Monthly Newsletter of Camden Mental Health Consortium

ISSUE 64

DECEMBER 2002

In Camden & Islington, we are constantly reminded about the success and benefits of the new Crisis Response and Resolution and Assertive Outreach Services.  They have reduced the number of Mental Health Act assessments and the bed occupancy across the District.

A recent Department of Health report showed that more people than ever were detained under the provisions of the Mental Health Act 1983.

These two positions appear to be contradictory.  What it would seem to mean is that there are fewer people actually in hospital so that the ridiculous bed occupancy of 130% (a figure only possible because at least 30% of the patients are on leave) has been reduced below the 100% norm.  Of this figure, a significantly larger percentage than before are formally detained – ‘sectioned’.

If this is the case, then the wards have a higher percentage of ‘iller’ people than previously and the staffing and support levels should be increased.  So far, it seems that this has not been done so that the same number of staff has to deal with a higher proportion of illness, which would tend to the conclusion that the staff are under greater pressure.  This cannot be good for the patients.

At Camden Council’s last Mental Health Liaison Group, the Borough’s Director of Mental Health Services said that the number of hospital beds in the Borough had not been reduced. 

When Six Oaks Ward at The Royal Free Hospital was closed to be replaced by The Helen Boyle Unit, eight beds were lost.  The further changes at The RFH have reduced still further the number of beds.  No more places have been created.  Thus the Director of Mental Health would appear to be wrong.  Before we call in the police to look for the missing beds, let us consider what he was counting.  In his figures, he included The Mornington Unit – an all-male Psychiatric Intensive Care Unit within The Huntley Centre.  Of course, this provides an added number of beds, but they are not beds available to anyone – they are only for people requiring intensive care.  Like all politicians, he has able to truthfully answer the question he wanted to answer because the one asked was not specific enough.  The assertion that we make is that the number of ‘general psychiatric in-patient beds in the Borough has been reduced.  Let the Care Trust deny that.   That number will be further reduced with the new developments of the Nurses’ Tower.

Tuesday, November 26 saw the last SCUF of 2002.  There is not one in December because it would clash with the Christmas celebrations.  Charlotte Pomery came along to a poorly-attended meeting to talk about the important topic of ‘Fair Access to Care Services’ – the changes the government is making to the way that care will be allocated on a needs basis. 

The South Camden User Forum has now been running for four years and for two of those it has had a permanent base at Jules Thorn Day Unit from 5.00 – 6.30 pm on the last Tuesday of the month.  Attendances waxes and wanes and the dark nights and cold weather always tend to reduce the numbers.  It is as established feature in the Camden mental health landscape and will continue into 2003.

The first meeting of the New Year will not be on the last Tuesday of the month, because it would clash with the Mental Health Liaison Group meeting on Tuesday, 28 January.  SCUF will be held the week before and it will bring Sue Salas, who is the Assistant Locality Director at The Huntley Centre to talk about ‘Faith & Mental Health’ and in particular, the Islamic faith project that has been running at The Huntley Centre.

The February meeting will be held on Tuesday, 25^th ,  when Lee Furniss the Care Trust’s Chief Pharmacist who is based at St Luke’s Hospital will attend to talk about ‘Better Drug Information’.  If there is any one subject that users of the mental health service want more information on it’s drugs – their effects and side effects.  Lee will be talking about a couple of ideas which would serve to improve the information available to people about the medications that they have to take and increase the choices available to them.

NORTH  CAMDEN  USER  FORUM (NCUF)

We usually have speakers at Forums meetings, because in the past we have found that when there is no-one to start the discussion then it often does not start.  So it was a bit of a risk to have a December meeting of NCUF which had no speaker and the difficult topic of ‘Surviving Christmas’.  In fact, the experiment went very well and a lively debate took place with the mince pies and sandwiches which are so generously supplied each month by North Camden Mental Health Service.  People spoke about Christmas they remembered and the Christmas that they are expecting and it sounded as if most of them had made arrangements to survive quite successfully.

The meeting commenced with Professor Michael King, Head of the Department of Psychiatry and Behavioural Science at The Royal Free Hospital Medical School and someone who has spoken at previous NCUF meetings, talking a little about a new research project in which his department is involved as part of an international study looking at the care that people receive.  He is trying to recruit people who have been given a diagnosis of schizophrenia (nut do not necessarily accept it) to be involved in some Focus Groups led by service-user researchers to discuss their care – not just medical care but the wider issues of benefits and housing too.  Service users will be rewarded for their participation.  Anyone interested should contact Sokratis Dinos, the Research Fellow involved, on

This year’s Annual Service Users’ Conference was held on the afternoon of Wednesday, 27 November at Hampstead Town Hall and had as its subject ‘Dealing With A Crisis’. 

An overview of the crisis position within the statutory services was provided by Camden’s Director of Mental Health Services, Colin Plant.    This was followed by presentations from the North and South Camden Crisis Response and Resolution Teams which are the newest of the services established to try and help people in crisis and now also in coming out of hospital.  Since its inception the South Camden Team has had service-user input from the Crisis Advisory Forum, and it was interesting to learn how this has informed the development of the service.

For many years now Camden has been fighting to try and establish its own Crisis House and although the will is there, so far it has proved impossible to find a suitable building.  However, the search continues and the next part of the meeting heard the models of care used in different forms of crisis houses.

Anna Minogue talked about ‘The Haven’.  This is the Crisis House run by Umbrella in Islington which currently has some Camden provision.  It has had continuing difficulties with the drop-in centre that it runs alongside the crisis house.   This is interesting and important for Camden, since in the survey people indicated that they would like such a facility with the Camden house.

Shirley McNicholas talked about the ‘Women Only’ provision at Drayton Park and this led on to the wider question of the provision of services which women want to use.

Leonard Williams talked about Hackney’s Nile Centre which is a specialist provision for people of African and Caribbean origin and how the different cultural values attached to family and faith play a specific part there.

Anam Cara run two Crisis Houses in Birmingham and their presentation was clearly inspirational to the service users at the meeting.  This is a provision where service users (known as Recovery Guides) work with other service users who are in crisis to see them through it and out the other side.  The model has been in place for some time, works well and is much liked by those who use it.

Oriana Mitton was one of the five service users who worked on the Camden Crisis House Report which CMHC prepared in 2001 and is available on our website at www.cmhc.org.uk   She told the meeting about that piece of user focussed research and what people had told the interviewers they would like to see in a Crisis House.  There was no doubt for most people that they would like a Crisis House which also had drop-in facilities.

It fell to Ray Keane, Senior Development Officer with Community Commissioning, to bring the meeting up-to-date with developments.  There is a commitment to establishing a Crisis House in Camden and the money to run it has been secured and is ring-fenced, The problem has been with finding a property.  In two years, a number of potential sites have been looked at, but none of them has met the necessary criteria.  However, the search goes on overseen by the Crisis House Working Group which is Chaired by Councillor John Rolfe who was also at the conference.  A Crisis House Commissioning Group has been set up to take the process of finding a property further and a Crisis House Operational Group is working on  the possible operational model for the house.  Ray was keen to obtain volunteers for this group.  Properties are still being looked at and there is the possibility that one of these will become the Camden Crisis House.

The Annual Conference was Chaired by Dr John Carrier who is Chairman of Camden Primary Care Trust and he will be able to take back to them the views of service users.  Councillor Penny Abraham, Camden Council’s Executive Member for Health and Social Services, who was champion of the original idea, was there to carry the message back to Council.  Colin Plant and Hari Sewell, both Directors of the Mental Health and Social Care Trust represented the Trust.  Cheryl Weetman from Camden’s Community Commissioning Team heard the message to the Commissioners.  The message – Camden service-users very much want a Crisis House, and they would like it soon.  (It’s an interesting sidelight that in his recent book on the mental health services ‘Pure Madness’, Jeremy Laurance, Health Editor for The Independent, sees Crisis Houses as a way forward).

In a spirit of partnership, the catering was provided by NDC’s Chameleon Catering Project, and CMHC would like to thank Reshad and his team for the excellent spread and we look forward to using them again in the future.

The Service Users’ Conference is an Annual Event and the next one will be held on Wednesday, 26 November 2003 at Hampstead Town Hall. 

Hari Sewell, Director of Social Care gives a review of the month’s events within Camden & Islington Mental Health and Social Care Trust. Hari may be contacted at Care Trust Headquarters, 2^nd-floor, East Wing, St Pancras Hospital, London NW1 0PE, by telephone on 020 7530 6303 or by e-mail hari.sewell@candi.nhs.uk

Firstly, the Care Trust extends warm season’s greetings to all service users, carers and others we work with.

The Care Trust Draft Service User involvement Strategy will be out for consultation from January to the end of March 2003.  The strategy makes specific commitments to developing service user involvement in the Care Trust.  It makes proposals about who is involved, how service users are supported and rewarded for involvement and it describes the areas of activity in which involvement will take place.  Please respond to this consultation.  It is a real attempt to organise the involvement of service users without making the process so bureaucratic that it no longer feels dynamic.  We look forward to hearing from you.  The strategy will be widely circulated.  If you have not seen a copy by late January, please contact Hári Sewell, Director of Social Care: Tel 020 7530 6303.

Camden and Islington Mental Health and Social Care Trust successfully gained accreditation as an Investors In People employer.  Investors in People is a national standard awarded to organisations that demonstrate levels of good practice in the training and development of their staff.

Some staffing issues:

Two key members of staff who have been strategically involved in service user involvement will be moving on.  Sandra Miller, Assistant Locality Director in South Camden is currently taking an employment break until May.  Stuart McMullen, Assistant Locality Director in North Camden will be moving on at the beginning of January, arrangements for cover for his post are yet to be confirmed.

The Department of Health in London has been leading work to create a information exchange system between London Mental Health Trusts, the police and probation services for when service users move between areas and agencies in London.  The pilot phase of the work involves services in the boroughs of Westminster, Camden and Islington.

The Homelessness Directorate of the Home Office has agreed to fund the expansion of the Focus team for the Homeless Mentally Ill to North Camden for an initial period of one year, starting February 2003.

The first National Mental Health Patient Survey, National survey of mental health service is part of a rolling programme of patient surveys in all NHS trusts, PCTs and Care Trusts.  Service users on CPA registers in mental health trusts, care trusts and PCTs providing specialist mental health services will be surveyed.  A standard questionnaire will be used for all trusts.  The objectives of the surveys are to provide feedback from service users that can be used by providers to identify areas for quality improvement and to provide a measure of the experience of service users using mental health services. 

The implementation of the Mental Health National Service Framework (NSF) is monitored by the Primary Care Trust (PCT) commissioners.  Of the forty-one standards for assessment, only two areas were given a red rating.  These are (a) The Early Intervention Psychosis Service, which is rated red as the service is not yet up and running, but plans are in place for the required start date of March 2004 and (b) CPA Carers Assessments are not being carried out sufficiently to demonstrate whether services are adequate for local need.  The Care Trust has agreed a plan to improve the number of assessments.

The Care Trust has taken on service management of Shaftesbury Road – a six bedroom house from Islington MIND.  The small staff team were transferred to the Care Trust.

Wards at The Royal Free Hospital are being refurbished.  New lighting is being fitted on Nicol Ward and this has meant that a number of the beds have had to be temporarily closed.  Many of the bedrooms are being redecorated and new flooring is being laid.  This work will improve the overall environment and create a space which is more therapeutic and comfortable. Alice Ward and the Helen Boyle Unit will also have some re-decoration and refurbishment. 

The Care Trust held another Recruitment and Selection Training session for Service Users in November.  The session was well attended and a further nine service users have expressed the wish to go on to participate on Care Trust Interview Panels.  The Care Trust is endeavoring to involve more service users in the recruitment and selection process and extends it's appreciation to all service users who have participated in this important process.  Angela Hall, the Service User Involvement Co-ordinator for the Care Trust, reports that positive feedback is forthcoming from staff who have highly praised and valued service-user participation in this process.

The Care Trust Annual Honours Awards will this year include awards for service users and carers, in recognition of the outstanding and valuable contributions made by service users and carers in the field of mental health.  If anyone is interested in nominating a service user or carer for an award please contact Samantha Jayaram from the Communications Department on 0207 530 3178 for more information and a nomination form.

Hari Sewell, The Care Trust’s Director of Social, Care attended the November CBUG meeting to talk about his role in service user involvement and the Trust’s Service User Involvement Strategy which he is drafting and which is expected to be available for consultation in the New Year and will be the subject of CBUG’ Meeting on Wednesday, 19 February.  Hari arranged his presentation so that it was fun with everybody interrogating him on a key point.  The second part of the meeting heard about the Umbrella Mentoring Project to employ service-users in the role of mentors for other service users.

It has been important for CBUG to set its own agenda and decide what work it wants to take in.  This was the purpose of its December Working Group.  There are only six CBUG Members at the moment and it well recognises the importance of recruiting more people to strengthen the team.  This will be one of the principal tasks in the coming year and the CBUG members will be making presentations about the group at various venues in the Borough.  But this is only one of the tasks.  It is involved in the Audit of Service User Involvement and the Camden-side of this has been completed.  CBUG ha agreed to take on the Islington part of the audit working alongside Islington service-users and with the help and support of the Care Trust’ Service User Involvement Co-ordinator, Angela Hall to try and complete it as soon as possible.  Once this audit is completed and analysed, there should be a clearer picture of what is going on across the District and what the strengths and weaknesses of user involvement are.  This will provide a guide to future investment in service user involvement locally.  CBUG has set itself to undertake three discrete pieces of work in 2003 besides recruiting to its own number and this is one of them.

The second large piece of work that it is going to taken on is an audit of the Mind In Camden Patients’ Advocacy Project currently working in Camden Mental Health Service on Level 2 at The Royal Free Hospital.  This will require an instrument for obtaining the views and comments of people who have used the service and finding a method of asking these questions.  CBUG will be developing the method and the questionnaire in conjunction with the advocacy team, and it is likely that we will be asking someone to come in and oversee this project.

The third piece of work is an Audit of the North Camden Crisis Response and Resolution Service, probably in the form of a Customer Satisfaction Survey.  CBUG Members will be working with the North Camden Crisis Team to develop the questions and to devise a method of asking them to users of that service.

CBUG has received an offer of help from the Tavistock Consultancy at The Tavistock Centre to work with the group to try and develop it so that it works more effectively.  It will also work with the consultancy to develop a Protocol of Engagement, which will attempt to set out the terms on which it takes on pieces of work or gets involved with groups. CBUG Members have asked for presentation training to help them with the job of roadshowing the group and recruiting to its number, and they will be receiving this in a one-day session in January.

The first CBUG Open Meeting of 2003 will be held at Hampstead Town Hall on Wednesday, 15 January and will have as its subject ‘Consulting Service Users’.  This is something that happens quite often, but service users seem to have little say in how they are consulted.  This issue fits neatly with the role of ‘Scrutiny and Overview’ and Councillor Janet Guthrie who is Chair of Camden’s Scrutiny Commission will be attending.  It also leads into the second CBUG Open Meeting on Wednesday, 19 February, which is the consultation on the Care Trust’s ‘Service User Involvement Strategy’.

SERVICE  USER  ADVSORY  GROUP

The November meeting of this group heard from Dr Steve Pilling and Sue Balmer about the plans to establish and Early Intervention Service.  This new service is intended to ensure that people – particularly younger people – with early onset psychosis are seen and treated quickly.  The reason is that there is evidence to show that if this is done there are better outcomes for the service user.  This new service us likely to appear in the early part of 2003 and it was recognised that there should be good user input into its establishment.

The group was obliged to postpone its usual December AwyaDay at St Luke’s Hospital, where it reviews its work and makes decisions for the future.  It will now be held in 2003.

The UAG decided that a proper use of the money that it has been given in recognition of its work would be to engage some training to make the group more efficient and effective.

The group asked the two Service User Advisers to the Care Trust Board, Barrie Hall from Islington and Scott Stevens from Camden, to approach the Chief Executive and the Trust Board about the establishment of a Service User Resource Centre where interested and active service users could find the information that they need and the facilities that they require for effective user involvement.

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