Sunday, February 10, 2008

The Social Spaghettification Model Of Mental Health In The UK And Locally


Spaghetti Politics

By UserWatch

The UK wide social and political forces acting on mental health economies and locally to Birmingham and Solihull are almost totally driven now by a welfare benefit purge across the whole spectrum of mental health by the Govt ...We note the US connections too - they've been talked about in the UK and are influential in being pretty mean to human beings

(See BBC Wisconsin & Tory Story )

Locally new constituency groups (in Birmingham called Community Interest Groups CIGs) are springing up to examine how to get the unhealthy "workless" back to work ... The signals have been clear for years though to mental health Service Users who know that the bureaucratic power of the NHS is actually anti-patient in mental health at the point of REAL recovery choices . In others words if you are a mental health patient you cannot really choose and shape the recovery environment (post crisis) you need for better mental health - the NHS alongside other agencies crushes that. Often quite cleverly by labelling Users and gatekeepering them outside of treatment regimes . So how some Users recover on the ladder and gradual-rung approach is already undermined UserWatch observes. (See too the Taxpayers Alliance story about the lethal NHS)

Service Users in Birmingham UK have approached UserWatch to tell us the "Social Inclusion" treatment and recovery work in the local Birmingham And Solihull Mental Health Trust is just "too work and training orientated"....Its a big turn off for people with core problems of just surviving who they are .. But the "fitter" (mainly staff and a few Users too ) are driving the agenda rather than looking at it as a more recovery-by-degree laden agenda in terms of application. We wonder if terms like "Fascism of the fit" might be adopted in mental health circles ?

The lost opportunities for REAL patient choice (which equates to careful growth under the control of the User) can be traced to the way the costly US inspired NIMHE (100 million by 2008 end) and the mental health charities shaped the mental health environment for themselves and their own pet views via numerous advisory groups into the highest reaches of the Govt . The Dept of Work and Pensions (DWP) created their own workarseing welcomed spin, courtesy of the Sainsbury Centre For Mental Health (SCMH) under Dr Bob Groves and others like Helen Lockett who espoused work-externalisation of day services in the NHS services for Users.

A politically calculated attention grabbing substitute of "stigma flag waving" was also (from 2003 onwards) put in the way of patient's vision and has misued their "Voices" more generally as the influential work dominating policy influenced by the few dominated the many, and an SCMH connected mental health charity named Mental Health Media led in that .. Angela Greatley the CEO of SCMH was heavily involved in that too as a Trustee of Mental Health Media ...Their ideology is still being spun out as choices of treatment in mental health lags and a new work push is being played out and employers will be targeted ...And of course naughty people who use the term "Nutters"....

False User-voice mechanisms across the UK to play to the audience have also been put into place by NHS Trusts and others and those "Voices" have often been compromised by cherry picking the most useful malleable Users and paying them to become NHS managed bureaucrats, rather too directly ...In Birmingham it is rife .

The NEW Labour mental health Service User thus is assailed by great forceful holes around them made up of diversionary (from Patient Choice) bureaucratic enrichment.

Selective and selected service-bureau-ex-Users now rule the roosts across the UK . This makes a nonsense of equable social inclusion. Its retrograde - its back to the days of the staff "ward favourites" - played out in another way . "Modernised" ..

Trusts dominate the agenda with ritualistic good performance image-play and support a few groups here and there in their local various provinces.. Selective Inclusion though like this still means "NO Choice" - No help in some localities and in Birmingham and Solihull the Trust orientate around the creation of some Users Groups that have implied a whole new section of new bureau staff ... Oh right ...A bit more bureaucracy ...More lost opportunity for an economy of real patient CHOICE and locality cash-underpinned groups.

We know of one User led group that was very sustaining but hit funding problems and though it catered for a lot of Users per week the local Trust has left it to husk and blow away ..

"The Trust is actually in competition effectively with independent (Service) User led groups in Birmingham" Said one Service User to UserWatch.

"But we have always know this for years - it favours its own inward looking elites "

Says another accusingly ...

" It likes control in Birmingham - it cannot let go " Added another when a UserWatch local correspondent spoke to them ..

The solution of truly democratising mental health has probably disappeared under NEW Labour who want to make everyone regardless of degree of capacity into a "Freudian" worker

(see our last story on David Freud here with cartoon) now in macro conditions that hardly favour that. Yet many Users are still bereft of lives of choices of treatments, supports and power and better creativity ...

It has been kept that way by corporate service delivery and the massively crushing politics of the Dept Of Health rather than breaking the NHS chaining monopoly with Patient CHOICE ...

It could have been exemplified in "Therapy Choices" with a mixed skilled base of private and public being driven to quality by Patient Choice ..If only some had the money NIMHE used up without much audit of what value it had really produced

It could have happened in social inclusion terms if medium to long term Users had been given the right to use earmarked 2 - 3 year sustainable grants to form local groups in their local community centres which they could have run and then re-applied for mental health specific funding.....But all this "Clubhousing type talk" by the authorities in 2006 in Birmingham has replaced by "We are in control" from the local bureaucracies in health and social care...

They could not even be bothered to inform Users properly about the use of Direct Payments (a local authority grant based method to purchase selective services by Users) and Birmingham UK has disgracefully low figures of 1.8 per 100,000 of mental health Service Users using that empowering method ..

The mental health charities are also guilty of stoking the anti choices situation up with advice and carefully timed system delivery therapy logics (one size fits all CBT ) that have favoured themselves in the eyes of the Govt embedded as they are within the new creation of an increasingly "Charitised Welfare State"

Who remains at the bottom after several years of false promises by New Labour ? The Patient without recovery treatment choices whose "voice" should have been measured by a culture of recovery treatments guided by themselves through their own purchasing power - not by the creation of a new class of Service Users who have diverted power and NHS money into new bureau-career structures ..

UserWatch has no objection to Independent User Organisations who are accountable first and foremost to the democracy not to the NHS bureacracy which has a vested interest in creating more of itself at the default expense of the patient. But New Labour set the tone ..

Users Voices have to become their own, through their own owned choices of recovery treatments through purchasing powers....Otherwise in the great noodles voices and mystification surrounding the mental health economy, the forces over-archingly governing the Users miss the point, and destroy the coherency of User needs and experience, making it into a tangled spaghetti politics that tears medium to longer term Service Users apart ...

Divide and rule sauce anyone ? - On your social spaghetti experiences ? Or do you just want to be sick ?........We hear there is talk though in Birmingham now of large petition guns a-forming to combat the cowboy ways of the new Spaghetti Services with their zero hoops some Users are disappearing in ...

Linking Stories

(See also Richard Blundell Paper here )

(See A4E ref Palestinian Story Connection here)


Anonymous said...

I am an unemployed long term MH service user , another victim of Care home abuse unfortunately, and I am currently trying to get on a professional TEFL course to get back into employment I can actually do.

I have asked my local services for help and after 11 months been informed by Stuart Bell , Chief Executive of the South London and Maudsley NHS Trust that its education fund meets once a year and makes decisions around June or July.

My bouts of depression dont allow me to plan that far ahead .

In fact I have had a battle with my local Trust since August 2007 to use the local MH gym ,thats how committed the £120,000 per year Mr Bell is to helping those who are able and want to get back into some form of flexible employment , he is a useless bureaucrat but of course Mr Freud wont dare turn his penny pinching bankers eye on the NHS system itself which now employs more people than the Red Army and clearly isnt providing choice or value for money.

The course I want takes 4 weeks and starts next month.

Freud, Bell and co could pay for this course out of their spare change but of course they arent interested in directly helping little people they want to fund yet more useless disability employment and training schemes , private or otherwise , that simply rake in hundreds of thousands of pounds in bonuses from the DWP for juggling service users around between themselves.

Its not Freud its Fraud.

So, even if you want the help the Government says it is anxious to provide it isnt there, there is just bullying and bulshit.

PatientGuard said...

Mental Health services will get worse in the age of the performance driven mass spin image-world. The corporate mind-set looks for that as an escape from the reality of dealing with people more individually and realistically... Real people are too difficult to deal with by the DoH and NHS bureaucrats who prefer mechanical mass agreements actioned by mass system delivery economics..Sod the locality its subsumed now in bureaucratics ..

Rotational "welfare to work" schemes applied to mental health that hide the real problems of a lack of individuation are nothing new but are likely to increase. The "Wisconsin Model" does NOT in fact succeed in lowering welfare costs but in fact creates a pool of financial enrichment for privatised middle class welfare businesses who have a perverse incentive to keep the circle going. It also satisfies the superficial rage of an electorate that also refuses to deal with disability social reality and social failures properly

It would be better to engage people into another format of valuable creative contribution which is not so black and white as the "get em back to work model" and coupled with better and kinder supports (powered by the lottery and locality focused) that is likely to achieve a better more socially innovative and less pressured form of social health as well as gradualistic "individuation" for the disabled groups (including mental health) with their unique problems .

The problem is we are in the age of satisfy the superficial thinking and tax breaks of the electorate in order for them to remain self righteous and comfortable rather than more humanly engaged with costly social problems . What they should know though, is their money has been wasted on things like NIMHE which diverted money from simple patient choices (recovery therapies) and created a class of Users reliant on their own new bureacracy as opposed to getting out into the community with small grants and forming real working bases of support which could have been sustained over time into a new form of social productivity that in turn helps Users break the chains of NHS bureau-dependency ..

The system cannot wait to grind into gear and indiscriminately attack two thirds of those on Incapacity Benefit (David Freuds own estimate of those who should be at work) - the mental health charities are busily helping with their asses hip locked to the Govt's values..

This is a mentally-ill system not a mental health system because the individual does not exist under Labour only the detachable concept does and the evidence base for that is User-experience. Not the Users who have become the new bureacracies either . Yet the detachable concept of the "empowered Service User" becomes its own core minoritised reality inside the NHS that walks in the corporate mind-set like a disembodied bleached cleaned up ghost ...

Its voice rather more deeply is the voice of nothingess dressed up in chromium parties and shiny hollowness..

Hail The Emperor of mental health Services and over Users for he is dressed wonderfully ....Isn't he ?