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NEW ANALYSIS REVEALS:
Mental Health Trusts Left With Less Funding Than 2012 Due To Government Cuts!
Mental health trusts have been left with less funding in real terms than they had in 2012 as experts warn patients with mental illness are “bearing the brunt” of government cuts to the sector.
Time and again we at Recovery In Action are finding our efforts to help people in the community - recovering from mental ill health - undermined by the worrying situation of ever diminishing services within the NHS.
Staff shortages, service cuts and the increase of our clients 'falling through the gaps' in existing mental healthcare structures can often perpetuate their suffering! Some are caught in a cycle of progressive relapses - despite working very hard to stay well.
New analysis by the Royal College of Psychiatrists (RCPsych) shows that while the Government states mental health spending is at “record” levels, the income of mental health trusts in England is lower than it was six years ago once inflation is taken into account.
NHS England has disputed claims, saying they “ignore the fundamental fact” that some trusts provide services unrelated to mental health, and that responsibility for funding many of the services provided by the trusts has transferred from the NHS to local government.
But RCPsych said mental health trusts were central to treatment of mental illness in England, with almost 90 per cent of all psychiatrists in the country working in trusts. They urged the fact that some trusts provide community services not directly related to mental health should "not distract" from the figures.
The analysis of figures, based on annual reports and accounts for mental health trusts and the latest set of GDP deflators from the HM Treasury, shows more than half (62 per cent) of trusts reported lower income at the end of 2016-17 than the amount for 2011-12. Only one saw an income rise in all five financial years, while nine trusts saw their income fall in all five years.
The total amount of income that mental health trusts in England received in 2016-17 was £11.829bn. While the figure has risen overall in each of the past two years, it remains £105m lower than in 2011-12 at today’s prices. The picture across the UK was similar, with mental health spending in Wales, Scotland and Northern Ireland all lower now than it was in recent years.
In October 2017, Mr Hunt said the NHS had spent a “record” amount on mental health, and pledged to a “commitment to maintain a healthy flow of investment into mental health services”. He also referred publicly to the extra £575m spent by clinical commissioning groups (CCGs) in 2016-17 compared with the previous financial year.
The RCPsych claimed the funding situation was “opaque” due to the fact that it is now up to the CCGs to pass this money on to mental health trusts and other providers.
The Health and Social Care Act in 2012 changed the way mental health services were funded, with mental health trusts now only part of the picture, as funding is also distributed through GPs, local councils, private providers and the voluntary sector.
While spending by commissioners is monitored by NHS England’s mental health statistics “dashboard”, the RCPsych claims there is no regular publication of high-quality data for those other organisations.
The organisation is now calling for mental health trusts to be given more money and for better ways of tracking where mental health money is being spent, amid fears that some of that money is failing to reach the frontline.
Professor Wendy Burn, the president of RCPsych, said it was “totally unacceptable” that when more and more people are coming forward with mental health problems, services are receiving less investment than they did seven years ago.
“Patients with mental illness continue to bear the brunt of an underfunded sector experiencing unprecedented demand with limited supply,” she added.
“Prioritisation of mental health is about getting the right care, at the right time, in the right place. This can’t happen when mental health trusts continue to receive inadequate investment.”
Barbara Keeley MP, Labour’s shadow minister for mental health and social care, said: “This analysis has dealt a hammer blow to Tory claims that they have made mental health an equal priority to physical health.
“Real-terms cuts added to the fragmentation of services have come at a time when demand for mental health services is increasing. Tory ministers must increase investment in mental health services and ring-fence budgets, as Labour pledged to do at the last election, so that funding reaches the front line.“
An NHS England spokesperson disputed the claims, saying: “This sloppy press release contains basic flaws and obvious mistakes.
“Firstly it ignores the fundamental fact that many of the trusts it references provide both mental health and community services entirely unrelated to mental health. So changes in the trusts’ total income tells us nothing about their mental health revenues specifically.
“Secondly, their press release seems to forget that during the period in question, responsibility for funding many of the services these trusts provide, such as sexual health clinics, transferred from the NHS to local government.
“Thirdly, it suppresses the inconvenient truth that NHS mental health investment has been increasing in real terms both last year and this. Indeed even on its own flawed maths, the briefing concedes: ‘the total in 2016-17 was higher than any of the previous four years’”.
Responding to this, a RCPsych spokesman said they had "absolute confidence" that although trust income has gone up since 2014 – in real terms it is still below the levels achieved five years ago.
The added: “As NHS England highlights, mental health finances in England are confusing and it is extremely difficult to track how every penny of tax payers money is being spent. This is a shocking state of affairs which must be remedied so that voters can be confident that money intended for mental health services is being spent on them.
“A particular source of confusion, highlighted by NHS England, is that 29 of the 55 trusts (2016/17) also provide community services such as district nursing and sexual health not directly related to mental health. This should not distract those seeking to ensure that more money goes to front line mental health services from the essential truth here."
The spokesperson urged that trusts "have a primary responsibility for treating mental illnesses" and that the amount of money they have to spend must therefore be a "key indicator" of their ability to fulfil that purpose.
“RCPsych pays tribute to the efforts that NHS England has made – through developments such as the Mental Health dashboard – to improve transparency of mental health spending," the spokesperson added.
“We have and will continue to assist in every way with these vital endeavours and call upon NHS England to publish the update to the dashboard which was due in the autumn of last year.”
HEALTHWATCH LAMBETH
'MAKING IT BETTER' EVENT!!
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So here we all were - Lambeth mental health service providers, service users and carers coming from far and wide! There was a mixed menu of topics for discussion, but the main course was what was a broad and reaching discussion on 'Making It Better!'
Making what better? Well from Lambeth Health Watch research in the borough it was found that a sizeable number of mental health service users found existing services to be not delivering what they needed - both when in crisis and when struggling in the community. So in varying focus groups all attenders were invited to tease out possible solutions and / or ways forward (image below).
The main areas of discontent were:
- Inadequate or less than satisfactory crisis support!
- A lack of consistency & continuation of care!
- Difficulty in navigating the mental health services systems!
- A lack of readily available information on mental health services available in the borough!
So attenders were invited to join an array of focus groups to discuss and thresh out possible ways forward.
In the summing up Mike Rogers (image above) from Lambeth Health Watch promised to draw on the ideas we all came up with around how things might be improved and promised to keep us all updated during the process.
So we at Recovery In Action were particularly interested in an embryonic idea around service users engaging with a 'Trusted Key Person' who could help them in their recovery. This might be anyone from a family member or peer mentor (us) to someone working in the local Community Mental Health Team. This Key Person - who would have comprehensive understanding and knowledge of the service user - would be recognized by everyone working with the service user and would be an integral part of the service users care structure.
This approach might be wide ranging in it's potential - and among other things the Key Person could:
- In some cases act as an advocate!
- Help the service user navigate the mental healthcare system!
- Be someone trusted by the service user!
- Have extensive knowledge about the person they're supporting - helping enable good communication with care staff!
There are of course varying things that would need ironing out like (i) how to prevent Key Person 'burn out' (ii) processes to be in place to prevent any abuse or harm coming to the service user via the Key Person (iii) how clinicians and other staff will work with, recognize and respect Key People etc. However many of us were excited amidst the talk about the possible new way of working to support those who still struggle with their mental health in Lambeth.
============================================================================================================MENTAL HEALTH EDUCATION TAUGHT IN SCHOOLS
Mental health education is to be made compulsory in schools across the country.
Children are to learn about good mental health, the importance of good relationships and how to be physically healthy, the Department for Education has said.
The government said youngsters will be taught about topics such as consent, keeping safe online and LGBT+ issues. All children will also learn about healthy lifestyle habits.
Children will also be taught how to recognise when others are struggling with mental health and how to offer help. In a statement, the DfE said: “The guidance – which was last updated in 2000 – will become compulsory in all schools across the country from September 2020, and will put in place the building blocks needed for positive and safe relationships of all kinds.”
According to the DfE, teachers will talk to children as young as primary school age about the features of healthy friendships, family relationships and other relationships they may encounter. And at secondary schools, teachers will build on this and, “at the appropriate time”, talk to children about intimate relationships.
Children at both levels will be learning about staying safe online, how to use technology safely and how to keep personal information private. The new teaching guidelines have been developed in response to a “national call” for topics such as these to be covered, the DfE said.
Education Secretary Damian Hinds said: “I want to make sure that our children are able to grow up to become happy and well-rounded individuals who know how to deal with the challenges of the modern world.
“Part of this is making sure they are informed about how to keep themselves safe and healthy and have good relationships with others.
“Many of today’s problems did not exist when we last gave schools guidance on how to teach Relationships and Sex Education 18 years ago. “The action we’re taking is important to help support teachers and schools design a curriculum that will enrich their pupils in an age appropriate way.
“Good physical and mental health is also at the heart of ensuring young people are ready for the adult world. By making health education compulsory we are giving young people the tools they need to be ready to thrive when they leave school.”
The move to include these subjects has been welcomed by campaigners, who called for personal, social and health education lessons (PHSE) to be made compulsory to tackle the rise in mental health issues.
But some have expressed disappointment that the change will not come in until 2020.
Paul Whiteman, general secretary of school leaders’ union NAHT, told the Independent: “The government’s announcement today covers important elements - like online safety and LGBT issues as well as sex and relationships and mental and physical health - but does not go as far as PSHE.
He added: “We are also disappointed to note that the government is rolling back on their commitment to statutory relationships and sex education by September 2019, with the deadline pushed back a year.
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RECOVERY IN ACTION - SPREADING OUR TENTACLES!
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Since we've been given a small grant for a pilot to support people in Lambeth we've been really getting about - working collaboratively with more services that include:
We also facilitate the Exploring Beliefs Peer Support Group for people using mental health services in Lambeth struggling in the community. This group now have an allotment (see above image) which we're developing - so we'll soon be eating our own food!!
From the Evening Sanctuary we offer follow on peer mentoring support, advice and help for people who have been discharged from that service - who still need a bit more support.
- Brixton Pound Cafe - Urban Foxx Project where we meet up with those we support every Wednesday for food, chat and networking!
- Mosaic Clubhouse - Evening Sanctuary for people struggling out-of-hours with their mental health! (see above image - of Lenka who manages The Evening Sanctuary at weekends)
- Lambeth Health Watch - Monitoring services in the local community and influencing positive change!
- South London & Maudsley NHS Trust - Moving On Project where we meet patients nearing discharge and share info on what might help them in the community!
- Lambeth & Southwark Mind - Kindred Minds BME Therapies Pop-in; a peer support group for people in the BME community who struggle with social isolation and loneliness!
- Certitude (Community Connectors) We are also working alongside Certitude's Community Connectors helping people find things in the community that might enhance positive well being!
- Certitude (Solidarity-In-A-Crisis Peer Support Crisis Line) - An 'Out-Of-Hours' Peer Support Crisis Line service offering listening support & community visits to people struggling with their mental health in Lambeth, Southwark & Lewisham.
We also facilitate the Exploring Beliefs Peer Support Group for people using mental health services in Lambeth struggling in the community. This group now have an allotment (see above image) which we're developing - so we'll soon be eating our own food!!
From the Evening Sanctuary we offer follow on peer mentoring support, advice and help for people who have been discharged from that service - who still need a bit more support.
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RECOVERY IN ACTION
URBAN FOXX PEER SUPPORT GROUP!
AT BRIXTON POUND CAFE
77 ATLANTIC ROAD
BRIXTON
LONDON SW9 8PU
COME AND JOIN US EVERY WEDNESDAY 3PM - 6PM!!
ENJOY SOME FOOD, DISCUSSION AND INFORMATION SHARING!!
'PAY WHAT EVER YOU CAN AFFORD!!'
'YES YOU READ IT RIGHT - YOU PAY WHAT YOU'RE ABLE TO!!'
MEET THE GANG!!
**COME ALONG - TAKE A LOAD OFF - HAVE A CHAT - ENJOY A MUNCH**
**GET UPDATED ON SERVICES IN YOUR BOROUGH**
**FIND OUT ABOUT ACTIVITIES GOING ON IN AND AROUND YOUR COMMUNITY**
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ENJOY SOME FOOD, DISCUSSION AND INFORMATION SHARING!!
'PAY WHAT EVER YOU CAN AFFORD!!'
'YES YOU READ IT RIGHT - YOU PAY WHAT YOU'RE ABLE TO!!'
MEET THE GANG!!
**COME ALONG - TAKE A LOAD OFF - HAVE A CHAT - ENJOY A MUNCH**
**GET UPDATED ON SERVICES IN YOUR BOROUGH**
**FIND OUT ABOUT ACTIVITIES GOING ON IN AND AROUND YOUR COMMUNITY**
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SAD NEWS
FIRST 'WINDRUSH SCANDAL' DEATH!
Dexter Bristol, a 58-year-old man who was born in Grenada on the 11 March 1960 and whose death is attributable to the problems he had trying to prove that he was a British citizen, is to be buried tomorrow 17 May 2018 at the Honor Oak Crematorium in south east London at 3.00 pm. His death, on the 29 March 2018, is subject to an inquest in July 2018, but initial thoughts are that he either died by taking his own life or that he had a heart attack.
Dexter's attempts to prove that he was a British citizen put him under enormous stress. The family have not heard from anyone in the government with offers of condolences or any other information despite bringing his death to the attention of Amber Rudd, the former Secretary of State, in person, at a meeting of Caribbean High Commissioners held at the Home Office on the 20 April 2018. Instead the government has tried to obfuscate the issue by advising the media that he did not make an application to the home office.
Dexter arrived in the UK in 1968, aged just eight, on his mother’s British Subject passport. In May 2017, Dexter’s life was to change forever. He had been unwell but had been deemed fit to work and had been offered a cleaning job. He was shocked to find that an offer of a job would fall through when he could not prove that he was a British citizen and that his right to receive benefits was being challenged. He described this reality with a mixture of humour and incredulity, believing that it would be a matter of days or weeks at the most before he could prove his immigration status. What followed however was a ten-month trek through an almighty bureaucracy which started when the Home Office would tell him that there was no evidence of his immigration status or that he was lawfully in the UK. He was told that he could make an application for Indefinite Leave to Remain but to do so he would need a passport of his country of birth.
This took Dexter to the Grenada High Commission but owing to a spelling error on his birth certificate and a family name which differed from the one he was known by in England, a passport could not be issued until a correction could be made. Dexter finally got a new birth certificate in August 2017 and a Grenada passport in November 2017. However, whilst all of this was going on, Dexter was also required to prove not just the day that he arrived in England but the story of his life in the country. This proved very difficult. Both his primary and secondary schools no longer existed, his National Insurance records went back to 1976 only and his medical records went back to the 1980s. He was required to show that he was in England on the 1 January 1973 and that he had remained for at least five years. This was despite him being named in his mother’s British passport as an eight-year-old minor.
With Dexter’s newly obtained Grenada passport, an application for a subject access of his file was made to the Home Office on the 19 December 2017. On the 10 January 2018, three weeks later, the Home Office wrote back advising that the photo ID submitted required a certification that this was a true likeness of Dexter. On the 16 January 2018, this information was sent to the Home Office. Under the Data Protection Act, the Home Office have 40 days to provide this information. This request is still pending in May 2018 and the matter has been reported to the Office of the Information Commissioner.
It was hoped that if there was a file for Dexter at the Home Office, that it might contain a landing card or details of his mother’s own naturalisation application, which might in turn provide some evidence of his own life in England. A slight breakthrough arrived in a document from the London Borough of Southwark on the 12 March 2018, which placed him in England in June 1974. His lawyers tried to reassure Dexter that he would be fine based on a similar case they had done. He was not so sure and would sink deeper and
deeper into despair as each piece of evidence came in or not as in the case of the request to the Home Office. To lift Dexter’s spirits, his lawyers wrote to him on the 29 March 2018 to say that we wanted to submit an application to the Home Office for a No Time Limit Stamp, using the evidence dating back to June 1974 and his mother’s passport which had his name in it. Dexter died that night and that letter, unopened, was found amongst his very few possessions. A copy of that letter was sent to his mother and she got hers on the 31 March 2018. Dexter’s death is the subject of an Inquest which is currently scheduled for July 2018.
Jacqueline McKenzie, Dexter’s family lawyer said” We have been doing Windrush cases for the past five years but in the past year, the numbers have increased as a result of employers, universities, landlords, banks and the NHS conducting checks on person’s immigration status. The fact that British people have been made to feel so unwelcomed and unworthy in their own country is a damning indictment on a government that was proud to predicate its immigration policy on the basis of hostility.”
Patrick Vernon, Director of mental health organisation Black Thrive and originator of the Windrush Petition believes that the “Windrush scandal has highlighted the issue of the impact of multi-generational trauma and mental wellbeing and these issues must be reflected in the compensation package offered from the government.”
YOUTH MENTAL HEALTH SUPPORT - WHAT'S HAPPENING?
A recent report from the Independent Commission on Children and Young People’s Mental Health is the latest in a long string of research drawing attention to the poor state of children and adolescent mental health services (CAMHS).
What do we know about these problems and what can be done?
Access is patchy. For a start, children and young people often have trouble accessing treatment, information and support for their mental health.
Nearly a quarter of children referred to children and adolescent mental health services (CAMHS) are being turned away. The reason? Their condition is not seen to be serious enough; in some areas their referral is only accepted if the condition has a major impact on “the child’s life such as an inability to attend school or a major breakdown in family relationships”.
We also know that there is wide variation in how long children and young people (CYP) wait to access CAMHS. The median waiting time across all providers is one month for a first appointment and two months until start of the treatment. However, some children and young people may wait as long as six months for a first appointment and 10 months for start of treatment. Late intervention has not only a significant human and social – potentially irreversible – cost on the lives of children, young people and their families, but also a financial one.
Secondly, we know that there are very high rates of self-harm in younger people yet, when in crisis, they often don’t know where to seek help.
The 2014 Adult Psychiatric Morbidity Survey found that self-harm has been increasing over time. In 2014 one in five young adults aged 16-24 had self-harmed; young women twice as much as young men (25.7 per cent vs 9.7 per cent). Likewise, at a recent conference, Dudley Youth Health Researchers presented figures from their survey of over a thousand people aged 11-19, and found that almost half (44 per cent) of those surveyed or someone they knew had been affected by self-harm, while 33 per cent had been affected by an eating disorder.
Yet one in five respondents said that they would not know where to seek help or information in these situations. This reflects national statistics. Hospital admissions as a result of self-harm for CYP are on the rise, as are A&E attendances in under 18s with a primary diagnosis of psychiatric condition or intentional self-harm. While these increases may be a good thing – the result of more awareness and more CYP reporting and seeking care – they could also be a signal that CYP don’t know where to turn when they need help early on.
Despite the frequent use of the internet and social media, the majority of young people said they would prefer to speak about their health problems face to face – mainly to parents/carers, followed by a doctor and friends. These findings are consistent with those of the Adult Psychiatric Morbidity Survey which shows that young people seek help after a suicide attempt in a different way to adults, who were more likely to go to hospital or a specialist service. Therefore the help available has to be based on an understanding of these behaviours and better tailored to the needs of the young.
Surveys have their limitations, but taking their findings together with the nationally available figures is truly worrying. So how do we respond to these challenges?
One of the biggest barriers to progress in CAMHS identified by an Education Policy Institute (EPI) review was poor staff recruitment, which results in large expenditure on agency staff. Despite the increase in funding to local areas, high agency spending means that any additional funding granted to CAMHS may not ultimately be used for mental health services for CYP at all.
However, in spite of funding challenges, there is lots of good work underway that we can learn from. The EPI review provided some excellent recommendations around prevention, early intervention and the need to deliver better treatment. One of the key pillars of early intervention was a stronger focus on health and wellbeing at school and easy access to appropriate care – through drop-ins or self-referral.
There are many passionate professionals, CYP, parents and carers who seem to be getting it right and it is important to celebrate these. For example, the city centre hub called "Pause" in Birmingham – part of Forward Thinking Birmingham – which plans to revolutionise mental health care for CYP by providing a safe, comfortable and supported space for young people to come, sit, relax and access therapy. Hearing from a young person who is a client of "Pause" recently made it clear that relatively simple solutions can have a huge impact on people's lives.
Another great example is the Well Centre in Lambeth, a one-stop-shop drop-in centre (with a youth worker, CAMHS nurse and GPs) for young people with any physical or emotional concern. This service demonstrates the importance of youth-friendly, flexible and accessible services for CYP.
The Nuffield Trust also looked at some of the new (and not-so-new) models of care for CYP earlier this year and found that many of them were providing easy and flexible access to high quality care.
National Mental Health Day may have been last month, but for a lot of young people, every day is a ‘mental health day’. Without addressing some of the barriers to treatment – and an urgent look at funding – more children and young people may be denied access to lifelines when they need them the most.
But we don’t have to wait for national policy change or additional funding to take action. We all have a collective duty to help the youngest and most vulnerable in our society. New and innovative models like Pause and the one-stop-shop offer hope on the horizon, and the NHS can learn a lot from these services. However, we can all make a contribution to helping our young by making small changes – every contact counts.
Suggested citation Kossarova L (2016) 'How can we improve access to children’s mental health services?' Nuffield Trust comment, 5 December 2016. https://www.nuffieldtrust.org.uk/news-item/how-can-we-improve-access-to-childrens-mental-health-services..
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LAMBETH HEALTH WATCH - HOSTING BLACK THRIVE
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Healthwatch Lambeth is hosting the staff team of Black Thrive, an independent partnership of Lambeth community and services.
People of African and Caribbean descent suffer disproportionately when it comes to mental health and wellbeing. Black Thrive has been established as a partnership between statutory and community partners to continue to the work started by the Black Health and Wellbeing Commission (BHWC) to improve mental health and wellbeing for Lambeth’s black communities.
Black Thrive seeks to build a culture in Lambeth whereby black communities are able to thrive and improve their mental health and wellbeing, supported by relevant, accessible services, which provide the same excellent quality of support for all people regardless of their race. There is an urgent need to address these unequal outcomes.
Visit the Black Thrive website
Become a Black Thrive friend
People of African and Caribbean descent suffer disproportionately when it comes to mental health and wellbeing. Black Thrive has been established as a partnership between statutory and community partners to continue to the work started by the Black Health and Wellbeing Commission (BHWC) to improve mental health and wellbeing for Lambeth’s black communities.
Black Thrive seeks to build a culture in Lambeth whereby black communities are able to thrive and improve their mental health and wellbeing, supported by relevant, accessible services, which provide the same excellent quality of support for all people regardless of their race. There is an urgent need to address these unequal outcomes.
Visit the Black Thrive website
Become a Black Thrive friend
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THE LIVING WELL NETWORK ALLIANCE!
WHAT'S IT ALL ABOUT?
Faced with a tight budget and fragmented services Lambeth’s CCG and council have taken the radical step of pooling budgets and services into the Living Well Network Alliance
Lambeth Clinical Commissioning Group (who are responsible for organising health services) and Lambeth Council face a problem when looking at the mental health services. It was recognised that change was necessary because we are not fully addressing the issues that people with mental illness say are important to them. The evidence shows that all too often those suffering from mental health issues end up in hospital which, whilst necessary for some, may not be the best place for everyone, and too many stay in hospital longer than they need to.
The system is not joined up and there are too many handoffs and referrals which results in too many admissions. While people using the beds need them when they are admitted if help was provided earlier people will get the care in the least restrictive way. A more streamlined and better linked up system will achieve this. Coupled with this, there is need across the whole public sector to make the most of the money we have. So, rather than muddling through and carrying out salami-slicing cuts the CCG and the council have come together to set up the Living Well Network Alliance. The aim is to join up services around the needs of those who use them; providing easier access and better services whilst also making the best use of the ‘public pound’.
Bring services together
The Living Well Network Alliance brings together those who use services, those who plan and buy services (commissioners) and those who deliver them (providers) to design, develop and deliver a new model of adult mental health services in Lambeth. For people who use services, this will make it easier and quicker to get the service they need and reduce the merry go round of referrals from one part of the system to another. The new approach will also make better use of professionals’ time and expertise by involving the voluntary and community sector where this makes sense. Importantly, the new approach will treat those who use services as equal partners, recognising that they come with strengths and ‘assets’ and involving them in the design and development of services generally and their care in particular.
Preventing illness
The Alliance will use this joined-up approach to focus more on preventing people getting ill in the first place and supporting them earlier when they are ill. As well as providing faster care, which is likely to mean a better result, it will also reduce the need for more expensive and less suitable hospital care. The Alliance is building on significant joint work which is already bearing fruit in the borough. For example, over 500 people each month are being supported by the Living Well Network Hub. Without this, many of these people would have had no support; some would have been left to manage alone, with the risk that they could get worse and be a risk to themselves or others or even need care in hospital.
The Alliance recognises that certain parts of Lambeth’s community, particularly black men, are often over-represented in the mental health system and that they report a worse experience of these services than others. The Alliance will do everything in its power to ensure that all sections of Lambeth’s community are treated equally and will work with those traditionally less engaged to design services that best meet their needs.
Want to find out more and get involved?
If you want to get involved please click here.
Lambeth Clinical Commissioning Group (who are responsible for organising health services) and Lambeth Council face a problem when looking at the mental health services. It was recognised that change was necessary because we are not fully addressing the issues that people with mental illness say are important to them. The evidence shows that all too often those suffering from mental health issues end up in hospital which, whilst necessary for some, may not be the best place for everyone, and too many stay in hospital longer than they need to.
The system is not joined up and there are too many handoffs and referrals which results in too many admissions. While people using the beds need them when they are admitted if help was provided earlier people will get the care in the least restrictive way. A more streamlined and better linked up system will achieve this. Coupled with this, there is need across the whole public sector to make the most of the money we have. So, rather than muddling through and carrying out salami-slicing cuts the CCG and the council have come together to set up the Living Well Network Alliance. The aim is to join up services around the needs of those who use them; providing easier access and better services whilst also making the best use of the ‘public pound’.
Bring services together
The Living Well Network Alliance brings together those who use services, those who plan and buy services (commissioners) and those who deliver them (providers) to design, develop and deliver a new model of adult mental health services in Lambeth. For people who use services, this will make it easier and quicker to get the service they need and reduce the merry go round of referrals from one part of the system to another. The new approach will also make better use of professionals’ time and expertise by involving the voluntary and community sector where this makes sense. Importantly, the new approach will treat those who use services as equal partners, recognising that they come with strengths and ‘assets’ and involving them in the design and development of services generally and their care in particular.
Preventing illness
The Alliance will use this joined-up approach to focus more on preventing people getting ill in the first place and supporting them earlier when they are ill. As well as providing faster care, which is likely to mean a better result, it will also reduce the need for more expensive and less suitable hospital care. The Alliance is building on significant joint work which is already bearing fruit in the borough. For example, over 500 people each month are being supported by the Living Well Network Hub. Without this, many of these people would have had no support; some would have been left to manage alone, with the risk that they could get worse and be a risk to themselves or others or even need care in hospital.
The Alliance recognises that certain parts of Lambeth’s community, particularly black men, are often over-represented in the mental health system and that they report a worse experience of these services than others. The Alliance will do everything in its power to ensure that all sections of Lambeth’s community are treated equally and will work with those traditionally less engaged to design services that best meet their needs.
Want to find out more and get involved?
If you want to get involved please click here.
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A MEMORABLE QUOTE - CHOSEN BY GARRY ELLISON
From time to time we'll be selecting a quote chosen by a member of Recovery In Action. This one has been chosen by Garry Ellison - one of our project leads.
“Living from a place of authenticity is difficult because those living in distortion see you as a threat to their delusion and some are so attached to that delusion that they will behave in erratic ways to defend their ego’s projection of wounding.” Suzanne Wagner
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CALLS FOR BETTER YOUTH MENTAL HEALTH SERVICES!
We at Recovery In Action have welcomed the publication of a House of Commons Health Committee report looking at mental health services for children and young people which criticizes the Departments of Health and Education, NHS England, Ofsted and the Care Quality Commission.Our Chief Executive, Jenny Edwards CBE says;
'The report is a timely summary of the many complex issues which lead to inadequate and fragmented services being provided in many parts of the country which can lead to lifelong mental health problems. Whilst some areas do have examples of good practice, overall the report makes for grim reading. Services are under enormous strain and the system hasn't made them a priority in terms of funding, commissioning or inspection.'
We congratulate the Committee on its thorough work and recommendations, as well as their engagement with the issues raised. We hope that the Committee will continue to scrutinise this area and the issues it raises will be made a priority by ministers and all political parties.
The Foundation welcomes the focus on improved perinatal and infant mental health services and on embedding mental health in the education curriculum. Proper information that drives adequate commissioning will provide a deeper understanding of what services are available now, what is needed, and what the prevalence of mental health problems are. Without understanding the true scale of need, and what it will cost to meet it, these urgent changes cannot be implemented. We must act quickly - within the lifetime of the next Parliament - or we risk losing a generation of young people to mental health problems. This could so easily be avoided, if treatment were to be made readily available.
So we at Recovery In Action are witnessing more young people being affected by mental health issues and although we only work with people over 18 we are time and again hearing from those we support that they have been using services since their teens and to some degree have become institutionalized. There must be something done to help these young people when they're struggling in our communities and we (with others) are gearing up for a campaign to influence positive change in this area!
November 2014
'The report is a timely summary of the many complex issues which lead to inadequate and fragmented services being provided in many parts of the country which can lead to lifelong mental health problems. Whilst some areas do have examples of good practice, overall the report makes for grim reading. Services are under enormous strain and the system hasn't made them a priority in terms of funding, commissioning or inspection.'
We congratulate the Committee on its thorough work and recommendations, as well as their engagement with the issues raised. We hope that the Committee will continue to scrutinise this area and the issues it raises will be made a priority by ministers and all political parties.
The Foundation welcomes the focus on improved perinatal and infant mental health services and on embedding mental health in the education curriculum. Proper information that drives adequate commissioning will provide a deeper understanding of what services are available now, what is needed, and what the prevalence of mental health problems are. Without understanding the true scale of need, and what it will cost to meet it, these urgent changes cannot be implemented. We must act quickly - within the lifetime of the next Parliament - or we risk losing a generation of young people to mental health problems. This could so easily be avoided, if treatment were to be made readily available.
So we at Recovery In Action are witnessing more young people being affected by mental health issues and although we only work with people over 18 we are time and again hearing from those we support that they have been using services since their teens and to some degree have become institutionalized. There must be something done to help these young people when they're struggling in our communities and we (with others) are gearing up for a campaign to influence positive change in this area!
November 2014
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BBC SHOW LOOKS AT ERADICATING LONELINESS
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This week sees BBC 1’s James Martin host a five-part series; Operation: Meet the Street. The programme - which airs every morning from Monday 15 December and runs consecutively for five days - focuses on the eradication of loneliness by reconnecting the UK’s communities. It will also feature expert views from our Director of Development and Delivery, Isabella Goldie, on the topic of loneliness and isolation. “Loneliness is different from social isolation,” says Goldie. “You can choose to be alone, but loneliness is a more subjective experience and [is] based on aspects like how you were brought up and how important social connectedness is for you.”Operation: Meet the Street follows celebrities such as retired Olympian Denise Louise, TV presenter Alex Jones, and one half of Hairy Bikers outfit, Dave Myers. Martin James and the celebrities have teamed up with Goldie and other mental health experts who are working to end the stigma around loneliness and isolation.
Our 2010 report, The Lonely Society?, highlighted poverty, unemployment, and physical disability as just a few of the ways one’s life may shift to include fewer interpersonal interactions. “Being older and having mobility issues, having a physical illness or disability that makes it difficult to get out of the house, having poor access to transport, being excluded due to difference” are all factors that contribute to loneliness, Goldie explains. “Many international human rights activists view isolation as the cruellest form of torture, yet as part of daily life we leave many older people confined to their homes on their own.” The report shows that levels of loneliness and isolation rise during the Christmas period, so the airing of Operation: Meet the Street comes at a significant time.
The programme will look into the childhoods of five celebrities but its main purpose is to raise awareness about loneliness. Rather than giving the spotlight to the celebrities and their experiences, Martin will aim to highlight the stories of local residents who may be experiencing feelings of isolation and low self-esteem. No demographic is exempt from feelings of loneliness - according to Goldie, “people who have encountered adversity – such as young people with long-term conditions or those who have experienced trauma or discrimination – can experience both social and emotional isolation.”
The Lonely Society? points out that as the holiday season approaches, the financial and emotional weight of this time can simply add to the burden of loneliness that has been building all year. “Poverty is a big factor – you need money to be able to socialize,” says Goldie. Not having parties to go to or money to shop with, many people already experiencing loneliness this year will shrink further into their isolation.
Watch Operation: Meet the Street on BBC 1 at 9:15 every morning starting Monday, December 15, with the final episode airing on Friday, December 19.
Follow the show: #OperationMeetTheStreet.
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LATEST PIP STATS
Today sees the release of the latest personal independence payment (PIP) statistics, giving details of how many claimants are still waiting and how many new claimants and DLA transfer claimants are getting an award.
Today also brings the first mandatory reconsideration statistics. These suggest that DWP dirty tricks have managed to cut the number of employment and support allowance (ESA) challenges by more than half. And they still won’t tell us how many of those challenges are successful.
We explain how to beat the dirty tricks, whether your mandatory reconsideration – the new first step in the appeals process – is for ESA, PIP or another benefit.
The DWP have also announced that a new ESA50 questionnaire is due out early next year which will place more onus on claimants to provide supporting evidence.
Meanwhile, it will come as no surprise to readers to discover that IDS continues to twist statistics, mangle facts and bluster his way out of every hole he finds himself in.
He claimed on the BBC on Sunday that benefits are now paid on time in 96 – 97% of cases compared to 88-89% under Labour.
This contrasts with the reality that only 20% of people who claimed ESA in January to March of this year have had an assessment. 40% are still stuck on the assessment rate of ESA waiting for a medical and another 41% got better or died before Atos got round to them.
It also contrasts sharply with the finding by the Office for Budget Responsibility that the DWP will have to spend an extra £1bn on ESA this year because of delays with processing claims and an extra £1bn on disability benefits because of delays in the roll-out of PIP.
The ‘on-time’ statistic was produced by IDS during his fight-back against a report by the Church of England which found that that benefits problems are one of the main causes of the rapid rise in food bank use in the UK.
IDS also argued that Germany is a much richer country and pays more generous benefits and yet has higher food bank use, proving that the increase in UK food banks can’t be due to benefit changes.
In fact, anyone Googling “German food bank use” will find as the very first result an article by the London School of Economics. It explains in detail how the meteoric rise in food bank use in Germany since 2005 is due to cuts to unemployment benefits which have, in turn, been used to fund tax cuts.
Sound familiar at all?
Still, at least all the fuss about food banks has allowed IDS to distract attention from the revelation last week that the Treasury still hasn't signed off the business case for universal credit and that it is also on the amber/red warning list of the Major Projects Authority.
This is in spite of IDS telling MP's in a written ministerial statement in October that UC had been “assured by the Major Projects Authority and signed off by HM Treasury”.
It seems that IDS can fail in almost every endeavour, twist statistics and lie to his heart’s content yet still keep his job, so long as he continues to convince the press that the Coalition are cracking down on claimants.
Source: Benefits and Work website 17th Dec Newsletter.
www.benefitsandwork.co.uk
Today also brings the first mandatory reconsideration statistics. These suggest that DWP dirty tricks have managed to cut the number of employment and support allowance (ESA) challenges by more than half. And they still won’t tell us how many of those challenges are successful.
We explain how to beat the dirty tricks, whether your mandatory reconsideration – the new first step in the appeals process – is for ESA, PIP or another benefit.
The DWP have also announced that a new ESA50 questionnaire is due out early next year which will place more onus on claimants to provide supporting evidence.
Meanwhile, it will come as no surprise to readers to discover that IDS continues to twist statistics, mangle facts and bluster his way out of every hole he finds himself in.
He claimed on the BBC on Sunday that benefits are now paid on time in 96 – 97% of cases compared to 88-89% under Labour.
This contrasts with the reality that only 20% of people who claimed ESA in January to March of this year have had an assessment. 40% are still stuck on the assessment rate of ESA waiting for a medical and another 41% got better or died before Atos got round to them.
It also contrasts sharply with the finding by the Office for Budget Responsibility that the DWP will have to spend an extra £1bn on ESA this year because of delays with processing claims and an extra £1bn on disability benefits because of delays in the roll-out of PIP.
The ‘on-time’ statistic was produced by IDS during his fight-back against a report by the Church of England which found that that benefits problems are one of the main causes of the rapid rise in food bank use in the UK.
IDS also argued that Germany is a much richer country and pays more generous benefits and yet has higher food bank use, proving that the increase in UK food banks can’t be due to benefit changes.
In fact, anyone Googling “German food bank use” will find as the very first result an article by the London School of Economics. It explains in detail how the meteoric rise in food bank use in Germany since 2005 is due to cuts to unemployment benefits which have, in turn, been used to fund tax cuts.
Sound familiar at all?
Still, at least all the fuss about food banks has allowed IDS to distract attention from the revelation last week that the Treasury still hasn't signed off the business case for universal credit and that it is also on the amber/red warning list of the Major Projects Authority.
This is in spite of IDS telling MP's in a written ministerial statement in October that UC had been “assured by the Major Projects Authority and signed off by HM Treasury”.
It seems that IDS can fail in almost every endeavour, twist statistics and lie to his heart’s content yet still keep his job, so long as he continues to convince the press that the Coalition are cracking down on claimants.
Source: Benefits and Work website 17th Dec Newsletter.
www.benefitsandwork.co.uk
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PROJECT SMITH - COMMUNITY CONNECTORS!
Join Project Smith and train to connect community networks, health services and local initiatives to help your community get the help they need for their wellbeing.
Project Smith
Project Smith works to connect local neighbourhood forums, community networks and grassroots neighbourhood organisations with each other and to health services. It is funded by NHS Lambeth CCG and Lambeth Council, and supported by Healthwatch Lambeth.
Aims and objectives
Project Smith supports people to manage their own health and wellbeing (or condition) with access to information and assistance, and helps people (especially those living independently) avoid crisis, or minimise it. Community Connectors signpost people to local services and organisations to improve their wellbeing.
Community Connectors say
What’s in it for you?
Studies show that lending a hand can:
And connectors can earn a qualification – Level 2 in Supporting Behaviour Change accredited by the Royal Society of Public Health.
FOR MORE INFORMATION CALL 0300 365 7300
Project Smith
Project Smith works to connect local neighbourhood forums, community networks and grassroots neighbourhood organisations with each other and to health services. It is funded by NHS Lambeth CCG and Lambeth Council, and supported by Healthwatch Lambeth.
Aims and objectives
Project Smith supports people to manage their own health and wellbeing (or condition) with access to information and assistance, and helps people (especially those living independently) avoid crisis, or minimise it. Community Connectors signpost people to local services and organisations to improve their wellbeing.
Community Connectors say
- “Community connecting has given me the knowledge and confidence to build relationships and promote health & wellbeing within the community” – Dena, Community connector, mentor and community activist, SW9
- “I have learned so much through the connectors programme that I feel like a walking/talking community notice board,” – Charlotte, connector who helps run Loughborough Farm Café.
What’s in it for you?
Studies show that lending a hand can:
- Increase your sense of purpose
- Lower your blood pressure
- Reduce depression and anxiety
- Improve your social life
- Help relieve chronic pain
And connectors can earn a qualification – Level 2 in Supporting Behaviour Change accredited by the Royal Society of Public Health.
FOR MORE INFORMATION CALL 0300 365 7300
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CONNECT & DO!
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SOCIAL NETWORKING
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Connect & Do helps you build friendships around shared interests in your local area, by making the most of opportunities available near you.
Connect & Do is a social networking site, where you can find groups and events in your local area, join in to create your own profile, meet new people, share ideas, set up your own groups, and help other local people or groups near you. Find out more about what Connect & Do can do for you by signing up today.
http://www.connectanddo.org/locations/the-connect-and-do-space/
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AUSTERITY OR OPPORTUNITY?
CAN MENTAL HEALTH SERVICES THRIVE REGARDLESS OF CUTS?
MIKE SMITH AT THE ALTERNATIVE FUTURES GROUP SAYS 'YES!'
The NHS spends more than £12bn on treating mental health issues, yet we feel so poverty stricken. What is even more concerning is that our outcomes are so poor when compared with those of countries that spend much less.
There is no doubt that the financial challenges ahead will have an impact on future mental health services. Whoever is in government after the 2015 general election will still be taking policy decisions to lower the deficit. Andy Burnham MP, shadow secretary of state for health talks of a whole person approach to care and repeal of the Health and Social Care Act 2012. But is this radical enough for the service and/or workforce re-design which I believe is needed within our sector?
Poverty of thinking, poverty of creativity and a poverty of action seem to colour mental health services in the UK. This absence of new thinking along with tradition mean there is an apparent lack of political will to radically change the way we do things. We have a huge amount of money invested in traditional structures and there is much emotional and personal investment in the status quo which is hampering our approaches.
As mental health services adopt an ethos of recovery, growth and aspiration rather than maintenance and stability alone, they are seeing the changes that are needed to transform expectations, services and people. The good news is that some of the best ways of doing things need not be expensive. Hertfordshire partnership NHS trust support family placements, as one alternative to hospital, supporting crisis resolution services.
Alternative Futures Group has a two-year partnership with Mobee, a charity in West Africa that is developing community mental wellbeing practitioners to support the polyclinics in Gambia. The community workers are trained in self-help and in personal and community capacity building techniques. The self-help tools are based on person-centred counselling and solution-focused therapy but use written questions and small group exercises run within schools and polyclinics, as well as community groups and postnatal classes etc.
Two groups of support workers and senior personnel from our organisation have visited Gambia to share good practice and develop new skills and techniques in an environment where there is little resource, financial or otherwise. We've also formed strong links with mental health service professionals in Italy and Denmark to find out how they are dealing with austerity within their countries and communities.
In Trieste, the importance of a whole system response to mental distress rooted in the community not within the patient is highlighted. This approach and the need for strong and effective case management has proved a success.
Another, perhaps even more radical, approach focusing on workforce changes has been adopted at Lyngby Tarbaek Kommune in Copenhagen. Here they have changed the thinking that underpins their provision. They have done away with staff meetings and handover periods in all forms.
In the UK, we should use austerity to look at how we deal with chronicity, avoid creating dependency and a hopeless model of maintenance by learning from other countries and offering alternatives for change.
Article sourced from The Guardian and is written by Mike Smith.
Mike Smith is vice-chair of the International Mental Health Collaborating Network (IMHCN) and clinical director (mental health) at Alternative Futures Group.
There is no doubt that the financial challenges ahead will have an impact on future mental health services. Whoever is in government after the 2015 general election will still be taking policy decisions to lower the deficit. Andy Burnham MP, shadow secretary of state for health talks of a whole person approach to care and repeal of the Health and Social Care Act 2012. But is this radical enough for the service and/or workforce re-design which I believe is needed within our sector?
Poverty of thinking, poverty of creativity and a poverty of action seem to colour mental health services in the UK. This absence of new thinking along with tradition mean there is an apparent lack of political will to radically change the way we do things. We have a huge amount of money invested in traditional structures and there is much emotional and personal investment in the status quo which is hampering our approaches.
As mental health services adopt an ethos of recovery, growth and aspiration rather than maintenance and stability alone, they are seeing the changes that are needed to transform expectations, services and people. The good news is that some of the best ways of doing things need not be expensive. Hertfordshire partnership NHS trust support family placements, as one alternative to hospital, supporting crisis resolution services.
Alternative Futures Group has a two-year partnership with Mobee, a charity in West Africa that is developing community mental wellbeing practitioners to support the polyclinics in Gambia. The community workers are trained in self-help and in personal and community capacity building techniques. The self-help tools are based on person-centred counselling and solution-focused therapy but use written questions and small group exercises run within schools and polyclinics, as well as community groups and postnatal classes etc.
Two groups of support workers and senior personnel from our organisation have visited Gambia to share good practice and develop new skills and techniques in an environment where there is little resource, financial or otherwise. We've also formed strong links with mental health service professionals in Italy and Denmark to find out how they are dealing with austerity within their countries and communities.
In Trieste, the importance of a whole system response to mental distress rooted in the community not within the patient is highlighted. This approach and the need for strong and effective case management has proved a success.
Another, perhaps even more radical, approach focusing on workforce changes has been adopted at Lyngby Tarbaek Kommune in Copenhagen. Here they have changed the thinking that underpins their provision. They have done away with staff meetings and handover periods in all forms.
In the UK, we should use austerity to look at how we deal with chronicity, avoid creating dependency and a hopeless model of maintenance by learning from other countries and offering alternatives for change.
Article sourced from The Guardian and is written by Mike Smith.
Mike Smith is vice-chair of the International Mental Health Collaborating Network (IMHCN) and clinical director (mental health) at Alternative Futures Group.
