The Current Position for 'Empowerment':
Apart for the more fully independent groups like AA and NA (Reference Groups that were never very popular with institutions) most other 'Self Empowering' groups have been severely neutered by the 'Funding' & 'Service Providing' Institutions 'constraints'.
The Radical Practitioner’s reverted to working in the background, trying to keep the principles alive, within the institutional practices. Many Service Users became disempowered, disillusion and ‘institutionally dependent’ once more.
Many have now reverted to simply complaining about the excuses that are made for the late arriving, inadequate and frequently poor service, accepting these are going to be provided in this way for the foreseeable future, without any 'independent' say in this.
A few, more vocal Service \users have accepted, and effectively been ‘silenced’, by being provided nominal position on ‘reference groups’ chaired and controlled by the managers of Institutions, from the perspective of their given objectives.
The positive initiative that Government has taken (in the last 20 years or so) to ensure that Human Rights are fully protected, have been responded to, by Institutions and the Professions, in very risk-averse, self-protecting and typically Bureaucratic ways.
The repeated failures, at local levels, have driven the avalanche of Government directive, with increasingly bureaucratic responses. This further entrenches the 'fear of failure', 'cover our backs' and 'record-record; to justify what we are doing', approaches to providing services.
From a time 35 years ago, when 'service users' (within all groups, including Learning Disability & Mental health) were actively participating in and sometimes helping to run their services, we have now reverted to the 'do it to them, we know best' styles of working.
The problems is, that proper 'Self Help' and 'Self-Empowerment' services are very effective and those who are most motivated tend to move on, leaving behind those who are largely institutionalised and sometime less vocal, or less skilled to speak up.
Professionals have to be ‘Proactive’:
For 'Empowerment' to properly work, Institutions, in the form of the Professionals and their Managers, have to keep nurturing and helping to re-build the remaining Service User’s confidence, competences and skills.
This is difficult within institutions where any initiatives are so often stifled out of fear, or largely commandeered, so that they have no semblance as ‘Equal Partnerships’. Even the modern Community replacements have become increasingly ‘Institutionalised’.
Radical Professional have always had to take a lead in stimulating these Service User led initiatives. We are very unpopular as a result. Not all Service users have the confidence to ‘speak up’ without the ‘protected space’ to do so.
They need informed advocates, who are capable of starting the process and act as referees, once the Service Users find their own voice, learn to negotiate and gain the confidence to look at the various, ‘more empowering’ options available, rather than choosing form the ‘Prescriptive List’ of preferred provisions.
The 'institutionalising' response to Government directive and the criticisms of the remaining outspoken Service Users, have driven the initiative back to 'Nominal', largely fragmented, 'involvement' of Service Users, rather than the proper 'Inclusion' at every level of development and running of services.
The Institutional argument that the pro-active and empowering approaches are more expensive than the Institutional options is complete nonsense. They are less costly from day one. They take the professionals out of a large chunk of these service.
How do I know this? What evidence is there to demonstrate this? Look at the books. I have practice this way for 35 years and have always been able to give ‘empowered’ clients what they ‘really’ wanted, with reduced risks, greater freedom and at less cost (when allowed to).
The fact is, professionals and managers are largely missing the point here. Making people more dependent, by removing their ‘inclusive’ participation at every level (assuming incompetence, to risky & increasing demands) is obviously more expensive.
We only end up giving our Service Users ‘More’ resources, when we fail to give them what they really wanted and needed to begin with: The opportunity to engage in our communities on the same bases as everyone else, with the ‘Community’ adapting for their proper inclusion.
If I can help make that happen decade after decade, why is it so difficult for competent professionals, managers and local politicians to see the light and ensure every opportunity and freedom is provided for them to provide their own essential services and critical support.
Everything needed to do this has been made available by Governments of different persuasions, over the last 35 years. There have been a couple of glitches, but the whole process is driven by fundamental Human Rights, reinforced by ‘clarifications’ within ‘Disability Rights’ that are actually appropriate for most of us.
No half intelligent human being naturally sits on their Butt, demanding more and more of the same old crap, in the highly dependency creating form they often take, unless they have learned that this is the only way to get half way to being Empowered & Respected.
Basically:
Give people the essentials that they need and help them empower themselves daily (whatever competence) to draw upon their resources, skills & Responsible Rights.
Then assist them to co-operate together to provide the support they can share with each other, as recognisable groups and with others within the wider community.
At the same time, help them develop, provide and purchasing any additional services they require, from those competitive services that are available generally, to all disabled and non-disabled groups, within the community.
It is the ‘Outcomes’ we need to focus on, whichever disadvantaged group and individuals we are considering. What produces the best, most empowering, Best Value results? We need to provide the opportunities for Empowering and Enabling Outcomes; ‘Simples’.
Prejudicial Fears that Disable People:
It is the fear that Service Users will succeed, rather than the fear of what happens when they fail, which most motivates the institutions to continue in their largely dependency creating and often disempowering ways of working. The Governmental ‘Expert Guidelines’, could not be much more seriously misinterpreted and poorly implemented that they are.
Sadly, professional institutions have largely succeeding (once more) in convincing the general population of families, friend, neighbours, communities and other institutions, that these 'Enabling' possibilities are ‘too risky’ and have to be avoided at all costs.
The general prejudice that results from long term institutional isolation means that communities are happy to accept this excuse for continued ‘Exclusion’, ‘Prejudicial’ conduct and even blatant ‘imprisonment’ at the extremes of some professional practice.
The fact is, although we succeeded in closing down the big bad institutions of the past, we have now created mini-institutions of a similarly disabling and disempowering nature. The attempts to improve on this, by these Homes, are being disabled; fed by the ‘paranoia’ of some powerful and fearful professionals and managers.
These facts now make little difference now: All service users who are: A) of an appropriate age; B) capable of expressing their dissatisfaction, or C) requesting ‘informed’ alternative options (whatever their Mental Capacity), D) in any expressed form and E) with necessary advocating support (once made aware & assured they will be listened to appropriately):
“Have the ‘Right’ to have their views heard and acted upon to their empowered benefit, in a form that enables and positively includes them within the community”. For this to happen, all institutions of any size or purpose, must seek all reasonable means to achieve this and can do so within the current budgets and requirements. These human principles cost nothing and have the potential to reduce institutional dependencies to such a degree that they will free up resources for those who are currently more needy.
All professionals within all Community institutions, of any kind:
A) Have an ‘explicit’ responsibility to enable Service Users to express their fully informed wishes, from;
B) fully informed choices ‘whether we agree with them or not’, and;
C) to provide existing services, or implement appropriate services which are;
a) enabling, b) empowering and c) respect their human dignity while;
D) ‘Adequately’ managing any risks, ‘as in any other civil arrangement.
Mental Capacity is the latest wonderful instrument that will enable this to happen; once it is properly understood and fully implemented. No longer will it be possible for professionals and families to override the freedoms and wishes of people who have been ‘disenfranchised’ by the fear of ‘fantasy risks’, as they have in the past.
There is once more a clear mandate for all professionals and managers of all Community Institutions, to fully inform Service Users of their wider options, to educate and inform them of the risks and work with ‘them’ to ‘manage’ those risks where we can and implement the ‘least restrictive’ methods for otherwise managing them..
On the basis of this Legislation, and all other legislation (and extant Human Rights) that have gone before; there is no escaping the obligations that this places upon us all. Any attempts to muddy the water, or which can be show to be over restrictive and disabling in character, will be challenged and are ‘required’ to be challenged.