Hamilton Sarah, Szymczynska Paulina, Clewett Naomi, Manthorpe Jill, Tew Jerry, Larsen John, Pinfold Vanessa
The McPin Foundation, London, UK.
Social Care Workforce Research Unit, King's College London, London, UK.
Health Soc Care Community. 2017 Jan;25(1):158-166. doi: 10.1111/hsc.12286. Epub 2015 Oct 4.
Personal budgets aim to increase choice and independence for people with social care needs but they remain underused by people with mental health problems compared to other disability groups. The use of personal budgets may impact on families in a variety of ways, both positive and negative. This paper draws on interviews, undertaken in 2012-2013 with 18 family carers and 12 mental health service users, that explored experiences of family involvement in accessing and managing personal budgets for a person with mental health-related social care needs. The sample was drawn from three sites across England, with additional carers being recruited via voluntary sector networks. Our findings show that for many people with severe mental health needs who lack motivation and confidence to negotiate access to personal budgets, carers may provide the necessary support to enable them to benefit from this form of social care support. We illustrate the role carers may play in initiating, pursuing and maximising the level of support available through personal budgets. However, some carers interviewed considered that personal budget funding was reduced because of practitioners' assumptions about carers' willingness and ability to provide support. We also report perceived tensions between family carers and practitioners around appropriate involvement in decision-making. The study findings have implications for local authorities, practitioners and family carers in supporting the involvement of family carers in support for people with severe mental health problems.
个人预算旨在为有社会护理需求的人增加选择机会和独立性，但与其他残疾群体相比，有心理健康问题的人对其利用率仍然较低。个人预算的使用可能会以各种方式影响家庭，既有积极影响，也有消极影响。本文借鉴了2012年至2013年对18名家庭照顾者和12名心理健康服务使用者进行的访谈，这些访谈探讨了家庭参与为有心理健康相关社会护理需求的人获取和管理个人预算的经历。样本来自英格兰的三个地点，另外还通过志愿部门网络招募了照顾者。我们的研究结果表明，对于许多有严重心理健康需求、缺乏争取个人预算动力和信心的人来说，照顾者可能会提供必要的支持，使他们能够从这种社会护理支持形式中受益。我们阐述了照顾者在启动、争取和最大化通过个人预算获得的支持水平方面可能发挥的作用。然而，一些接受访谈的照顾者认为，由于从业者对照顾者提供支持的意愿和能力存在假设，个人预算资金减少了。我们还报告了家庭照顾者和从业者在适当参与决策方面存在的明显紧张关系。研究结果对地方当局、从业者和家庭照顾者在支持家庭照顾者参与对有严重心理健康问题的人的支持方面具有启示意义。
