Welcome to a quick update from the Southwark Mental Health carers forum. I know I have not been blogging for around a month, but I have recently suffered a bereavement. It has taken a fair bit of energy to do much, but I am quite proud to be able to continue to run the forums even though I have to take time and look after myself.
Given the time I will eventually write more about the current situation, but for now I want to at least update carer members. On the February update of the MH carers forum for Southwark, we are able to get support and engaged with King’s College Hospital NHS Foundation Trust, Guys and St Thomas NHS Trust and South London & Maudsley. For February King’s college hospital Mental Health Lead kindly attended the forum to speak to carers about Kings Mental Health strategy, which is still going through development.
Due to the nature of our forum carers focus on mental health services, although the core interest is how health and social care services engage and involve families and carers. We get a lot of support from the healthwatches and are constantly looking for support from the CCGs, but at the same time families and carers must get the chance to be updated by health providers.
The february Southwark MH carers forum has moved to the Maudsley site for now, although as of the blog, I am running the forum remotely.
Going back to King’s College NHS Trust, their MH strategy is a Five year strategy for mental health. I felt it so important acute trusts not only focus on physical health, but also include mental health, which will be even more important because once the covid-19 situation moves on, there will be an immense strain on mental health for staff, patients and their families.
Gavin Smith the MH lead of King’s NHS Trust explained that the strategy should take into account several things
Population need: High levels of mental health need, including mental health presentations at the Emergency Departments.
Outcomes and experience: People with a mental health condition have poorer health outcomes and experience.
Current range of service provision: Areas of excellence, but inconsistency of provision of mental health support across services and sites.
System working: Strong relationships with SLaM and Oxleas and KHP Mind & Body programme; opportunity for improved relationships with primary, community and voluntary sector.
Training and development: Distinct training programmes mean few staff have skills across mental and physical health; some bespoke training exists for staff and mental health training is available via KHP Mind & Body
Governance: Mental Health Board and Mental Health Lead post established but intermediate structures around mental health are inconsistent.
Out of these areas mentioned, the system working and governance stands out as important not only to the Southwark MH carer forum, but to all the other forums. It was expained to carer members that the accute trusts will co-produce many things with involved carer champions.
The forum was then presented with an update on how far Kings NHS Trust have been working with these outcomes.
Next we were presented with why mental health is important to the health sector
Mental health has an impact on people’s physical health, wellbeing and outcomes.
30% of people with long-term physical health conditions also have a mental illness
Shockingly 15-20 years shorter life expectancy for someone with a severe mental illness or learning disability
It does not help that patients with mental health needs have a poorer experience of care due to stigma
There can be a lack of confidence and awareness of staff regarding mental health
It does not stop there as 8 Billion a year is spent by the NHS treating the effect of poor mental health on physical illnesses.
As you can see Kings NHS Trust has a clear interest into tackling mental health with what was raised to the forum. Of course more was mentioned in the presentation, but by focusing on meeting Kings NHS Trust patients’ mental and physical health needs, they will :-
Respond to the population needs and system priorities.
Improve access, outcomes, experience and safety.
improve the sustainability of their services
As presented at the Southwark MH carers forum, King’s operates within a complex landscape of mental health services in South London.
Members of the forum were taken through a whirlwind tour of King’s services and how they seek to improve mental health provision on those services including
KCH services regarding SLaM and Oxleas.
Local Emergency and s136 services
Key acute and hospital-based services
Other specialist teams including – Drugs and Alcohol, Adolescent At-risk and Forensic Service (AAFS) and Forensic Services provide by SLaM.
Primary care – Being General practice and Improving Access to Psychological Therapies (IAPT)
Voluntary and social care
Self-help – being IMPARTS resources, COMPASS (in Southwark), Wellbeing Hub & online Mycommunity Directory
It is important King’s engage with their staff on producing these outcomes, as they must engage with Core delivery partners and external stakeholders. King’s have engaged with the following of their staff.
Acute and emergency care
Maternity – Took up a good discussion at the forum
Neurosciences – will be interested on their response
Divisional Management Teams
Public and Patient Engagement – should include families and carers
Research and Innovation
Princess Royal University Hospital Transformation team
Online survey to all KCH staff
Member of the Southwark MH carers forum were then presented with how King’s have explored areas of good practice and areas for improvement. Then we were presented with the strategic aim being that to continue to build on good practice, they will focus on their priority areas, and ensure the will consistently meet their patients’ mental and physical health needs. However King’s are well aware that their priorities must align with system priorities.
Kings have developed three priorities being
KHP Mind & Body priorities
NHS Long Term Plan priorities
SEL STP priorities
There are challenges to these aims being
The highest proportion of patients with a mental health condition recorded as primary at King’s is in A&E (27%).
The Emergency Department (ED) is frequently the default, but often an adverse, environment for people in crisis. Patients frequently spend over 12 hours in ED waiting for a mental health inpatient bed – the majority of our 12 hour breaches are for patients with a mental health condition.
There is a lack of mental health inpatient beds across South London, particularly CAMHS beds.
Patient feedback highlights positive experiences, as well as challenges including instances of stigma and lack of awareness, lack of confidence in adequately signposting or supporting patients with mental health needs, and long waits in a busy environment.
Nevertheless the forum was presented with how King’s will meet those challenges.
I am thankful for King’s engagement with carer members of the forum all of the members are more than happy to see how the MH strategy works out. A further update of the Soutwark Mental Health carer forum is we were presented with South London & maudsley’s involvement register into improving services and a way for the forum to engage with SLaM staff on familiy and carer engagment at the trust.
The forum seeks to work with SLaM’s family and carer committee when issues arise, although due to covid-19 SLaM’s involvement is on hold, but engagement will still continue with use of technology. For the March Southwark MH carers forum Guys & St Thomas NHS Trust presented their mental Health strategy.
I am as of present continuing to run 3 carer forums remotely and run the Greenwich carer peer support group remotely. This concludes the update for the Southwark MH carers forum with thanks to Kings NHS trust and SLaM.
Thanks for dropping by my carers blog post. This site raises awareness of unpaid carers and mental health. As of this blog post I am caring for someone close and just coping the best I can, while keeping a close eye on events. As of the title, this blog post is about the Corona virus and its implication to carers like myself and those in the community.
If you have been following my tweets on twitter, I have been posting that carers need to take care of themselves. Sometimes I have done a blog post about carer wellbeing and sometimes I will do a video blog or podcast.
Feel free to listen to a podcast on looking after yourself as a carer.
For carer health and wellbeing, it is now a vital challenge that carers must take care during the corona virus, not just for their own health, but also for those who they are caring for be it someone with Mental illness, physical health problems or an older adult.
A brief about the CoronaVirus
If you are still unsure what all the fuss is about. What is the Corona Virus or COVID-19?
The Coronavirus is a large family of viruses that cause illness ranging from the common cold to more severe diseases. It has spread all around the world causing many to become unwell and causing many deaths. You might think that the corona virus is just a health risk, but it is much more than that as it poses an extreme challenge to the economy, functioning of society, trust in others and the community. The corona virus unfortunately has hit via a perfect storm of the flu season where the vulnerable are most at risk.
Still it is not all bad news as if you have a strong immune system or are under 60, most people recover depending on the symptoms. The big problem is carers are caring for those who are usually in the other category and it is a big concern for many carers across the globe. Many in the UK are concerned how governments are fighting the virus, especially in the UK
Focusing on the UK at the time of this blog post. The government is moving from the ‘Contain phase’ to the ‘Delay phase’ due to the number of Corona virus cases appearing in the country. From what I understand, many experts feel the virus cannot be stopped anymore and that we must now slow the spread of the virus. If a person becomes infected, when they isolate themselves and recover, they become immune to the virus and thus cannot spread the virus to others in the community.
The aim of the strategy called ‘herd Immunity’ is that eventually much of the population will be immune to the virus. There are big gains with this strategy as the nature of the virus can behave this way, but there are also big risks and gambles. For ‘Herd Immunity’ to work, means that the virus needs to target those who can easily recover and thus the vulnerable can be kept safe. The other aim is to reduce pressure on the health services so those who can recover just isolate themselves while the vulnerable can use the health services.
When many unpaid carers heard the statement from the government about slowing the spread of the virus, there were many concerns because not one carer would want to be infected and bring the infection to those who they are caring for, because it could be a death sentence for the caree.
Many carers would prefer more emphasis on the government to focus on stopping the virus on spreading, but again there is a trade off because that could mean disruption of services, closing schools, lock downs and disruptions across the board. All this of course probably will come about, but the government would want disruption to be minimal, but at what cost?
What is happening for carers during the epidemic
Carers Trust and Carers UK both national charities campaigning for carers also have concerns and have issued a joint statement. From what I understand, the core of the statement is that Carers will come under severe pressure from the current climate. As if unpaid carers were not struggling already.
The Joint statement is aimed at Carers and also those who make important decisions regarding health and social care.
From the joint statement, the information that i focused on was the importance that Services must be in place for the following situations especially during the epidemic.
Other important concerns raised by the joint statement is about The role of mental health services. Please read the joint statement below.
My views on the current challenges for carers
As if carers were not struggling enough already, even more will be asked of them. The whole situation is not even any carers fault as they are only doing what the community asks of them. To provide care and support for those close to them.
Never before have carers needed to focus on their own health needs because the ‘cared for’ will unfortunately suffer due to health and social services will come under more strain.
The current climate will test communities to their limit and will cause major heartbreak and unfortunately many will lose their loved ones to the virus.
As a carer, I will do my best to let other carers know about their duties, but no more will it be just about caring, but understanding what the virus is and how it will change things. It will request carers understand what has changed in health services, using your voice as a carer to request support needs. Of course I will continue to run my forums remotely and network with carers who become isolated.
Us carers must come together, be counted and look out not only for who we care for, but also other carers. The challenges are only just beginning and it will be a long one.
To follow up on understanding the virus and what you need to do. Please check out the following sites.
Welcome to the February update of the Lewisham BAME Mental Health carers forum. The forum is aimed at black Afo-Caribbean, Asian and other minorities carers in the borough of Lewisham, however I am happy for other carers in surrounding boroughs to attend. The forum is run from Bromley, Lewisham and Greenwich Mind centre under the arm of Community Wellbeing.
The forum is more educational and allows carers to discuss with mental health service providers any queries about services. A high majority of the BAME community use mental health services and some of the issues are specific regarding race, culture and even language. The issues are complex and deep, but discussions, forming relationships, education and working together is the way forward.
For the February forum we were blessed to have an outreach ad support service engage with the forum. The service was called OASIS and they kindly provided a workshop for the members of the forum. OASIS is a mental health service for young people (14-35 years old), living in the London boroughs of Lambeth, Southwark, Lewisham and Croydon. They provide support for up to two years, for people struggling with experiences like hearing voices or feeling paranoid.
OASIS ran a workshop for the forum, which was on ‘Psychosis and Unusual Experiences’. Many members of the forum in the past often asked for more education on psychosis. The members wondered how Psychosis affects the person they care for. So I was really glad that OASIS stepped in and provided a lovely workshop for us.
I was amazed to see that OASIS came along with a patient to tell her story, which I thought was inspiring and left a great impression on me. It showed there is always hope no matter how difficult things became.
Back to the presentation and workshop. OASIS talked us through how broad the definition of Psychosis really is, but they broke down that term into a number of factors.
The presentation looked at how sufferers could get
Confusion and changes in thoughts
Changes in speech
Loss of motivation
Feeling like something controlling them
Experiencing upsetting thoughts
Paranoid thoughts and ideas
Deterioration in physical health
and a lot more.
This is not to say those who experience psychosis had all of the symptoms, but they are common among those affected by psychosis.
The presentation moved on to explaining the Early warning signs. This part of the presentation was so vital for carers as not all carers are alert to when someone if beginning to relapse or fall unwell.
Some of the signs were.
Memory and concentration problems
Again, its not like the person experience all the signs, but maybe some occur when the person becomes unwell. These early signs then eventually change to more difficult experiences shown below
Changes in perception – seeing/hearing things
Paranoid or suspicious thoughts
High sense of threat
Change in behaviour and functioning
So eventually the above then leads to full blown psychosis. I was amazed how well the group explained things so easy and I wished more members turned up to view the talk.
It was not always talking to the forum, we also did some fun quizzes to test our knowledge. Then we heard from the service user experiences. There was many thought provoking questions from the forum members which centered on cultural awareness and understand, but I still feel that the BAME community must also make steps to engage with services and not wait till someone becomes so unwell that they is no choice but to provide MH care.
No one likes things being done to them, so there must be some focus on what services we can use before we get into a situation where services are forced on us.
I have decided to advertise the event off eventbrite as well as getting support from SLaM to place up posters on their wards and out in the community. I cannot thank SLaM enough for being very supportive of the forum and continuing to engage with the BAME community.
For those who may not know, the Oxleas, SLaM and SWLSTG Mental Health trusts are working heavily with the community to update what they are doing for their BAME staff. I am glad the services is using this forum to engage with the community since diverse communities often query about staff and not always the service themselves.
Here is the update from the Lambeth Mental Health carers forum. The forum is run over at Brixton 336 building hosted by Lambeth Carers Hub.
Carers’ Hub Lambeth is an independent local charity based in Brixton. They offer advice, information, emotional support, signposting, peer support groups and events to unpaid carers of Lambeth. I often attend their MH carers support groups. Without Lambeth carers hub, many carers in the borough would feel isolated, abandoned and having to cope through a crisis.
The Lambeth MH carers forum aim is to bring Mental Health carers together to inform, educate, offer some form of empowerment in their role to engage with health and social care services.
The main agenda for February was engagement due to worrying concerns about the closure of Lambeth hospital. Some carers are fine that some action will be taken by SLaM (South London & Maudsley), because they feel some wards on the hospital are not fit for purpose. Other carers are not sure what is going on and are happy to attend in order to be informed and feel part of the discussion.
Some carers from the Southwark area are worried development will further reduce needed space to access services. There are many reasons why unpaid carers need some form of engagement, so we hope the forum can offer some dedicated insight that SLaM takes the views of families and carers seriously.
We had hoped the Service director for Lambeth Hospital would be free to engage with us, but he was unable to make it, although members had a very lengthy and informative discussion about the consultation process regarding Lambeth hospital.
The forum also is awaiting a visit from Kings college hospital NHS trust MH lead regarding the trusts Mental Health Strategy. I have noticed many Acute NHS trusts developing mental health strategies, but members are worrying if there is consultation with carers in the boroughs regarding established forums and groups.
Gavin Smith the MH lead for Kings College hospital could not make both carer forums, but he did manage to attend the Southwark MH carer forum the next day, which was brilliant and showed how much dedication he has in putting mental health at the heart of the NHS trust. I will report the Southwark MH carers forum update soon.
The Lambeth MH carers forum was kindly co-chaired by myself and another carer who is learning more about the NHS, mental health services and the obligation of social care services. She presented the minutes from the last forum very well.
The carers forum discussed carer awareness at GP centers in the borough of Lambeth and if carer registers are kept up to date, or even if GP surgeries have them, we hope there is engagement from Lambeth Carers Hub towards GP practices in Lambeth.
We also discussed the mental health strategy from Guys and St Thomas NHS Trust as that trust is very busy linking with both the Lambeth and Southwark MH carer forums. There has been some great news as both trusts are inviting carers to involvement in order to raise carer voices even more. I am very impressed with both Kings and GSTT NHS trusts as they have made it clear to work in partnership with the community.
Both NHS trusts MH strategies and Carer strategies will take some reading, but at least there is some way to hold the trusts to account as members get worried if no plan of action is in place or if there are no policies.
Guys and St Thomas NHS Trust are back again over at the Southwark MH carers forum later this year. The forum also discussed updates on Lambeth Healthwatch questionnaire, which I believe is still in development.
I also updated the forum on my plans for the other forums I do and hope other carers have a chance to get educated on the complex system of MH care, health care along with the duties of social care. Plus I updated the forum on CarersUK developments with their new ‘Learning for living’ app and their ‘State of care’ Survey.
This concludes the February update for the Lambeth MH carers forum.
Hello fellow reader. Welcome to the February edition of the Lewisham Mental Health carers forum. Each of the 4 MH carer forums I run focus on mental health service engagement for MH carers. The forums also seek engagement, updates and involvement from other parties, but usually mental health services come first.
For the Lewisham forum with thanks to SLaM’s public and patient engagement lead for Lewisham & Croydon, we were delighted to have in attendance SLaM’s Lewisham Quality Improvement clinical Nurse.
I also presented the new Carers UK online application to the members and shared this on our Carers Whatsapp group. If you are a carer and are interested in boosting your skills. Please check out the following link.
Going back to SLaM QI I can almost hear the following.
What is Quality Improvement I hear you ask?
There has been a drive at mental health trusts to strengthen services through quality engagement and indicators. The quality improvement drive has unfortunately come from reports due to serious incidents in the past, but it has led to action and families and carers need to know more about NHS Trusts QI.
Emma Jones who is the SLaM QI clinical Nurse spoke to us about the importance of QI. She spoke about the recent visit from NHS England querying the trust on involvement and co-production. From what I remember, SLaM were good in some areas, but struggled in others. Emma admitted there was still a long way to go.
We were shown a video which can be viewed below.
I felt the video was very good and certainly set the agenda for a good discussion.
The forum felt more carers need to be involved on SLaM’s carers register and more carers need to be involved on SLaM’s projects. The Lewisham MH forum await the focus groups QI are planning. There was a lot of discussion on SLAM’s changing lives strategy.
The core components of the Strategy are
Quality – SLaM will get the basics right in every contact and keep improving what matters to services users.
Partnership – SLaM will work together with service users, their support networks and whole populations to realise their potential.
A great place to work – SLaM will value, support and develop our leaders, managers and staff.
Innovation – SLaM will strive to be at the forefront of what is possible, exploiting our unique strengths in research and development, with everyone involved and learning.
Value – SLaM will make the best use of our assets, resources, relationships and reputation to support best quality outcomes.
The forum fed back on if the changing lives strategy has a space for carers and was not keen on the word ‘support networks’, although they agreed the word could stay, but certainly wanted the word ‘family and carer’ to be added. The view is even carers are also users of services not as patients but what SLaM can provide.
There were also talk about other words as in the word ‘Huddle’, which is an american term for taking action and planning strategy instead of consulting.
There was more discussion on Carer & Service User Involvement in QI
Where the forum was presented on how SLaM QI in Lewisham or overall were engaging with those off the Involvement Register. The following was presented.
How the Inpatient Care process Model works – A Lewisham Pilot.
How each acute ward eventually had a 1 hour group every 2 weeks.
How to get patient involvement/feedback.
Positive & constructive Feedback from persons supporting group.
Pointing out that patients change ideas do make a difference.
How patients feel listened to, more informed of what to expect & given feedback from actions.
Moving Forward: Each Ward to take ownership of group with IR.
Again the forum pressed QI for carer focus and involvement, however the good thing is that SLaM QI were there to listen. Near the end of the talk, the forum discussed SLaM’s patient discharge follow up regarding SLaM’s suicide policy and touched on the QI projects each ward was working on. A lot of projects were focused on patiet flow, but some looked at the patient and carer experience.
All in all, I was happy that Emma from Lewisham SLaM QI attended, even though she was pregnant I felt this showed dedication to her role and set an example to engaging with carers. I shared the forum notes with carer members to 2 other forums in the hope those members can query Quality Improvement in other SLaM boroughs.
Next up was Carers Lewisham new support worker who has a vast amount of Mental Health knowledge. He updated the forum on some new groups that Carers Lewisham is running and we look forward to working with him and Carers Lewisham.
This concludes the update for February Lewisham MH carers forum.
Did you know that there are around 7 million carers in the UK? Give or take many more hidden carers? Did you also know that around 1 in 5 carers leave their job to care and many more carers provide care for so long it is harder to get back into employment. Carers across the UK save over £150 billion for the economy and even if it was not about the costs, then it is certainly about valuing what carers do.
Often when I hear from unpaid carers, they tell me how difficult it is to develop skills for the future. Just the look off a carer’s face shows me and that their confidence is gone.
By the Way, I have done a Vlog on this. You can view the video below.
It is not like they want to just leave the person they are caring for in order to work again, but there is a nagging feeling that carers are being forgotten in education and being unable to attempt a future for themselves.
It is understandable that many carers worry about what will happen when they become a former carers. They worry that they have given so much time and dedication to that special person, that they have neglected developing skills for themselves.
I would like to mention it is not like no one is trying to help, there are often activities, advice and skill sessions from carer centers. I would like to praise those giving much of their time and energy to help carers find those skills and confidence to access work, but the pressure is still there.
Carers want to find skills for work that relates to their values. Carers want to be welcomed into a job market that understands the attributes of dedication, serving others, being there and a willingness to continue learning.
It just so happens that Carers UK (A leading national charity giving carers a voice) have been looking into how carers can develop confidence and skills that ca help with employment.
Carers UK understands the stigma faced by many carers who feel they are locked out of education and looked down upon because they are not doing what every other person is doing….that 9 to 5 job.
The situation is that carers work all sorts of hours and carers would love a chance to develop more skills, but unpaid carers need the tools to help them access such skills.
A couple of days ago I tested an online application that teaches carers about developing learning skills, which can give more confidence to many carers seeking a way to make a future for themselves.
The online application is simple and easy to use. It does not take a moment to register and then you are on your way. The online application is called ‘Learning for Living‘ and I really hope carers understand the importance that there is life after caring, or even during caring.
If there is anything I can take from the application is its flexibility as you can come back to the application any time and it does not have to be done in one sitting. The application is well thought out and delves deep into the virtues of caring and relates caring into developing skills.
You should be able to access the ‘Learning for living’ application below.
Some carers do not even think they have skills due to their caring role, but all that needs to happen are tools that explain to carers that they already can developed skills and it just needs to be awakened.
There is no escape, carers have to engage with technology and the UK seeks to develop its technology infrastructure more. Us carers cannot be left behind and using such applications is certainly the future.
As a working carer, I was invited to Carers UK HQ and submit my views of the application The discussion raised several interesting aspects among carers and representatives and it was excellent to see Minister for Care Caroline Dinenage attend, debate and listen to carers views. I admired her compassion and determination to support the developments for unpaid carers.
We all agreed carers have something to offer and even more to gain, even though carers have been giving so much all their lives.
‘Learning for living’ gives carers that chance, we cannot sit back and hope opportunity comes our way, us carers need to take the chance and develop the confidence, understand our value and challenge the future.
Us carers have given so much to society, something that should be valued and treasured, it is about time we get to live for ourselves, its not selfish is it?
Thank you for Carers who attended and Carers UK working hard to not only get carers that voice, but also the skills and a future.