Personalisation: Where are we going?

This post is by Mark Jukes Reader in Learning Disabilities at BCU - (technical problems are getting in the way of my being able to credit him properly)
SCHOOL NURSE TALKS WITH 14 Y.O. BOY

In mental health and learning disability nursing what does Personalisation mean and what impact does this new wave of ideology and policy have on nurses? 

In the context of mental health and learning disability services, Personalisation accommodates mental health promotion and maintenance: having choice and control over one’s life contributes to well-being. Personalisation is about meeting the needs of individuals in ways that work best for them,(Carr, 2008)

In specialist mental health and learning disability nursing there appears to be a number of competing paradigms in terms of how our clients are perceived.  For those nurses who suscribe to a psychodynamic/behavioural school of practice how does personalisation fit, when after all, Carl Rogers has influenced person-centred practice?

So if determinism is part of your frame of reference for therapeutic relationships, where does the concept of freedom of choice feature in the eyes of mental health and learning disability nurses, who are required to promote individualism,where a full range of psychosocial interventions can be delivered?

Skills need to be developed by professionals so that genuine person-centred assessments incorporating the person’s own view of their needs become the norm.

 

a father and son sit on the floor and talk

Supplementary prescribing is another area where in developing clinical management plans – concordance of medication is strongly advised from such prescribers, but where the client may see things differently in terms of personal choice and not wishing to endure adverse side effects!

Additionally, how can we apply the concept of person-centred practice across secure settings, in prisons and young offenders institutions? where a balance is required to be achieved between order and freewill. There are particular concerns about the management of risk in certain situations for people choosing to opt for a personal budget,(Spandler,2007).

In communities, individuals who attain either individual or shared tenancies and therefore become tenants not clients in residential care – how do we safeguard against vulnerabilities where the evidence clearly identifies hate crime on the increase for individuals who are vulnerable,yet perceived by society as having equal status and rights when living independently?

I suggest we need to take seriously the fact that personalisation is now in the mainstream and as mental health and learning disability nurses. As a Profession we need to decide how best to move forward with our clients whilst developing new ways of working  across agencies (such as housing consortias) whilst remaining responsive to possible negative effects on clients in a variety of situations and environments.

 References:

Carr S (2008) “Personalisation: a rough guide” SCIE, www.scie.org.uk/publications

Spandler H (2007) Individualised Funding,social inclusion & the politics of mental health.Journal of Critical Psychological Counselling,7 (1): 18-27.

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Comments

Personalisation has been around for a while now, however I do not feel it is being fully embraced by professionals and agencies. In learning disabilities there is often still the concept of welfare notion, where these people need looking after. The philosophy of personalisation has been swamped with various assessments and paperwork ontop of all the other documantation in care settings. I still feel the biggest challenge to people with a learning disability and mental health is about attitudes towards them. Not only from society but also from professionals and agencies working with them. Personalisation needs to be everyones value base.

As a student at university, I hear a lot of emphasis being placed on personalisation. I think that when the person-centred approach to care is understood then people may realise that this perhaps is the best way forward in terms of understanding those with learning disabilities or mental health issues. Being person-centred can be achieved and if it is consciously done by everyone, then maybe it will become the norm one day. However, as a professional striving to be person-centred the last thing you need is those working within the team not supporting or following through with personalisation. Hence, why I agree with Carl, stating that personalisation ‘needs to be everyone’s value base’. Unfortunately, and perhaps this is merely an excuse but, the common responsibilities and pressures of things such as keeping up to date with documentation is perhaps putting a strain on delivering or even initiating person-centred care. Perhaps if professionals and agencies realised the impact and effect personalisation had on people with mental health and learning disabilities, then perchance it may motivate them to make an effort to embrace and exercise the person-centred approach more in practice.

It is no surprise that personalisation has become very common nowadays but sadly it may be argued that some are still failing to see the importance of personalisation. I mean is there any point in (blindly) delivering care to someone who, given the time, chance and voice, can direct the professionals into helping them achieve their needs and goals in ways that work best for them?

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