Davinder Jhuty, national head of service – learning disability at Turning Point, discusses the importance of multidimensional support strategies in treatment outcomes.
By putting the lives and choices of people at the centre of transition and transformation thinking, it has brought about radical change in the way we can enlarge people’s opportunities for empowerment and self-determination. The process starts by looking beyond a referral document and supporting the person to reimagine their ambitions and priorities in a life recontextualised by the opportunities afforded by a supported safe independent home.
The essential quality of human life is the core measure of success in transformative support services; yet the concept of quality is highly individual and someone’s choices may be abstract and seemingly subjective to others. How do we start the conversation about quality of life with someone for whom emotional and physical harm, substance use, traumatic experience and instability in housing, work and education have been the fragile building blocks of their early lives?
This came to mind when I was looking at a post-transition review of support for two women with whom we worked recently to achieve move-on from secure custodial environments into their independent supported homes in the community. Fundamentally the achievement of improved quality of life has been rooted in a collective understanding of what is required to resolve past experiences so we can support each woman to start visualising a better future.
As professionals, we are too well aware of the challenges of prioritising and coordinating support requirements with people experiencing complex needs; especially when historical behaviour is often used by many in the referral pathway to determine assessments of current risk and need. Considering these two women, their individual and collective complex needs span traumatic experiences, mental health conditions, substance use, physical conditions, autism, unsafe living environments, destructive co-dependencies and resultant criminal behaviour. Both had detailed referral information which told us much about their past lives and less about their present priorities and future aspirations; yet it was clear both women had so much potential to achieve that previously elusive better quality of life.
So how did we start to understand what ‘better’ looked like? Core to the success now achieved by both women was the deployment of a multidimensional support strategy led by an experienced skilled manager who acted as a key worker. The manager created a small highly knowledgeable internal Turning Point team from learning disabilities, substance misuse, mental health and forensic colleagues.
This team worked as one – a bespoke complex support panel – with a defined lead. This minimised the number of assessments and conversations had with both women whilst optimising the richness of those conversations. The key worker manager became a central coordination point for a multitude of external stakeholders across mental health, physical health, housing, social care, the justice system and now for natural support networks.
Read the full blog post here.
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