Alienation Over Mental Health Zero Policy

Acccording to some Users in the UK Mental Health Services are either disappearing or people cannot use them. In 2006 A Cafe in Luton supporting MH users to "socially include them" has had its financial supports pulled. Userwatch was contacted by a User associated with NIMHE this week who told of a story in which two men were crying in pain in a MH group because they could not get treatments off their Trust that fitted them .

Another User tells of two suicides in quick successsion.

A user on the UK survivors message board expressed great worry that the new rules for accessing the proposed Employment Support Allowance (2007) are so draconian that they will lead to suicides. Userwatch agrees after reading some of the criteria.

We note a theme therefore of radical undermining of mental health Users by all sorts of social engineering tricks which miss the hub of the problem for most Service Users - namely getting the right treatment in the first place . The Daily Mail (24th Oct 2006 ) carried a detailed critique with realitistic patient examples by therapist Oliver James on the superficial wave of CBT skimming the UK as an inadequate gloss-over answer to deeper human pain see : Here

A User of a Day Centre in Birmingham in his late 60's told Userwatch :

"What the fuck is going on with this "Social Inclusion" theory- We have been told to go to college and bid for a place or something , to use our own Centre ..If we have wanted to go to college we would have done that years ago "

Userwatch agrees and was also told by another Birmingham User :

"Too many of fitter "mad" are running "mad" policy for those of us who are "madder" and the Govt is full of psychological escapists anyway .. what chance do we have ? "

Asylum as a concept is pejoratively used by the new "Anti stigma" fashion in the UK and those who wave that flag as a "bad thing".. At the heart of services however there has been little asylum that heals and that is still an unaddressed unmodernised issue. If you are different-of-mind enough do not look to stressed underclass communities to look after you .

Equally the uniform application of new labour "push em out to work" ethos powered up by the brigades of the chosen fitter Users who populate NIMHE and its groups now is another cruelty which misses the individuals that cannot fit into society easily . Userwatch doubts there will ever be a social negotiation with really maginalised Users .. They are after all "represented" by others who have their "voice" even if there is no representational constitutionality in that position.

In other words "New Labour agenda-mis-fitting" Users have disappeared down the same black hole as real reform and Patient Choices of treatments has in mental health . Birmingham UK is no exception . We are all in socially warped space . How is your local health black hole ?

Birmingham Petition Pinches Aidens "Bottom Line"

In a cheeky copycat move by the organisers of the Birmingham UK petition for more local mental health patient democratic mechanisms of representation , one of the organisers a sympathiser of : Kiss It was determined to pinch Aiden's Shingler's "bottom line" for sheer joined-up cheek ..

The organisers explained :

"There is a UK wide and local need to support more action and more autonomous patient voices generated from the bottom-up not the new Top-down mental health hierarchies , because for all the fine rhetoric from the new architects of modernisation , the old controlling mentalities still exist in the NHS bureacracies. Patient power is depressed and even oppressed by in house partnerships with the NHS . We want to see Patient's having independent voices that are not suppressed by the NHS bureacracies . "

Aiden's 1000 signature petition against psychiatric violation was delivered to No 10 on August 10th 2006 and reported by Userwatch below (or see archive) on Oct 8th . The new "Cheeky" crossed bottom gesture originated by Aiden is to "Kiss my Axx" . Bottom Up power has arrived !

On the 20th Oct 2006 the organisers of the Birmingham UK 123 signature petition hand delivered it to the offices of Birmingham M.P. Dr Lynne Jones who sits on the all party mental health sub committee. Copies of the petition have been sent so far to the Independent Regulator "Monitor" of NHS Foundation Trust applicants , and the local Council's Statutory Health Overview Scrutiny Committee . The organisers plan to send a copy to the local Statutory Patient & Public Involvement Forum too and send information to a mental health resource group at Birmingham University UK .

The petition header reads :

"We the undersigned understand that the Birmingham & Solihull Mental Health Trust is not planning to have a patient constituency in its proposals for Foundation Status. We feel there should be a separate patient constituency from which representatives can be drawn . We also feel the current in house User Voice mechanisms at the Trust must become completely independent of the Trust and made accountable to a wide patient membership base… "

Society Guardian Knights Sir Userwatch

Userwatch (Birmingham UK) is indebted to Phil Hoad of the Society Guardian who has run a story in Oct 18th 2006 about UK Mental Health Blogs which include this Blog

Here

Phil Hoad is right to show interest in the tide's begining because Service Users are not taking too much more of promises of better services that according to Prof Nick Bosanquet in his study

Here

Are not happening .

A lot of Users in the community are not getting therapeutic supports they need , core elements of MH services with a theme of custodial care have increased according to Nick Bosanquet and Userwatch adds that the new mental health bureacracies have not shifted the emphasis at all toward "Patient Choices" of treatments and supports to further patient independence in the community. If anything they have diverted useful money which could have actually done that ..

NIMHE alone has cost £65 million in 4 years of operation ..

A new song might go : "Where has all the treatment gone ? Bureau-bypassing ?"

Patient Choice of therapies is crucial for moving toward independence or better creative social contribution as is using patient purchasing power through (the currently impoverished and inaccessible for some ) Direct Payments method and new forms of GP commissioning which lead to a mixed economy approach . Even in Doncaster as Nick Bosanquet points out the CBT therapy pilot did not involve the private sector . Userwatch believes the State sector has to to quality-drive Patient Choice and weed out inadequate service in itself or otherts by patient-satisfaction data .

Userwatch also wishes to point out the Society Guardian missed a dynamic Blog story and evolution of the Surrey & Borders Partnership Campaign to re-instate payments of £3 a day for 179 Services Users which that Trust had taken away from them in a dubious overapplication of a "Pathways To Work" and "Externalisation of Services" ethos . The Campaign was successful.

The Blog link is Here

Finally struggles continue in Birmingham UK to get justice at Day Centres like Albert Rd that Userwatch is aware of have had services altered without lawful Section 11 (Health and Social Care Act 2001) . This matter is not concluded and Userwatch can report activists will hold the services to account (more on this later and see previous stories )

See also JARMI

And Aiden Shingler's campaign against psychiatric violations deserves another mention - Good Luck Aiden ! KISS IT

The Dual Petition - The Duel For The Voice

By the end of this week Userwatch hears the petition group in Birmingham UK asking for both a "Patient Constituency" in the newly proposed mental health Foundation Trust and an independent User Voice with democratically accountable features will be delivered to several chosen parties .

One of them is intended to be Dr Lynne Jones M.P. and apparently others will include the Health Overview Scrutiny Committee at Birmingham Council as well as Monitor the independent regulator for Foundation Trusts .

Interestlingly enough some current members of the User Voice in-house mechanism at Birmingham & Solihull Mental Health Trust reportedly agree that they need to become independent. The model exists for a transfer of management from the local mental health Trust that employs them to an arms length source of financing from the local Primary Care Trusts.

The Primary Care Trusts are an arm of the NHS which purchase services from Local Hospital Trusts and they have seperated administrative powers . This is route by which Derbyshire Voice is financed successfully and it has a robuster model of representation of the patient-voice and interests ..

The "Sidelined" Dec 2004 Day Services Report In Birmingham (Update)

Sue Turner the CEO of the Birmingham & Solihull Mental Health Trust in Birmingham UK promised to do an investigation as from June 2006 into why an important Patient & Public Statutory Involvement Forum Report recommending tracking patient satisfaction after any Day Services were altered in Birmingham had never reached her or the Trust Board in early 2005.

The PPI Forums were set up by Govt in 2003 to be independent monitors of the patient's experience and perspective .


Finally as of yesterday on the 10th Oct 2006 Sue Turner's investigation was issued as below.

There are still a number of important concerns surrounding the Trust's willingness to properly create records of patient satisfaction in order to make available means whereby their experience of changing services can be checked deeply enough and independently as was supposed to be done if the Dec 2004 Reports recommendations had been adopted. The Report does not even appear to have been "adopted" by the Board even though Dr Lynne Jones has reportedly written twice now that the recommendation to track the patients own voice after Day Services are changed are simple good practice .

Investigation into the Tall Trees Report (Author Sue Turner CEO)

Context

The Trust Board approved the strategic direction for day care services in 2004. In line with Government policy on ‘social inclusion’ this set out the Trust’s intention to reorganise existing day care services so that people with mental health problems are better able to enter/re-enter work and are supported to enjoy social participation in mainstream community services. The first stage toward implementing this strategy involved the reconfiguration of services known as ‘Tall Trees’ located on our Uffculme site, Moseley.

Fortnightly consultation meetings were held with service users directly affected by these changes from May 2004 through to September 2004. These consultations were facilitated and chaired by User Voice. Proposals were presented to Birmingham City Council’s Health Overview and Scrutiny Committee, the Trust’s own internal patients’ forum, and a range of other meetings/forums. This was the first major service change proposed by the Trust since the inception of Public and Patient Involvement (PPI) Forums.

In September 2004 I met with members of the PPI Forum and Lynne Jones MP to review the Trust proposals concerning ‘Tall Trees’ services and the consultation processes which had been undertaken. At this meeting it was agreed that ongoing consultation with service users was important, but that these should be auditable. As a result, a parallel stream of work and joint discussions were initiated with the PPI Forum to clarify expectations and intentions concerning:

• Day-to-day consultation with service users.

• Ongoing auditable consultations with service users about future priorities and changes.

• Formal consultation processes for significant service changes and developments.

• How members of the PPI Forum might join internal Trust meetings overseeing social inclusion strategies.

Led by our Executive Director of Strategic Development, aspects of this parallel work was delayed due to her period of ill health (October 2004 – February 2005).

The reconfiguration of services previously based at Tall Trees has been completed and the Board have received two reports (June 2006 and September 2006) detailing the follow-up audits of service users following this.

Specific Issue

In our Board meeting in June 2006, a member of the PPI Forum questioned why a report produced by the Forum in December 2004 had not been acted upon. That report is shown at attachment 1. I have now completed an audit trail and can confirm the following:

1. The Forum report was emailed to our Director of Corporate Affairs on 20^th January 2005.

2. This was acknowledged on 21^st February 2005.

3. A fuller response was dispatched 22^nd February 2005 by our Executive Director of Strategic Development.

4. The PPI Forum report specifically recommends a follow-up audit of patients who had been attending Tall Trees centre by early February 2005. More generally that auditable consultation should be undertaken in relation to any other proposals to reconfigure day services.

5. The written response (22^nd February 2005) is shown at attachment 2. It confirms:

   • Follow-up audits in February 2005 would be premature.

   • A Project Board and Service User Advisory Group would be established to oversee implementation and follow up.

   • Representatives of the PPI Forum are invited to join the Project Board

6. The PPI Forum minutes show that the Forum made reference to “auditable consultation’” at their meetings held in February 05, March 05, April 05, September 05 and February 06. In particular, the minute in September 05 states “auditable consultation – the document was adopted at the Trust Board meeting” (September 05). In February 06 PPI Forum minutes make reference to auditable consultation having been carried out on changes in ‘workability’ services.

6. I have found only one reference to the actual PPI Forum report itself. This was in February 05 where the minute reads “Also concern at the lack of response to the report on Day Care services. Send the report to Jonathan Shapiro, Chair of the Board”. The Forum support officer has confirmed that this did not happen due to the receipt of the letter from our Executive Director of Strategic Development on 22^nd February 05.

Assessment and Conclusions

• Acknowledgement of the report was tardy, and informal.

Action:

• I have agreed with the Forum Support Officer that hard copies of correspondence will be used in the future, and our Trust Board Secretary/Company Secretary will be routinely copied in.

• The Forum report was not formally received by any of our formal Board sub-committees.

• The essence of the Forum report has been acted upon.

Further action:

• PPI Forum minutes will be routinely forwarded to the Trust and reviewed in our Patient Experience Board sub-committee.

• The recent appointment to our PPI liaison post should avoid any similar reoccurrence in the future.

• Should there be any outstanding concerns by PPI Forum members these will be raised when they meet with me on a quarterly basis.

Sue Turner

Chief Executive

WHAT USERWATCH HAS LEARNED :

An email by way of response has been sent to Sue Turner from Paul Brian Tovey , ex Vice Chair of the PPI , and copied into Dr Lynne Jones M.P, In Selly Oak Birmingham UK. , one of the Joint Chairs of the all party mental health sub committee. Essentially the email expresses the concerns of others succinctly enough and has asked to be put as a question to the Board meeting of 11th Oct 2006 :

"In the light of the CEO's investigation does the Board Intend to adopt the good practice of the Day Services Report (Dec 2004) which asks in essence not for staff audit of the patient's voice but in fact an auditable record of the patient's own voice about their satisfaction or not when services are varied and changed around them at Day Centres in Birmingham ? "

Overnight Dr Lynne Jones M.P. backed this position consistent with her concern too and copied Mr Tovey into her response to Sue Turner CEO to his question to put to the Board on 11th Oct 2006 (See Below )

----- Original Message -----

From: JONES, Lynne

To: Sue.Turner@bsmht.nhs.uk

Cc: P Tovey

Sent: Tuesday, October 10, 2006 9:56 PM

Subject: FW: Question To The Board

Could you please let me have a copy of your reply?

Thanks

LYNNE JONES MP

House of Commons
London
SW1A 0AA

www.lynnejones.org.uk

Aiden Shingler Presents The Petition's Bottom Line

Aiden Shingler and Catherine Ingram presented the "KISS IT" petition of 1000 petitioners to No 10 Downing Street on August 10th 2006 .

The serious side of the petition is to bring to public attention the abuses of psychiatry from poor treatment experiences to forced Electro Convulsive Therapy and uses of drugs on patients to make them compliant..

The petition was linked to action on the same day to a group 0f mental health survivors and supporters of the "Kiss It" campaign led by Dr Rufus May who had led a 60 mile hike with a hospital bed which finally arrived at the old site of Bedlam where "lunatics" were "treated".

The combined events have brought attention to the way the State treats people even though it claims to be modernising.

Userwatch is sympathetic to Derbyshire Voice a more genuinely independent and representative version of the "User Voice " than many NHS Trust sponsored in-house mechanisms. Many Derbyshire Voice supporters have supported the "Kiss It" campaign since its beginings ..

See :

Kiss It

"Stakeholder Involvement ? Or Fakeholder Involvement ?

Userwatch has received an email dated 6th October 2006 , to Catherine Underwood :

Head of Commissioning and Contracting Adults of Working Age
Adults and Communities Directorate
Birmingham City Council
Louisa Ryland House
44 Newhall Street
Birmingham
B3 3PL
Tel: 0121 464 5121


The email below puts forward a number of important views and questions the apparent lack of Section 11 (Health And Social Care Act) 2001) consultation in Birmingham UK on certain parts of the Mental Health Day Care Services ..

The original email was copied in to Netter Carder a Director at the Birmingham & Solihull Mental Health Trust , To Sue Turner's (CEO) secretary and to the Statutory Forum for Patient & Public Involvement and others ... :

"Dear Catherine



I believe part of the Adult MH Day Care services is adrift of appropriate Sect 11 consultations. I am very concerned that the MH Services co-admined by Social Care and yet under the service provision via section 31 agreement with Birmingham & Solihull Mental Health Trust - appear to be chaotically adrift of openly announced Section 11 consultations.

Was the statutory PPI ever involved in being told what Section 11 arrangements were put into place at The Hawksley MH Day Centre ?

The Albert Rd Day MH Centre for instance appears to have had its services varied almost by stealth over some time ; subtracting an activitiy here , and an activity there ...Making it less attractive .

Reducing Service Users numbers and dependency on it . A self fulfilling service prophesy of under-use apparently .

The current broad brush approach for 2006 - 2011 "Commissioning Strategy For Adults Of Working Age " would also appear to be , I am sad to say , democratically perverse.

It has every sign of becoming a substitute for individual Mental Health Day Care Centre Section 11 consultations sensitised to local context and Service Users at specific Day Centres.

The rush to "socially include" and "mainstream" and create a "clubhouse" modernising services is poorly thought out and ideological.

Arising partly from Dr Bob Groves (et al) work involving the Sainsbury's Centre For Mental Health " Pathways to Work" with its initial limits of application placed on those on Incapacity Benefit for up to two years , and with some initial age cut off's involved - we now see a massive overapplication of its theme justified by the "Social Inclusion Unit" and major pushes to shrink down the budget for Mental Health still further ..

Sensitivity of application over these "social inclusion" processes and careful thought has been lost Catherine , in a dash to force national policy onto everyone and bypass the check and balance of what Service Users want individually . Evidence in Birmingham of Service Users wishes is flawed because it hardly exists . Please demonstrate where your MH Day Careservices have carried out properly announced Section 11 consultations involving the PPI monitors on the following locations : Hawkesley Centre , Albert Rd Day Centre , and Main Street Centre .

Fitter users and younger ones may well wish to work . But there are other Users who are being cornered by the false modernisation drive which does not involve better supports and treatments ..Some users are lumped in to the drive to "socially include" and frankly are not fit enough and feel intimidated by the whole process and rarely are their direct voices audited. If you have any evidence of audit then please do share it with the PPI .

My position is very clear : apply social inclusion where people want it , are fit enough , and are actively engaged in that and preserve the asylum value of MH Day Centres because long terms Users need them . "Recovery" is not possible for some . Being permanently different is actually their reality .. Seeing that , is the job made possible by individual Centres following the Section 11 law and recording patients voices properly .

I dont think this is happening properly .

Finally I tried to get a place at the Sapphire Suite (a consultation event on 27th Sept 2006 ) and was told it was fully booked by your Secretary Kath Cunningham . I have now been sent a letter by someone who was there which deeply questions how many Service Users were in presence if at all any.




Regards


" ....

USER RAGE ? OR SERVICES THAT DO NOT MEET NEEDS ?

A political Di-oxide Policy is causing Mental Health Service Users in the UK to get even warmer and some say boiling . A service-choking government policy some Users say , is slowly throttling the services in the UK. The result is "User-Rage"...

It expresses itself in many ways and appears to be less of an intrinsic condition and more of a genuine expression of cumulative service poverty and unmet need .

Userwatch has heard now from several Users in Birmingham , and further afield who are not part of the cherry picked groups that can all gas off together - in a relatively passive atmosphere ofcourse.

Division is all in the U.K. with its class structures that are reflected in all walks of life . The mental health system is no different and its better services are claimed by the more self empowered Middle Class , some Users claim .

An article by a Journalist in 2005 working for "psychminded" , wrote about therapy services in Birmingham and highlighted the disparity of a type of family therapy treatment resource between the more middle class areas of nearby Olton and others areas of Birmingham which the Birmingham & Solihull Mental Health Trust has included within its entire service province.

Some Users In Birmingham and further afield cannot get advocacy for claiming benefits or even creating letters because they cannot write as part of their condition. Some claims they need this kind of help to respond back to clinical mis-targeting of their needs ..

Mental Health charities appear to be part of the problem now in the UK. with their eyes on becoming larger and more corporate and receiving more grants . Often Users claim these charities are seeking to create smooth images of representation of Users while agreeing with Govt on policies which are blunt on employment and therapy needs .

A backlash of sorts is happening in the UK. Slowly insight and experience of hopes for better services is being dashed and is gathering force but in the UK most social forces are overcome and socially muffled quite quickly.

The question is will "User Warming" and its symptomatic rage alter UK Government Di-oxide Policy. It all depends on the strength of social gales and how many there are in the next year or so ..User Rage is real enough though , and its been created by social contradictions and some services that no longer meet needs ..

MORE CONSULTATION ANOMALIES

There are reports that the recent "Consultation" event for "stakeholders" on 27th Sept 2006 at the Sapphire Suite in Birmingham UK lacked Mental Health Service Users .

Userwatch has heard from 3 Service Users in Birmingham with concerns about this event. 2 were told that the event was fully booked and a 3rd reports they knew of Service Users who also were told the event was fully booked .

Userwatch hears this story is going to develop because some kind of joint protest is likely to be made outside of the sticky professionalism that usually acompanies protests that Service Users were not involved . Userwatch can reveal that a report is being prepared which has some details in it of those who attended , and how many spaces and places were empty at the event.

There are some apparent deeper anomalies surrounding this event and the lack of joined up application of Section 11 of the Health & Social Care Act 2001 . There a number of Service Users and others now who are not convinced that there is a solid will to create consultations directly inside "stakeholder" spaces such as Mental Health Day Care Facilities themselves . The obvious choice anyone might think.

One Service User claims : "There is a very slippery approach by services in enfranchising our rights and giving us clear knowledge of time scales in which we could study proposals for change at our own Mental Health Day Centres "

Userswatch is aware that often proposals to vary Mental Health Day Care services are embedded in a fait accompli approach by staff who traditionally have been in charge of the process of institutional change . In the case of vulnerable adults sometimes , carers are not fully involved in learning about service variance or the right of "evidenced" consultation which their areas Overview Scrutiny Committee for Health has a legal duty to uphold ...

.