Time to act on the Mental Health Bill and provide support for people with autism - Michael Short

A family I know had their son, a 17-year-old, being detained 170 miles from their family. Visits were for only one hour per week and the family were not even allowed to see the room they were living in. It is indeed time to act on the Mental Health Bill and provide the right level of support for the people concerned.

Finding the right support is however another challenge and the statistics also show that 230 of these individuals had their discharges delayed as a result of a lack of suitable care providers and housing. This bed blocking system results in people being held when they shouldn’t be, and also in some cases being treated with medication they don’t need and with no psychological or relevant support.

At the PBS Centre of Excellence and Happy Futures, we turn this approach on its head, and the focus is entirely on the individual. We have recently supported someone who had been stuck in hospital for over 30 years after being sectioned in their early 20s- she simply got lost in the system. She now has her own accommodation, and her life has literally been transformed. She has been out buying items for her own home, and with the right approach of PBS, is finally leading, in her own words, “my best life”.

Medication is not always the answer, simply making reasonable adjustments is what is needed. By identifying what triggers an individual’s behaviour, you can make changes to help them cope with challenging situations. Positive Behaviour Support (PBS) has been around since the 1980s, but it is often referred to without being properly implemented.

It is a science-based approach, which is evidence and data driven. An average assessment takes at least 30 hours and it focuses on providing individuals with the tools and strategies they need to lead fulfilling lives and making changes to their environments.

We have had people who initially needed three-four carers, and through working with them and using the PBS model, reduced this down to one carer. Not only does the level of care change but also their independence and lifestyles. Actively working with them to enable them to do more things for themselves and live a more rewarding and active life.

All of this through understanding how they behave and giving them the tools and environmental changes to adapt that behaviour.

However, much more funding is needed by the government to ensure that people have access to this type of specialist support and to ensure they are aware it exists. Instead of sitting and waiting for this to happen, as part of Yorkshire Futures we are looking to work with universities to actively push for further research to take place. Health inequalities need removing, as do the barriers that prevent a person accessing the services they both need and should be entitled to receive.

We have also started to change how accommodation is provided for individuals. Instead of placing someone in a property with support from carers, we have changed this all round to look at what the individual needs first.

For example, we had someone who joined us at 16, now 19, still wanted quality time with his family but his ecological needs had changed. So we designed an evidence-based assessment and reporting tool to identify his needs now and in the future. We spoke with his family about what they wanted for him and what he enjoyed and liked the most. Working with the local authority we then formulated a package of care that was specifically designed around the person – not the property.

We then looked for the right property for him, based on the scoring tool, so he would be able to stay there long term. If this is how we all choose where we live ourselves, why not use the same approach for everyone?

Supporting people in the right way needs to change and we are actively making these changes and genuinely improving people’s lives.

What is needed is for this type of service to be available nationwide and accessible for everyone who needs it. These are people whose lives could be significantly improved, and whose lives need to be improved. We have seen first-hand the difference the right approach can make, and it is our mission to make this available for everyone.

Michael Short is Head of PBS Centre of Excellence at Yorkshire Futures.