Welcome to the January update of the Lewisham BAME Mental Health Carer forum. This is one of the 4 carer forums I use to help engagement between unpaid carers and mental health or even health services. I feel if patients and their families are at the heart of health services, then there should be some form of engagement, involvement and influence.   The forum is run from one of the Bromley, Lewisham and Greenwich MIND offices with support from Community wellbeing.

The Lewisham BAME Mental Health carer forum is fairly unique since its aim is to generate understand of mental health pressures on Black and Minority population in Lewisham and sometimes in other boroughs. Since afro-caribbean are high end users of the mental health services, the forum helps in understanding some of the issues.

We hope the forum can shed light on the following.

• Education regarding mental health in the BAME population
• Reducing stigma from both psychology, psychiatry and from families and carers
• Working on culture and diversity and trying to understand that in partnership with our local mental health trust.
• Raise the profile of BAME families and carers in the mental health system.

The are more points the forum tries to cover, but that can be for another day. I would like to mention BAME issues are some of the most complex and challenging aspects in mental health, so even then a forum cannot possibly solve those issues, but it can provide a platform of understanding, providing compliments if things are working (and some things do work) or querying if health or MH services are failing families and carers. The forum is particularly interested in what consultations or involvements are taking place in the borough.

For the January forum Isabelle Ekdawi SLaM’s Trust Advisor for Family Therapy presented to us about Open Dialouge and Trauma Informed care. I was very greatful Isabelle took time out to engage with the members and the BAME community.

To touch a bit more about Open Dialouge.

It is a form of therapy that includes patient, clinician and carer, with less emphasis on the medical model and treating those who use the services as equals.

As far as I can remember Open Dialouge has 3 or more aspects to it, being

• Philosophical and ethical approach to distress
• Psychosis seen as response to difficult life situations
• Avoiding the ‘them and us’ relationship and using just ‘us’
• A Way of organizing services (which can be a challenge
• Community based services, networks engaged from beginning, ‘open’ decision making.
• Use of particular type of therapeutic conversations

Isabelle mentioned some NHS Mental Health Trusts are using Open Dialouge in their services, one of them being North East London Foundation Trust. Off NELFT’s website it explains “Open Dialogue is a model of mental health care which involves a consistent family and social network approach where all treatment is carried out via a whole system/network meetings, which always include the patient”.

There has been much criticisms of the recent medical model for mental health where there has been a lack of psycho-therapy and too much emphasis on medication. The outcomes for the patient can be very poor and thus more beds are often needed as patients fall through the system time and time again. Open Dialogue aims to challenge such outcomes, but it all starts with education.

Isabelle explained the Overview of the service model to the forum.

• Treatment team at the time of crisis
• No separate professionals meetings
• Planning together becomes the treatment
• Different voices and dialogues coming into conversation
• Feed into other treatments – such as individual therapy, social work, family therapy

There was lengthy discussions on the method, but if anyone is interested they can check out the links below for more information.

http://www.opendialogicalpractices.eu
http://podbulletin.com/
http://www.developingopendialogue.com

The Lewisham BAME carers forum was also joined by Juliana Onwumere who does research over at the Institute of Psychology, psychiatry and Neuroscience, she is a senior lecturer and is very inclusive when it comes to families and carers. She wanted to speak to the group about carer related research that might be of interest.

Each member of the forum gave their opinions, but for me. I feel if we can collate some of the major research done from the past couple of years on families and carers, that would be a good start. Which is why I joined researchgate.net and checked out past research papers. My particular interest is how far did the Care Act 2014 affect carers

If anyone wants to see a list of research papers done on carers, here is the link below.

https://www.researchgate.net/search.Search.html?type=project&query=carers

Please join research gate and contact the researcher to get such papers. I am not a research myself, but I do value research and how it uses evidence to initate change, no one can deny evidence and it can be a strong tool to pressure services or at least get services to understand someone point of view. It was that reasons why I engaged with IOPPN and I am hoping they do a lot more regarding families and carers. I am aware research can stall often, but it is worth doing if it can help in change.

Lastly we had updates from Juliana Frederick-james who is the Community Development Services Manager for Oxleas MH Trust. I have to put a lot of praise on Oxleas for engaging with both the Lewisham Carers forum and also the Lewisham BAME carers forum.

I am aware Oxleas MH NHS trust covers the boroughs of Bexley, Greenwich and Bromley, but Oxleas often try to support engaged carers especially at groups and forums.  I have been impressed with Oxleas so far, although there is always work to do.

Juliana updated us on how Oxleas is looking to track carer groups and engagement forums, I am hoping that Oxleas engages with BAME projects and one of the comes from the Royal College of Nursing in regards to BAME staff development.

All this is integrated from the South London Partnership, which includes South London & Maudsley and also South West London & St Georges NHS Trust.

I feel BAME projects should not just only come from queries of families and carers but should look into the impact of BAME Mental Health staff and how they relate to diverse communities.

This concludes the January update for the Lewisham BAME MH Carers forum.