Mental health day centres "maintain" stigma , says government report

March 6, 2006
by Mike George

Traditional mental health day centres reinforce the stigma of having a mental health problem, a new government report states.

Day centres “maintain segregation" by restricting interaction among its users with the wider community and failing to help users shed the identity of “mental patient”, said the report.

The report, published last week, quotes one mental health day centre user as saying: "I want a way forward, not just sitting there, just drinking tea and talking about the side effects of various medication."

The service commissioners' guidance report - entitled From Segregation To Inclusion: Commissioning Guidance On Day Services For People With Mental Health Problems - is one of four launched last week by mental health minister Rosie Winterton in a drive to help people with mental health problems return to work.

To help achieve this, Ms Winterton wants a move away from traditional day services based in one building to services which link up with existing community resources. This, the report states, will promote both “recovery, social inclusion and self-determination” and opportunities to return to work.

The report recognises that traditional day centres may be valuable meeting points or ‘drop-ins’. However, it urges that "ordinary” community facilities or organisations - such as cafés, faith groups, leisure and sport providers, further education colleges or community centres - be used to help provide day services. This is seen as a way to shift emphasis from day services which host social activities to those which provide genuine vocational pursuits.

The report also suggests that more day care services be run by users/ex-users and for service commissioners to explore additional funding sources, such as from the Learning and Skills Council and regeneration budgets.

The report also stated that traditional day services fail gay people, ethnic minorities and the disabled.

“With some notable exceptions, day services often fail to meet the needs of the diverse populations that they serve,” read the report.

"In particular, they may fail to meet the needs of, and be under-used by, people from minority ethnic communities, women, younger people and older people, and they may not provide services that are sensitive to religion, sexuality and disability."

The four new sets of government guidance for service commissioners are designed to help find ways to re-integrate people with mental health problems into society.

As well as day services, the guidance covers vocational services, women’s only day services and direct payments.

Launching the guidance, Winterton said providing opportunities to people with mental health problems was a "key objective” of the government.

The guidance has been drawn up following a report of the Social Exclusion Unit in June 2004.

However, some campaigners feel the guidance will be ineffective without additional funding.

Simon Lawton-Smith, King's Fund senior policy officer for mental health, said: "The guidance for mental health commissioners is very welcome. However, at a time of severe financial pressures, it would have been more welcome if it had come with some extra resources for implementing these services.

"The resources put into mental health anti-stigma work are miniscule compared to the billions of pounds that mental illness costs the country each year."

Read for yourself:
Government guidance to service commissioners:
* From segregation to inclusion: Commissioning guidance on day services for people with mental health problems (pdf)
* Vocational services for people with severe mental health problems: Commissioning guidance (pdf)
* Direct payments for people with mental health problems: A guide to action (pdf)
* Supporting women into the mainstream: Commissioning women-only community day services (pdf)

See also:
June 28, 2004: Government launches scheme to tackle mental health stigma

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Radical edge

Comment from: Laura Davidson, ward-based mental health nurse, Aberdeen, Scotland
Date: May 19, 2006

This article is a godsend. I am applying for the position of manager of a mental health day centre. The centre needs re-designing and points discussed in the article have given me food for thought and hopefully some sound ideas that will form the basis of a radically different day service provision, should I be appointed to the post.

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Parochial and petty

From: Graham Peacock, voluntary administration worker, Cooltan Arts, London
Date: September 17, 2008

I would like to put the view of a mental health user. On leaving hospital in 1999, I was referred to a local day center 300 yards from where I lived. Whilst the activities were varied; a french class, yoga, helping in the kitchen and some computer studies; I found the atmosphere parochial and with an excessive emphasis on time keeping. I found the whole atmosphere rather petty and not at all geared to getting back to work nor integrating back into the community. I left after 12 months.

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