Triangle of care – Excellent NHS carer engagement

10177241_747738765268892_5890142387668348507_nIt has been a while since I blogged off my site, almost a month now. Still I have been very busy, lots going on and still lots to do. I run 4 carer forums each month and am also an unpaid carer working part time and contributing to so much in the community.

Yet I am aware many unpaid carers supporting those with mental health needs cannot easily engage with services. This is one of the many reasons why I chose to write this post. I am an unpaid mental health carer in south london, and have been involved with the Triangle of Care at a high level. Due to the involvement I am proud to be part of such a successful initiative. My trust has not been part of the Triangle of Care scheme even though I battle on, but it has got me wondering.

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What would it be like to be a carer whose NHS Trust is part of the Triangle of Care scheme?

If you do not know about the Triangle of Care policy, let me enlighten you.

Taken from the Carers Trust website, which is national charity fighting for the rights of young carers and carers alike.

“The Triangle of Care guide was launched in July 2010 by The Princess Royal Trust for Carers (now Carers Trust) and the National Mental Health Development Unit to highlight the need for better involvement of carers and families in the care planning and treatment of people with mental ill-health.”

Many Mental health NHS trusts up and down the country have taken the challenge and value the needs not only of their patients/service users, but also unpaid carers who often can be forgotten in Trust Policy, let alone in government policy.

The triangle of care gives six standards

1) Carers and the essential role they play are identified at first contact or as soon as possible thereafter.
2) Staff are ‘carer aware’ and trained in carer engagement strategies.
3) Policy and practice protocols re: confidentiality and sharing information, are in place.
4) Defined post(s) responsible for carers are in place.
5) A carer introduction to the service and staff is available, with a relevant range of information across the care pathway.
6) A range of carer support services is available.

I have mentioned such standards because there is a lot more to the Triangle of Care, but if you are not versed in policy then at least focus on the standards above.

So what could it be like being a carer linked to ToC?

If you are a carer whose mental health trust has signed or is working towards the triangle of care, I will list why it perhaps is a good thing.

1) You are lucky enough to have a trust working towards a national standard.
2) As a carer you can learn more about what your trust is doing for carers and their loved ones.
3) You can use these standards to protect your rights.
4) You have a mental health trust that can link into partner trusts all working together for the good of unpaid carers.
5) Standards that can be measured and assessed by others.
6) A mental health trust brave enough to change its culture on unpaid carers.
7) A way to hold mental health trusts to account on how it engages and provides services for carers.
8) Hidden issues that can be unraveled by triangle of care.

Obviously the list can go on and continue to go on, but an NHS trust that can put some resources to the Triangle of care should be held in high regard among carers.

I am not saying that the system is perfect, it is NOT a quick fix solution, especially in the era of NHS cuts, cuts to staff, cuts to community services and a lack of understanding in mental health. We are also living in a complex society where so much is demanded from us, be it Brexit, having to struggle for education, fragmentation in communities and the lack of volunteering since everyone wants to be better off.

All I am saying is if you are an unpaid carer thinking how can your NHS trust support, engage or value you, then please see what they are doing with the Triangle of Care.

Although the triangle of care is going through some changes. You can find out more about the Triangle of Care below.

https://professionals.carers.org/working-mental-health-carers/triangle-care-mental-health/triangle-care-membership-scheme

 

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Gone too Soon

Sad man sitting head in hands on his bed in a bedroom at home

Just to note this particular blog can be triggering and not just for those suffering mental ill health needs, but also for families and carers.

As you can tell by the title of this particular blog post, this centres on the devastating experiences which mental ill health can cause to families and loved once.

There are some families that do not often get a chance to share their experiences when something tragic has happened to the person they are trying to support or care, although I know full well that this can also happen two close friends, relatives and perhaps even a neighbour.

As a care of myself I know in the back of my mind that there will a time when I will have to fight a mental health crisis for the person I support. Perhaps I will succeed, but I know out there carers up and down the country will have to deal with the devastating experiences when a loved one by finally succumbs to mental ill health.

melancholy and sad young  woman  at the window in the rain

I’m afraid I’m not going to pull any punches, when I mean succumb to mental ill health. I am talking about suicides, deaths due to addiction (alcohol or drug related), death Due to an accumulation of medication side effects causing massive strain on physical health. I am talking when the mental health sufferer cannot cope anymore with dementia, Parkinson’s or degenerative illnesses affecting the brain.

I am not going to use this blog post to lay blame at anyone’s door. However I just would like to raise the issue that’s such experiences need to be highlighted and discussed. We should never expect families and mental health sufferers to just cope and get on with it.

Coping with death

It is never easy to try and deal the situation when someone loses a loved one two mental illness. Unpaid Carers and families can often blame themselves as if they feel they have not done enough to save the loved one’s life. Some people think mental illness can only affect the one person who has been diagnosed with the condition.

In some ways this is possible, but not often the reality. We should try to avoid putting people in boxes. When death strikes a family due to mental ill health, i’m sure that grief, depression and anxiety will affect those that was close to the patient or service user. If you were a carer caring for someone long-term suffering from mental health, the grief stricken experiences will climb to unsustainable levels.

As unpaid carers it is important to respectively raise the awareness of coping with death, especially if you have been a long time carer. We all need to work together with the health services and our loved ones to avoid situations where patients might end up being failed by the system.

If anything off this post has affected you please call Samaritans on

116 123 (UK)
116 123 (ROI)

Thanks for reading.

Top 70 Contributions to Psychiatry and Psychology

Relationship psychology concept created with man and woman heads profiles, vector logo or symbol of gender problems and conflicts in family, close relations and society. Classic style simple design.Its been a while since I have made another video. This one is back on the psychiatry field. In this video I have introduced a list of notable figures who have made an impact on sub fields of psychiatry.

I have made a video which can be viewed below showing the top 70 contributors to different fields within psychiatry.  It was not possible for me to include anymore due to time and length of the video.

The video includes names such as :-

Adolf Meyer
Carl Gustav Jung
Elisabeth Kübler-Ross
Eugen Bleuler
Eve Johnstone
Franco Basaglia
Frantz Fanon
Hans Steiner
Jaakko Seikkula
John Cade
Pierre Janet
Robert Spitzer
Seymour Kety
Viktor Frankl
Wilfred Bion

…and many more.

Hope you enjoy!!

Carers Rights Day 2018

smallerBefore you read this blog considered this, if you are an unpaid carer think of all the outcomes that you have experienced so far. Think of all the hardships that you and the person you care for has gone through.

Carers rights day

Every year organisations that deal with unpaid carers and support those using the health services come together and try to raise awareness of unpaid carers. CarersUK promote the awareness day and theme this year is “caring for the future”.

carers-rights-day

Just so you know I will introduce the few terms in this blog. When I talk about an unpaid carer, I am not talking about a care worker.

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The stigma of an unpaid Mental Health Carer

matthew-mckenzieWelcome back to another blog from unpaid carer in the south of London. As world Mental Health Day draws near, a lot of emphasis is placed on those suffering angel problems. I find it quite important that you must not forget the hidden Heroes who’s tape in when their loved ones are in most need. This is not to take away the difficult battles mental health survivors face, however all too often sigma hits out at more than one person.

Mental health stigma hits the family, the friend, the husband, the wife and even the neighbour. This blog will concentrate on another type of stigma, which can be all Too Well forgotten. I am going to talk about carer stigma. Now it is very important that not all unpaid carers suffer from carer stigma.

First you must differentiate what or who is an unpaid carer. I am talking about the person who suddenly finds themselves caring for someone close to them who has been unfortunate to pick up either physical or mental health problem. I am not talking about paid care workers, although I do admit care workers to find they can have a difficult job, they are paid for their role and can be protected by Union.

Arguments.

With carers they are not trained and often care out of closeness and love for the person they are trying to look out for. It gets really difficult if that person has a mental health illness.

The types of carer stigma.

So Let’s Begin, I cannot really produce an exhaustive list of different types of carer stigma, but the ones that i am showing i’ll probably the most recognisable types of carers take life out there.

Depends on the illness.

When a loved one become very unwell, he often try as hard as he can to support them. The problem is the more chronic the illness the more is stigma lash out. A good example is when a carer is caring for someone suffering psychosis, those suffering from this difficult illness can often present challenging behaviours. If such behaviour is out in public, then the challenge is not only faced by the mental health Survivor but also the carer.

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It only takes one person to ridicule the suffering from a mental health problem. This can then extend to the person family, the risk is once a community starts to gossip about the situation, it can cause the carer to become more isolated. This in turn leads to stigma of both mental health and carer. As a note not or carers go through this and it probably can depend upon the illness anyway.

The Label

Although not as devastating as the first form of carer stigma, it still can be rather destructive. Some people carry on caring and supporting those close to them out of desperation. They carry on caring regardless of the support mechanisms that amen applied to the family network.

At first it seemed really brave, it is great to hear a carer battle it out no matter what the situation. However there is one big problem, no matter what are the carers might say to this situation, the person still feels that they do not deserve the term of being labelled a carer. The problem is that this person will then like the support network available for carers.

Clashing forms of relations

This type of stigma is actually quite similar to the one mentioned previously. A good example is when a person marries someone they marry for better or worse. When the worst does arrived, the person cares especially out of love. They care because they are either the husband or wife. If you try to tell them that they are now a carer, that person may become very irritated. They refuse to be labelled as a carer, and yes this is the right, but the risk is lack of support network available to them.

This care stigma can also extend to other relations within the family, another good example is a young person caring for a parent, or even especially a young carer. Can you imagine as a child having to suddenly provide care for an older adult suffering a mental health condition?

The terrible characteristics of an unpaid mental health carer

There are several characteristics, which are aimed at carers. I am going to go through a few that come off the top of my head.

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Being labelled as lazy

All too often we have to work for a living, we have to pay our dues. The harder the work we do, the more we expect to be paid. The more complex the role, the more we expect be rewarded. There is this review going around that the Caring role is fairly easy, because some people think that it is easy, they think that the carer does not have to do much at all. This can lead to carers being labelled as lazy. Once a person is targeted as lazy, they do not really want to be labelled as a carer.

Being blamed

This is quite common in the field of psychology/psychiatry, especially in America. When someone is unfortunate enough to develop a mental health problem, all too often psychiatrists tend to probe the family structure. All too often, it says if the carer is not doing their job properly. It might even go so far as to state that the carer is causing the mental health relapse or has caused the mental health problem to manifest itself in the first place.

One of the main criticisms of psychiatry, is at one end it might exclude the carer in their supporting role/care plans or confidentiality and at the other end label the carer as the problem within care plans and assessments. This can lead to a person not really wanting to find the energy battling a mental health system that can misunderstand the caring role.

Confrontational

Another good example of how the mental health system might fail families and carers, is if the carer has experienced failures in support of their loved ones and even the care of them self. It then becomes only a matter of time before the carer becomes more confrontational. No one really wants to be labelled as aggressive, uncooperative and confrontational. This is just another label a person can do without, so why would they want to be labelled as a carer?

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Risk of declining health

Again this might depend upon the type of illness the person is trying to care for, the more chronic the illness, the most stressful situation is for the carer. Since the NHS is under severe strain, a person would have to think hard and long before they would want to commit themselves in becoming an unpaid carer. It is like that there has been a secret contract, stating that the carer now must take the role of the lack of staff within the health system. This could be administering medication, advocating, understanding side effects, understanding social welfare, mental health legal matters, engaging with doctors and also mental health advocate and peer supporters.

Is there any wonder why carers can end up with depression, anxiety, stress and worry? One could say that mental health illness can be catching.

Hiding it all away

I’m afraid I have bad news, for what I have mentioned is only the tip of the iceberg when it comes to Carer stigma. I did not want to make this blog post overly long. With the above issues mentioned, is it any wonder why someone wants to hide themselves from being labelled as a carer?

Lewisham MH Carers forum September 2018 update

133This is the last of the four MH carer forum update for September. This one runs from carers Lewisham, the Carers Centre is run by and for carers: many of their staff, trustees and volunteers are or have been carers.

The carers Centre provides information, support and advocacy for carers for the borough of Lewisham. You were hoping to have the head of social care for Adult Mental Health attend the forum, but she was unable to make it due to being unwell. The forum members are interested in her role and how it impacts on families and carers.

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Lewisham BME MH Carer/SU Forum September Update 2018

965946_fa217b70Here is the September update from the Lewisham BME carer/SU forum. This is one of the only carer forum, which Focuses on carers from the Black Minority Ethic Community, mainly Afro Carribean, but not strictly.

For this update we were fortunate to have the Lewisham HR lead for mental health staff attend and brief the forum. As a forum we did not know how much the HR lead has to do, which is quite a lot!! The fun runs from the Family Health Isis centre over in Lee.

You are thankful for having the public and patient lead for Lewisham and Croydon link the HR lead with the forum, although I did feel a little sorry for the HR lead being thrown a lot of questions, but she did mention she was glad she came to hear first hand what Service Users and carers had on their mind.

-POP(1)

As a forum, questions were raised on the following.

1. What is HR doing to promote more BME staff to higher positions at SLaM
2. How are HR tackling disciplinary issues among BME staff.
3. How is SLaM reducing the need for Agency staff.
4. Why isnt carer awareness/engagement training manditory on wards and in the community.
5. What carer training is provided anyway?
6. What is the latest updates regarding interview panel involvement.
7. Do BME mental health staff less sympathetic to BME service users?

The forum was quite excited to hear that more BME staff were promoted within the Lewisham area and as a form we hope to engage with such staff.

We also have a discussion on how the SLaM board could try and engage with community groups. Plus I updated the Forum on the recent SLaM family and carers listening event. We are looking forward to see if a carer support group can be set up at Ladywell unit, the forum was wondering why newer carers are having trouble being referred to community groups.

The BME carer/SU Forum looks forward to Lewisham’s Police Mental Health lead and also the SLaM place of Safety staff, along with one of the MPs for Lewisham attending the October forum.