Welcome to my brief update of my joint Southwark & Lambeth mental health carer forum for October 2021. As with my other carer forums, this forum runs once a month and provides a platform for health & social care organisations to engage with those who care for someone suffering mental ill health. The primary focus for engagement is obviously South London & Maudsley who heavily support the carer forums, however a fair bit of the time the forum gets engagement from other parties, this could include Kings College NHS trust or Guys & St Thomas who also advertise the carer forum.
Speakers for October were
Dr Siobhan O’Dwyer – Spotlight on Care
Danny McDonagh – Employment & Education Engagement Worker (Mosaic Clubhouse)
Welcome to the October update of my Greenwich Mental Health carer forum. As with my other carer forums, this one focuses on engagement from the local mental health NHS trust that covers greenwich, that being Oxleas MH NHS trust. I run this forum with heavy support from Greenwich carers who fight and advocate for the needs of unpaid carers in the Royal borough of Greenwich.
Speakers for the October Greenwich MH carer forum were
Peter Ley (Oxleas NHS) – Service Manager Sue Horbury (Oxleas NHS) – Online Patient system Laurelle Morgan Bruce (Oxleas NHS) – Oxcare
Welcome to a brief update of my South West London mental health carer peer forum. This group is a mixture of carer peer support and mostly engagements from health & social carer organisations, especially the local mental health trust South West London & St Georges. This carer’s group cover’s 5 boroughs as all 5 carer centres including the mental health trust work hard to promote it.
South West London & St George NHS
An extra bonus of this group is I do open it up to national speakers so the following speakers for September
Welcome to another brief update of my BAME mental health carers forum for October 2021. I have not been reporting off my carer forums that much due to finishing up my latest book about mental health carer experiences.
You can by my latest book on the link below.
You can also find an overview of chapter 1 from my YouTube channel below.
I am now working on my 3rd book which will be a large number of poems also on the carer experiences. It is not set for release until 2022, although I have been reading out my poems at carer groups for preparation.
The carers forum usually runs once a month and its focus is on ethnic diverse carers who are caring for someone with a mental health issue, although the forum started in Lewisham, it has expanded with the support of mental health services of Oxleas, so it has extended to Bromley, Greenwich and Bexley.
Speakers for September 2021
George Hosking OBE CEO of Wave Trust – Wave Trust on Young black wellbeing
Dr Tim Ojo – Psychiatrist on Black History Month Reflections
Doreen McKenzie – Black History month Poetry
Emilie Wildeman – Patient Research project at Institute of Psychology, Psychiatry and Neuroscience
Lara Sengupte – Breakfast Clubs again Racism.
This particular forum focused a lot on Black History month which ran for October 2021. One of the speakers from NHS England & Improvement could not make it, but they did attend my BAME carers group for Novemeber, which I will blog about soon.
George Hosking OBE presents on his project for youth mental health
George Hosking CEO of Wave Trust spoke about his charity, which helps to prevent children suffering child abuse, neglect, and those witnessing domestic violence in their homes. Over a number of years, the charity has become very aware of the impact on mental health, which has led to people suffering childhood trauma in some kind or other. George mentioned a huge number of mental health problems can be traced back to childhood experiences in that way. George stated the charity has experts on trauma. He himself is a clinical criminologists, psychologist, and traumatic stress counselor, his charity supports organizations and individuals to learn how to support people who have suffered trauma in their lives.
George included that one of the things they do is they help set up trauma informed communities around the UK. These are communities which really try and provide the best possible support to people who have suffered some form of trauma in their lives. This includes a lot of people with with mental health issues and these communities can be of two types. They can either be created top down by working with the NHS and local authorities and police to create a rather statutory based organization, or else it can be created from the grassroots working away from individuals in the community. They have been working now for about two years with the Black and ethnic Community where the charity is based, leading to creating a trauma informed community.
George was thinking about the possibility of doing some trauma informed community work in Lewisham, due to Lewisham Council recently inviting organizations to make an application to provide emotional health and well-being training to those working with young people in leadership.
What his charity is looking for is people who will help young people to spot the signs of poor mental health, and guide those young people towards mental health support especially in the black community. WAVE charity has got a background on this because of their knowledge of trauma and mental health, that they can provide that kind of guidance and support. They have got the facilities to train people to be more adept at doing this sort of thing. Unfortunately what they don’t have is the links in Lewisham to people who are working with young people, particularly people who are working with young people with an interest in mental health. George did realize that our forum’s focus is very much on carers rather than supporting young people. He did do a Google search to look for an organizations in Lewisham with interest in mental health and thus Matthew’s forums came up.
So George contacted Matthew who kindly invited him along today just in case, someone from within carers forum is aware of or are even interested in what that charity could potentially allow involvement in.
Lara Sengupte presents on Breakfast Clubs again Racism in Lewisham
It was Lara’s turn to speak about her project and how it came about. They are currently in the pilot scheme phase. So they have been running projects since July, and the piloting finishes in December. By then they are going to be analyzing the results of the clubs. They run two breakfast clubs, one in Catford, and one in Peckham (Southwark). The goal is basically to educate young people on racism, how it shows up in society, and how to combat it. This particularly on internal racism.
Lara knows for a lot of young people of color, which relates to mental health, that can carry around a lot of negative self talk and negativity, all the negativity that we see in the media, and through like school exclusions there is a lot of racism against young people of color. The big challenge is that young people and children don’t exactly know how to process it. So that’s one thing that our clubs want to tackle. So they are running educational Saturday breakfast clubs for young people throughout autumn term. This is not just for Black History Month since they have been running them since September, and will finish them in December. Our clubs have got about 10 weeks with the kids where the purpose of the breakfast clubs is to teach young people about racism, how to challenge it in a safe space surrounded by like minded peers.
So all the kids that are signing up to the Breakfast Club all care about racism, and all care about combating it. So they can share ideas in a safe space, that perhaps in a school it would be different. The clubs don’t just cover personal racism, they also look at deep institutional racism, and internal racism that is often carried around by young people of color. This can show up as negative self talk or self destructive behavior. So the clubs give the students an understanding of the societal problems that we have in this country. The clubs also work on self confidence and leadership skills to empower the young people and children to take action where they can.
The breakfast clubs next session was in October where the clubs work with young people from around like 10 to 14, but they are also quite flexible and ages.
A while ago Dr Tim a psychiatrist wrote a piece for the Royal College of Psychiarists regarding the importance of Black History Month, which you can see below.
Dr Tim has been very busy promoting equality through the power of psychiatry and I felt it important to invite him to engage with BAME carers and even NHS staff.
Dr Tim felt it was a pleasure and a surprise for Matthew to connect. Dr Tim spoke about the piece he wrote for Black History Month in 2019. He is a psychiatrist by background of British born, But his heritage is in southwestern Nigeria and as part of the Royal college of Psychiarists celebration of Black History Month, which became something only a few years ago, he was invited to write a blog. Dr Tim is an associate Registrar for policy support the college. That means the things around the Royal College of Psychiatry led to reports and statements that they make, in addition to supporting people with mental illness, their families, and communities. This includes Improving the mental wellness of society in private colleges, professional body for all qualified psychologists.
Dr Tim felt what was the important facets for Black History Month is a special where we come to terms with the fact of needing to understand history from the perspective of recent events. This has happened after his blog has shown that reflection point where it’s absolutely necessary, where people of color and their white allies think about history from a different perspective, because for too long, it’s been written from the perspective of one vantage point, that vantage point unfortunately positions, people of color, black folk, particularly at a disadvantage in producing narratives that arent helpful, realistic, and are incomplete. So what he thought Black History Month now takes upon an additional layer of importance, because first of all, it is about a celebration, about the fact that across the world cultures, black people have come together even in the face of suffering, can celebrate on resilience and psychological robustness that is happening through the facets of our history, and throughout our communities. Dr Tim felt we can find people, individuals and communities doing great things where it reminds us that we have a history of a human or a connected global trajectories of history that we assume we have music culture, we have literature is important for all of us as human beings to function make no apologies for our issues about how do we use structural position to address questions of inequity and problems inclusivity in society. Dr Tim feels as carers we can speak to a very important aspect of the black community in terms of inadequacy of access narrative support.
Dr Tim also thinks having four electives is important to come together to illustrate actually, every month, although Black History Month appears once a year. it’s important for people to focus on sharing stories, not as a disadvantage, but through the use of positivity. Dr Tim mentioned where his blog gave a historical link between psychiatry in Nigeria, where the Western world in how we have trained psychiatrists who took it upon themselves to negate the negative picture over history in psychiatry, and came up with a very good book, which is called “black skin, white coats” by Matthew M. Heaton.
The book is a legend and looks at psychiatrist colonization, and the globalization of psychiatry, this led to an informed decision of him becoming a psychiatrist.
Dr Tim thinks it’s important also to recognize people like African Caribbean senior psychiatrists, who retired, but stood firm in the face of strong opposition to actually question what was happening, vision and mental services of color in this country. Dr Tim spoke more about Matthew M. Heaton on his work since the 60s and 70s, which was very important in shaping the new agenda around a shared understanding of how history is restricted, which is advantageous, specifically why he was talking about Black History Month being symbolic.
Doreen McKenzie poet and author on Black History Month poem.
I invited my aunt Doreen to read a poem for my carer group. She had two poems that she wanted to read to us. Doreen read the shorter one first. The poem was called “Proud to be black”
This woman is so darn proud to be back. Despite the fact that she’s very aware that her color is constantly under attack. Black is the color achievers with pride. Nothing will ever entice her, her beautiful black skin to hide.
She was born black, and will die the same color. And she knows many people whose thoughts are similar. She hears people talk about the blonde bombshell. But she repairs the curvaceous black hair.
Black skin really wrinkles with age. Therefore, the age of a black person can hardly be gauged. It is a mystery how many elderly people look so good, despite the fact that they are plagued with a magnitude of challenging evidences.
And when it comes to her hair, please don’t even bother to go there. It is so unique and versatile. That in just one day, it can be crafted into a variety of magnificent styles.
The Bible says that man is made from clay. So claiming to be made in God’s own image is nothing outrageous to say. Claim your blackness with gladness and pride. Because the beauty of blackness, one must never tried to hide.
You can check out Doreen’s book “The Purpose of My Life: Now, Then, and in the Future”
Emilie Wildeman presents on her Research project
Last to present was Emilie on her research project. She usually attends my groups a couple of times over the past year. She was here today to push for recruitment and to raise a bit of awareness about her study that she is conducting as part of her PhD project. Emilie is a PhD student at King’s College London. Her research is all about informal family carers for people living with severe mental illness. Emilie gave us a bit of background to the study, in many health conditions, including mental health, we know that people living with these conditions will often live with or be supported by a close family member or friend, who mental health services refer to as informal or unpaid carers.
Emilie continued to mentioend that they also know that in some relationships, there can be difficult periods that might include sort of episodes of disagreement, and in some cases, can include active aggressive behavior from one person towards another. Her research is focused on carers of relatives living with severe mental health conditions and for her study, she is looking to speak with family carers who have experienced any type of aggressive behavior from the relative that they care for. So that could include sort of episodes of verbal disagreement and verbal conflict, conflict, verbal aggression, emotional and psychological. It could be physical, it could be some sort of destruction to a property. It’s very broad. She knows that this can be a very sensitive topic, and that there can be a lot of stigma around mental illness as well as aggressive behavior. So she really want to emphasize that this project is not about passing any judgment or making any assumptions about relationships. she is just interested in exploring carers lived experiences.
Emilie hopes that through doing this research, they can help to reduce that stigma. Participation is on carers completing an interview with herself. This is around giving carers the opportunity to voice their experiences and their opinions about what impact these experiences can have on themselves personally, on their relationship with the relative to their care and also for the family.
She is also really interested to learn about “What support families and carers have received in relation to dealing with experiences of aggression”. So that could be from personal support networks, but also professional services because she wants to identify what aspects have been helpful, but also maybe where support might be lacking.
This concludes my brief update of a special Black History Month special for October 2021.
Welcome to the brief september update of my BAME mental health carers forum. The forum focuses on updates, information and queries regarding mental health services and how they impact on ethnically diverse carers who are caring for someone suffering mental ill health.
The speakers for September were
Mushtaq kahin – Her projects reaching out to the community Macius Kurowski – South London & Maudsley NHS Equality Manager on Equality updates Dr Stephen Goggins – South London & Maudsley NHS on carer’s strategy
A new research study by Cassie Lovelock will be looking into the identity of those who support someone in their life with a mental illness. Cassie is PhD student at the London School of Economics; before that she was a carer for her sister who lived with schizoaffective disorder.
The aim of her study is to learn in what ways supporting a person impacts a carer and their identity. As well as what their day to day supporting that person looks like. This will be done via an hour(ish) long interview with her via zoom or teams (or telephone if that is easier for the carer). It will take part at a time convenient for unpaid carers.
To take part the carer must be over the age of 18 and able to give informed consent. Unpaid Carers will be paid £30 for the interview – or thy can request a voucher to the same value.
If any carer other there is willing to make part – or would like more information before deciding please email Cassie on c.lovelock@lse.ac.uk or you can text/whatsapp her on 07429428992.
Welcome to a quick blog from carer matthew mckenzie. Just last night I went to the excellent (Health Service Journal) HSJ Awards 2021.
Taken from the HSJ website – The 41st HSJ Awards culminated in a ceremony shining a light on healthcare excellence at Evolution London. From senior leaders to front-line staff, all finalists have been a source of life-changing and much needed work sharing best practice, improving patient outcomes, and being innovators of better service.
As we all know due to the pandemic and a few other things, the NHS is under immense pressure and whatever pressure the NHS and social care suffers from, it does not take long before unpaid carers take on that added strain. Many patients and unpaid carer’s are often forgetten and although awards are necessary, it is so important to award the work done to identify, support and keep track of the many millions of unpaid carers across the country.
The entries for 2021 were very impressive and numerous as many healthcare systems took up the challenge. For those who managed to get their projects to be judged, I can say there are all winners, but unfortunately there can only be one HSJ winner.
As one of the judges for the entries I felt I learned a lot on the system led carer category. I found out how dedicated the healthcare professionals were in pairing up with stakeholders and those who support unpaid carers.
The judging process was led by Jennifer Kenward who is the senior NHS England lead for experience of care, which is a much needed role for increasing the identity of carers all around the country. You can read her blog in the link below.
I was a bit late arriving to the event due to fighting with my bow tie, but the venue was easy to get to from pimico underground station. I was worried about the covid situation of such a large ceremony, but the way the event was run, everything was strictly monitored.
As a judge we were placed on the front tables to get an excellent view of the awards hosted by the brilliant Sue Perkins who is a great British icon and is passionate about the NHS. The food was excellent and HSJ staff looked after us very well.
I managed to greet friends and partners from Carers UK, Carers Trust and NHS England as well as fellow judges. Obviously I gave them a signed copy of my book (I never miss a trick).
The winner for our category ” System-Led Support for Carers” was “Care for the Carers” on their Intensive Support to Carers in Hastings.
The highly commended award went to West Yorkshire and Harrogate Unpaid Carers Programme, Covid-19 Vaccination Programme for Unpaid Carers.
You can find out more about Care For the Carers off their website below.
All in all, I felt very previllaged to be included as a judge for the HSJ System-Led Support for Carers category for 2021. A very challenging year for the NHS and also challenging for unpaid carers, but entries for such awards set the standard for others to follow. I urge those across the country to take up that challenge and care for the carers.
Well done Care for the Carers, your HSJ award is historic.
Welcome back to a brief update of my South West London mental health carers forum. It is not like my other forums since this one tends to be a hybrid of peer support and carer engagement. Plus its probably my largest carer forum which cover’s 5 boroughs or six boroughs if we engage with NHS South West London CCG, because the commissioners cover six boroughs that being the borough of Croydon.
Anyway, one of the main focus is on how South West London & St George engages with unpaid carers, especially about mental health services, but the forum can then become a networking forum for other carers even outside SW London as sometimes national speakers may appear.
The speakers for August were
Elizabeth Stirling the new CQC inspector for SWLSTG
Tristan Brice from London Association of Directors of Adult Social Services.
Elizabeth presents on what the CQC is about
Since the CQC spoke at length regarding roles and plans, I can’t blog too much about that, however Elizabeth was kindly referred to engage with our group since their interested in how the group is supported.
Elizabeth spoke on the following.
How she has Worked in health and social care for 23 years
Worked as a support worker for four years
How she has been a Social worker since 2005
Worked for Mental Welfare Commission for Scotland
Has lived experience on caring regarding mental health.
Elizabeth then moved onto what the CQC does as in that the Care Quality Commission monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety, and they publish what they find, including performance ratings to help people choose care.
The CQC also set out what good and outstanding care looks like, and they make sure services meet fundamental standards below which care must never fail. Obviously, the CQC use information and evidence throughout their work, including people’s views and experiences of care. The CQC work closely with the public, other organisations and local groups across everything they do, that includes patients and carers of course.
Next Elizabeth explained the core fundemental standards for the CQC and what they look for. These would be
Person-centred care Dignity and respect Consent Safety Safeguarding from abuse Food and drink Premises and equipment
To also mention although the above is important, the CQC do look for other things as well. With the list above, they apply to fundemental standards that apply to mental health trusts
There was a very long Q&A session regarding these standards that apply to the rating of SWLSTG, but the important distinction was that it was coming from a carer’s perspective.
Each of those standards mentioned must follow a criteria of questions usually 5 of them, which are
Safe: you as the patient protected from abuse and avoidable harm. Effective: your care, treatment and support achieves good outcomes, helps you to maintain quality of life and is based on the best available evidence. Caring: staff involve and treat you with compassion, kindness, dignity and respect. Responsive: services are organised so that they meet your needs. Well-led: the leadership, management and governance of the organisation make sure it’s providing high-quality care that’s based around your individual needs, that it encourages learning and innovation, and that it promotes an open and fair culture.
Of course there has been a massive impact regarding how the CQC works and I had asked Elizabeth to talk in depth on covid-19.
Elizabeth talked about how the CQC had to adapt on how they work. This was a mix of on-site and off-site methods. In March 2020, the CQC suspended their routine inspection programme in response to COVID-19 and developed their ability to monitor services using a mix of on-site and off-site methods. Other changes were on improving the CQC’s ability to monitor risk to help them be more targeted in their regulatory activity. With that, by bringing information together in one place for inspection teams, presented in a way that supports inspectors with their decision making and by testing elements of how they want to work in the future, including how they provide a more up-to-date view of risk for people who use services.
I myself have always stressed to carer’s that the CQC is not a one way system, unpaid carer’s must provide the CQC with information and also requests so carers are working in partnership with the CQC. Elizabeth expanded on this by stating Information from patients and carers is very important to the CQC. All the information the CQC receive will be added to the records they have for each care service. The CQC can use this information to help decide where to inspect next, and what to look at when they do. When the CQC receive information about a concern for someone’s safety, they will treat it as urgent.
The CQC also use what people tell them to understand the quality of care they get from services like care homes, care agencies, hospitals and GPs. It helps make care better for everybody.
Again there was a very long question and answer session from members of the forum, but for those reading this blog please see the below.
Welcome to the September update of my Lewisham mental health carer forum 2021. As a note, the carer’s forum is an engagement group aimed at those caring for someone who suffer’s mental ill health.
Since the carer’s forum focuses on carer’s from Lewisham, we tend to get engagement from mental health services of South London & Maudsley NHS foundation trust. I am grateful for the support our local NHS trust gives to families and carers. It is important that families, friends and carers remain that strong link in coping and recovery.
The speaker’s for September were
Leonie Down – Lewisham Head of Occupational Therapy and Partnerships Lead from South London & Maudsley
Ros King – Regional carer lead for London from NHS England
Charles Malcolm-Smith – People & Provider Development Lead from NHS South East London CCG (Lewisham)
Leonie Down presents on the importance of Occupational Therapy
As mentioned earlier, South London & maudsley prides itself on the engagement and involvement of those who use it’s services and those who care for patients. It was great to have Leonie engage with our carer group on the importance of Occupational therapy.
Leonie stated her talk on how occuptional therapy can help people manage their routines at home, and also occuptional therapy helps look at the physical health component and ways for people to adapt to disability. Leonie presented an example from The World Federation of occupational therapists (WFOT).
“Occupational therapy is a client-centred health profession concerned with promoting health and well being through occupation. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life. Occupational therapists achieve this outcome by working with people and communities to enhance their ability to engage in the occupations they want to, need to, or are expected to do, or by modifying the occupation or the environment to better support their occupational engagement” (WFOT 2012)
Leonie admitted the defination was a bit wordy, but it does encompass the fact that it’s about activity and occupation and that’s the medium through which Maudsley NHS deliver their interventions.
Leonie has worked as an OT for around 30 years, a lot of people ask her, what’s an OT do? So she often responds that it’s about supporting people to do the things that makes them feel better. So it’s very much about what people spend their time doing, what people feel, what activities that make people feel feel better, make them stronger in themselves, plus setting their direction towards recovery. As an OT, it’s a degree that they have three years in training as an occupational therapist, which ultimately equips them to be able to understand the needs of each individual. These could be what strength and barriers might be around the person or being able to access activities that make me feel better, and that could be multifaceted.
Leonie then presented on the following, where how can service users benefit from OT. The following points were explained.
How OT promotes self-expression, creativity and the development of hobbie
Where OT can improve / develop
feelings of self-esteem and confidence
level of self-awareness, understanding and insight
ability to manage health conditions and ADLs
social interaction and communication skills
coping strategies and self-management techniques
How OT supports the development of roles, responsibilities and routine, as well as identifying and working towards goals
Promotes healthier lifestyle choices and greater levels of physical activity
Increases the chances of an earlier discharge and the likelihood of them being able to remain safe and independent in the community
Improves the patient experience and wellbeing.
Leonie then moved on to present the work being done in Lewisham regarding OT, where they are trying to work with as many social inclusion partners as possible. So one half is Lewisham community connections, where people are helping those using the services navigate through to something that they can be doing to help their health.
The other aspect of OT in Lewisham, is very much about trying to co-produce and co-deliver a program of groups. Which is for people that that may benefit from the environment that involves other people. This is because other people, from the same environment can learn or hear different insights, which can lead us to start making sense of our own experiences and possibly develop tools to become self reliant.
There was then a Q&A session from carer members of the Lewisham MH carer forum.
Ros King from NHS England speaks about ICS changes
Ros King kindly engages with my carer groups when she can, so today she was invited to speak about the important of Integrated Care Systems. Ros started explaining about NHS England and how it is a huge organization and can be very complicated. Ros mentioned how NHS England is basically the body that sets health policy with the department of health and social care. Such policy helps plan for what the health service will be focusing on where It also holds allocated budgets. The budgets are then allocated down to CCGs where Ros explained that there has been quite a few changes.
It was explained that a couple of years ago, the responsibility was around Clinical Commissioning Groups, and NHS improvement was concerned with providers, so acute trusts and some changes were implemented which led to a merger to become NHS England & Improvement.
Ros then explained a bit about The national teams and the regional teams. Where there are seven regions across England. As in other countries just NHS England we have Wales, Scotland, Northern Ireland, which have different arrangements.
Ros talked about the London region and what sits within the London region, where there are five integrated care systems. These being Southwest London, southeast London, North Central London, northeast London and northwest London. Ros joked that she really hopes nobody has any questions around which CCGs sit within such ICS because that would take some time. Ros talked about how the CCGs have merged to cover such regions around London.
Ros moved on to talk about how NHS England & Improvement would demand lots of information, especially very complicated information about how the CCGs and providing trusts were performing in all sorts of areas. Such requests for information could be at a very short notice because those at NHS England & Improvement have to feed this info back to the organisation.
Ros felt there has been a lot of changes as to whilst regions do still have accountability, So if an acute provider in Lewisham, has really serious concerns and risks about performance of the quality of the services they’re providing, then it is still very much NHS England regional team responsibility to manage and try and work with the provider to improve.
The idea is rather than an acute provider struggling with performancing issues, they should learn from other providers and network together. Still, NHS England has commissioned a lot of things, but now only comission small amount of services which are specialist services. These will be transferred out into ICS.
Ros then talked about how they manage complaints around a primary care service. So GPS, dentist, ophthalmologists, pharmacists and so on. Such complaints would come in to NHS England depending on the complaint e.g. if you have a complaint about any of those services, it would come through to NHS England, or if you had a complaint about a service that was commissioned by your ICS, or your CCG, that would go into the CCG or directly to the organization that’s providing the service.
Charles Malcolm-Smith presents on ICS at a local level.
I had a lot of support from engagement representatives of NHS South East London CCG where Greenwich, Southwark and Lewisham CCGs had organised what to present to carers and also who can support Ros Spink’s presentation.
In the end Charles who is the people & Provider Development Lead from NHS South East London CCG (Lewisham) continued the presentation.
Charles talked about what integrated care system changes that are in the pipeline and how they are designed to work together better. With all the talk about health and social care needing to work better with physical and mental health services, community acute services and primary care, it’s all about the different parts of the system working together and this is about structural change.
It was explained that we have had integrated care systems for a while, but their status had changed from the sustainability and transformation partnerships, where they became ICS even though it is still a partnership status, with the health and social care bill now making ICS statutory organisations. Charles explained that there will be four building blocks to do an ICS. So the ICS for southeast London will have an integrated care partnership board and this is the alliance of organizations that represent across southeast London. These will include the NHS organisations, local authorities and made up of the chairs of the trust.
Elected representatives and elected leadership from each of the local authorities as well as the representative director from Adult Social Care, children, young people services, Healthwatch and voluntary and community sector organizations. Charles reassured us that in southeast London, there aren’t any private sector organizations involved in the partnership since there were a lot of questions from members about privatisation creeping in.
Charles talked about how the Integrated Care board brings the NHS together so it brings commissioners and providers around the table. Charles mentioned it was an important development because the last couple of decades, it has always been a commissioner and provider that were split causing queries with contracts. although there will still be commissioning and providing but the approach to it will be about joint planning. So there will be working together more closely than before.
There were many questions from carer members on if the Local Care Partnership board will debate the importance of unpaid carers and include them in their decisions.
This concludes the brief update of my Lewisham mental health carer forum for September
This is a brief update for my BAME mental health carer forum covering a mix of London boroughs between Oxleas NHS Foundation Trust and South London & Maudsley NHS Foundation Trust.
Obviously out of my 6 carer groups, this forum focuses and discusses on the unique experiences of Black Asian Minority Ethnic groups. I know some people want such groups to be specific, but to be fair a lot of the topics raised in this forum do focus on the afro caribbean element, although some members are mixed from the Asian community, which is growing as members from other MH NHS trust attend.
The speakers for the month of August were
Malik Gul – Ethnicity & Mental Health Improvement Jacqui Dillon – Race and mental health Cordwell Thomas – Black Thrive Dawn Irving – Maudsley NHS Quality improvement
Malik Gul presents on Ethnicity & Mental Health
Malik was really pleased to be among carer members of this forum. Malik felt the issue of race and mental health is not new, this is especially in the field of discrimination and racism in the services of our communities. Malik stressed that what we’ve had to endure as black and brown people has been known since we first landed in this country, But since the main kind of population of migration into this country, following the Second World War, and what is euphemistically known as the Windrush generation.
Since the days that we’ve arrived in this country, we have been discriminated against. Racism is built in to the very fabric of the systems that we all live in, and we must admit that it is a part of the system, and all of us in this conversation have experienced that. We’re all a part of it and we have all been discriminated against, in one form or another.
what Malik finds really interesting about the work he does, is that he has been working in Wandsworth at the Wandsworth Community Empowerment Network for the last 20 years.
It is now their 20th anniversary and the organization was founded in 2001. The thing is the organisation knows about the history of black discrimination. Many of us will know about David rocky Bennett, a black man, Rastafarian man, who was in mental health facility in Norfolk, and unfortunately there was a dispute on the ward, something really minor, Malik thinks it was about who could use the phone and who somebody jumped in front of the queue, or something like that. He was held down by the staff, and died in mental health services, what is worse is this is just one of the many cases of ethnic minorities dying not of mental health services, but within mental health services.
So the history of black people in mental health services being discriminated against is a story that we’ve all lived and experienced for the better part of 40 to 50 years. Malik felt that he has to us that nothing has changed.
Malik works very closely with Southwest London & St. George’s mental health trust, and also very closely with South London & Maudsley as well. In fact the new chief executive of SL&M is David Bradley who was the former chief executive of SWL&STG. Malik mentioned how he worked with him for about seven years and over the last 20 years, if you look at the figures for black people where it comes to over representation in medical health services for 20 years, it shows little to nothing has improved, and in fact, in some cases, things have got much worse. Malik mentioned that he has great admiration for David because he always had the foresight to work with the community and is bringing over ideas from his previous MH trust over to SL&M.
Malik challenged us that if you go on to the wards of Springfield hospital, as he does on a regular basis, about 50-60 70% of the people on the wards are for black and minority ethnic communities. Malik pointed out that we had to look at the over representation of black people in communities particularly in services particularly black, Caribbean, and black African.
Malik stated that he has to say that our mental health institutions are not the ones who are going to address this type of problem. He felt SL&M is not the solution to over representation of black people in mental health services, nor is Southwest London St. George’s mental health trust. Nor are any of the institutions that we are relying on to fix this issue. They are not going to address the over representation of black people in mental health services. It will have to be lead by the community, but there is a power problem, an owership problem a distrust problem. This overrepresentation in mental healths services has been going on for so long that the community has felt apathetic to any drive in order to change the status quo.
There was a very long discussion on what was needed to begin to address this issue, but the conclusion is it must from ethnic minorities, but controvesally we cannot expect the victim to solve the problem as we cannot expect the masters tools to change direction.
Jacqui Dillon presents on Race and mental health
Dr Jacqui wanted to talk a little bit about her own experiences, and on why Matthew invited her to the BAME forum. Jacqui Dillion is the former chair of the national hearing voices network, which is a user led charity that was set up about 30 years ago to provide an alternative to mainstream psychiatry.
Jacqui felt she is basically a survivor. she has used psychiatric services and one of the things that she often says about why she has worked as an activist in mental health for 25 years, is because her experiences of psychiatrists, which unfortunately was pretty devastating.
Jacqui felt that one of the things is if she managed to survive services, she would do all she can to try and change them. So that’s what she has been trying to do for about 25 years now. One of the things that she thinks is really important in terms of what we’re talking about today, in terms of the hearing voices network approach is that we do not advocate a Eurocentric model of the mind.
She felt that this is one of the problems that Malik talked really passionately and eloquently about on the huge over representation of black, Asian, and other minority ethnic people using the mental health services. One of the things that’s really important about the hearing voices approach is that this space within that approach is to both acknowledge the live reality of racism and oppression, which in her experience is often taboo in traditional settings, a lot of people flinch and are very frightened, and can get quite defensive about acknowledging that black and Asian people are massively over represented in services, and what’s at the heart of all things, which ian macpherson talked about in the macpherson report.
Our colonial history is built into the fabric of the these institutions, and things like unconscious bias that professionals come with, and often they’re not aware of their own biases, and then making treatment decisions based on some quite racist assumptions that have been intertwined with such systems.
Jacqui feels a lot of despair, about the over representation of many different people from different ethnic backgrounds, although she is really uncomfortable with the term minority ethnic groups, because since she lives in Hackney people from black, Asian and other minority ethnic communities are 50% of her community. So she finds the description a bit reductive and these kind of acronyms we use can be a little bit dehumanizing.
Jacqui also felt she hasnt seen things improve, there used to be an organization’s called family health, ISIS, which she worked with, about 17 years ago with someone called Dennis who she did a lot of work with in terms of trying to bring the hearing voices approach to FHI as an alternative to traditional psychiatry. She was sad to hear that Family Health ISIS is now closed as with many community groups looking to set up protected spaces for those who are vulnerable and what remains are these massive mental health trusts overpowering the voices of the vulnerable.
One of the things she would like to see is a move away from locating people’s problems solely within themselves and seeing that we’re all part of a system. Jacqui feels that one of the problems with the biomedical model, is by saying that people have illnesses, what we’re doing is we’re kind of saying, madness and distress don’t really make sense and limiting away the causes of such illnesses such as the pressure of society, racism, isolation from the community, no safe places, lack of resources, lack of community, lack of understanding and so on.
Jacqui felt that we give illnesses these bizarre names like schizophrenia, which she thinks, further mystifies what are actually very human ways of coping with devastating and overwhelming experiences. So she personally does not subscribe to that kind of biomedical language and feels that it is really unhelpful. There’s actually tons of research that has shown that using medicalized language actually increases stigma and decreases people’s empathy. Jacqui mentioned that someone put on the zoom chat about how trauma informed her, Jacqui felt this was more interesting about how something like trauma informed care can develop, but talking about language is a problem where the term trauma can minimises experiences. We have a long way to go in psychiatry before we even get to the idea of recovery.
If you want to know more of Dr Jacqui Dillon’s work see the link below.
Next to present was Cordwell thomas on his role within the organisation Black Thrive. Cordwell spoke about what Black Thrive is doing to promote and also promote what the imbalance of what Malik and Jacqui clearly stated, and also the questions coming from what carer members raised, Cordwell felt there is a concern on black individuals within the black community, having a say in their mental health and promoting the services and shaping the service to be fit for purpose. Cordwell wanted to go into a small conversation about the Patient Race Equality Framework.
On Cordwell’s role, he has several hats. He has a full time role mainly within the community, one of which is on the Black Thrive committee. On the Black Thrive committee, there are various agencies from public services, these are ranging from social workers, public health officers and directors, where they also have the police and many more. So fortunately they also have directors and decision makers who are on the table of Black Thrive and they shape the way they engage with communities and how those services engage with black communities in particular.
So, within that role Cordwell helps to represent the community, but within Black Thrive, he is an independent advisor, which enables him to liaise with South London & Maudsley NHS, and also help develop services within SL&M. In particular those services that have been disproportionately affecting black individuals within the community, like individuals from Caribbean descent.
With such roles it is what brought him to this forum to have a conversation with us, because one of his roles, actions or projects, is to be the lead person from the black community driving the trusted friend project,
Cordwell mentioned that he presented with a colleague from SL&M the trusted friend project, a couple of weeks ago at the Lambeth Carers Hub peer group, which Matthew attended. from that forum Matthew requested us to speak about trusted friend for this forum. Basically what it’s about is if you imagine a situation where you’re in a strange environment, ie as if you’re now a psychiatric inpatient, at one of SL&Ms hospitals, if you imagine yourself in a strange environment and you do not have a voice. Now the role of the trusted friend is to ease and promote that de escalation. So the impatient ward may go through all their various roles of de escalation on an issue, however the trusted friend will come on the ward and be that middle person that liaises with the ward staff and say what the wishes of the individual are.
There was most in-depth discussions about other Black Thrive projects, but for now this was the brief update of the Bromley, Lewisham & Greenwich MH carer forum for August 2021
A Caring Mind 