Mental Health' that personal health budgets will become available within mental health services.

One of the best examples to date is the work done by the MerseyCare Mental Health Trust who introduced recovery budgets which were admisitered through a local third sector organisation (so were not actually direct payments and which enabled people to make very significant changes in their lives).

[Robin Murray-Neill]

"Coz it's just too complicated to think about. Sometimes I can't even remember my own name let alone try to sort direct payments..because of the process you have to go through to get them I would imagine #pullingteeth"

"made lots of enqiries re direct payments but CHMT have little understanding of how they work..seems too complex"

First of all it should not have to be complicated or any more difficult than accessing a mental health service ordinarily (although I appreciate even that can be a trial). Contacting the local direct payments support service can make all the difference because in many cases they are funded to support people through the complexities of doing this. The direct payments guidance is quite clear that adequate support needs to be made avaialable to people to enable them to be able to consider direct payments where they are eligible to receive them. Local advocacy or peer support groups are often the best way of trying to resolve the difficulties that people experience as we have heard elsewhere on the forum today it is far too often made difficult for people.

[Peer - Rethink]

Another question just in from Twitter:

“I feel that having a dog would really help my mental wellbeing, and having read a bit about direct payments in the papers, I was wondering how flexible they are. Could I use them to help me get and look after a dog, as I feel this would help me be more comfortable about going out (I sometimes have agrophobia) and also it would be nice to have a pet in the house.”

[Robin Murray-Neill]

In our area, the CMHT staff do not understand direct payments, therefore patients at risk miss out. " - From Twitter

It is really not acceptable. The duty to make direct payments came into force in April 2003 and clearly included people who use mental health services and support. Training for CMHT staff on direct payments should be standard and there should be a responsible person within every mental health trust who can support people where, for what ever reason, their care co-ordinator is unable to do so. It might be worth asking who that person is or else, as I mentioned earlier on the forum, going through the local direct payments support service, local advocacy or peer support groups or contacting the council's direct payment/self directed support officer directly.

[Robin Murray-Neill]

“I feel that having a dog would really help my mental wellbeing, and having read a bit about direct payments in the papers, I was wondering how flexible they are. Could I use them to help me get and look after a dog, as I feel this would help me be more comfortable about going out (I sometimes have agrophobia) and also it would be nice to have a pet in the house.” - from Twitter

There are already a number of examples of people who have purchased dogs using their direct payments, generally to help overcome isolation and loneliness. So, there is no reason why, if you were assessed as requiring support for those reasons, this couldn't potentially be an option for you. There is a DVD produced in 2008 which includes the story of a person who bought a dog with direct payments whilst using mental services in Rotherham.

[Robin Murray-Neill]

"Reasons: 1. Bureaucracy. 2. DPs can = rationing (for every happy DP recipient are 10 who get zilch).3.Burden of responsibility." - from Twitter

The numbers of people who use direct payments have increased dramtically over the years, but unfortunatley it hasn't increased across the board. It will appear to people in some areas that people are not able to access direct payments, however this does not mean that the system itself has to be operated in a way which means only one in ten people can only get a satisfctory direct payment. It is just taking far too long!

Whilst I am keen to see direct payments available as an option to all those who are eligible to receive them, on the other hand it is quite clear that direct payments are intended to provide people who wish to use them with an altenative but there must also be support services that people can choose that do not require them to take on a direct payment. The responsibility should not have to be taken on by everybody. It should be an individual choice.

If you feel that the burden of responsibility relates to employing someone, there are options for using direct payments which don't involve becoming an employer, such as using agency staff, or using the money in other ways.

[Robin Murray-Neill]

"Direct payments have really improved my life. i'm gaining confidence, self esteem, and my depression has really improved." - From Twitter

Thank you very much for taking the trouble to demonstrate that where people are able to access direct payments the huge difference and benefit they can make. It is so important that those of us who have knowledge and influence in these matters, particularly strong third sector organisations such as Rethink Mental Illness, Mind and Together, continue to highlight the failure of so many local councils and NHS organisations to make direct payments the standard option that they should have been since 2003.

[Peer - Rethink]

New message from Twitter:

"3 carers for son, one of whom is s/e. Use payroll service, but feel rather alone with process. Audit time is a royal pain. If payroll service sent docs to auditors I'd only need to send bank stmnts & invoices from s/e carer. Freedom to recruit one's own carer is only great if you already know who to recruit. Otherwise it is a very lonely place. had diff spending son's ££, then spent £££ over the Summer (crisis time). Audit picks up earlier low spend & have to return ££££"

[Robin Murray-Neill]

New message from Twitter:

"3 carers for son, one of whom is s/e. Use payroll service, but feel rather alone with process. Audit time is a royal pain. If payroll service sent docs to auditors I'd only need to send bank stmnts & invoices from s/e carer. Freedom to recruit one's own carer is only great if you already know who to recruit. Otherwise it is a very lonely place. had diff spending son's ££, then spent £££ over the Summer (crisis time). Audit picks up earlier low spend & have to return ££££"

As your experience indicates there are some payroll and support services that offer some people more comprehensive support than others. You may want to speak to your council to see if there is any further support available to you. A number of support services offer very good support right throughout the recruitment process and have enabled people to employ people they didn't know but who have proved to be extremely valuable supporters.

As you indicate where this is not in place or people are not properly informed about it, it can be a very lonely place.

The last point you make is very important indeed, since it indicates that the local council are not taking into account the fluctuating nature of mental health problems. This amounts to discrimination. At the very least, people should be asked if there is any reason why they have an underspend and the money should not be reclaimed where there are legitimate reasons for keeping it in reserve to meet precisely the needs it was given for in the first place.

[Robin Murray-Neill]

A last question from the web form from 'Kazzhunter': Your question: 24 years of suffering depression with no help from the government, have never heard of direct payments or recieived any, is there any financial support available to me. Thankyou

It will dependent on whether or not you are in contact with your local mental health services and receiving support from them as direct payments are not additional money, they are money made available in place of a service you are otherwise receiving.

[Sarah - Rethink]

Kazzhunter: please do contact the Rethink Advice & Information Service either by e-mailing advice@rethink.org or by calling 0300 5000 927 Monday to Friday 10am until 1pm. We can offer practical advice about the services and support that may be available to you.

You can also read a lot of useful information in our suite of factsheets: http://www.rethink.org/factsheets

[Peer - Rethink]

Alas we have run out of time but Thank you to Robin and Sarah for taking the time to answer some our questions; Robin has told me that he is more than happy to answer more questions after this session which you can send to him by using the form at http://www.rethink.org/dpwebchat

Remember Rethink Mental Illness has a lot of information on the website about managing your finances and what to do if you find yourself in debt by visiting:

http://www.rethink.o...http://www.rethink.o...http://www.rethink.org/living_with_mental_illness/money_debt_benefits/index.html

Thank you everyone for taking part!

[Robin Murray-Neill]

Thank you to everyone who has taken part and also to all of you who have observed but perhaps didn't have a question to ask this time. It's been a pleasure.

If you do think of any further questions, please do post them here or send them via the online form Peer has mentioned.

Best wishes to you all,

Cheerio!

Robin

[christhegoth]

Robin Murray-Neill, on 24 October 2011 - 02:13 PM, said:

"My view? Income will drop with DLA cuts, & healthcare will increase with Direct Payments. You'll get care, you'll lose petty cash.With the loss of petty cash everything will have to be hugely pre-planned. You'd lose freedom, spontaneity & independent choice."

I understand those concerns, there is evidence of some local councils appearing to want to take a step back from mental health services and leave it to the NHS. However there are some very encouraging examples of creative thinking about introducing peronal health budgets alongside direct payments for social care and whilst direct payments for personal health budgets can only be made by a very limited number of trusts presently (whilst the personal health budget pilots are running) it is quite clear from the recent mental health strategy 'No Health without Mental Health' that personal health budgets will become available within mental health services.

One of the best examples to date is the work done by the MerseyCare Mental Health Trust who introduced recovery budgets which were admisitered through a local third sector organisation (so were not actually direct payments and which enabled people to make very significant changes in their lives).

Interesting. I think Direct Payments are great. But teh money is ring-fenced, and cannot be spent without receipts being kept in Croydon. And you have to declare everything. That would be fair enough for Care you need, as it is a medical thing.

DLA did not require receipts. So myself and the many others with Lower Rate Care are really in danger of ending up with less disposable income at present. Which will have a huge impact on the quality of our lives, as we are already mostly poor. Losing £20.00 per week is a very big deal. That's heating money, repairs to the home, the sort of stuff you can't really predict for a Direct Payment claim.

It's also a Social Life. Which is hugely important to our well-being. And it will be gone under PIP.

So much as I think Direct Payments are great the need for receipt makes Direct Payments a benefit for the supply of Care and Services only. You can't really use it for regular Socialising down the pub, or a bite to eat in a cheap restaurant with a friend, or a visit to the cinema ( say 1/ week, which is all £20.00 is really ). Where-as DLA does help with that. And helps keep your well-being up due to that.

The Govt needs to stop hitting the poorest, and start taxing the richest more.

[Peer - Rethink]

christhegoth, on 24 October 2011 - 02:20 PM, said:

Interesting. I think Direct Payments are great. But teh money is ring-fenced, and cannot be spent without receipts being kept in Croydon. And you have to declare everything. That would be fair enough for Care you need, as it is a medical thing.

DLA did not require receipts. So myself and the many others with Lower Rate Care are really in danger of ending up with less disposable income at present. Which will have a huge impact on the quality of our lives, as we are already mostly poor. Losing £20.00 per week is a very big deal. That's heating money, repairs to the home, the sort of stuff you can't really predict for a Direct Payment claim.

It's also a Social Life. Which is hugely important to our well-being. And it will be gone under PIP.

So much as I think Direct Payments are great the need for receipt makes Direct Payments a benefit for the supply of Care and Services only. You can't really use it for regular Socialising down the pub, or a bite to eat in a cheap restaurant with a friend, or a visit to the cinema ( say 1/ week, which is all £20.00 is really ). Where-as DLA does help with that. And helps keep your well-being up due to that.

The Govt needs to stop hitting the poorest, and start taxing the richest more.

Robin replies:



My apologies, I answered the question from a different perspective than you asked it.

Direct payments have been around since 1997 as an alternative way of meeting assessed needs, and are not a Benefit payment or related in any way to the reduction in DLA, which will certainly hit those with least money and inevitably affect well-being for the reasons you give.

Direct payments do have to be accounted for (how this is done varies between councils) and the principle has always been that they are available to meet identified needs following an assessment by a care co-ordinator. However, many people do use direct payments to give them access to a social life, including meals out and going to entertainment like the cinema, in fact it is probably the aspect of people's needs most usually met through direct payments because, as you say social activity meets so many other needs we have.

So I agree with what you say about DLA, and just wanted to clarify that direct payments are not in some way supposed to replace or make up for this decrease in income, they are a quite separate thing.
Very best wishes,

Robin.