Tag Archives: BAME Mental Health

Lewisham BAME MH Carer Forum January 2020

enteranceWelcome 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.

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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”.

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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

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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.

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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.

Lewisham BAME MH Carer Forum November 2019

Carers Nov2019Hello again!! Here is the Lewisham BAME Mental Health Carer forum update for November. This is usually the last forum I run out of all the 4 forums per month. The forum is quite unique as the other forums promote mental health carer inclusion and awareness in the other London Boroughs, but this one focuses on Black Asian Minority Ethnic queries. BAME carers and service users suffer a whole different set of issues in regards to mental health services. Most are complex, cultural and historic, but there MUST be some platform for important parties to discuss, network and work on these issues.

Another thing different between this forum and the 3 others is sometimes this forum is a mix of patients and unpaid carers. I often try and leave space for the Service user Rep or chair to update the forum.

Who Attended and spoke

For the November update we had a discussion from Pharmacist Della Bishara in regards to medication and its affects on the patient and how unpaid carers could and should be involved.

We also had a detailed presentation from Rachel Ellis who is from Table Talk, which is a new initiative that aims to help inform senior residents throughout the borough, with the help of volunteers. Table Talk provides leaflets, information and a table in order to engage with the older population.

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We were also joined by a number of unpaid carers and patients, along with a representative from Lewisham Homes, plus Metro’s Representative who provide one-to-one counselling for people who identify as LGBTQ and/or those experiencing issues relating to diversity, equality and identity. We were also joined by Lewisham CCG Engagement Teresa and also Natasha from Greenwich Carers who I approached to set up some carer groups. We were also joined by the rep from Community wellbeing from BLG-Mind who I will also bet setting up a peer support group.

On Medication

We had a very lengthy discussion on medication with Della. Many questions from the attendees she took away to raise at SLaM especially in regards to clinical trials and reporting on side affects. Carers need to be involved because of the patient might not always be able to advocate for their need, especially if dementia takes hold. I raised with Della if there were studies looking at medication effects on BAME groups and if there is a SLaM trust wide forum that engages pharmacist issues.

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It was mentioned that Lewisham Integrated Medicines Optimisation Service (LIMOS) is working in improving medication safety for older people. Basically LIMOS is integrated across the hospital, local care homes and community settings, which means that, if a care home resident is admitted to hospital, or vice versa, there is a seamless approach to managing medication.

As with the psychiatrists bible being the DSM, the pharmacists have an important book, that being the British National Formulary (BNF), the book is not easy to get hold of and is the UKs pharmaceutical reference book that contains a wide spectrum of information and advice on prescribing and pharmacology, along with specific facts and details about many medicines available.

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Della discussed the BNF in detail and how it can help pharmacists, which the forum played close attention to. The forum also discussed the issue of miscommunication of medication between hospitals, covert medication and the issue of control & release medication.

Table Talk presentation

After the discussion with the pharmacist, we moved on to another topic regading older ages people. This was the Table Talk project, which was presented by Rachel Ellis. Rachel has been an outstanding promoter of senior citizen’s causes throughout the borough of Lewisham and has visited a large number different venus in Lewisham this year alone. As mentioned before Table Talk engage with the public on raising awareness of activities, information and support for senior citizens. This is specially important due to the population is ageing as we all are living longer.

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Table Talk work closely with Lewisham council and with Age UK. The Lewisham BAME MH carer forum were shown several leaflets, which can help older people in regards to meter readings, warm homes, fire alarm checks and transport. We discussed how isolated older people can be in the community as Rachel described more information and leaflets.

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Carer led Support Groups

Lastly for the Lewisham BAME MH Carers forum. I discussed the importance of carer-led peer support groups. I will be setting up several carer support groups in a few boroughs. Usually the forums are strategic and engagement focused and there is not enough time to hear carer stories. In fact carer support groups are meant to feed into the carer forums for empowerment purposes, but there were only a few carer support groups in the borough and none carer-led, which means there is not much motivation for carers to connect with each other.

I will be setting a BAME and a general MH carer peer support group with the help of Greenwich carers for that borough and I was so glad Greenwich carers engagement and community officer (Natasha) came along and support me at the Lewisham BAME forum.

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This will be the same for Lewisham as we will work closely with the CCGs. The forum talked about how they felt about the Bromley, Lewisham and Greenwich Mind peer support group event that was held on wednesday the 27th over at York Hall in Beckhenham. We are very glad that they are able to fund that startups of the groups, however I pressed that we do not really need the funding, it will be the passion, drive and connection that can help, not to say funding will not be helpful.

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With Lewisham CCG engagement, the forum has been aware of NHS England’s long term plan and we have made it clear they need to involve patients and carers in that plan. The good news is that the NHS England’s long term plan is beginning to take shape and involve us, but no matter what I do, I want to connect with carers and make them aware that the health system is trying hard to involve them. I am not sure about the social care element, but at least with NHS England, there looks to be some very good and exciting projects coming our way.

BAME Carer experiences Research

As promised I promoted a trainee psychologist’s study into African Caribbean experiences of supporting an individual with MH needs in a forensic setting. She contacted me after reading my blogs to see other researchers were engaging with forums about their own research. The researcher feels there is not enough literature or research papers detailing such experiences and Lewisham CCG will follow this up with the trainee Psychologist studying at the University of East London.

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As usual I thank Kelvin (one of the proactive members) for setting up the talk with the pharmacist.  I also thanks Community wellbeing and BLG Mind for hosting the Lewisham BAME forum and thank Greenwich Carers for the support they have given me and look forward to exciting projects ahead.  I would lastly like to thank Lewisham CCG engagement officer (Teressa) and the other CCGs for engaging with the Carer forums and I am very impressed with the plans they are looking to involve us in.

This concludes the update for November and I will be preparing for the groups with the support of Oxleas and Greenwich carers.