It is well-recognised that there is an increasing rate of mental ill-health. If this is the case, why is there an increasing wish to reduce the number of hospital beds? Both the new units in Islington and Camden will actually provide fewer beds than are currently provided. This is puzzling. Is the reason that the increase is only in minor psychiatric problems which do not require hospital treatment?
Part of the answer, we are told, is that people can now be treated at home by the Crisis Teams and that this provides both more choice and for some a more satisfactory treatment than being admitted to hospital.
However, some believe that there is an economic argument at work here. Hospital beds are expensive; home treatment is very much cheaper. The Crisis Teams may provide choice, but not if they keep someone out of hospital who needs to be there. They only offer choice if there is more than one option, and if there are no beds to be admitted to anyway then the only choice is to be treated at home.
On Tuesday, 24 June 2002 a new acronym NIMHE, pronounced ‘nime’, became a significant part of the mental health vocabulary with the launch of the National Institute for Mental Health in England at a large gathering in Newcastle. NIMHE represents everything that is good about mental health. More evidence based good practice. More information in the form of the website ‘Ask NIHME’ at www.nihme.org.uk (a link to which will be on the CMHC website at www.cmhc.org.uk). Promises of much more user involvement and carer involvement. The Newcastle Conference was regaled by the mental health Czar Prof. Louis Appleby (who was one of the few psychiatrists, there because most of them were at The Royal College of Psychiatrists annual conference in Cardiff) and the joint head of mental health at the Department of Health and Chief Executive of NIMHE, Anthony Sheehan, with the promises of a bright future for mental health with the investment of a great deal of new money, the National Service Framework and a higher profile and national priority. There was a video from the Minister, Jacqui Smith, welcoming the initiative and telling everyone how much difference this would make and even a message from the Prime Minister welcoming the developments. Perhaps while everyone was feeling good up in the North East of England it was a good time to release some bad news in the hope that no-one would notice. That same afternoon in Westminster, Jacqui Smith was unveiling the government’s proposed new Mental Health Bill, which will be one of the most repressive pieces of legislation for service-users and will bring into law the famous threat from Paul Boateng that ‘non-compliance is not an option’. If you do not take your medicine when told to, you will not be forcibly injected over the kitchen table as we were warned might be one of the tragi-comedic possibilities. Rather you may be sectioned, and forcibly medicated in hospital. This is the ‘new law for new times’. There is a consultation period for this proposed bill which runs for twelve weeks from 25 June until the 16 September. This is the opportunity to resist it by writing to both the Department of Health, but more importantly to Members of Parliament and Peers and the press.
NEW APPOINTMENTS The Camden & Islington Mental Health and Social Care Trust has made further appointments at Director level. Colin Plant, well-know to us and a long-time friend of CMHC, has been appointed as the Director of Mental Health for Camden. Wendy Wallace has been appointed as the Director of Mental Health for Islington. Hari Sewell will become the Director of Social Care. Colin Plant takes up his post almost immediately – he’s been doing the job anyway - and Hari and Wendy will be joining later in the year. As Director of Social Care, Hari will have responsibility for user involvement, and we expect to have a very close relationship with him. Further service-user appointments have taken place at Trust Board sub-committee level. Two service users from Camden and two from Islington have been appointed to the Complaints and Incidents Committee. The appointments will take the form of a job share so that only one service-user from each Borough will sit on the committee at any one time. A process is being considered for further service-user appointments to the Trust’s Clinical Governance Committee. DEVELOPMENTS This month’s Camden Bugle has some new developments. Besides the regular column from our Co-ordinator, ‘John’s Diary’, we are introducing reports from the Islington Service User Co-ordinator, Angela Hall, and reports from the Trust written by Stuart McMullen, Assistant Locality Director for North Camden and the Trust’s Camden user involvement lead. Next month, we hope to have Jackie Drury, Assistant Locality Director in Islington and the Islington lead on user involvement, writing the Trust’s Islington News. These new columns, together with occasional pieces from our own Patrick Dalton and other contributions are likely to make The Bugle bigger and therefore we are looking for help at this time of the month to undertake the process of getting it from the press to the public. If anyone has time to spare to help CMHC with collating, stapling and enveloping, we would be very grateful and we can offer you travel expenses and a meal allowance in return. If you are interested and would like to help, then please contact us on 020 7419 4196. As part of our development procedures, we are making the organisation’s key documents available on our website. The Code of Practice for Management Committee Members is already there and we are expecting this to be followed soon by the Constitution and our policies. This will be part of our moves towards the development of a larger mental health information website for Camden & Islington, which should be available towards the end of the year. CMHC HELPLINE The beginning of June saw the launch of the Helpline. Each Wednesday, Linda Polan will be available from 11.00 – 3.00 pm on 020 7419 4197 to provide callers with help and information on mental health issues. This is a test run of the idea to see what the take up is like and we will probably continue it until Christmas before deciding what its future should be. USER ADVISORY GROUP (UAG) The Mental Health Service User Advisory Group is a district-wide group of service users which meets once a month to receive information and discuss issues. At its last meeting, the UAG looked at the Trust’s Service User Involvement Strategy and gave its views on the consultation document. It also heard reports from the South Islington and South Camden Crisis Teams. MENTAL HEALTH LIAISON GROUP This month’s Mental Health Liaison Group met at Fordwych Road Day Hospital. After electing Cllr John Rolfe to the Chair, the Mental Health Liaison Group went on to look at the Care Trust’s Service User Involvement Strategy. Many of the views echoed those heard elsewhere, although there was one interesting new proposal about outreach for home workers. It agreed that at the next meeting it would look at service for the street homeless and this may mean a joint meeting with the Homelessness Liaison Group.
The subject for the May meeting of the South Camden User Forum was medication. Anees Al-Mushadani, a pharmacist from St Pancras Hospital came along to talk about the subject and to give news of new medications now available. As so often with this particular topic, the discussion veered off into surrounding issues like information about medications and compliance, which is now called ‘concordance’. It was good to learn that the Trust will soon be having a new information system about medication and that this will be available to patients. It is also good to see the interest taken in these meetings by the Trust’s Chairman, Professor David Taylor, who often attends. As a Professor at the University of London School of Pharmacy this meeting possibly had a special interest for him. The June, SCUF looked at the Care Programme Approach (CPA) - what it means and how it works. Sue Christie and Colin Plant came to discuss this very important issue and to hear peoples’ views and experiences. There is no July meeting for SCUF because it would clash with the CMHC Annual General Meeting. The next meeting will be on Tuesday, 27 August. NORTH CAMDEN USER FORUM (NCUF) ‘Benefits’ is always a lively topic at one of our meetings, and the June North Camden User Forum was no different. Joe Barun who is welfare rights worker at The Hoo came to tell people about recent developments and how they affect the right to welfare benefits. Inevitably, the question of the new rules about ‘Permitted Work’ and how this will affect people who become involved was an issue. This subject is currently being looked at by a number of people to try and find a solution which will allow people to be rewarded for their involvement without prejudicing their benefits position. It was reassuring to hear that the fears about the Camden FreedomPass which came up earlier in the year do not seem to have become reality. July’s meeting on Tuesday, 2 July, will bring Ian Butler from North Camden Mental Health Service and Keith Jarman from Camden Social Services to talk about ‘Seeing Your Records’. People often want to know which records they may see and what the process is for accessing them. This meeting should provide all the answers as well as telling people what they are not allowed to see.
Stuart McMullen, Assistant Locality Director in North Camden, writes about developments on the Camden side of the Care Trust. He will be contributing a monthly column to The Camden Bugle. In North Camden our main focus over the coming months will be the in-patient services. We are committed to improving the environment and the care on all the psychiatric wards at the Royal Free Hospital. One of the first initiatives is the development of a Ward Round meeting information leaflet. This is information which will be given to all in-patients setting out what people can expect when there are meetings held on the wards to do with their care. It will explain what the various meetings are for and how patients can expect to be involved in these meetings. Currently, this is being considered by the ward staff, including the doctors and they will feed back their views to managers over the next month or so. When it has been agreed, I will let you know how this is to be taken forward. The other news I wanted to tell you was that in North Camden the Community Mental Health Team and Tenancy Support Team base, The Hoo on Lyndhurst Gardens has recently begun to offer appointments to service users. The Hoo is an old Royal Free Trust building previously owned by The Lipton family. We have interview rooms and meeting space available where service users can now be invited. In July we have invited Glenda Jackson, MP to come to an opening ceremony and this will shortly be advertised. In South Camden, over the next few months, there will be the further development of the Crisis and Assertive Outreach Teams. The Crisis Team are to concentrate on their links with in-patient wards and to support early discharge back into the community. The key strategy for the Trust is of course the Service User Involvement Strategy and staff are currently being consulted about their views on the discussion document. Already there has been some lively debate about the many different issues the discussion document brings up. Of course, this is exactly what was hoped for by launching the document itself. What is very clear is that members of Trust staff need to feel closely involved in this strategy for the strategy to work. Next month I will be giving more detailed news from in-patient services along with any key appointments which take place.
Camden Borough User Group (CBUG) has been in existence for six months and is now beginning to take control of its own activities. The membership is still short of the twelve people that were originally envisaged as making up the Group and the seven members regard further recruitment to their number as one of the prime tasks for the present, and they will be undertaking a road-show as part of the attempts to increase numbers. CBUG meets formally once each month and in a Working Group of CBUG Members and the Co-ordinator at mid-month intervals. It is now beginning to consider which projects it will undertake and what it will not be able to do for the present. The request for user involvement from CBUG continue to flow in, and there is no possibility that it will be able to meet all of them. It will need to prioritise heavily and sometimes dimply say ‘no, we cannot do this at this time’. One of the first on its list of activities is the Monitoring of the Mind in Camden Patients’ Advocacy Project at The Royal Free Hospital. The Advocacy Project has been running within the in-patient wards for more than a year now and there is a need to monitor it to see how effective it is for patients. It is hoped that CBUG will begin to undertake some User Focussed Monitoring of the Service by the Autumn of this year. Although CBUG will be responsible for the monitoring, it may be possible for interested service users to be involved in it. Anyone who wants to know more should contact CMHC. CBUG is committed to Open Meetings on a quarterly basis and the next one will be on Wednesday, 21 August at Hampstead Town Hall from 1.30 pm. These Open Meetings are themed and the August one will be concerned with ‘In-Patient Acute Care’. This is often the most difficult part of any mental illness and the environments on in-patient wards are often criticised as not being conducive to improvement of health. Among the issues that will be discussed will be ‘Risk Assessment and Violence’. There will also be an opportunity to hear about the Nurses’ Tower proposals for the new North Camden Mental Health Service In-patient Unit and how attempts will be made to produce a unit which has a ‘healing atmosphere’. At the Open Meeting, we are also hoping to launch the User Focussed Monitoring Reports on St Luke’s Hospital and The Huntley Centre together with the original Report on The Waterlow Unit. The afternoon will simply be an opportunity for these reports to be brought into the public domain at the same time as they are launched on the CMHC website. It is hoped that there will be a meeting later in the year at which the contents of the reports can be discussed.
Patrick Dalton, CMHC’s Treasurer, writes another of his articles giving his own unique view of the mental-health world. The Curious tale of Doctor Strangelove Or - How I learned to stop worrying and love my Mental Health Some years ago, my venerable GP announced his retirement and said that perhaps I ought to seek a replacement. As I had recently moved, it seemed a good time to change. I made an appointment to see a local GP whom I shall call Doctor Strangelove. I would name him, but he would probably sue us for damaging his incomparable professional reputation. It is said that the truth always hurts. I sincerely hope so. When I told Strangelove that I had a Mental Health problem he suddenly developed a fascination for his surgery carpet and seemed unable to look me in the eye. He explained that, from 'long experience' of patients with Mental Health problems, he knew that I needed a 'certain sort of service' which regrettably he could not offer me. He was sure I would be much better off elsewhere. He also said that he wanted to treat his patients in a particular way, and that he did not agree with recent NHS changes (this was some time ago). He did not even want to know what my problem was, and obviously thought that I would waste his time. The reality is that I seldom need to see my GP, and having come to terms with my difficulties, I found it very sad that a doctor could not do so. Clearly I was neither the first or last to get such a reception from this man of immense conscience and undoubted medical talent. GPs have every legal right to refuse Mental Health patients, and we all know that some of us can be very demanding. However, to refuse an entire group of patients out of hand is contrary to the Hippocratic Oath in my opinion. Why not reject young children or elderly people too? They also have frequent illnesses. I took myself to another GP, told her what Strangelove had said, and she took me on her list without question. Some years later my new GP was obliged to move her surgery, and ended up sharing with - the very same Doctor Strangelove. I can now walk through the door he banished me from, and sometimes catch a glimpse of him as he booms at his receptionist. Naturally, he does not remember me, but I certainly remember him. I do hope Strangelove never has a Mental Health problem himself. It would be very unfortunate if he could not get treatment, wouldn't it?
Since the last Bugle was issued I have been very busy, and there have been some significant developments. The usual day-to-day work of attending meetings, helping to arrange the North & South Camden User Forums, printing, collating and mailing ‘The Bugle’ continues as usual. In addition, we have been preparing, and mailing all the essential forms and papers for the forthcoming A.G.M.
I have been continuing to visit people and places in Camden where there are important contacts, and where potential members of CMHC & CBUG might be found. However, as I have almost completed my fact-finding visits, I am now concentrating on finding and attracting users who want to participate in User Involvement at any level.
We have established the Monthly CBUG Working Group in addition to the full CBUG meetings. This Group consists of CBUG Members and myself. It exists to plan how we are going to approach the tasks we are asked to do: to allocate the work to small groups, or individual CBUG Members; and to decide what work we want to do, or are in a position to take on. It also helps to identify training needs, and where possible find and allocate training appropriately. Last but not least, the group is there to help with recruitment to CBUG. This is extremely important as we are being asked to do increasing amounts of work, with a limited number of people available.
The first meeting was very productive with an agreement being that CBUG would take on the Audit of the Advocacy Service at the Royal Free. The most pressing issue for CBUG remains recruitment. All the existing members see the recruitment of at least 12 members as a priority. Some very positive ideas came up for presenting CBUG to potential members and CBUG Members are very keen be involved in the recruitment programme.
I have been out and about trying to increase the awareness of CMHC & CBUG. I did an introductory slot at the most recent User-Focussed Training and I am working on the Bridge Project, Fe So, and CAST, as places where interested users can be found. I also attended a Special User Group Meeting at NDC Jamestown and St James House have agreed to let me speak at a forthcoming client-group meeting.
My monthly meetings with Angela Hall (User Involvement Co-ordinator for Islington) continue to be fruitful. We are jointly embarking on an Audit of User Involvement in Camden & Islington If anybody reading this is interested in joining CBUG or finding out more about us, please contact me at the CMHC Office.
Each month, Angela Hall the Islington Service User Co-ordinator will talk about Islington developments. She can be contacted at 60 Bath Street, EC1V 9DP, by telephone on 020 7530 2744 and by e-mail angela.hall@cichs-tr.nthames.nhs.uk FEEDBACK Many of you will have seen the Trust’s Service User Strategy Discussion Document, and this is just to remind you that the deadline for returning your comments is Friday 28th June 2002. If you haven’t got a copy and would like one, please contact me. I have received many comments and ideas around service user input on Trust Interview Panels, and will be putting together feedback to highlight your experiences, and ideas around ways in which the process can be improved. If anyone out here wants to share their experiences please ring me for a chat. NEW INITIATIVES A new St Luke’s Service User Action Group has just formed to explore the setting up of a “Friends of Noel Harris” and Patient’s Council for St Luke’s Hospital. Although in it’s early stages, this will be one to look out for ‘THANK YOU’ The Lady Gould Charity has donated funds for the purchase of a pottery wheel to the Belle Ridley Day Hospital invited along Kenneth Smith from the charity and David Taylor (Chairman of the Trust) among others to say ‘thank you’ and display their pottery works. EVENTS The Waterloo Unit is holding a Summer Fete on Saturday 13th July. The day will feature good food, bric-a-brac, music, Tom bola Raffle, stalls and prizes. Everyone is welcome. For further details please contact Jo Lawrence on 0207 530 2248 who is organising this event.
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