For some time now, The Camden Bugle has been asking the question about user involvement ‘where are all the service users going to come from?’ We have worked with our Commissioners and others to try and develop a strategic approach to this problem, and as part of the solution we have developed the Camden Borough User Group (CBUG) with twelve committed people who will be trained, supported and rewarded for their input. However, it is becoming increasingly apparent that the demands for service-user input are beginning to far outstrip the supply. The consequence of this is that too few people have to take on too many tasks, and the pressures upon those involved become unsustainable. The backhanded reward often comes with remarks like ‘the usual suspects’ Surely the time has come to look again at how this can best be achieved, and it must be a proper task for the Commission for Patient and Public Involvement in Health to address this problem and come up with a real plan to deal with the shortage and fund the process properly. If this is not done, then it seems unlikely that there will ever be a position where there is real involvement and it will always be a minority who struggle to bring about some change. SHOOTING FROM THE LIP Dr John Hoult is the Care Trust’s Crisis Guru. He provided both the evidence and the experience for the establishment of Crisis Intervention Teams. He is a decent man and perfectly friendly. It is extremely unfortunate to see him reported in the Camden New Journal as wanting greater powers to medicate patients against their will. That piece makes it clear that Dr Hoult is in favour of compulsion and compliance. It is tempting to speculate that he has missed his vocation and should have been a policeman since it seems that what he would like to establish is a psychiatric police force armed with syringes full of sedatives ready to administer to any recalcitrant patient they come across.
WELCOME and FAREWELL CMHC would like to welcome Robert Jones to his new post as Social CARE and Inclusion Development Manager. We look forward to working closely with Robert over the coming months. At the same time, we say ‘goodbye’ to Joe Bishop who is leaving as the Social Inclusion/Service-User Involvement Project officer. We have enjoyed working with him during his short tenure. Tina Purcell is crossing the border and moving from Islington to take up the post of Service Manager, Specialist Services for Camden. Tina will be based on Level 2 at The Royal Free Hospital CONGRATULATIONS We would like to congratulate CBUG member Richard Leader on having the cushions that he made exhibited in the window of LIBERTY’s, the Regent Street store. There was a report in the Camden New Journal for August 21st where Richard explains how he made them during a recent depressive period and tells something about his own life, his illness and his relationship with the Manic Depression Fellowship (MDF). We would also like to congratulate Jules Thorn Patients on their highly commended ‘One Drew Over the Cuckoo’s Nest’ art exhibition which is still open in the corridor at the Conference Centre, West Wing, St Pancras Hospital. CARE TRUST BOARD MEETINGS This month’s meeting of the Mental Health & Social Care Trust Board will be held on Thursday, 25th September from 2.00 pm at the London Voluntary Resources Centre, 356 Holloway Road, LONDON N7. This meeting is open to the public and papers may be obtained from the Board Secretary, Kate Wilkins, on 020 7445 8427 or by e-mail kate.wilkins@candi.nhs.uk There is provision for the Board to consider at its discretion notified questions from members of the public and these should be sent to Kate Wilkins by 5.00 pm on Tuesday, 23rd September. In the same venue, the Board Meeting will be followed at 5.00 pm by the Annual Public Meeting of the Care Trust. We would urge as many people as possible to attend. TAVISTOCK & PORTMAN NHS TRUST The Tavistock & Portman NHS Trust will be holding its Annual Public Meeting from 6.00 pm on Monday, 15th September in Seminar Rooms 2 & 3 on the Ground Floor of The Tavistock Centre, 120 Belsize Lane, NW3. There will be a keynote presentation by Dr Caroline Lindsay, Consultant Psychiatrist on The new face of mental health services for children and adolescents and their families. Board Papers are available from Mrs. L. Higginson, Executive Office, Tavistock Centre (Tel. 020 7435 7111 ext. 2335) LAUNCH OF THE CAMDEN LIT One of the most important developments in mental health in recent years has been the National Service Framework (it can be found on the CMHC website www.cmhc.org.uk at Key Documents). The NSF is the plan for improving mental health services and the performance management system to see that this is done is the LIT (Local Implementation Team). Previously there was a District LIT in the form of the Mental Health Development Group, but it has been decided that each Borough needs its own LIT and Camden will be launching its team of professionals from Camden PCT the Care Trust and other areas, voluntary sector members, service users and carers in September. The LIT will be Chaired by Stephen Conroy who is Director of Commissioning at Camden PCT. The service user representatives will be drawn from CMHC/CBUG. The Islington LIT came into being earlier in the year. MORE ROOM At the beginning of August CMHC took on extra office space at Hampstead Town Hall. The space became available when our erstwhile neighbours the Sudan Relief and Rehabilitation Organisation gave up their office which they had been using and which abuts on to the CMHC office. The British Chinese Arts Association still have an office within the CMHC office. This additional space will provide more privacy, serve as a base for CBUG and in future all the CBUG Working Group meetings are likely to be held in it; provide an area for Management Committee meetings and discussions; and provide extra room for the assembly and despatch of The Camden Bugle and other mailouts. Eventually, we may be able to use it as Resource Centre for all the information that involved service users need and want.
This year’s Annual General Meeting will be held in The Sir William Wells Atrium at The Royal Free Hospital from 6.00 – 8.30 pm on Tuesday, 9th September 2003. Nomination forms for the posts of Honorary Officers and Management Committee Members were sent out at the appropriate point. At the close of business on Tuesday, 26th August, the nominations received for Honorary Officers and Trustees of Camden Mental Health Consortium in proper form were: CHAIR: SCOTT STEVENS Proposed: Robert Watson Seconded: Marianne Hooper VICE- CHAIR: ANGELA RAJA-CHOWDHURY Proposed: David Hayes Seconded: Martin Elman SECRETARY: C. R. ‘ARUL’ ARULAMBALAM Proposed: Noel Walker Seconded: Richard Leader TREASURER: W. PATRICK DALTON Proposed: Andie Traintafillou Seconded: Maureen Griffiths MANAGEMENT COMMITTEE: Mrs AME DUNN-LEWIN Proposed: Caren Watson Seconded: Angela Raja-Chowdury HUGH STURROCK Proposed: C. R. Arulambalam Seconded: Caren Watson CAREN WATSON Proposed: Ame Dunn-Lewin Seconded: Hugh Sturrock Mrs MALTI ZAVERI Proposed: Col-in Burrell Seconded: Sean Cashin In accordance with the Constitution 9(f): ‘Nominations shall close fourteen days before the Annual General Meeting, and in the event of there being more nominations than vacancies, the Secretary shall circulate details of the nominations, to all eligible members seven days before the Annual General Meeting. The election will be conducted by a secret ballot at the Annual General Meeting. In the event of there being insufficient nominations for the vacant places, nominations can be received at the AGM.’ Since there is only one nomination for each of the Honorary Officer posts, the person nominated will hold the post for the next year. Since there are fewer nominations than there are vacancies for the Management Committee, the four people concerned will become Management Committee Members for the next year. Since there are still four vacancies for Management Committee Members, nominations will be taken from the floor at the Annual General Meeting. Nominees, proposers and seconders must all be Full Members of CMHC on Tuesday, 12 August 2003. This year, with the permission of the meeting, the proceedings of the meeting will take the interactive form that they had last year. The Annual Report and Financial Statements have been sent out to allow people plenty of time to read them and to negate the necessity of going through them line by line. The Agenda for the meeting is quite heavy and therefore CMHC is asking people to notify us of any questions by 12 noon on Thursday, 4th September to be sure that they will be answered on the night. Other questions may have to receive a written reply. Our Guest Speaker this year is Jeremy Laurance, Health Editor of The Independent who will talk about his book ‘Pure Madness – How Fear Drives the Mental Health System’ (Published by Routledge at £9.99) which was reviewed by Kim Janssen in the Camden New Journal for 21st August (Pg 23). Before we take to the food and drink, there will be the prize draw for CMHC Members to win gift vouchers worth £25, £20, £15, £10 and £5. The prizes will be drawn by the Mayors of Camden and Islington who have both agreed to attend as has our local Member of Parliament, Glenda Jackson CBE.
The August North Camden User Forum was almost guaranteed to attract a good audience since it was on one of the subjects which service users are interested in and care a great deal about – Medication. Dr Phil Harrison-Read is a North Camden Psychiatrist and therefore he prescribes the medicines which service users often have to take even though they would rather not do so. But then Dr Harrison-Read’s speciality is drugs and he freely admits how little doctors often know about the powerful medications that they use. He was able to look at the proven effectiveness of drugs and the beliefs that people have about them, both doctors and patients – some quite false. It was clear that both sides need to have more information about these powerful medicines and that they need to look at some of their false beliefs. Doing this might make it easier for doctors to prescribe drugs that their patients felt able to take. Information seems to be the key to this process and one of the conclusions seems to be that patients should be able to obtain more and accurate information in a form that they can understand. Erville Millar is the Chief Executive of the Camden & Islington Mental Health and Social Care Trust. He is the Chief Executive Officer of the main provider of mental health services in Camden and Islington. In a unique trial, Erville is coming to the September 2nd meeting of the North Camden User Forum (NCUF) so that people can ‘Ask the CEO’. We will be encouraging as wide a range of questions as possible and it will be useful in obtaining this breadth if people would notify their questions in advance either in writing to us at CMHC, Hampstead Town Hall, 213 Haverstock Hill, London NW3 4QP or by e-mail: administrator@cmhc.org.uk Erville will be asked questions, but he will not be answering questions which relate to individual complaints about treatment or care, or about Care Trust employees. There is a procedure for this and as the CEO he must abide by it. If you are in doubt about a question, please give CMHC a call on 020 7419 4196 and we will try to help. If this meeting works then we would hope to hold more meetings where the Care Trust opens itself up to questions to those who use its services. This is an attempt a public inquisition and we hope that it will represent a way forward for the people who use the services to actually question those who are charged with the responsibility of supplying them.
The venue for this month’s South Camden User Forum was changed from Jules Thorn Day Unit to the St Pancras Conference Centre and it was disappointing that so few people attended a meeting which service users had particularly requested on ‘Psychiatric Diagnoses’. There may be an important lesson for CMHC from this. Dr Kwame McKenzie is a psychiatrist who was working with the Haringey Antenna Outreach Team and is a Senior Lecturer in the Department of Psychiatry & Behavioural Sciences at The Royal Free Campus of University College London. He has an unusual approach to mental illness in that he is not concerned too much with categorising it and applying labels to it but takes a more problem-based view. He is concerned with the person that he is seeing, and trying to resolve the difficulties that they may be experiencing. He is not keen on diagnoses because he sees them as not being particularly useful and tending in some ways to be a ‘get out’ – once there is a diagnosis then you know what to do. He admits that this approach does not always find favour with his colleagues and that he is unable to persuade the Department of Work and Pensions and the Housing Departments to go along with it. They seem to need to know what something is called before they can make decisions on what they should do about it. The meeting held an interesting discussion which ranged away from the original topic but was centred on the stigma associated with some diagnoses and the damage that the label may do to the patients and their relationships with the world. This theme will be followed in the next SCUF meeting, which once again will be held in the Conference Centre and will bring Dr Peter Byrne from University College London to talk about STIGMA. This is the rescheduling of the July meeting when Dr Byrne was unable to make it. Since Stigma is one of the most common experiences of the mental health system (although not a mental illness, it may cause them) and one of the things that service users most often talk about we hope that this meeting will be well attended. There are then only two further SCUF meetings before the end of the year. There is no December meeting because it would fall during the Christmas holiday, but 2004 will have the SCUF at its regular spot each month. The SCUF attendance has been patchy this year and the February meeting had to be abandoned but the January meeting on ‘Faith & Mental Health’ was one of our best-attended meetings for the whole year. CMHC will be looking at the attendances and trying to respond in a positive way.
The August meeting of the Camden Borough User Group was held at Hampstead Town Hall on Wednesday, 20th August and provided an opportunity for the group to look at how and why it came into existence and what its role is in the wider mental health economy. It has been in being for nearly two years now and it is still trying to establish its own identity and workplan. The group was originally set up to train, support and reward service users who wanted to become more involved and had the time, energy and capacity for this. It was based around a group of twelve people. It is funded by grants from Social Services and Camden PCT to the level of £37.5 thousand per year and this year this funding was agreed for three years and was consolidated with the Camden Mental Health Consortium funding which means that CBUG is now an ongoing CMHC group. How has it done in terms of its intentions? It started with a launch in November 2001 and there were a lot of service users who expressed an interest in joining and becoming further involved through CBUG. The reality turned out to be more modest and there were only six people who wanted to play a part. However, this was a start and CBUG began to hold regular meetings. In 2002 it appointed its first full-time Co-ordinator, John Lavery, who set to work to recruit to the group and develop a workplan which was both realistic and achievable. One of the first steps was to send out CBUG members as ambassadors to other groups to explain what it did and try and increase its own membership. This took some time, but the numbers rose. Unfortunately, they did not reach the target. John found another job and left our employ. This placed us in a dilemma. We had the funding and we had begun to build the group, but it was still a long way from achieving anything like the ambitious targets that had been set – two projects each year. It became difficult to see CBUG continuing and developing unless there was some greater input. This was provided by Nicky Coombes who filled the breech and took over as part-time Co-ordinator after John’s departure. Nicky worked in this post until April of this year and during that period the membership grew to 10 and the first of the CBUG projects, the audit of service-user involvement in Camden was undertaken. Training packages were also put in place and CBUG Members have now been trained in Presentation Skills, Time Management and Mental Health Act Law and most recently in the CORE (UCL) User Focussed Monitoring. There is still no Project Officer and in consultation with our commissioners, CMHC has decided that this is a role that it probably will not fill. Instead we will be looking to CBUG Members to lead on individual projects and this should help Members to develop other skills. For the time being, Linda Polan has taken on a lead role in the two monitoring projects that we expect to undertake this year. The Report on the Audit of Service User Involvement has still to be written and the delay is due in part to the hope that a similar audit will be done with the same audit tool in Islington and there will then be a picture of service-user involvement across the whole District. This has taken some time to bring about, but the funding has now been agreed and CMHC is working with Angela Hall, the Care Trust’s Service User Involvement Co-ordinator, to try and find the Islington service users to undertake the work alongside CBUG Members. CBUG is also involved in monitoring the North Camden Crisis Service using the CORE UFM method, and it is hoped that in addition to the current rather slow postal questionnaire there will be the possibility of an assisted interview. It is hoped too that this will be extended to the South Camden Crisis Team so that in November both teams will be audited using the same method. It will shortly be undertaking monitoring of the Mind in Camden Patients’ Advocacy Project at The Royal Free Hospital. This is the first collaborative venture with a voluntary sector partner and CBUG is working with Mind in Camden. This work should have been undertaken some time ago but for a variety of reasons it has taken longer than expected to get under way. CBUG is also considering whether it wishes to hold monthly Open Meetings or whether these should be converted into Working Group Meetings with Open Meetings once each quarter. It now has nearly its full complement of members and they are regular attendees at its meetings. They are keen to be involved in further work and see the monthly Open Meetings as distracting somewhat from this. There will be an Open Meeting on 17 September at ‘The Hoo’, but there will not be one in October and CBUG will not be meeting at St Luke’s that month because it will be having a meeting to look at how the group can best develop its own work and programme and establish a Protocol of Involvement for itself with the services that may wish to commission it to undertake tasks. It has much to do and is keen to get on with the job.
Traditionally, August is a relatively quiet month. Even so, there is much to report. I am very pleased to report that the Board meeting on 31st. July agreed the commissioning programme for the New Highgate Wing which will be called The Highgate Mental Health Centre. Although the building work is almost complete, there is an immense amount of work still to be done in deciding between the various options for using the available accommodation, configuring the new ward space, preparing staff for the move. However we anticipate that this long planned and exiting new development will be ready to start providing services directly to Service Users in January. Feedback from the consultation pointed to a desire to see a women-only facility within the ward accommodation. The Board agreed in principle to an Option that included this important development (Option 3), but raised important questions of detail that the Project Board has been asked to resolve. Over the next few months I will endeavour to keep you in touch with progress towards the unit’s opening. The Care Trust ran the Recruitment and Selection Training afternoon as planned at the end of July. There was an impressive turn out for the training, resulting in a further 16 service users who have said that they wish to go on to participate on Care Trust recruitment and selection panels. The Care Trust would like to take this opportunity to thank service users for their ongoing interest in, and commitment to becoming actively involved in Care Trust business. We have now completed the recruitment exercise for Service Users to join several Care Trust committees. The Service Users were interviewed over two days, because of the level of interest. The standard of the candidates was extremely high, leaving the panel with several very difficult choices. As a consequence the Care Trust has been able to recruit Service Users to sit on all three committees. However, it is likely that there will be a further recruitment drive later in the Autumn, as it is felt we would like to appoint “shadow” members who can deputise and gain experience in these important aspects of the Care Trust’s business. Jules Thorn Day Unit is currently displaying their art works in the reception area of the West Wing in St Pancras Hospital. The exhibition is called ‘One Drew Over the Cuckoos Nest’, and consists of a range of art works in various forms including painting, creative writing, pottery and sculpture. The exhibits are extremely impressive and all are welcome to come along to see them. The Job Club will recommence on 25th.September at its usual venue at Bath Street. Further dates will be confirmed in the next issue. Bruce Buckmaster, Project Manager for Service User Employment has also asked me to tell you that he anticipates the Employment Road show will begin in Camden, starting with a session at the St. Pancras site in early Autumn. The Road show is intended to offer informal advice and support for Service Users who are interested in exploring ways back into employment. Also on the Service User employment front, I am able to report that earlier this month Bruce participated in an Early Intervention Workshop. This was attended by Mental health professionals, Service Users and Carers, together with Voluntary and Statutory Partners across Camden and Islington. The event, looking at constructive ways to assist people in employment, who may be experiencing Mental Health difficulties, avoid this employment being at risk. I understand that the event was extremely successful and some worthwhile ideas emerged. I am happy to record again that Robert Jones, the permanent Social Care & Inclusion Manager, takes up his new post on the 26th. August. After a few days handover, Joe Bishop moves on to pastures new. He has asked me to say a big ‘thank you’ to all the Service Users he has had the pleasure of coming into contact with for their ideas, interest and on occasion support and advice. He also asked me to pass on his good wishes to all of you and his fond wish that you welcome and support Robert in a similar way. CAMDEN COUNCIL’s MENTAL HEALTH LIAISON GROUP The next meeting of the Mental Health Liaison Group will be from 6.00 – 8.00 pm on Thursday, 24th September in the Upper Room at The Spectrum Centre, 8 Greenland Road, Camden Town when the main topic will be talking therapies.
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