Recommendations for integrating personal budgets for people with mental health problems

Clear, accessible information about integrated budgets should be provided for users in accessible formats, using film and digital approaches as well as the written word.

• Risk enablement/positive risk-taking: staff should support people in positive risk-taking and managers must offer guidance and support, showing their commitment to personalisation and risk enablement. It is essential that practitioners have confidence in organisational risk management systems. Practitioners should be supported to define risks and negotiate risk management strategies in collaboration with users.
• Brokerage and peer support: commissioners should consider funding for voluntary and community organisations to offer brokerage and peer support to enable more users to get the benefit of personal budgets. Brokers and peer supporters will need both training and support to take on these roles, enabling them to reach out to users who often have a long history of being disempowered and having no real choice. [2]
• Joint working around the individual, with an integrated assessment process across health and social care, is essential for making integrated budgets work. It will be more difficult for them to succeed in areas where social workers have been withdrawn from mental health teams.
• Pooled budgets make the whole process of integrated personal budgets more straightforward for both mental health practitioners and users. They show organisational commitment to joint working. However, local implementers should not wait until they are established before proceeding with integrating personal budgets.
• Local integration: good local communication, involving shared protocols across health and social care, joint working with co-located multidisciplinary teams and shared information systems will enable integrated budgets to work well.
• Reduction of bureaucracy: health and social care should work together to reduce bureaucracy and be prepared to give up some control over the money in personal budgets. Complicated resource allocation systems, assessment processes and excessive monitoring merely reinforce a feeling that people with mental health problems are not trusted to have their own budgets
• Interdisciplinary training: joint cross-boundary training, possibly provided by ‘recovery colleges’, can bring mental health practitioners, users and their families together to learn. [3], [4] Concentrating on ‘areas of cross-over’ where users and workers have the same agenda is likely to achieve more of a consensus than currently exists. [5]