Mental Health Statistic Is Flawed - "One In Four" of UK Population is Incorrect

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Polly Paradoxrot Says "1 in 4" Is A Flawed Statistic

Its an overdue article running on the Guardian : Is the oft quoted "statistic" 1 in 4 (suffer eventually from mental illness) a realistic projection ?

Jamie Horder on the Guardian questions it :

"It's taken as fact that one in four people will suffer a mental health problem, but the research is less conclusive"

We at UserWatch think its not the quote so much as why its being used that needs examination and UserWatch was contacted by two mental health Users who gave these reasons and the analysis of political and mental health charity sub agendas for its social use :

1.

"The problem with the 1 in 4 statistic is that its a socially engineered lie used by Government mental health quango NIMHE - now the National Mental Health Development Unit - and leading mental health charities like Mind, Rethink and the Mental Health Foundation to justify Walden II-like social policy goals on the back of wildly exagerated claims about the dire state of the nations mental health.

It's certainly telling that the main mental health charities who have received massively duplicated anti-stigma campaign funding on the basis of the 1 in 4 stat have declined to comment on the debunking of the 1 in 4 myth and we really should be looking more closely at Government mental health policy, the lack of independence of Britain's leading mental health charities, their conflicting service provider vs representational roles and increasing dependence on Government for contracts and scrutinising outfits like the secretive Mental Health Foundation which inserts itself on to various Government mental health advisory bodies in order to sell a range of faddish CD based treatment 'toolkits ' through captive NHS networks from the Foundation's luxury suite of offices on the South Bank.

It's time to brush aside the silly 1 in 4 agenda and re-focus on challenging the Government's discriminatory exclusion of all NHS mental health services from the Patient Choice agenda , a discriminatory policy the mental health charities have ignored because they are more interested in securing Government contracts."

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The way the figure 1 in 4 has often been used socially and economically by the mental health charities - all of which are highly involved with each other's economic and bidding strategies - is to sell to the public the notion that "stigma" too is prevalent and that has been used in turn to skew vision into somehow its all society's fault that people with mental health conditions cannot get work .

1 in 4 thus has a use and its use, is manipulation of social vision towards an argument which in turn is constructed for an "anti-stigmatising" social cause .

Closer examination of the 1 in 4 charity and Gov't led anti stigma approaches reveals quite a money making making machine for the MH charities who have not seriously challenged Government to stop discriminating against all MH Users to give them legal "patient choice" mechanisms for instance .

That equal human rights reform has been missed even though its clear many non acute (non sectionable) MH Users need to choose service designs that help them have equal rights as the general population does with surgery and other medical legal "patient-choice" menu's of options.

Thus "1 in 4" have the largest Gov't stigma being operated against them as from Jan 2009 whereby the Directions and Guidance to PCT's forbade patient choice mechanisms to MH Users .. When checked with the DOH its ALL MH Users . The Jan 2009 DOCUMENT IS HERE - its signed off by the Sec of State's senior civil servant

Is 1 in 4 a true figure ? Possibly not . But the way its being used is to ramp up the chances of the MH charities (in league with parts of Govt) to bid for large pots of lottery cash and "convince" everyone through projects that we are all subject to each other's discrimination that hold us back from a life of work and recovery. That is questionable . The quickest way to treat people with equality in MH is for the Government to open the doors of Patient Choice mechanisms and to stop denying that mental health equal rights agenda .

Is there a part industry out there exploiting the Mental Health economy and trying to steer it too (with claims of 1 in 4 ) etc

Of course, its possible to point directly to it , and it does involve the interest of big MH charities and their policy steering networks . They need examining ."

'Nuff Said ..

The Problems With The Birmingham LINk What Has It Done For Mental Health ?

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Below is copied the minutes from the Birmingham City Council UK Health Overview Scrutiny Committee of 17th March 2010 distributed only in the last few days . As part of their tasks they had to examine whether the local Birmingham Local Involvement (Health and Social Care) Network LINK was of good value. The minutes really do show what a sorry state the Birmingham Local Involvement Network (LINk) is in . The Bham Post has previously carried a critical story about them too.

From the now published minutes Councillor Anne Underwood on March 17th made a good point about whether the Bham LINk had built on the work that the previous Patient and Public Involvement (PPI) Forums had created . Those forums were not perfect by any means but they did respond to situations and health policy roll outs as they happened .

The Bham LINk seems to have concentrated not on good previous PPI practices and evolving them forwards usefully but on constructing a very centralised body without that much of a base . That appears to have been costly in time and human resources and it seems to have diluted its capacity to do work on its all important working groups . They should have been the priority from the beginning we think .

David Spilsbury's observation too within the minutes below is damning because after over 18 months of meetings and organisation the Bham LINk has hardly carried out any useful health monitoring work that is on any records UserWatch could examine . (see Bham LINk records Here)

From the OSC minutes Nick Hay the Chairman of the Bham LINk :

"advised that the LINk was determining who could speak officially on its behalf"

Well that's odd for a Chairman to advise and seems underpinned by an uncertainty of approach that indicates it may not be him (!?) How so ?

Users who have contacted UserWatch about the mental health aspect of the LINK asked what has it done for mental health in Birmingham . Userwatch is not sure at all - there's been no information coming out of the Bham LINk that shows very much . What we are aware of is some Users who joined in the local MIND-promoted User Group do not like the LINk.

There is no record either we could find of the Birmingham LINk having referred the Birmingham mental health Trust's Main House Borderline PD Service closure to the Health OSC formally which surely it should done .

The lack of a Bham East and North Primary Care Trust LINk Health Group mentioned in the minutes below is very concerning too but in reality as soon as the Patient and Public Involvement PPI Forums were disbanded in March 2008 then a very good Bham East & North PCT PPI Forum diminished that had been looking after the interests of the public .

The Bham LINk it appears failed to capitalise on previous PPI practice . Why ? We think it appears to have run with a degree of ignorance and lack of realised ability to have learned from what went before. From what we can also see in the Host that was chosen is it appears they had no experience of PPI monitoring and that Birmingham City Council chose them and therefore it too showed very poor judgment .

From the Overview Scrutiny Minutes of 17th March 2010

"BIRMINGHAM LINk UPDATE The following report from the Birmingham LINk Project Manager was submitted:- (See document No. 4)

Maria Bailey, LINk Project Manager, gave a brief introduction to the report, advising Members that Gateway had improved the LINk membership by 1,300 people over the previous 12 months, including individuals and groups.

The 3-year funding for the LINk would come to an end in March 2011 and there had been no indication from the Department of Health regarding future funding.

Nick Hay, Chairman of the Birmingham LINk, gave a short presentation to Members and advised that the LINk was determining who could speak officially on its behalf. He acknowledged the importance of the LINk working with the Committee and playing a complementary role and advised that the LINk had made constructive contact with the Strategic Director of Adults and Communities.

Furthermore, he drew attention to the importance of health, social and welfare links with City Council Departments and the Third Sector.

Bill Poacher, Gateway Family Services CIC, advised that the transfer of responsibility from Gateway to the LINk was moving forward and that it would be important to increase the visibility of the LINk and people’s awareness of it.

Nick advised three immediate priorities for LINk:

developing engagement strategies; agreeing work priorities for the next 12 months; and developing the relationships outlined.

In relation to the earlier discussion on Personality Disorder Services (Minute No. 222), Nick Hay advised that the LINk’s working relationship with BSMHFT had been first-rate and that BSMHFT was the only Trust to have signed an agreement with the LINk on joint working.

Councillor Anne Underwood expressed concern that the membership of the LINk remained low and she expressed doubts regarding what was being achieved. She questioned how the LINk would avoid ‘re-inventing the wheel’ and whether it was building on the work undertaken by patient forums who previously had the same responsibilities.

Bill Poacher advised that the membership included groups and covered a wide range of people and that the LINk had also a range of contributors to activities who had not signed up as members. He reminded Members that the LINk had been in operation for only 18 months.

Maria Bailey advised that Warwick Research Consortium had suggested structural and organisational arrangements had not engaged interest to date, but that the advances by the LINk in looking outwards and setting priorities would raise greater awareness and interest.

In response to questions from the Chairman she advised that there might be no funding to the LINk after March 2011 and that the situation was not clear.

Nick Hay pointed out that there was a requirement for local authorities to establish LINks. In response to questions from Councillor Ansar Ali Khan, Nick Hay confirmed that there was no functioning sub-group in the Heart of Birmingham area nor in the Birmingham East and North area because there had been insufficient interest to date in Birmingham East and North and the Heart of Birmingham sub-group was in the process of being established.

Bill Poacher confirmed that community language leaflets were being used and advised Members that participatory appraisal approaches were being used in work with local black and minority ethnic groups. He advised Councillor Zaker Choudhry that the 500 ‘active’ members were active in terms of consultation and engagement and that a significant number were from black and minority ethnic communities. He noted Councillor Zaker Choudhry’s concern that the expenditure to date had attracted only a small membership, but advised that the membership consisted of a representative core group that formed an important base.

He confirmed to the Chairman that there was a wide age range of people involved in the LINk and that an Older Person’s Action Group had been established to engage with older people. Members noted that the Women’s and Maternity Group for the LINk had found it difficult to engage with relevant groups of local people, but that 150 people had attended a large event on Tuesday 9 March 2010.

At the invitation of the Chairman, Gerry Moynihan, Bordesley Green Neighbourhood Forum, addressed the meeting and drew attention to the Birmingham LINk’s role in relation to the delivery plan for the Local Area Agreement. He noted that £650,000 of funding had been set aside to meet indicator NI4 and questioned what the LINk was doing to meet that indicator.

Maria Bailey advised that an area based grant had been provided to fulfil the indicator and that everything undertaken by the LINk contributed to meeting that target.

In all, there were 22 to 30 different organisations involved with the LINk. She noted Mr Moynihan’s concern that there was low awareness of the LINk, but advised that, while people may not identify with the LINk, they may have participated in activities involving the LINk.

In response to questions from Councillor Margaret Byrne, Nick Hay advised that the LINk had been established by Gateway Family Services CIC and that it was funded jointly by the City Council and the NHS. He noted Councillor Margaret Byrne’s concern that a handyman service funded in Hodge Hill, which had helped with people’s physical and mental health, had been lost.

The Chairman invited a local resident, David Spilsbury, to address the meeting and he advised that he had been the Chairman of the South Birmingham Community Health Council until it had been disbanded. He had contacted the LINk and local groups, but had been concerned that they were not fulfilling a health function, that Gateway was making money from the LINk and that little progress had been made in 2 years.

He was concerned that that situation had arisen mainly because the LINk had been organised by a host organisation rather than by its members. Nick Hay advised that establishing the organisational arrangements had been an important function and that there was a legal requirement to have a host organisation.

Bill Poacher advised that the LINk had begun to change and did involve diverse groups now.

The Chairman proposed, Members agreed, and it was - RESOLVED:- That the report be noted and a further report from the LINk be requested for September 2010."

Mental Health : Birmingham Community Personality Disorder Services New 2010 Information

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Userwatch is reproducing the information below that Service Users have given us regarding the growth and functions of the relatively new 2010 Community Personality Disorder Services located in North-ish Birmingham . The information is from different sources so pardon us for its part repetition of this and that .

Its up to you to contact us and let us know how these things bed in and what you think but its certainly long long overdue that Personality Disorder came out of the invisible corner of no recognition into the world of some kind of inclusion .... How will it pan out ? Will it shine ? Will it sift some gold of life and value ? You will know .. Let us know ...

Community Personality Disorder Service

(From Birmingham & Solihull MH Foundation Trust Texts)

Mission Statement We are committed to offering hope to those suffering the long-term impact of childhood trauma and neglect, complex enduring difficulties and personality disorders including service-users themselves, their carers and staff who work with them.

Through working jointly with service users, carers and staff and targeting individual needs for support, therapy, education and training, the service offers inclusion, empowerment and therapeutic optimism while reducing stigma and promoting equity of service provision

The Team

We are a small team specialising in the management and treatment of personality disorder and complex difficulties across Birmingham. The team includes doctors, psychotherapists, a psychologist and experts who have experience of both service user and carer roles. These 'experts by experience' support and develop the involvement of service users in the planning and delivery of the service and the formation of service user and carer networks.

Services we offer :

Joint working with teams:

We provide support, training and supervision to teams working with service users with these difficulties with the aim of improving the care teams are able to provide.

Joint assessment:

We may offer specialist assessment jointly with your referrer to think about the best options for future care and support. This may include therapy in CPDS.

Therapy:

We offer group-based therapies using a variety of treatment approaches including analytic and cognitive behavioural psychotherapy. Individual work is undertaken to support the group programmes

Service User and Carer Networks : to link up with others in a similar position and share experiences and ideas

Education and Training :

(NHS, non-NHS and third sector) A Managed Clinical Network to link up agencies and improve consistency and continuity of care

Aims : To include service users with personality disorder and complex difficulties in mainstream services where possible

To support and empower : those working with this service user group to provide care which is informed, effective and sustainable

To provide therapy and signposting : for those service users whose difficulties are too complex to be managed solely within secondary mental health care teams

To train staff : including delivering the national Knowledge and Understanding Framework

To increase awareness and understanding and reduce stigma in relation to this group of service users

You are eligible if: you are 16 or over, have left full time education and your GP is in Birmingham (Birmingham East and North, South and Heart of Birmingham Primary Care Trusts but excluding Solihull Primary Care Trust) you suffer long term difficulties in your relationships and repeating patterns of self-defeating behaviours (meeting criteria for personality disorder diagnosis or with similar complex difficulties).

Referral process

The Community Personality Disorder Service (CPDS) accepts referrals from both primary and secondary mental health care. These may be for informal telephone advice and support, for a consultation visit with the team on one or more occasions or for a joint assessment to look at the individual service user's needs and how they might best be met.

This may include therapy delivered by CPDS in one of its programmes or joint working between CPDS and referrer.

For all but informal enquiries, we request the referrer complete a Referral Form which includes a part for the service user to complete. Accompanying letters are welcomed.

CPDS involvement is designed to support the existing care rather than taking it over. Because of this, it is very important that the referring team remain involved before, during and after any episode of care with our service. The respective levels of involvement of the different services may change over the course of the service user's journey and this will be made transparent to both professionals and service user.

Referrers may obtain a referral form through the Trust Intranet or direct from our team base.
The COMMUNITY PERSONALITY DISORDER SERVICE (CPDS) is a new service which has been commissioned to provide a pan-Birmingham (excluding Solihull) service for personality disordered service users aged sixteen and over.

It is based on a model of empowerment and collaboration with existing teams in all sectors who are working with this group of service users. Our work is underpinned by the principles of accessibility and inclusivity and informed by service user and carer involvement.

Our service is a Tier 1 - 2 service for service users with mild (Tier 1) and moderate (Tier 2) personality disorders as defined in 'Recognising complexity: Commissioning guidance for personality disorder services' (Department of Health, June 2009) although we also provide specialist advice and signposting in relation to Tiers 3 and 4.

We welcome referrals from all Primary Care and secondary Mental Health Care services and offer:

Telephone consultation

Team consultation and/or supervision

Joint assessment

Diagnostic formulation

Management planning

Co-working

Signposting

Therapy Programmes

CPDS involvement is designed to support the existing care rather than taking it over. Because of this, it is very important that the referring team remain involved before, during and after any episode of care with our service. The respective levels of involvement of the different services may change over the course of the service user's journey and this will be made transparent to both professionals and service user.

For these reasons, formal referrals require the referrer to continue to hold a coordinating function in relation to the service user. In Secondary Care, this means being subject to Care Programme Approach with a named Care Coordinator. In Primary Care, this function may be held by the General Practitioner or Primary Mental Health Care Worker BUT if CPDS feels that the service user's needs are too complex or high risk to be managed in Primary Care, we may request referral to a Community Mental Health Team. Should this arise, CPDS will support the referral to Secondary Care.

REFERRALS FROM PRIMARY CARE

If you are working with a service user who suffers from enduring difficulties in relationships, recurrent self-harm, poor impulse control or other self-defeating behaviours and would like support in managing this we are pleased to accept a referral to CPDS. This may be for informal telephone advice and support, for a consultation visit on one or more occasions or for a joint assessment to look at the individual service user's needs and how they might best be met.

If we feel that the service user's needs are too complex to be managed entirely within Primary Care we may request referral to a Community Mental Health Team. This is likely to be the case if it is felt that the service user may benefit from a CPDS Therapy Programme. This is not the case for Stop and Think groups as these are based within teams and do not usually require referral to CPDS.

REFERRALS FROM SECONDARY MENTAL HEALTH SERVICES

If you are working with a service user whose difficulties appear too complex to be managed solely within a Community Mental Health Team (CMHT) we are pleased to accept a referral to CPDS. This may be for informal telephone advice and support, for a consultation visit with the team on one or more occasions or for a joint assessment to look at the individual service user's needs and how they might best be met. This may include therapy delivered by CPDS in one of its programmes or joint working between CPDS and referrer.

Such service users are likely to present with complex and enduring difficulties in relationships as well as problems engaging effectively with services, mild to moderate risk behaviours towards self/others and possible comorbid substance misuse.

Some may have learned to manage their difficulties through avoidance of interaction with others resulting in social isolation and self-neglect. Many will have struggled to get their difficulties recognised and may have suffered multiple rejections by statutory services which repeats experiences from childhood.

We are pleased to accept telephone enquiries and to provide informal support or advice over the phone. Formal referrals of named service users require the referrer to complete the brief CPDS Referral Form which includes a part for the service user to complete. We appreciate any additional information and welcome an accompanying letter of referral.

Community Personality Disorder Service

Thomas Telford House

Ardenleigh

285 Kingsbury Road

Erdington

B24 9SA

Tel : 0121 301 6855

Fax: 0121 301 6856

Mental Health Users See Jack Dromey's Erdington Chocolate Miracle

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Jack Son Of Labour Pictured In BourneVille-Erdington

Jack or Bobby - Who's your choice ?

First it was water into wine but Jesus was just an amateur. Jack, Son Of Labour can change Erdington into Bournville ... Yes a whole shift of one Brown area of class, into another . Erdington locals must be smiling at Jack's parachute fabric flappy coat.

Bourneville is the home of Cadbury's , hmmmmmm very nice too ..... Its full of middle class people ... Uni-student bedsit land and the cosmopolitan professional classes who skip about the country and have a base there too.

But anything is possible if you believe.

Chocolate is brown through and through and if you need a Chocolate Erdington then Jack's yer miracle man. He will save Cadbury's there too . UserWatch advises people in Erdington to search their bowls for local chocolate traces and if you cannot find any then vote for Jack because he will give you plenty of Brown ..

This kind of brown locality pooper would never be made by Robert Alden the Tory Councillor who has lived in Erdington for some time and whose Mother Deidre Alden is the Health Overview Scrutiny Committee Chairman and whose Father is also a Birmingham Councillor. What Robert Alden and the local Tories also understand is Kingstanding is also an area where progress can be made . Gary Sambrook a local young Kingstanding Man and Robert Alden have wooed the vote there for some time on small ward issues .. Do they think Erdington is Chocolate ? Nahhh ... They know its different classes and it difference from Bourneville ..

Who will become the MP for Erdington ? Well it appears it might be close run . The Labour majority vote looks set to drop or change . UKIP are standing there and there is certainly an anti european and anti immigration sentiment in North Birmingham local's attitudes on the street . If Labour cannot hold the vote and it slips to disaffection to others then Robert Alden stands a chance. The Lib Dems do not appear to be a serious force locally and may serve only as a Labour vote diverter. Its going to be interesting, but Erdington does need a change and yet the whole voting system and country needs to alter too . We are carrying too much State dominion and UK made constipation and need to furnish another type of economy of skill and hope .

Mental Health UserDog Uncovers Stigma By Instinct

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By sheer instinct and straight senses Mental Health UserDog found the real stigma flag to wave . Its the one inside you all . The one waiting for you to unfold .

See the Govt Jan 2009 Document that discriminates against

ALL PATIENT CHOICE IN MENTAL HEALTH UK

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Care Summary Record Problems NHS Has To Inform Patient Better

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IF YOU WANT TO OPT OUT THAT'S YOUR RIGHT

DOWNLOAD THE DOCUMENT HERE

The DOH has had a rethink and is delaying the roll out of this big Govt records move despite the fact some Primary Care Trusts have already done this and probably not as well as they should have done . In Birmingham UK we hear Opt Out forms were not sent out with letter requests. Patients were informed signing up to the Care Summary Record was automatic if they did nothing at all ..

Really inspiring isn't it ? Especially as records and patient files have been regularly lost and the State is simply not secure nor will it ever be unless we accept total surveillance .. Think about it .. Hard ...

NURSING TIMES today states :

Medical records will not be uploaded to a central computer system in some parts of the country until the public is made more aware of the move, the government has agreed.

The British Medical Association raised fears that some regions were seeing an accelerated rollout of the summary care record without proper consent from patients.

More than 1.25 million patient records have already gone online and some 50 million will be uploaded on to the database over time.

The record contains basic details like name, allergies, medication and adverse reactions, with further details possibly being added over time.

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Sainsbury Centre For Mental Health What Happened To Patient Choice In Mental Health ?

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By UserWatch Correspondents

The Sainsbury Centre For Mental Health Patient Choice Tangle Angles

What has been clearly established in the preceding stories (Here 1 and Here 2) is there is no UK legal equivalence of Patient Choice in Mental Health. You cannot choose a secondary care provider and or have a choice of consultant on the first appointment even if you are not "sectionable" under the 1983 Mental Health Act ....

We have shown the key Jan 2009 document that erases all Patient Choice in UK Mental Health.

Where was the loud protests from the Mental Health Charities ? Well there were some statements here and there but little real action to safeguard equal rights of Patient Choice in Mental Health .

Mostly the mental health charities energies went into the strands of compromise with a system that feeds their careers all too often as they became both closer and closer advisors over the years 2000 - 2010 to Gov't and finally recipients of big lottery and other grants that were given for policies they had actually shaped . Who is better off then ?

Careerists inside the charities ? Quango agencies all pushing the mental health User-herds into work corrals that do not in fact exist ? What were the lost opportunities this form of development took away ?

Was it individualised Patient Choice of recovery ? A new mental health recovery culture that developed and grew . Yes it was partly .

Patient Choice of talking therapies might have been the first gateway possible with the GP axis and some purchasing power being used intelligently at that point and both State and private supply sides of therapy being a competitive choice and quality driver. Labour took the GP purchasing mechanism away though which existed in the late 1990's . It feared the GP's as drivers and market ideas , and so did others, but "Patient Choice" was a concept driver that was created by Labour as a prioritising ability that over-ruled GP's . Why fear that ? GP Practice Based Commissioning bodies (read on) could have created local talking therapy choices in mental health and piloted those . Certainly GP's in their recent March 22nd 2010 survey demonstrated a nationwide impoverished lack of talking therapy services in 2010 with 65% claiming therapy access for adults was rare and the figure for children was 78% claiming access was rare .

Labour prior to 2004 put forward the Practice Based Commissioning ( pro-choice) method in which GP's could cluster on a local basis and bid for Primary Care Trust funds to target local population health needs where they indicated a good argument for better service supply . The PBC's have been very slow to develop under Labour despite the need for local sensitivity in targeting unmet health need.

Sainsbury Centre For Mental Health had this to say about PBC's and mental health in 2004 :

"The Government recently set out new plans for general practitioners (GPs) to commission a range of specialist health services for their patients. The plans, called practice based commissioning, allow for budgets to be devolved from primary care trusts (PCTs) to individual practices.

The scope of practice based commissioning includes most mental health services. The Sainsbury Centre for Mental Heath (SCMH) is concerned that this may be premature. There is a risk that the payments system for mental health care (which will soon be different to many other NHS services) will put cost above quality and patient choice in making decisions about what to commission.

While there are important benefits to the new system, SCMH recommends that practice based commissioning is not extended to mental health services until it can be done on an equal basis with other parts of the NHS. "

It seems this kind of SCMH advisory tack was also taken forward and consolidated in 2005 as Richard Layard gave his September 2005 speech at the SCMH centre about promoting Cognitive Behaviour Therapy and access to it. He advised access was not to be being governed by the GP route but by a new trained workforce . Its at that point that once again Patient Choice is defeated and the State takes over with its now often criticised one-size CBT fit as opposed to using a mixed economy approach which creates Patient Choice possibility . GP's could have been aided by PCT's to ensure a provisioned approach which created a market and patient quality questionnaire/outcome measuring . There were operable ways to do that .

Richard Layard stated of his own ideas on State governed training (which seperated itself off from all other psychotherapy supply in the market community) that CBT was "evidence based" and that various critiera had to be met ideally to deliver it . (SEE FULL SPEECH)

"These criteria cannot be satisfied within a system of GP-led provision, and I suggest that the new offer of therapy to people with depression and anxiety disorders be delivered through treatment centres.

Why?

· They would provide a much better framework for the supervision of casework and for in-service training and professional development than would a service run by GPs.

· They would make it possible to monitor whether therapists were achieving results through standard self-assessment measures where results were made available to the senior staff of the Centre.

· They would make it easier to organise the right therapist for each patient, and reduce the chanciness of whether your own GP practise has the therapist you need. They would make it easier to organise the effective use of human and physical resources, due to economies of scale.

· They could provide a route of self-referral for patients who did not want their GPs to know about their problem."

But what became the State IAPT roll out (Improvment In Accessing Psychological Therapies) used up a lot of money immediately to train up graduates for CBT and the question was why capacity for patient outcome measuring was not built into PCT community worker managment and private therapy supply used ? Well of course we all know that State central control was favoured at all times and argued as more efficient . But was it more efficient ?

In 2005 Jenny Rankin of IPPR (Institute for Public Policy Research) wrote a paper on Mental Health Patient Choice (working Paper 3) supported by Rethink . What was partly refreshing about her approach was the part-demystification of what Patient Choice in mental health meant . Where it might really go .. Into a new landscape. Has it got there though ?

"Choice means the power to make decisions. It goes beyond ‘voice’ mechanisms, such as surveys and consultations. It is more specific than ‘personalisation’ and the amorphous concept of ‘modernisation’, although it is undoubtedly part of both these agendas.

In their manifesto for the General Election of 2001 the Labour Party promised to give patients more choice in the health service (Labour Party 2001). Although at that time, choice was more aspiration than policy, it has since been spelled out as meaning choice of provider in elective surgery, as well as greater convenience for patients.

In mental health, the choice agenda has had a different evolution to the development of choice in the rest of the NHS. Arguably, it has been shaped by mental health’s unique history.

People with mental health problems have been stigmatised, subject to poor practice or not taken seriously (Prior 2003). The underlying assumption of past mental health services was that patients were unable to make choices. Also unique to mental health are the coercive aspects of the service. As such, choice poses a significant challenge to established ways of delivering services and interacting with people. In the long run, the concept of choice could have a transformative effect, both on how mental health services work, as well as how society responds to mental health problems. These are the themes this paper will explore."

Jenny Rankin writes further on in the paper :

"Following these principles, this paper makes two recommendations. First, the GP should no longer be the sole gatekeeper into services; instead there should be new ways to access mental health support through different types of worker based in community organisations.

Secondly, people should be entrusted with their own personal recovery budgets, adapted from the current practice of direct payments. This would require pilots to test how joint health and social care personal budgets work in practice. In turn choice will only become a reality, if certain conditions are put in place. In particular, this paper singled out extended resource capacity, better commissioning, use of individual care plans, a change in professional attitudes, creating roles for professionals and independent advocates to support choice and good information. Resources are a key issue here; the current allocation of resources does not reflect people’s preferences, and there are high levels of unmet demand for certain treatments, especially talking therapies. "

Where that paper's directions failed we think was in two ways . The GP axis of importance was underestimated almost as if GP's were part of the problem rather than the solution and also "market supply" is not openly spoken enough of as more options for Patient Choice . Its as if the CBT supply (in the talking therapies which came on stream patchily in 2010 ) and new workers in community organisations were going to take the place of real Patient Choice options which should have included partly the market. Yet therapy supply from the market was shut down on the back of arguments with private therapists pressured to come under State regulations despite having their own code of ethics , complaints processes and being able to be selected as approved providers or not by PCT's . Some PCT's as a matter of approving supply had in fact approved counsellors previously . The experience was there. It was not built on though .

It seems the paper has to be partly decoded inside the political and social context it was made and within the mental health Charity orbit of interests.

There are good Patient Choice points (Page 19) about vouchers for therapy that Jenny Rankin mentions but they have never crystallised very fully and appear to be rolled out very minimally :

"Personal recovery budgets

The NHS has often proved fairly unresponsive to people’s demands for different kinds of services, notably talking treatments. Introducing greater individual budget holding, through direct payments or specific vouchers for talking therapies could help to remedy this. If people were given their own personal recovery budget they could choose their own treatment. This would also help correct a theoretical anomaly where people (at least, those who are eligible for community care) have choice in social care, but not in health care."

Did we get Patient Choice in Mental Health UK legally recognised ? No . Not at all . Did people get talking therapies yet ?

Jenny Rankin also re-stated John Reid's much quoted Secretary Of State July 2003 statement : from Page 9 :

“Trust me, I’m a patient” should be the guiding principle of [the] new agenda.

We are still waiting to be trusted and in fact are often as patients inside a new inequality-form of partly invisibilised existential strait jacket designed by the State for the State's application on us and provoking people sometimes into being "in a state" .....We still have a State recipe for continuing illness. There's no choice .

further refs

Choice 2007 docs

Mental Health Artist Edward Munch Repaints Scream About No MH Patient Choice

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Truth Repainted For Mental Health Users In The UK
By Edvard Munch's Astral Form

Thanks Edvard for passing with some spirit of rage through the veil of death and mists back to support the truth . What can we say ...We love you very munch and sorry about the spolling mistaykes but hell you are right.... Download this :

SEE THE LABOUR GOVT'S ANTI MENTAL HEALTH
PATIENT CHOICE DOCUMENT FOR ALL UK
MENTAL PATIENTS

Produced Jan 2009

By the way Ed , the UK MH Charities
lost their power to scream out

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Late In Day Rethink UK Challenged No Patient Choice In Mental Health

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By UserWatch Correspondents

WE AGAIN PRODUCE THE Jan 2009 DOCUMENT THAT SHOWS THE LABOUR GOV'T
STIGMATISING AGAINST PATIENT CHOICES IN MENTAL HEALTH


But Why oh why so late in the day Rethink with your "reforming" Rethoughts ?

Lets Explain :

In Jan 2009 The Labour Government , Secretary of State produced a document that barred Patient Choices in Mental Health - See our article with document HERE

In February 2010 Rethink after asking around for mental health patient issues to put to the Gov't NHS Constitution consultations, we finally see Rethink DID put the lack of the (legally empowered) Mental Health Patient Choice Agenda to the Gov't. Finally Rethink showed concern in the same year as the election . (see their FEB 4th 2010 document)

Rethink have sat at DOH advisory meetings on mental health and have been inside these networks for years alongside MIND and Sainsbury's Centre For Mental Health and could have liberated MH patients by making Mental Health Patient Choice the central reforming axis back in 2002 when the Charity combine all got involved building NIMHE which was architected by the big wheel SCMH .

MIND has been partly been busy becoming a CBT provisioner and stoking up its own concerns about the "nasty" private therapists market, because those "nasts" do not wish to fall under the Gov't prefered Health Professions Council but do have perfectly adaptable ethics and complaints systems that suit . Contractuality at the point of agreed supply can also sort out the patient safety issues regarding patient safety but the arguments regarding therapy supply like other things are neatly diverted to favour State designed supply - and those who agree with it .

Frankly private therapy services mixed with eclectic approaches could have been directly purchased or accessed to, years ago via GP's, as in fact happened in Dorset under PCT purchasing arrangements in the late 1990's . But New Labour screwed up those arrangements and re-invented the power of the State and the MH Charities sniffed the air .. Didn't you just all . Charities are provisoners and part of the market now .. That needs serious scrutiny . The cross woven conflicts of interests with Charities on DOH related advisory groups are just too much and need boundarising quite seriously ..Transparency into all of this matters .

The TIME FOR A CHANGE charity-combine anti-stigma project with oodles of cash swilling about(£20 Million) about, is another partial red herring . A big show . The real stigma New Labour and the mental health Charities have supported by default with diversionary flag waving, and inside their own narrowed anti stigma vision is Mental Health Patient Choice by de-prioritising it ...

The show goes on .. The networkers know it, and the money swills ..The Ducks and swimmers are out in the show ..

If indeed Patient Choice was ever fully noticed by most pained MH Users who think State or its close agents is all, and whose lives are dominated by that . There's no CHOICE .. No culture that sees and upholds Mental Health Patient Freedom and actually drives it . The so called USER MOVEMENT is just a narrow often middle class collective of careerists posing as "representatives" .. They represent their own needs but not everyone else's . Patient Choice can free everyone . They cannot .

When is the MH Patient going to be free of State dominion and by default its circular envisioned supporters ? Maybe get UserWatch CBT to stop this self defeating co-reinforcing strands of behaviour ?.... Nahhh just start seeing what you already know is real .. You are , your needs are, and the State isn't ..

When is the Patient going to be free of the politically manipulative corrals and bullshit bureaucratic economy that has grown up on the back of the avoidance of Mental Health Patient Choice ? NIMHE cost £ 100 Million 2004 - 8 and beyond its name change to the National Mental Health Development Unit what is it set to waste now ?

The UK User Trance-dance continues . The NHS loves it . People who own corrals are secured . Hope though is inside freeing choice not being captured by the State or its dominion Charities who need to possess the branded patient for their own economic and social needs.


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Labour Created Discriminatory Document Against ALL Mental Health Patient Choice UK

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By UserWatch Correspondents & Art De Rivers

This report shows the full document finally signed off by a Senior Civil Servant Jan 2009 .

It shows a deliberate exclusion by the Secretary of State of ALL mental health patient choices as a legal mechanism across the UK, which is a legal right already enjoyed by the rest of the public as of April 2009 .

FULL DOCUMENT HERE

We believe this document is firstly discriminating on disability grounds , and secondly its stigmatizing through its second class citizenship implications and we NOTE the mental health charities like MIND, Rethink and Mental Health Foundation, and SHIFT (whatever it is), have done little to press for reform of full patient choice legal equality in mental health . Where were they when this document was drafted ? The MH charities currently glove puppeting the Labour Govt, are however service provisioners and competitors with any other forms of choices, market or otherwise, that could exist under Mental Health Patient Choice legal mechanisms, were indeed those mechanisms to exist .

AND THEY KNOW IT. Is real Patient Choice in Mental Health at odds with Charity interests - of course, because it creates freedom of choice and real options other than a rigged shallow corralled market.

Thirdly the document is actually at odds with the new legal right from April 2009 to go to your UK GP and get a 1st appointment choice of consultant (from a choice of consultants) and then onto an elective choice of Secondary Care Provider (treatment/therapy) - from a choice of Secondary Care Providers ..

The Dept of health have been contacted (we have the material) and argue in response to accusations of discrimination that mostly mental health does not present and travel that pathway of : GP - Consultant - Secondary care provider, but they interpretively locate the mental health care pathway as mainly the Community Care Team etc ...

Well, they are not really correct at all, but have tactically shifted their own attention to the care pathway as it becomes evolved further on from the initial GP and Consultant area ...

Below we show extracts but download the document above .. It first appears as if Mental Health Patient Choice is ruled out only for those on the 1983 Act i.e. on "Sections" (legal orders requiring acute sufferers be contained within a ward) - yet when checked with the Dept of Health the block is on against all Mental Health Patient Choices of treatments .. Even non acutes .

EXTRACTS FROM THE CHOICES GUIDANCE DOCUMENT

The Primary Care Trusts (Choice of Secondary Care Provider)
Directions 2009

Services to which the duty does not apply:

3.—(1) Direction 2 does not apply in relation to—

(a) accident and emergency services;
(b) cancer services or services provided at rapid access chest pain clinics which are subject to
the 2 week maximum waiting time(a);
(c) maternity services;
(d) mental health services; or
(e) any other services where it is necessary to provide urgent care.

(2) In this direction—

“accident and emergency services” means services provided at the accident and emergency department, or a minor injuries unit, of a health service hospital and does not include any subsequent treatment connected with the provision of those services; “maternity services” includes all services relating to female patients from the start of the pregnancy to 6 weeks after the birth other than services relating to medical termination of the pregnancy within the meaning of section 1 of the Abortion Act 1967(b); “mental health services” means services provided to patients in relation to a disorder or disability of the mind.

Persons to whom the duty does not apply :

4.—(1) Direction 2 does not apply in relation to any person who is—

(a) detained under the Mental Health Act 1983(c);
(b) detained in or on temporary release from prison; or
(c) serving as a member of the armed forces.
(2) In this direction—
“prison” includes any other institution to which prison rules made under section 47 of the
Prison Act 1952(d) apply;
“armed forces” means the naval, military or air forces of the Crown.

Signed by authority of the Secretary of State for Health.
20th January 2009 Katharine Peters
Member of the Senior Civil Service
Department of Health


PS .. Watch Out For Distorted Messages From Labour

Mental Health Users Take Heed - From "Benefit And Work.CO.UK" Ref : IB And ESA . There's No-one To Vote For !

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LABOUR CREATE BENEFIT OPPRESSION - AND NO-ONE TO VOTE FOR

Bulletin from : "BENEFITS AND WORK.CO.UK"

BELOW FROM :

B.W. Blog

"The truth about benefits"

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« Is there anyone claimants can vote for?

Thousands will lose benefits as harsher medical approved

Tens of thousands of claimants facing losing their benefit on review, or on being transferred from incapacity benefit, as plans to make the employment and support allowance (ESA) medical much harder to pass are approved by the secretary of state for work and pensions, Yvette Cooper.

The shock plans for ‘simplifying’ the work capability assessment, drawn up by a DWP working group, include docking points from amputees who can lift and carry with their stumps. Claimants with speech problems who can write a sign saying, for example, ‘The office is on fire!’ will score no points for speech and deaf claimants who can read the sign will lose all their points for hearing.

Meanwhile, for ‘health and safety reasons’ all points scored for problems with bending and kneeling are to be abolished and claimants who have difficulty walking can be assessed using imaginary wheelchairs.

Claimants who have difficulty standing for any length of time will, under the plans, also have to show they have equal difficulty sitting, and vice versa, in order to score any points. And no matter how bad their problems with standing and sitting, they will not score enough points to be awarded ESA.

In addition, almost half of the 41 mental health descriptors for which points can be scored are being removed from the new ‘simpler’ test, greatly reducing the chances of being found incapable of work due to such things as poor memory, confusion, depression and anxiety.

There are some improvements to the test under the plans, including exemptions for people likely to be starting chemotherapy and more mental health grounds for being admitted to the support group. But the changes are overwhelmingly about pushing tens of thousands more people onto JSA.

If all this sounds like a sick and rather belated April Fools joke to you, we’re not surprised. But the proposals are genuine and have already been officially agreed by Yvette Cooper, the Secretary of State for Work and Pensions. They have not yet been passed into law, but given that both Labour and the Conservatives seem intent on driving as many people as possible off incapacity related benefits, they are likely to be pursued by whichever party wins the election.

We know that many people will find this news deeply upsetting and even frightening and we know that some people will condemn us for publicising the planned changes or for the language that we are using to do so. But we also believe that it’s not too late to stop these ugly plans in their tracks if claimants and the organisations that represent them act now.

With 1.5 million incapacity benefit claimants waiting to be assessed using the work capability assessment in the next few years and tens of thousands of people already on ESA and set to be reviewed annually, these changes will be of great concern to many voters – if they find out about them before polling day.

So, please spread the word in forums and blogs and to people you know who may be affected. Ask any disability charity you have a connection with to speak out now, before election day, against these plans. You might also want to contact local newspapers and radio to warn people about the proposals.

And above all, contact not just your MP, but the other candidates in your constituency, and let them know you will not be voting for anyone who does not loudly condemn this shameful attack on sick and disabled claimants.

These plans really are a potential seat loser, but only if enough people know about them.

Members can read a detailed breakdown of the changes – and who is responsible for them – in our examination of the revised work capability assessment in the members only news section.

Sources
Building bridges to work
http://www.dwp.gov.uk/docs/building-bridges-to-work.pdf
Work Capability Assessment Internal Review
http://www.dwp.gov.uk/docs/work-capability-assessment-review.pdf
Addendum
http://www.dwp.gov.uk/docs/work-capability-assessment-review-addendum.pdf

RE : Sussex Partnership Mental Health NHS Foundation Trust : Message To Interested Parties

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UserWatch Message To Interested Parties

You may wish to consider contacting the solicitors that appear to be acting for parties re: two of the 4 suicides still under police investigation at this NHS Trust :


SEE : The Hastings Observer (Report By Rob Alderson Feb 11th)

Sgt Bexhell's family have asked solicitors Russell, Jones and Walker to take on their case, and it emerged yesterday the same firm is acting on behalf of Susannah Anley's family.

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Mental Health Charity Replicants Cannot Let The Pigeon Fly Free

Freeing The Pigeon

Well , an animal that talks, gets attention for their issues for sure - but in mental health UK, where activists have had to battle the UK system's shadows over the last year, to loosen its oppressive grip on patient's lives and promote their supply to their legal entitlement to Independent advocates the caged and mishandled pigeons still get crushed, all too often .You cannot challenge a powerful system until it loosens it grip and accepts your power too. Its loss of power is your gain .

The UK public are happy enough to have new legal powers of "Patient Choice" which translates legally from early 2009 as a choice of consultant (from a menu of say 5) and a choice of elective care to secondary care providers (hospitals) or services outsourced by them .

In mental health UK there are no such rights. Who made it that way ? The Labour Party. The Labour Party's attention to mental health seems to have been high-jacked strongly by large Mental Health Charity Influences over 10 years on advisory committees and they have clear but publicly unstated serious conflicts of interest.

Instead of reform of the mental health system's economics for the greater number of MH patients to have the same equal opportunity as the general public, of choices of therapy and recovery managements "pre or post crisis", the MH Charities have progressively become provisioners for the things they have been talking up and influencing at Government level . That is not pro consumer led choice - its corral-dom . Choiceless-herd-economics

That's a restrictive step too far . Its a merging of charity-business interest into flawed "representative reforming interests" in a way that does not produce a proper base level of democratic engagement or real consumer choices. The pigeon is crushed by that too . Or kept still and held .

The pigeon is set to be held for a very very long time . Its wings will always be straining though .. Will the State Replicant let it go ?

The solution is, that Rutger a fiction Replicant realised the vulnerability and wonder of life with its losses and he finally let go. That was despite his State Replicant produced state .

His consciousness elevated beyond the system machine-being he was supposed to be ...

In the UK mental health scene there are DOH and Charity "replicant" armies of wandering State-bound-up careerists that will not let go of the birds and let them have winged choices for their own lives . The "replicants" need that compulsive grip that economically and socially keeps the pigeon held and caged, otherwise they cannot replicate .

Many replicants thus live as bought-off liars ... Pinnochio genes too have been self inserted .

SEE ALSO THE UK CHARITY SANE'S POSITIVE DOCUMENT ON MH CHOICE

Mental Health Animal Report : Aggressive Bipolar Pigeon Threatens Rutger Hauer

Just Free the Pigeon Rutger .... Okayyyyyyy !

FREE CHOICE MATTERS

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SEE : SANE ON MENTAL HEALTH CHOICE

Mental Health Patient Choice Is Sane - But Rethink Needs To Rethink and MIND Needs To Be Spined

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UserWatch Reports

The Userwatch team and individual RIP-orters while devilling about here and there on a cheek expedition noted and conversed about SANE .

The UK Charity SANE does have a 2008 document about Patient Choice and discusses it more openly than the UK State shadow-market developers Rethink and MIND .

That's a plus point and Sane plays less with political snakery than Rethink and MIND . We know that .

Patient Choice of elective care and a consultant that is part of that UK menu driven system, exists for the general population but in mental health UK you are scuppered and have no equality of opportunity of Patient Choice .. That is not tolerable , its discriminatory , and disenfranchises patients who need help via a choice of consultant, a choice of meds or therapies that are not merely crushed and tinned and cogged up by the State or indeed its overcompromised shadow-state - the UK MH charities like MIND and Rethink .

We know they've increased their provisioning status under Labour and that compromises their charity status as far as we are concerned as well as their ability to push reform for patients and not be inside a conflict of interest which now sees patients as a competing market to survive off ..

MIND and Rethink ought to be registered businesses now, because that is what they are concealing they are .

Got it ?

Good .. It will not go away from vision either .

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SEE ALSO : SANE CHARITY

Health Service Journal Cat HSJ Mogger Is Ass-pranged By Sindian Manager Tribe

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The HSJ Mogger saga sees the wicked Sindian Manager Tribes (NHS related) attack poor Mogger. YESSSS . In amongst the mental health deserts of no patient choice near the DOH cactus too !

Terrible ... Turn your eyes away from it all children ... ! Think of Blue Peter and BBC !

Health Service Journal Cat Picture Rescues HSJ From NHS Packs

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Mental Health artist Silvis Rivers known as "Pillvis Depressely" to friends (and UserWatch Colleagues) seems to have captured the real sense of ashamed slinking by Health Service Journal Cat (HSJ Mogger)

From what we are hearing the NHS dog packs, who were told on April 1st by Health Service Journal that their anonymous postings had accidentally shown their real identities , have been tearing up their blankets in further posts on HSJ which has said " Sorryyyyyyyy........" to its self kennelled class of readers who love shadows and confidentiality to the bone etc ..

Yeah it was a great April Fool's trick but who exactly was the fool ?

The laugh goes on and on .... Yeahhh ... So does the savage posts we hear with acid urine-letting spraying up them ..

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Mental Health CBT 117 Trial Study Shows Only 18% Effectiveness

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Save Coggy Now He's Only 18% Resolved

He's one of the 1.8 in 10

Oh dear, no sooner some of the Improvement to Access for Psychological Therapies (IAPT) Cognitive Behaviour Therapy national roll out almost gets underway, er, here and there, but not via your GP Surgery according to a GP study, so it also gets hammered by strong implication by a study published in the

British Journal Of Psychiatry.

The study done by Professor Pim Cuijpers and others were trying to answer a question :

"It is not clear whether the effects of cognitive–behavioural therapy and other psychotherapies have been overestimated because of publication bias."

The study reviewed 117 trials against 175 comparisons and discovered a considerable overestimation of effectiveness of the therapies on depression .

Jeremy Laurence (Independent Health Editor) probed it well in his March 23rd report :

"Does Cognitive Behaviour Therapy Work And Should The NHS Provide More Of It For Depression"

He states :

"But how effective is it?

Less so than its supporters think. Although approved by Nice, a review of 175 trials in the British Journal of Psychiatry published this month concluded that the effects had been exaggerated. Two-thirds of people (67 per cent) improved with therapy, which sounds impressive. However, 40 per cent improved without therapy. So the treatment delivered an extra 27 percentage-point "effect".

How has this been exaggerated?

By "publication bias". Publication bias occurs when publishers of medical journals choose to accept trials that show positive results and reject those that show zero or negative results. This skews the published literature to show a larger effect of the treatment than is true in reality. Pim Cuijpers from Vrije University, Amsterdam, who led the review, said that when publication bias is taken into account, it reduces the effect of CBT by "about one-third, to 18 per cent".

We at UserWatch note the British Journal of Psychiatry abstract of the study did seem to use interchangeable terms : "cognitive behaviour therapy , psychotherapy , psychological therapies" rather too much because it is State prescribed CBT that has been very promoted over the last few years and appears to be taught very stricturedly behind the scenes and is under the spotlight . Never mind the study is free in one year's time after yer cogs have only been 18% oiled .....

We thought some time ago that CBT will give useful deeper empathic therapies - genuinely trying to help people's damaged emotional lives, a really bad name by being lumped together as "psychotherapy" but then that's part of a bigger problem which might have been moving towards clearer resolution if patients had real choices and they as a genuine market drove quality over time .

We also note the social engineering tendency of the Guardian and BBC have hardly touched the efficacy of deeper therapy appropriate for people's life damages. And the need for greater supply of it to support people into better emotionally realistic navigation of themselves. What's wrong with hearing out people's pain , hurt, into witness ?

But then who needs cultures of depth of feeling and thought, other than those of the established status quo of State control and almost subtle social engineering colonial leanings ?

Try asking the 500 Afro Caribbeans who were wrongly diagnosed with onset psychosis and whose backgrounds of parental poor attachments and cultures of instability created their pain and behavior .. Strange isn't it how a large study with 500 Afro Caribbeans gets buried because basically it blows the myth of bio-medical standpoints into the winds of the social streets and their felt and experienced effects .. Yeahhhh lets ignore depth .... Its dangerous for class interests..

Mind you the Guardian did report the study, that's something ...

Dec 9th 2009 Guardian

"The worrying figures emerged from a large study carried out by psychiatrists and epidemiologists at the social psychiatry unit of the Institute of Psychiatry at the Maudsley hospital in south London. Named Aesop (Aetiology and Ethnicity in Schizophrenia and other Psychoses), the study involved 500 patients with mental health problems from various ethnic groups, comparing them with a control group of 350 healthy subjects.

The researchers ruled out genetic issues as the cause, and the previously held suspicions that psychiatrists were more inclined to diagnose schizophrenia when dealing with black males in particular. They concluded instead that the root causes lay in a whole range of social factors that lead to severe social isolation – people living alone, unemployment, and the vexed issue of separation from parents due to family breakdowns in the African Caribbean community amounting to a kind of "sensory deprivation" "

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