So often those who provide the services seem to want something different from those who use them. It has been rewarding to find that both service users and service providers in Camden share the view that a Crisis House would be a valuable provision. They share the reason, ‘that it would keep people out of hospital beds’ but for different reasons. Service users generally find the hospital experience a negative one: service providers find it an expensive one. It is agreed that any Crisis House would be best provided by the voluntary sector.

There is then a general agreement about the need and value of a Crisis House. The Commissioners have given the proposal their approval. But, there seems to be an important area of disagreement.

Moving

Tony Ewart, the North Camden Locality Director, will be moving at the end of June to take up a temporary secondment managing the Mother and Baby Services in the Liverpool Road Division of the RFH.

Katrina Anderson held a temporary post as Senior Development Officer at Camden Social Services and she has been working with CMHC on user issues. Kath McClinton will be returning to the Senior Development Officer post and Katrina is moving to a post in Islington.

In February CMHC working with Camden Social Services employed five service users to go out and interview other service users about what kind of crisis house provision they would like to see in Camden. They designed the questionnaire, administered it, analysed the responses and prepared a report.

This Crisis House Report will now have a well-deserved official launch on Tuesday, 19 June at Hampstead Town Hall. It will be the first item in another afternoon Camden User Event which will commence at mid-day with a buffet lunch. Copies of the Report will be available and at the same time it will be launched on the CMHC internet site, which now has a new address – www.cmhc.org.uk - although visitors to our old site will automatically be redirected. The launch will take place from 12.30 – 1.30 and its authors will be there to talk about the project and what they feel they got out of it.

The afternoon will then develop into a discussion about user involvement, with the first part of it hearing about why user involvement is necessary and some of the forms it has already taken for people in Camden and how that can be developed so that other organisations can begin to develop and implement effective user engagement procedures.

We hope to have the Report of the previous two User Events in November 2000 and April and some questions arising out of those events to put to the people who run the services to hear what they are going to do to respond to the concerns that have been raised.

Finally there will be a presentation about the Camden Borough Forum which is seen as the new model for involvement with members trained, supported and paid for their work. This new Forum will have links with the current North and South Camden User Forums and will try and develop links with other organisations, particularly the smaller ones, in order to increase the level of user involvement. These proposals have already found favour with the service commissioners and it is hoped that service users will respond positively so that we can consider an early start.

User involvement has become a big issue under the current government and there will be a number of new developments in which service users must be involved as part of policy. The Patient Advocacy and Liaison Service (PALS) and the proposed Patients Forums for every Trust are supposed to be in place next year. There is a need to involve service users in the Clinical Governance process and in the Best Value Reviews.

We hope that as many service users and representatives from the statutory and voluntary sector as possible will come along on this afternoon and share their views with us.

St Luke’s Audit

During the last few weeks, CMHC has been working with CORE at University College London to recruit some service users to undertake an audit project of people being discharged from in-patient treatment at St Luke’s Hospital, Woodside.

This is both a follow-on from a study conducted by The Waterlow Unit Patients’ Council at The Waterlow Unit and part of a wider audit of the experience of in-patients and people using community services across Camden & Islington. It is of particular significance to CMHC because it represents a collaboration with a service-user group in Islington to bring about a piece of user involvement.

People have been successfully recruited and the training process is now under way. The interviewees will be people about to be discharged from three wards at St Luke’s Hospital and they will be asked to complete a questionnaire about the experience that they have had as an in-patient.

Eventually a report will be produced and it will be presented to those who run the service to ask them what changes they propose in the light of the findings.

There are many people, not the least of whom are the CMHC office staff, who feel that the last Annual General Meeting has only just finished and now we have another one. They come around once a year!

Last year we held the meeting in June, but constitutional issues meant that it had to be adjourned twice and that it was not eventually concluded until just before Christmas. So those who feel that it is only just over have a lot on their side. Nonetheless, we are now preparing for this year’s AGM which will be held at 6.00 pm on Tuesday, 24 July 2001 in The Sir William Wells Atrium at The Royal Free Hospital. The meeting will have the usual format of formal business and guest speaker and will conclude with a buffet supper at about 7.30 pm. Once again we are grateful to North Camden Mental Health Service for providing us with a venue and the refreshments.

In accordance with the constitution, the Management Committee and Honorary Officers of CMHC hold office for a year. Elections are held at the AGM. Nomination forms for the positions will be sent out so that they reach Members before the 26^th of June. The completed Nomination Forms with the signatures of the nominee, proposer and seconder must be returned so that they reach the CMHC office before the close of business at 5.00 pm on Tuesday, 10 July. Only Full Members of CMHC on 26 June 2001 may stand for election and/or nominate and second a candidate for election.

At the last AGMs, Members requested that we send out some information about the positions available and the responsibilities that are entailed. We have already done this and we will repeat it again when the Nomination Forms are sent out. We will also be sending out copies of the Code of Conduct for Management Committee Members, which includes role descriptions. There was also a request that candidates say something of their reason for wishing to stand. The Management Committee has considered this, but decided that it is difficult and unwise to achieve unless there is a contest for a position. The reasons are that we do not necessarily know who the candidates are until fourteen days before the AGM and that it has been very difficult in the past to secure candidacies. If, however, there is a contest then the candidates could be asked to say a few words about why they should be elected.

If there is any Member interested in standing for election, we are offering the opportunity for them to observe one of the two Management Committee meetings still remaining for this present committee so that they may gain some idea of the work involved. The Management Committee usually meets once a month for about two hours. In order for CMHC to develop and grow, it needs an active management committee.

We gave notice too that we would like to be able to insert a clause allowing Trustees to take on any paid work offered through the organisation. This is a matter for which we need approval from the Charity Commission and our lawyers are still in correspondence with them so that we do not know as yet whether we will be able to bring such a clause to the AGM.

Since we have been using a return address on all our correspondence, it has become easier for us to identify when a member has moved. However, we often do not know where they have moved to and have effectively lost contact. In order that we have a consistent membership list and that we do not have the possibility of ‘ghost’ members, we will be proposing a clause which allows us to suspend the membership and voting rights of any members who we have been unable to contact over a three-month period.

Keith Russell is the Assistant Locality Director (Health) for North Camden Mental Health Service. He has been involved in trying to develop Patients’ Councils for the in-patient wards and day hospitals (Felix Brown and Fordwych House) within his service and during the process has already come twice to the North Camden User Forum to talk about the progress.

He came to the May meeting with the plans fairly settled to tell service users what they were and to receive some feedback. It is being proposed that there should be distinct Patients’ Councils for the in-patient wards, which will meet regularly and will have a facilitator. There will be separate PCs for the Day Hospitals. The role of the PCs will be to deal with issues of a general nature and they will have access to the management of the service at which ever level is appropriate to solve a problem. During the discussion periods – in which NDC, the Mind Advocacy Service and CMHC have been involved – it has been emphasised that what is requires is swift solution wherever possible and at the lowest level. There is no need to take a problem to a Locality Director if a ward nurse can solve it easily. There has, however, to be a route by which problems, which cannot be so easily solved, do move up the ladder to the top if necessary.

The proposals were welcomed and they now need to be taken forward and agreed by the new Camden & Islington NHS Mental Health Trust. It was recognised that there was a wider issue about whether there should be PCs across the Trust, at St Luke’s Woodside and The Huntley Centre too – the Waterlow Unit at The Whittington Hospital already has a long-standing and very active PC – with some consistency among them. However, this should not be a reason for delaying the implementation of the plan in North Camden. The proposals now have to be taken to a commissioning group to see if the money can be allocated.

There was also a question about who should manage the facilitator. There are a number of possibilities, but people at this meeting felt that it should rightly be the task of a user organisation and heard that CMHC had offered to take on this role. This would be a guarantee of independence from both the statutory and voluntary sector providers.

This is a development which is of great interest in N Camden and The Camden Bugle will keep people informed on its progress.

CMHC has been working with the Academic Psychiatry at The Royal Free Campus of The Royal Free and University College Hospital School of Medicine for more than a year to discuss topics of research which might be of special interest to service users and in which they could possibly play a part. The first topic that CMHC proposed was that of ‘stigma’. Almost everyone who has had experience of the mental health services has come into contact with this in one way or another. Some people consider that the stigma is almost worse than the mental health problem and that it changes people’s lives irrevocably. So it was this subject which CMHC thought should be the first topic for research. Looking at it from the users point-of-view to see what effect they felt that it had, particularly if it affected recovery rates and increased the likelihood of relapse. It might be possible to develop a measure of stigma and then try and do something about reducing it.

Camden Social Services gave a total of £20 000 from the Mental Health Grant to fund a researcher to undertake a pilot study whilst attempts were being made to obtain the substantial funding necessary to conduct a full research programme. Chris Bagley has been recruited to undertake this research, which will require him to have a great deal of contact with the service users in the Borough and may see him using some of them to help with the research. He took up his post at the beginning of May and it will be part-time for 18-months during which period we are hoping to obtain the major funding for the full research.

Chris will be the speaker at the June meeting of NCUF on Tuesday, 5^th at 4.30. The previous meetings on ‘stigma’ have been among the best attended that we have had for the NCUF and we are expecting that this one will also attract a good audience.

We have heard about some of the other topics of research in the past. The sexual attitudes study proposed by Dr Marc Serfaty, which is still awaiting funding. The ‘advance directive’ study which was being conducted and which has still to be reported back. So too has the study on discrimination by Apu Chakraborty – this has many links to the work on stigma. Some of the reasons why these studies have not been reported back to the North Camden User Forum is that they have yet to be published in the medical/psychiatric journals and this needs to be done first.

The relationship between mental health and the courts is a complicated and difficult one. Many people end up in psychiatric wards having been sent there by the courts after a criminal trial. Sometimes these matters lead to people being sent to Secure Units or even to one of the Special Hospitals. People often remain in these units for a very long time. They have high and complex needs.

This part of the mental health service is known as the Forensic Service and it tends to exist separately from the other mental health provision. The local secure unit is Camlet Lodge at Chase Farm Hospital in Enfield. Andy Mattin is now Director of the North London Forensic Service, having been for some years the Assistant General Manager of Mental Health Services at The Royal Free Hospital. Dr Richard Taylor is a consultant psychiatrist within that service. They are both coming to the South Camden User Forum at 5.30 pm on Tuesday, 29 May, at Jules Thorn Day Unit at St Pancras Hospital.

In late 1999 and 2000 CMHC had a regular Wednesday afternoon presence at Tottenham Mew Walk-In. Unfortunately, we did not really have the capacity as an organisation to maintain and support those sessions and in the end we had to abandon them.

As part of our CMHC at Tottenham Mews Programme we began an Open Support Group. This was in response to requests from CMHC members in the Annual Surveys of two years. We commissioned it for six months and then brought it to a close. It was not very well attended - although towards the end the numbers had increased - and there were issues about CMHC becoming a provider of services.

The members of the OSG were very disappointed to see it end and they asked that consideration should be given to restarting it. They considered that Tony, who conducts the Group, was very skilled and helpful. We have now resolved some of the difficulties and found funding from South Camden Mental Health Service and we are in a position to restart this group. CMHC regards this as a very good response from the providers and applauds them for undertaking an innovative form of therapy in response to the request of service users. This is an example of user action being successful in influencing service provision.

The group is led by a qualified counsellor ‘Tony’ and is not part of the statutory or voluntary sector provision. It is run independently by CMHC. There is no referral and there are no records. Although we hope that people will come regularly, they can come to one group and there are no further expectations of them. All that people need to do is show up and pay the respect for others, which is the standard that CMHC requires as an organisation. The first meeting will be at 6.00 pm on Monday, 18 June at the Community Health Council, 197 Kentish Town Road, NW5.

It will be held at the same day (Monday) and time (6.00 pm) and in the same venue (CHC) for four sessions – 18 June, 16 July, 13 August, 10 September. It will then be reviewed with Tony and if it is considered to be successful and the numbers are high enough there will be a further 9 sessions making up a year of the Group. It is considered that there will need to be about eight people attending each session to justify its continuation.

We would like to hear from anyone who is interested in joining this group since it is important that we try and find as many people as we can who would like to try it and see if it is for them. If it isn’t, they are not committed to keep attending. Obviously, its continuation for more than the initial four sessions and the possibility of it being considered a permanent feature are largely based on the take up.

This group, which has been in existence for a number of years, and is now organised by the Camden & Islington NHS Mental Health Trust has asked us if it may have some space in The Camden Bugle to report on its work. We are only too happy to agree and we look forward to future reports from it. This applies to any group which would like to have some news of its work included in this newsletter. We have asked some groups in the past and they have not responded. We want people to know what is going on and we want The Camden Bugle to report things so that people do know what is going on and what they can do. That is its purpose.