Wednesday, February 28, 2007

Crow A Doodle 10000 Signatures Lord Layard !


Will the e-petition for more psycholgical therapy choices on Tony Blair's (PM's) website reach 10000 ?

Ooooooo the climax is a coming ..Or is it ?

Will there be more therapy choices other than CBT ?

Will Choice have wings ?

Will it crow ?

We'll let you know.....................




We the undersigned petition the Prime Minister to consider other psychotherapy approaches, not only cbt, in the proposed expansion of psychotherapeutic services within the NHS, instead of restricting choice for members of the public to one only model of therapy. More details

Submitted by Sheila Haugh of British Association of the Person Centred Approach – Deadline to sign up by: 03 March 2007 – Signatures: 9,452

Friday, February 23, 2007

UserWatch Receives Summary Board Paper On Therapy

Userwatch has received a short CEO board paper regarding a Birmingham & Solihull Mental Health Trustwide audit of psychological therapy services from late 2006 .

The paper which UserWatch will report on in more detail later has used the term "Empathy" and puts it forwards as a future practice to improve the relationship between patients and the Trust's service delivery to them .

The problem though appears to UserWatch to be one of internal-emotional-capacity (i.e. Emotional skill) of the Trust's practices itself .

The Trust is dominated by an old culture of part bureaucratic practice and a predominant insistence on the chemical model which in practice is quite an unempathic model of mental illness according to actual patient experience ..

The Trust describe "empathy" in the 2006 paper " as a form of customer orientated "psychological mindedness". Userwatch would put it another way : Empathy is an internal emotional capacity to receive the feelings of others and show CARE- not to act in a "business role" as if that is the case . The difference is often enough experienced on an internal quality level by patients.

Empathic quality is unmistakeable to patients if they ever encounter it . Its the actual feeling that "one has been felt and received by another human being" ... In that sense its an emotionally providing experience . Its caring and partly healing . UserWatch thinks the Birmingham & Solihull Mental Health Trust has a lot to learn about being receptive to patients with empathic skill .. (more later)

The E-Petiton on the Prime Ministers Website LATEST :



We the undersigned petition the Prime Minister to consider other psychotherapy approaches, not only cbt, in the proposed expansion of psychotherapeutic services within the NHS, instead of restricting choice for members of the public to one only model of therapy. More details

Submitted by Sheila Haugh of British Association of the Person Centred Approach – Deadline to sign up by: 03 March 2007 – Signatures: 8,673



Saturday, February 17, 2007

Birmingham And Solihull Mental Health Latest Swasticka Image

Its funny isnt it ?

How the latest Birmingham and Solihull Mental Health Trust Board papers record in them that the Trust is going to make a 1.8 million surplus .

This is in the same year that they have put in their application to become a Foundation Trust and at least one of the qualifications is, they show they can produce a sizeable surplus .

So where did they produce it from ? Well (its funny) they produced it from underspending on staff wages or rather, put another way around : need is not met by having the right staff employed for all the patient demand there is .

That is what UserWatch believes.

This just gets hidden in waiting times to be seen and managed in other ways by partly ignoring patient's internal pain and crises and having inadequate systems that allow for the expression and even record of that. One example given to Userwatch was by a Birmingham User who claimed that a team were supposed to be contactable between 9. a.m. and 5 p.m. only to finally discover the person who took the phone messages only worked part time . There have been other examples too .

Are patients at risk ? You bet they are but UserWatch repeats that gets hidden too, in quietly unrecorded ways, and voices that will never be heard properly and recorded because the mechanisms are not robust enough . The Trust have certainly ensured some real unheard voices of pain with their financial squeezes on service capacity .

The "User Voice" just does not exist properly unless its somehow truly backed up outside of the Trust's slick and soapy apparatus ..

The Internal User Voice mechanism in the Trust knows it is hampered but will not strike out for its own independence. That is partly mystifying since they are unlikely to lose out. Strangely the new PALS manager an ex User Voice Co-ordinator is also still doubling up as "User Voice" in the Clinical Governance Committee minutes - a strange state of affairs .

User Voice as the internally paid User/staff mechanism too is also backed as desirable by the Trust Board in the latest Board Papers after Sue Turner gave out a panicky CEO report trumpeting the need to keep it internal after learning the PPI were examining a model of an Independent User Voice ..

Its all "funny" - in a sort of mystifying way isnt it ?

UserWatch learns that in 2006, the same year as the big push to get patient's "socially included" but without any funding support for any patient groups to form locally , the Birmingham New Hospital Project under Trust control has created a three year "arts plan" of sources of funding which amount to 324k. This year's input into that arts plan from the Trust is 20k . 10k of that is from the Trust charities fund .

This very centralised arts-plan is really more of an image promotion for the Trust because an alternative might have been encouraging patients joining in local and area competitions or workshops, or the like, to get their own paintings and art put up on the walls on good clean building lines produced by an architect. Give the space over to patients and encourage it to be used should be the ethos. Instead money is going to several professional artists and Userwatch has not discovered one with a mental health direct Birmingham connection.

Giving space over to patients happened in Leeds 2003 when a patient started off crayon groups and informal arts-cafe's . He was finally running 9 groups in 2004 with another patient and he resisted attempts by the Trust to assimilate him too closely ..

Its funny ....But where there is a will to do right by the patient without recourse to diversionary phoney image building - patient's will create more of their own arts "voice, and other voices..

Whatever happened in Birmingham ?

It was dominated by a pre-existing patient culture that wanted jobs with a very controlling Trust and although they are now compromised by becoming staff, it appears it no longer matters to them .

Its funny, but bad faith has a way of catching up with everyone ..Maybe not . Maybe they can laugh it off - its that funny .

Patients though are caught in compromising equations now :

"You can elect to have no voice and be pure in a kind of cornered impoverished way "

Says one in a group of others in Birmingham .

"Or you can wade in the new Labour compromise where patients cannot be more in control of their own health , choices and budgets , and the bureacracy is set to increase and increase on slight but partly unreal rituals of direct empowerment"

Says another ....

They add by nods of agreement as another says :

"Joining in the socially sickly weave of mental health modernisation that robs so many of treatments that fit them as its costs more ........The New Hell Service ..."

Its funny how the services gave up on the patient's needs first without employing one mechanism that would have slowly overturned the NHS dinosaur . PATIENT CHOICE .

Dope-oddy-cus, even with the help of ex patients is set to roam yet for a while.


Perhaps that's funny ...
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Thursday, February 15, 2007

CBT Versus CPT (Choice (for) Patient Therapy) The Boxing Match ?

In truth many psychological therapies maketh Patient Choice in mental health.

The petition requesting more therapy choices other than CBT has tonight as UserWatch reports UK time 10.55 p.m. very nearly become 7000 signatures .. (6998)

Mental health is not the most popular issue in the UK so the therapy petition is doing well really . Whether it will make a difference to a Govt with an eye for cheaper mental health is another thing but the hearted sideshow of a little spirit is good thing ..

It has sparked partly ambivalent attitudes amongst some Users in a context threatened by long term Govt attrition which has created an anxiety about availability of resources for Users . Yet the Govt has been criticised for creating a core policy which revolves more around crisis and less around purchase and choices by Users which will sustain the management of their conditions and or as much recovery as they can muster ..

The petition forms an insight therefore into not merely patient choice but also the right to recover with therapies that fit the patient . Who decides ?

Well right now we know who decides for the patient . This is a small moment therefore in the history of what might become possible for more patients if there is a will ..


"We the undersigned petition the Prime Minister to consider other psychotherapy approaches, not only cbt, in the proposed expansion of psychotherapeutic services within the NHS, instead of restricting choice for members of the public to one only model of therapy. More details

Submitted by Sheila Haugh of British Association of the Person Centred Approach – Deadline to sign up by: 03 March 2007 –


Signatures: 6,998 "

Saturday, February 10, 2007

WILL CBT COGGY GET A HEART TRANPLANT IN THE UK ? (Bham Source Reports)

The e-petiton started by Shelia Haugh on the Prime Ministers own website is fast approaching 5000 signatures for alternatives to the Govt's "one size fits all" Cogntive Behavour Therapy approach .

The concern behind the petition is the Govt's favouring of Cognitive Behaviour Therapy CBT which is being singly latched into its mental health get-back-to-work drives to the virtual exclusion of all other types of therapeutic approach.

It has been pushed hard under the banner of "choice" by the partly discredited NIMHE who have morphed more and more into the semi invisible CSIP (Care Services Improvement Partnership) who have also hailed CCBT (the computerised version of CBT (as evidence of "Patient Choice")

The claim that CSIP has become a sycophantic civil service made up of ex Service Users swayed by the original fire of claimed innovation is often reported to UserWatch.

Criticisms that CBT's wide applications are superficial and cannot help emotionally based depressions and the trauma of life events have been voiced by many patients and various therapy practitioners alike.

Users on UK survivors, an open public forum are having their opinions about the e-petition issues too :

" It should also be a fundamental human right to have therapies or assistance that are found helpful to the person.

The trouble with NHS therapies is it is one size fits
all-industrialized medicine, just like a factory."

Says one HERE

This was echoed and added to by another HERE

This User also spoke of the worry of the contradictions in the mental health system that can often define people as "well enough" beyond crisis care only to make them face a social and benefit system inadequately fitted to integrate and understand the continuing stresses they face if they even try to fit into the mainstream of society again ..

CBT application has been defined by up to 10 (maximum) sessions of thinking-based self control therapy (over triggering thoughts that reactivate bad feelings) for the moderate or mildly depressed followed by what ? Work and recovery ? Its the Govt's ideal .

Perhaps in some limited truly mild cases where thought is enough to block the energy of unresolved affect or draw back controlling focus on of some fragmenting patterns of negative thought and feelings, anxiety etc., a little thought-tinkering will do. But not so with large affective energies and traumas revolving through peoples entire systems often for a lifetime who never have any therapy. Several cases of these are known to UserWatch in Birmingham , and further afield there are many many more ...

The difficulty too is, in NHS Trusts the largest part of any therapy-budget will be devoted in future to CBT mainly or drug based control. There are whole sections of patient-type missing out on various form of psychological therapy to help them

CBT is really meant as a cheap measure for the psychologically screwed up"workless classes" on incapacity benefit who in truth do not have the privilege normally to have a therapy that will help resolve emotional pain and difficulties. Some of the incapacity benefit arguments are discussed on the British Psychological website HERE

The CBT applied model flounders around coping with the concept of feelings as the centre of a human being. Cognitive mechanics is all - to tighten the nuts up . UserWatch believes this conceals old fashioned victorianised social stigma and the national UK taboo against openly shown difficult feelings.

Reactive depression, one of the maladies which CBT is supposed to treat, is as its name implies, a reactive event. It is not caused or mediated into existence by "thought". It is caused often by reflex to survive pain and suppressed affect (feelings) which are attributable to various very negative external life events and are not solely residing within the orbit of cortical and neo cortical higher functions of the brain but are stored as suppressed affect in the feeling areas of the limbic system.

That "feeling system" needs re-engaging and resolving by using the internalised past for inner levels of recovery . Tears are part of the journey of the recalled self with that therapy because people with serious hurts when listened to , cry ... They grieve . That is not in the British CBT lexicon . It costs more money too, so the "workless classes" are to be treated to a "spanner for the head over heart" so to speak ..

One example of painful but resolving therapy UserWatch knows of is of a soldier in Northern Ireland. He suffered various life events of pain and loss as an early childhood development which was later added to because his best army mate was shot and killed by the side of him dramatically . He became seriously depressed and self violating until he could find the therapy (not on the NHS) which helped him feel the vulnerable self he had been taught to deny for most of his life . When the soldiering armour gave way to tears and grief over many sessions that built his tolerance up to his own emotional pain for suppressed internal events, he then found he could live with himself and let go of more of the events which were otherwise sending him mad. Ofcourse the British love denial ...... The mental health NHS is based on it ..

Related to the CBT poverty of application though, there have been criticisms of unjoined up mental health services without the capacity to follow through that were voiced in Birmingham after a "Suresearch" (Birmingham University) piece of research commissioned by the Patient and Public Involvement Forum in 2006 showed patients that came through immediate crisis in Birmingham often faced a very hard times indeed beyond .

The defrayal of costs for their support into the community and with adequate choices of therapy-back-ups could have been assured by now if NIMHE had never existed (65 million up to 2006) which has probably cost £80 million now ..

The Govt with NIMHE and its morphling CSIP is targeting the vulnerable with cheap resources and expensive bureaucracy and everyone including Service Users are mixed up contrarily within the new careerist illusory equation. NIMHE was a the career-carrot for many who are playing the game that old timers used to see on the wards. Those who "got well" quicker were those who did the washing up of the tea cups for the staff.

The Govt's approach will fail most patients, because the Govt's approach is anti-local, anti-individual at purchase level, anti depth and partly anti human, and it is systems-delivery driven on the basis of all Top Down planning thought is unlikely to get to the local and personal heart of the problems. Its a Govt of denial .

In fact it recreates the worst of the old staus quo on the wards recasting it into new form of oppression which has bureacratised the patient into a slickly denied Govt partnership of new social madness ...

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Tuesday, February 06, 2007

Mad For Arts : Culture Online Gives In And Advertises Flickr.com



(Above The Post Culture Online Censored Feb 6th 2007 was put back on the 7th after protest but navigating to it is almost impossible anyway )

SPECIAL MAD FOR ARTS & CULTURE ONLINE REPORT

From Our Correspondent On the Mental Health Arts Feb 6th 2007


The long running saga of the MadForArts (run by the Community Channel) Mental Health Users "rebellion" through parts of 2004 until Feb 2006 when MFA finally closed its narrowly run and restrictive "mental health arts " website, was partly about User's not forming the service THEY required.

The Govt funded site was Top-Down in flavour.

Culture Online its backers, allowed the Community Channel, the main project managers, to try and turn Mad For Arts into a model of a traditional media "virtuous circle". That was a phrase used in one of Culture Online's own reports . This meant the fairly (and ideally) TV-like pacified user-audience were fed a diet of prizes for choosing "public arts". They were supposed to debate the public arts as well, like good little online museum goers. It was all very "socially shaping" to create more museum attendances. That was one of Culture Online's open aims ..

This "Prizes for public arts choices" was a bone of contention amongst some mental health User artists since many mental health User artists who joined the MFAS "arts" website were mental health Users who were not supposed to be stigmatised against. Mental Health Media, subcontractors of Mad For Arts and the so called originators of the now largely "disappeared" anti stigma toolkit in 2004 were supposed to ensure that.

In fact Mad For Arts Users were victims of stigma since their arts were not chosen to be judged for some prizes.

They were second best to "Public Arts". That was voiced a number of times by Users amongst themselves and openly . The criticism was suppressed though .

An attempt was made by mental health Users of the Mad For Arts website to broker a way forward and cash money (£150 in total) was put up in Feb 2005 by Users themselves to plug this stigma-gap left by Culture Online and the other Charity subcontractors Mental Health Media and Rethink.

It fell through because the Community Channel had vilified the critical Users and barred them on spurious claims from the Mad For Arts website. Even the MFA moderators had stirred up arguments against them on the website ..

Later on as the Mad For Art website had its further trials of in-fighting amongst posters and further complaints by several Users that even reached the minister David Lammy M.P., the originally barred Users offered better art and mental health sanctuary to their User-colleagues on the failing Mad For Arts website at the free account giant site

http://www.flickr.com/

Mad For Arts however did not give in with its obdurate attempts through 2005 beyond its intial funding, to remain in place taking up more and more funding . The Charities which backed it, Mental Health Media and Rethink, were also still in the picture for a time but Rethink withdrew because Mad For Arts could not get any further funds. It took enough though .

By about the March of 2005 Mad For Arts had taken up some 370+k of public funds and now Userwatch can report that has risen after contact by a source to 424k . The VAT is still being enquired about through the Freedom Of Information Act . That figure comes from a document signed by Nicholas Holgate the Dept Of Media Culture And Sport, Chief Officer .

There will be more to report about figures in the future of this costly Culture Online sponsored failure .

There was a late 2005 - 2006 Users migration over to FLICKr and that was, to repeat , initiated by Mental Health Users themselves being contacted by the original Users who had "emigrated" to the then Canadian run private site (later purchased by YAHOO) and all the mental health Users were making friends and many contacts .

The ex Mad For Arts Users who migrated later in 2005 had also formed their own small groups :

Here and Here and Here


And they have merged into the wider community too. Flickr is more hygenic unlike Mad For Arts which saw moderators crawling all over it with a degree of anxiety according to some Users which was necessitated by its uncompartmentalised design .

Users (some Users often joked) were made up into MFA "sheriff's" or police. It was a kind of typical anxious U.K. BBC modelled board - too small, overcontrolled, slightly Blue Peter-ish and it created a feeling of claustrophobic classes all over again ..Prefects, and the British liking for social ladders of importance. It was in fact infantilising .

Flickr was experienced by the migrated Users as freedom from that with the power for any User to delete anyone or their comments on their own spaces without interfering with other's rights to belong to Flickr elsewhere .. In other words the User-sherriffs were not so immediate and active . They did not have to be . Flickr's board was designed right . It designed out conflict far better than the Mad For Arts 100+k costed website

One of the original Users barred from Mad For Arts got in touch with Culture Online as Mad For Arts was closed down in early 2006 because it had no exit strategy that helped those who had depended on it. That User asked a Culture Online officer about putting Flickr.com as a reference on the remaining website for an avenue of arts-link opportunity for other Users who came by and saw the rump of the Mad For Arts website ..

Culture Online never did that . Why would they ? It was like accepting criticism ...

Now the State and the Charities that tried to own the public and mental health Users have been left behind but are trying to catch up and own some of the action even though they help to shut others free speech down .

Mental Health Mad For Arts Users though were followed by the project manager of the failed MFA project Jennifer Topping who they recently discovered had migrated also to Flickr after her Barbados holiday which she posted a few snaps of on Flickr in April 2006 - perhaps to keep an eye on them and tell the culture carcass examiners who should maybe be called "Vulture Online" where the Mad For Art "revolutionary maggots" had got to so it could feed its limp de-feathered frame once more on the example of their free efforts ..

Culture Online now has given in flapping after quietly gaining space from its critics which it could not own up to , and it is now advertising Flickr.com and My Space . The site on which this information is posted though claims to be a "Blog" .

Noooooooo.........Its a Vulture Online .....


In fact by going HERE YOU SEE its Culture Online's own feathery little "friendly-ised" site :


Culture Online

55 Blandford Street London
W1U 7HW

T: 020 7487 7200
F:
» Click here to e-mail Culture Online
» http://www.projectsetc.org



No references ofcourse on this "Blog" site to Culture Online's learning curve, the pain it caused others by helping to deny free speech, and the waste of public money it spent on the Mad For Arts fiasco that still needs looking at ..

Finally Culture Online are still part of a London-culture that tries to suppress open discussion about its networking functions and costs . The top picture of a screen capture of a comment placed on their "Blog" was not published by them tonight even though that was attempted twice before another comment post was allowed by the same poster - because it was judged to be less critical no doubt .....A day after this protest and after a further unpublished protest on their own "Blog" it was published but navigating to it is a thicket job...

So democratic criticism is moderated now in the UK . That's clear . It was the same on Mad For Arts . Nothing changes .

SEE THE IMAGE HERE ALSO


Did we-the-Users of Mad For Arts convert Jen Topping to a version of freedom from Top Down media rule over an "audience". Partly I think Users had a lot to do with her growth whereas she just ran a tight ship that became intolerant of criticism that finally even evolved her...

From the Guardian Jen Topping and below :

"It's all about creative swiping: about reinventing, mashing up what's been done by others, to match your audience and your budget," says Jen Topping, now head of Channel Four's Video on Demand project. Until recently, Topping was head of new media at the Media Trust, which provides professional communications skills to the voluntary sector.

There are three key ways SMEs can keep costs down, according to Topping:

· Follow in the wake of larger organisations that can afford to test new technologies: see what works for them and adapt it

· Use free or low-cost software creatively

· Use blogs and podcasts - cheap to set up and run - to reach out to new audiences.

Topping believes organisations need to understand and get into new media techniques in order to widen their appeal and reach new audiences, particularly younger people. Charities need to reach out to new volunteers and donors; small businesses need to reach out to new potential buyers.

"These younger audiences cannot be reached using traditional media," she points out.

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Monday, February 05, 2007

The Unaccountable Face Of Mental Health Charities ? And Other News

UserWatch Birmingham UK reports also to the USA :

Mr Des Curley describing himself "a concerned citizen" is prepared to protest SEE "PLEDGEBANK" Sign Ups So far HERE outside the Charity Commission for a day regarding their alleged unaccountability and the unaccountability of some of the mental health charities whom they are supposed to view and partly regulate for "Openess" and "Public Confidence"..

Mr Curley's arguments with some mental health charities and their heads have never been properly investigated he claims and some of his evidence that UserWatch is aware of has not been viewed properly.

His allegations are that an ex charity head has been involved in creating several dubious websites the most recent of which he alleges contained pictures of pornography and references to drug taking .

The issue appears to be that Mr Curley claims he can prove that the charity head concerned in 2006 altered the "registrant's domain status" (record of the ownership of the named website) after Mr Curley had discovered the content of the site.

Mr Curley claims the content remained the same but the ownership of the site was put under someone else's name . Mr Curley claims there were several sites attributable to the one charity head ..

Mr Curley has never been offered an interview by the Charity Commission to demonstrate how he obtained his evidence and what credibility can be attached to it after proper view.

Mr Curley's stories surrounding this charity saga are on another seperate website Here

On other matters the mental health charities particularly Sainsburys Centre For Mental Health has rather biasedly applauded the roll out of Cognitive Behaviour Therapy.

UserWatch regards CBT to have limited and superficial applications . CBT regards "thought" as being able to control "affect" (emotions). Whilst that is partly true, criticisms are growing in the therapeutic community that it leaves out empathic skill and longer term healing of feelings and there is no amount of Cognitive Behaviour Therapy which will use "thought" to heal broken and damaged feelings of trauma and extremely bad childhood developments - rather deep grief from those damages needs to be "worked through". Yet the NHS has been turning into a cheap one size fits all option .. A sovietising supermarket model.

The caring-asylum deeper-care approach that might have been a truer modernisation of mental health by giving way to CBT drives to get people back to work, has embedded within it an old "workhouse" style approach. The stigma concealed within it is :

"your feelings do not count - get to work "...

Immediacy of a required functionality dominates .

Userwatch supports Patient Choice, patient pace and "Treatment first". Its a more logical approach and anything else is a waste of resources by ill fitting patients with therapies that are likely to be anti-feeling and anti-healing and will cause a emotional rebound effects in time .

The mental health charities that have soapily agreed and skated about with Govt CBT drives, anti-asylum approaches, and little patient choice combined with work-for-all NIMHE drives may well be surprised to learn that a large petition is a-building on the Prime Ministers own website .

This petition late last night was 1900 strong, today at the time of reporting it is 2400 strong. It is supported by doctors and mental health service users and staff .. Where were the charities? Long time buck-passing soapily, no doubt ..


Sainsbury's Centre For Mental Health also needs close scrutiny. It registered the UK. Dept of Health NIMHE (National Intitute For Mental Health Education) and was recorded as the domain owner of the NIMHE name ! Mr Curley discovered that . Userwatch has seen the proof.

SCMH clearly has very close connections with the Govt. One of its employees specialising on Work and MH disability matters Dr Bob Groves seconds in to the DWP. An ex head of SCMH , Andrew McCulloch was a senior civil servant working for the DoH and is now the head of Mental Health Foundation which is trying to use other mental charities to form a National User Network .

This cross organisational partly Govt-spectral development is not to be welcomed because "Patient Choice" and locality power of MH patient-development is partly undermined by the charities who soak up large funds and create lost opportunites at local levels for smaller patient groups to launch themselves. MH Consumers and groups of MH patients when given purchasing power will make choices that do not need top down costly bureacracies claiming representation over them.

The mental health "Users Voice " in this regard has become the political plaything of the NHS, Govt, and the mental health charities . Everyone wants their piece of the career user-action..

The mental health charity sector need a serious transparency overhaul . Who they represent needs to be scrutinised and the sooner the better ..



Reference Material From SCMH below :

We Need To Talk

The case for psychological therapy on the NHS

Anna Bird

31 October 2006

ISBN13: 978 1 903645 91 8

FREE


We Need To Talk examines the provision of psychological therapies. The report argues that evidence-based talking therapies such as cognitive behavioural therapy are as important for the nation’s health as any cancer drug or surgical procedure. Evidence shows that they can help millions of people in the UK who experience common and severe mental health problems.

The report calls on the Government to provide psychological therapy through the NHS in line with NICE guidance. It also says that the NHS should introduce waiting time measures for access to mental health treatments.

We Need To Talk is a collaboration between five mental health organisations: Mental Health Foundation, Mind, Rethink, The Sainsbury Centre for Mental Health, Young Minds and published by the Mental Health Foundation.

Download We Need to Talk PDF (1,070 KB)

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