Highlands service user expresses concern over personalisation push to independence

Personalisation aims to give people greater autonomy over care by giving them a budget to buy the services they want and manage their own care.

However, Heather Corpe, who suffers from obsessive compulsive disorder and is a member of Hug - an advocacy group for users of mental health services across Scotland’s Highlands - warns it may not be for everyone.

“We would all love to be autonomous. But do we all want complete control and independence? The answer for some people is no. They couldn’t cope with it.

“One of the features of mental illness is that we lose control. We lose the ability to make decisions. To think rationally. There’s no point talking about the goals we want to achieve when we can’t make a simple decision about what to eat or when to get up. When to do the shopping. How on earth then can we be asked to manage ourselves and support our needs?

“We are all different. Many people desire and need partners, guides and allies to give them advice and direction. Some of them want help to make decisions. They want help to manage their lives. For some people at some point in their lives greater autonomy can be the worst thing possible. What one person strives for may be another person’s idea of hell.

“Most of our decisions are made through consensus and co-operation. What pub to go to, for example. How to do things in the family home. Human beings are interdependent. Dependence and reliance is natural for people, but we live in an incentivised world obsessed with 'through-put'. The longer we need help the more expensive and inconvenient we are.

“What is the real aim of increased independence? If all people with care needs were able to get to a place of independence we would bankrupt the care system. In the rich western world only 23% of people get any help with their mental health illnesses. The vast majority don’t even qualify for care and those that do get what people think they need rather than what they need.

“When a person spends part of the day unable to answer the phone without crying or having suicidal thoughts, it is really difficult to imagine them managing their own care. Perhaps one day, but at the end of the day is it something they want to be burdened with right now? How much better to celebrate smaller steps than to push to the Holy Grail of independence?

“I can’t speak for everyone with mental health problems. But it isn’t enough to say self-directed support has the service user at the centre of the process – it has to follow through and give them what they actually need and want. For some that will mean not having self-directed support at all.”