What I think might be useful though is to set out what the environment is like in Leeds from the birds eye perspective I have here at Information for Mental Health. It is of course, my birds eye perspective though and I’m not sure I’m party to all the facts. But its a fuzzy enough overview to give something of a picture.

There have been sweeping Health cuts – they hit the Voluntary Sector first and the much deeper evidence of how they are and will continue to effect the Primary Care Trust themselves is still being revealed. Now we’re on the cusp of the Social Care cuts.

its a little strange that I find we are talking about Health cuts and Social Care cuts. Not re-organisation or re-configuring. I’m not sure if I’ve become so subsumed by it myself or if this is the language that everyone within HealthCare is talking.

And its not that I am in denial about the need for cuts or saving money. My issue is that the focus has gone straight there. And with that, all anyone can see or hear or feel is this terrible sense of chop, chop, chop. Now I have an almost unconscious image of a Commissioner with a big set of pruning shears sat somewhere waiting for me to show my branch and leaves.

I’ve put forward to Leeds Mental Health Commissioners my vision for how Mental Health information should be delivered in Leeds. My view is for an effective networked technical integration and a strategic development plan factoring in the digital technology and social media field. This would save money in the first instance and then would go on to provide a firm basis for building social capital, engagement and setting some kind of standardisation for telehealth and mobile health to plug into in the near future. But it doesn’t actually involve any cuts.

And that is a scary thing to do, because there is a general sense, an unspoken sense that if you put yourself in full view. CHOP.

I’m not sure that this is a correct view. In fact I think more of the Commissioners I know than that, and rationality tells me this is not any kind of solution that anyone will make. My primal fears however, prick a little and I’m tireder and find it much more energy consuming to keep those fears at bay to do the good, clear thinking we need in HealthCare right now.

I’ve made a few inferences from this about what will be happening Nationally – I think that fear and its draining nature its and will continue to take its toll. The more that focus can be put in a way that helps HealthCare to think about future flourishing and how best to prepare for that in the current climate, the better. The more it can be taken from thinking simply ‘cut, cut, cut’, the better.
Personally, I’d like to hear everyone getting more real, constructively.

The Adult Social Care  and Primary Care Trust Commissioners take the requirements of Local & National Government objectives at Service Delivery level (in say; lowering obesity in under 18′s) and use these to inform the services they commision.  The Health care sector is made up of Statutory Social Care Services, Statutory Health Care services, Voluntary Sector services and a smattering of ‘Other’ types of services.  These differing service providers have been around for a varying amount of time and came into being for a variety of reasons.

The non-profit or voluntary sector came from a socialist perspective – the amount of ‘leftie-ism’ varies from organisation to organisation.  They often grew ‘grass-roots’ from the gaps left by statutory services.  They were often started by the people experiencing those gaps in a very DIY way. They complimented and challenged those unwieldy systems and many of them grew to be major service delivery players.  They obtained money where available, often bypassing local contracts.  Some became at least partly, sustained by effective business models.  Others offering a much more philanthropical approach to their delivery.

They came from a different direction.  They weren’t by their very nature used to ‘being told what to do’ by health and social care commisioning.  In fact, they existed because, quite often, they had decided to do something ‘they weren’t supposed to do’ somewhere along the line.  The question ‘Who commissioned you to deliver your service?’ could only be answered by ‘service users’

But that was in the old days (although with Personalisation we can start to really say this again – but that’s a whole other story)

What interests me; is that this sector now is bound by the same commissioning conventions as the statutory sector.  Which includes being de-commissioned.

Of course there is a way round this for any non-profit sector organisation.  They need other sources of income.  They need to be business minded.  Actually, they needed to realise this some years ago and start to do something about it.   But to a large degree people didn’t go into the non-profit sector with business expertise.  Why would they? Invariably they brought a plethora of skills, talents and abilities, sometimes business minded but in many ways, not.

The organisations that responded well and effectively to the new contracting service model realised a need to become competitive and business focused.

Now, as the economy tightens its belt in an ever micro-fashion it is becoming increasingly clear who are the non-profit organisations that have chosen to invest their resources in developing business and market expertise and those who have not.

Cuts, closures and mergers look set to be on their way.

I’m not entirely convinced that the loss of organisations that weren’t able to recognise the gap of business ability and ensure it was met is necessarily a bad thing.  If service users are valued as the important thing then ensuring economic viability to meet their ongoing needs has to remain paramount.

Unsurprisingly, at the same time digital platforms have been engaged in how to best monetise what they do – often tied in with issues such as advertising, piracy, and privacy. These are a unique set of delivery tensions on regulation and use but a cross over of principles from a market perspective, have correlation to the social sector, non-profit start-ups and where they find themselves now.

Somewhere beyond what are health services currently and where digital health services will come to exist lies an effective business model.  I suspect that this where the next wave of Health 2.0 will arrive at in a very short space of time.

Increasingly it feels as if the way forward is to begin dialogue with the Department of Health (I use this a little as a blanket term to denote HealthCare in it’s broadest sense) Health service users (for me specifically I mean mental health service users but you get the idea) and existing Digital Platform providers (from outside of healthcare).

Perhaps this has already begun but it is so new I haven’t discovered it yet – or perhaps it is about to happen.  Either way.  I’ve bought a one way ticket for that destination.

A vision that four years ago was indistinct to most is becoming tangible in its possibility.

At exactly the same time and at what feels like an almost matching pace the ground from which this thinking sprang from is shifting.

This is because of the prevailing winds; political change and economic bootstrapping.

Much discussion is rolling around the internet hang outs of the Health 2.0 crowd.

The gist of which I read as;

How do we implement workable, connected social media & digital tools for our healthcare users?

As well as; How do we research how those users integrate with this way of working?

And; How do we do that within a healthcare system? (I’ll let you fill in the adjective blanks about the health care system that is relevant to you, global reader)

The answer to which I perceived as thus;

Please continue with high concept thought and application but also, come to ground level.  Work with a set of health care users with a specific problem/issue.

For example; Mental health service users with severe mental health problems based on psychiatric wards.  Support them to define their needs and tailor a digital network that enables peer support.  Identify the needs of the staff in administering that digital network.  Build in Research and Evaluation.  And quite simply; watch what happens next.

(I use this ‘group’ as an example, but take any ‘group’ you like and try it – the results of ‘tailoring-up’ will define what those engaged in developing digital healthcare, need to do next)

And that has been my intention and increasingly, well received wisdom*

I’m not at Ground level.  I am an ex-front-line worker from within the wider community and specific mental health services.  I started there and now with a bird’s eye view of the system; I have fingers in all the pies.  Service users leads, frontline worker needs, service delivery functions, local strategy, national policy and any other aspect of that system.

My point being – its straight forward from this place to see a way to bridge between direct level application of social media and digital technology within mental health and the conceptual and online development of the systems, resources and skill levels to support and facilitate its growth.

What I’m no longer sure of is if I will be ‘allowed’ to begin actuating that work.  And bizarrely it’s really nothing to do with anything other that what is a backdoor way of statutory services defining what is a ‘useful’ application of my mind and time.  Which is a little surprising to me.  Having made the (considerable pay) concession to work within the non-profit sector in order to have full exercising of said mind and time.  And if that perk is disappearing – what does that really mean?  For the big picture and for myself?

* don’t just take my word for it – Jim Symington of the National Mental Health Unit – The Improving Mental Health Care Pathways programme described after in-depth conversation this way of working as both ‘StarTrek’ (which I like) and ‘A walking New Horizon’s Service’

In-between I’ve been trying to find a starting point.  By December 2009 I had moved to the belief that I was in a Circular Invention that would not by it’s own defintion allow that starting point.  I wondered if I should give up.

In January 2010 I decided to stand outside the Circle.

Examining the blueprint of an online model of healthservice (devised around a non-profit creative wellbeing real world service) has led me to an understanding of the need for a new Business Model. One that draws together the Department of Health, social media platforms and wellbeing & mental health service users.
I suggest this as the Business and Market foundation  to physically build an online infrastructure that is an unbiased framework to house all current, new and future digital health information and services.  Offering a way in which navigation of pathways of health for individuals and services in the first instance and in the second instance as a way to share good practice and procedure grounded in wellbeing principles.

In the end – my goal is to see a new kind of service supported by this infrastructure.  One which individuals enter and collaborate in a shared space – creating (for example)  online art together as a group might in a real world service and developing the digital skills at their own pace to create their own wellbeing applications to be used by themselves and other peers within this online infrastructure.  And to see the fusion of the digital industry and mental health & wellbeing sector – leading to a new generation of digital health workers and digital health service users.

I was a little nervous to see what I’d actually been twittering about all this time!

But it turns out to be relevant, phew!

mindyourheadleeds:

Freshers’ Week is over and as usual campus was absolutely buzzing. Free pizza, medieval swordsmen, a game called ’spot the gay’, someone to throw wet sponges at (sorry mate..), cheerleaders, token sweets and pens, a not so token hypnotising dog, it was all happening! The girls on the committee did a brilliant job of promoting the The Mind Matters Society and signing up new members on Wednesday. Along with this, one of my highlights was undoubtedly the Counselling Centre’s promotion on Thursday and Friday.

I’d had a phone call off one of the lovely Counselling Centre ladies a couple of weeks before saying that they were thinking of putting a bed in the freshers’ tent and needed someone to occupy it. At first I thought it sounded like some crazy idea that I would come up with, and that it might later be discarded for a standard stall and flyers. But when I turned up I was amazed to see a typical student bedroom complete with pizza boxes, cans of Carlsberg, random rubbish and…a traffic cone. How do these guys know us so well !? Next to the bed was a stall and flipchart asking students what advice they’d offer this student that was struggling. The bed was covered with slips of paper containing responses. These included sensible suggestions like “talk to a friend” and “go for a walk in the park”, and a few more unusual ones like “listen to Wham” (huh!?). Manning the stall was Nigel, Head of the Counselling Service, wearing a cool jeans and jacket combo, and cheery smile. Another member of the team, James, was complete with  trendy scarf. The whole thing worked brilliantly, and the team showed that they are not just a thoughtful, friendly group, but that they are in touch with the student life, and are willing to go the extra mile to show this (although don’t expect to see them out in Halo anytime soon !). They have an impressive list of workshops planned for this term too, which cover topics like getting settled into uni life, improving communication and relationship skills and getting a good night’s sleeping. You can read about these in the GIAG booklets found in the Union, or at the Counselling Service’s website: www.leeds.ac.uk/studentcounselling.

As I started writing this I thought about the impression our society gives off. And I remembered that one of the great strengths of student-led stuff comes from our unique position. We are students reaching out to other students, and no else can offer this peer to peer approach. Our power comes from being ourselves, standing shoulder to shoulder with every other student on campus, and being representative of them all. It comes from us not pretending to be an authority, or to be always right; and from steering clear of the restrictions and politics that exist elsewhere. Let’s stay cool. If we do this we can offer society something really special – an enthusiasm, creativity, free-spiritedness and quickness in taking action, that rarely exist elsewhere. If the cost is that we’re a bit sloppy, and occasionally get things wrong, then so be it.

Eddy, The Mind Matters Society (www.themindmatters.co.uk)

But I did attend Yorkshire and Northern’s ASSIST event of the same name.

My intention was to develop my understanding of the NHS infrastructure and connection channels as much to understand the fundamental role that Information plays in developing that infrastructure.

ASSIST’s event affording me some greater clarity of the functionings of the NHS and the current challenges and difficulties as well as the reality of the working nature of ‘informatics’ within the system.

There are some key things I agree with.

1) Health Services produce Data.

Data is Data. It is not Information and turning that Data into relevant Information is the role of an Information Specialist.

2) Information Specialists need to be involved at service developmental level in order understand project development and how outcome data needs to be turned into relevant systems.  If they are not involved at the start point then implementation of the planned projects and service delivery may be untranslatable.

We know this because this happens in the NHS.

It also happens everywhere else in Health.

3) Systems that focus on the internal workings of themselves tend to use language that makes no sense to anyone else.

In fact.  We all tend to use language in different ways.

I could describe ‘Service User Involvement in the design of technical applications’ as ‘NHS to Patient Interfaces from the Patient perspective’

And indeed, this is the area in which design, research and development is fundamentally lacking in the NHS and everywhere else in Health.

Which is actually a clear opportunity.

If you fancy having a go at De-Mystifying the NHS yourself you are very welcome.

When I say that I mean where it sits on funding streams as well as approach.

The issue IMH have been raising at the conference during our address is the The Culture Shift in Information and Dementia in the context of wider Mental Health services.

As we begin to see the Recovery model become mainstream and we also see the beginnings of the implementation of the Dementia Strategy it is becoming clearer that the term Recovery is mis-leading within Dementia focused work.  And greater practical application of research addressing how society disables those with dementia is needed.   There’s an interesting mix of person-centred care, recovery and the social model of disability that seem to need to be employed when thinking about the individual who happens to be experiencing dementia.  Or those that are caring for that individual.

Dementia seems like an older persons issue (aside from the fact with early-onset dementia – it’s not).  Older people are using the internet on a more regular basis but at present online Dementia services seem a long way from reality.  And anyway what is an online dementia service?

The future of the next generation of older people and the next is that they will be using the internet.  They will be using online dementia services.  Once they are available.

IMH’s interest remains on the innovation that drives the development of those services.  We call it ‘The What Happen’s Next’

We’re as interested in doing the ‘What Happen’s Next’ as we are collaborating on it.  If you have any workable thoughts you’d be very welcome to get in touch.  We’d love to hear from you.

Lately all those active in mental health will have become aware of the commissioning processes now evident in implementation in Leeds.  We’re all involved in consolidation, cost cutting, quality driving and are now surveying the scene. Noticing the impact on ourselves and others.  Not least our service users who remain at the heart or core of everything we do and stand for – whatever our role.

IMH keeps itself on the cutting-edge of two fields.  Information.  And Mental Health.

We apply informatic thinking to the fundaments of the Local as well as National mental health big picture.  We keep tabs on the Global culture.  We talk about Health 2.0, 3.0, 4.0 in this office more regularly than we ever did.  When we do, what we are really talking about is a co-herent way for mental health (in all it’s aspects, policy, service info, peer to peer conversation, online learning, online therapies, facts, funding, researching and statistics) information to be available to all.  It’s not always easy to talk about.  The field becomes infrastructure as I write – currently it means that we remain involved as much as our time and financial resources allow us in the conversations that will set the tone of what the infrastructure will look like and ultimately it’s useability.

The Leeds Mental Health Directory grew out of similar, much more localised thinking.  The online Directory built upon that well trusted platform.  What happens next we will apply with the same onus as we always have – the service user, the survivor, the carer as well as the worker.

In the last nine months we’ve had some very interesting conversations.  Those conversations have led to some collaborative working with new types of partners.  From local tech types, to digital community builders, to business framework developers.

One solid piece of work that we are now involved in is with Dementia-Signage.

We will be speaking at three conferences in September funded by Boots on the pivotal role of Information Technology within Dementia Strategy Policy and the larger framework of Mental Health & Wellbeing.  We’ll be talking about the small things that make a difference.  It’s a similar ethos to Dementia-Signage themselves.  The way a red plate can mean that a person with dementia can see the food they eat and how this has raised food intake significantly statistically within care home settings.

How we in mental health know that methods that create space for an individual to keep making choices and taking control of their lives can make a difference too that individuals mental health as well as their experience of dementia.  Not least how a better diet impacts on mood.  This base of small things we reference is a much larger issue – Living Well, Living Longer.

IMH is always interested in shared thinking and the ways in which that thinking can reach others.  It’s how we got to where it is today.  It’s how we’ll get to where we want to be tomorrow.

Full Conference details will be published shortly.  If you’re in the Leeds area, earmark September 22nd.

SEMINAR on the emerging

convergence of mental health and

web2.0 technologies.

You’ll have heard of Twitter, Facebook, Second Life – but

how are these relevant to the mental health sector and

how can you utilise them effectively and safely whether

you are a service user, a direct worker, a Chief Exec or

a Strategist?

Where & When is it?

Old Broadcasting House, Woodhouse Lane, Leeds, LS2 9EN

you can see this on the Map

On Thursday 9th July 9am to 10.45.am

with an opportunity for conversation

you can book a place HERE

or for more info please email Kate Brown

or tweet her on twitter

or call her on 0113 2752417

There are only 15 places available so please book as soon as possible.

What will happen at the Seminar?

We’ll be talking through some of the  social networking and Web 2.0 applications.  You’ll be able to think about, question and see how relevant to your work and role they are and how you could make use of these developing technologies.

Why is it relevant to me?

Digital Inclusion is a fundamental strand to Social Inclusion.  Emerging trends in health care online are pointing towards cost effectivity and tighter networks.  Use of technology can be considered another tool or discipline within mental health – but it is early days.  An overview of current potential tools will afford some guide to  choice and inform the future development of networks and technologies.