title: Implementing personalisation for people with mental health problems: a comparative case study of four local authorities in England.
abstract: BACKGROUND
  Enhancing choice and control for people using services is a mental health and social-care service priority in England. Personalisation is a new policy and practice for delivery of social-care services where eligible adults are allocated a personal budget to spend to meet their agreed support needs.
  
  
  OBJECTIVE
  To describe approaches to introducing personal budgets to people with severe and enduring mental health needs, and to identify facilitators or barriers encountered.
  
  
  METHODS
  Within four English local authority (LA) areas, purposively selected to provide maximum variation, semi-structured interviews were undertaken with 58 participants from LAs, NHS trusts and third-sector organisations. An Interpretive Framework analysis considered within- and across-site insights.
  
  
  RESULTS
  Issues arising from the implementation of personalisation for people with mental health needs are presented under two general themes: "responsibility and power" and "vision and leadership". Key challenges identified were complexities of working across NHS and LAs, the importance of effective leadership and engagement with service user representatives.
  
  
  CONCLUSIONS
  Implementing personal budgets in mental health requires effective engagement of health and social-care systems. Change processes need strong leadership, clear vision and personal commitment, with ownership by all key stakeholders, including front-line practitioners.
authors: Research Department, Rethink Mental Illness, London, UK. john.larsen@rethink.org
authors: John
authors: J
authors: Larsen
authors: Emily
authors: E
authors: Ainsworth
authors: Clare
authors: C
authors: Harrop
authors: Sue
authors: S
authors: Patterson
authors: Sarah
authors: S
authors: Hamilton
authors: Paulina
authors: P
authors: Szymczynska
authors: Jerry
authors: J
authors: Tew
authors: Jill
authors: J
authors: Manthorpe
authors: Vanessa
authors: V
authors: Pinfold
mesh_terms: D004739:England; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D007407:Interviews as Topic; D007857:Leadership; D001523:Mental Disorders / Q000191:economics* / Q000628:therapy*; D008605:Mental Health Services / Q000191:economics*; D057285:Precision Medicine / Q000191:economics*; D013222:State Medicine / Q000191:economics