or mental health reablement-style service. Using this approach to set meaningful goals to the individual (for example, how they best manage their health and wellbeing if they have a relapse), alongside the process of reviewing can ensure that all parties share clear aspirations and expectations, and can support the individual to have the best opportunity to achieve their recovery outcomes.
However, this is often made challenging to achieve based largely on stigma and social barriers to accessing this support with the individuals’ diagnosis and potentially their history. Delivering optimum outcomes for this cohort often requires adult services to help individuals in this group work towards recovery planning, which is sometimes supported by an intervention from a mental health social worker
MH Cohort Two: Individuals with high levels of need whose packages of care are increasing slightly in cost
residents, including a number of people who have suffered from substance misuse, it is often targeted by local dealers.
Duncan is a 52-year-old man with bipolar disorder and psychosis. Having spent periods of time being homeless in his 20s and 30s as various tenancies broke down due to poor mental health, he moved into a residential placement with adult social care. Duncan has moved between different residential homes over the last 20 years, but he is largely supported through shared support from staff across the home rather than having any 1:1 needs. He goes out during the day on his own. With the property being shared with several vulnerable
Duncan would be interested in moving out but would need to explore local authority housing through the district council. He is aware that his history of poor tenancies, although over a decade ago, will impact his chances at finding a property.
How can improved outcomes be delivered for this cohort? Individuals in this cohort are likely to be living in long-term residential care. Evidence from within the sector suggests that, for approximately 25–40% of this cohort, this is not due to their level of needs requiring this high level of support, but rather is often driven by their inability to obtain an alternative tenancy, for example due to past behaviour or incidents. This then often leads to adult social care needing to provide accommodation at an average cost of £1,000+ per week.
Delivering optimum outcomes for individuals in this group often involves exploring alternative long-term accommodation options for these individuals, working towards a stable long- term community placement (similar to the accommodation moves approach outlined for individuals in cohort two). This often requires mental health social work teams to work closely with housing colleagues (at district level or within the authority if unitary), or with commissioning teams to ensure that creative housing options are being explored (e.g. renting, buying, or building).
What is known about this cohort:
Volumes
Based on the data analysed for this programme from the participating authorities, this cohort represents 20% of all individuals with a mental health condition, and 36% of total mental health expenditure. The majority of individuals in this cohort are over 40 years old and are spread across the older age groups, with 25% of individuals in this cohort being aged 80+ . Only 2% of individuals in this cohort are aged 18–25, and 11% of are aged 26–39. Similar trends are seen for the distribution of expenditure.
Demographics
Expenditure The average weekly package of £968 per person has increased by £67 a week on average per year of the package duration. Support types In terms of support types for these individuals, half of the individuals in this cohort are supported through residential care , with an average weekly cost of £1,033.
The proportion of working age and lifelong disabled individuals in this cohort ranged from 1.1% in one participating authority to 7.7% in another. Significant variation in cost is evident for individuals in this cohort. The average cost of packages of care for individuals in this cohort ranged from £715 per week in one participating authority to £1,582 in another.
Variation between authorities
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