Tag Archives: mental health

Lewisham BAME MH Carer Forum February 2021

Welcome to the February update of my Lewisham BAME carers forum. Out of all the carer forums and peer support groups I run, this one focuses on BAME carer experiences and challenges. The forum although focuses on Lewisham, BAME carers from outside the borough are welcome since there is a lack of BAME carer networking groups, especially BAME carer-led forums. I might even consider changing the name to Bromley, Lewisham and Greenwich BAME carer forum since I am very active in Greenwich and the actually BAME carer forum is fairly linked to Bromley, Lewisham & Greenwich Mind via the Community Wellbeing Hub.

For February our speakers were.

Dr Shubulade Smith CBE Psychiatrist from South London & Maudsley.

Dr Shubulade Smith CBE is a British academic and consultant psychiatrist at the South London and Maudsley NHS Foundation Trust. She is a senior lecturer at King’s College, London and Clinical Director at the NCCMH and forensic services at SLaM. Dr Shubulade is a heavy supporter of BAME causes especially due to her field and experiences, so it was an honour to have her engaged with BAME carers.

Danielle Perlman is a senior Project Manager at SLaM NHS trust and is passionate about engaging with the community with the South London listens project. More on that later.

We had other attendees some from other NHS trusts including Oxleas, West London and some from Manchester NHS trust interested in BAME engagement initiatives along with our regular BAME carer members. One of the members from Public Health Lewisham wanted to raise that part of her portfolio of work focuses on black, Asian minority ethnic and health inequalities. Which covers a range of issues, including mental health, and the kind of work that Lewisham Public Health are doing around COVID-19 specifically within their communities. This also being obesity and cancer as well. The Public Health Lewisham representative was interested to come to this group on a regular basis, and is available if anyone ever needs to contact her about anything that they’ve got regarding questions or queries about within the local public health.

Other reps were from disability advice Lambeth, those who attend the PCREF BAME network group and so on.

Dr Shubulade Smith Presents Importance of improving outcomes for the BAME community.

Dr Shubulade Smith felt she was asked if she present about the situation of the mental health of black people, How she feels it is a major concern for many of us. So she was going to give us a quick overview. But she was just going to talk about black mental health, what the issues are, and a bit about the impacts of social factors and racism. Where we then get time for questions. She hoped most of the attendees knew that there is a real problem, because there’s a profound inequality and that inequality exists for people from black, Asian and minority ethnic communities. This is especially for all people who, when it comes to mental health, are from ethnic minority groups.

Obviously, there are issues for people who have also have protective characteristics, as she pointed out, but there’s a particular problem for people from minority groups. And that is particularly that they’re over represented in crisis and secure services. And that’s especially safe for black people, but also underrepresented in treatment. So if you’re from a white British background, you’re twice as likely to receive treatment for mental health problems. And if you’re from a ethnic minority background, particularly if you’re from a Caribbean background, or if you’re from South Asian, South Asian background. One of the things to notice, of course, is that in fact, it doesn’t matter who you are actually, accessing mental health care is pretty difficult where Dr Shubulade showed us some stats.

Dr Shubulade concluded that one of the big issues the challenges for BAME community to be referred for, you know, psychological therapy or psychiatric care. Likewise, if you’re that Caribbean heritage, you’re much less likely to be offered improving access to psychological treatments as much as it should be. Dr Shubulade wanted to make these factors known because people to at least give an idea why outcomes are so poor for BAME community wellbeing and members understand what the issues are. The fact is that there are we know that there are many different factors that increase those froma BAME background developing a mental health problem.

Genetics and family history are important, including perinatal factors, that means all the things that happen around the time that we are born. So if your mother is exposed to certain toxins and viruses, the fetus might not develop in order to develop properly or there might be something that happens that impairs what’s called neural development. That’s the development of brain malnutrition, for example being malnourished doesn’t mean necessarily starving. It can be being deficient in certain vitamins for example, and obstetric complications. These are the if you like biological factors that increase your risk of developing a mental health problem. I put those in blue, because they’re fixed, there’s not much you can do about those.

Dr Shubulade pointed out that most mental disorders that we see, however, are related to other factors that are not things that necessarily have to happen. So trauma and physiological, physical, psychological, it could be a psychological trauma, could be a result of emotional trauma, physical trauma and sexual abuse, and adverse childhood experiences. Plus it could be things like having a bad accident or parents splitting up. These are adverse childhood experiences, early and or persistent substance use. Dr Shubulade mentioned that if you start smoking cannabis, from the time you’re in your mid teens, then the risk of developing a psychotic disorder by the time you’re 25 which is five to six times higher than usual negative life events as an adult.

CAUSES OF MENTAL ILLNESS

So when it comes to bereavement, job loss, moving house, homelessness, financial difficulties, all of these associated mental health problems, social isolation we’ve seen, particularly in the in the signs of COVID and how it impacts on people’s minds. Dr Shubulade just wanted to make sure that people had a better understanding of what goes on. People have massive fears about psychosis. When they hear the term psychosis, it’s often misunderstood. It essentially being detached from reality and it’s characterized by a person having delusional beliefs and or hallucinations. Dr Shubulade mentioned it doesn’t mean being violent or anything like that. delusions, inhibitions. hallucinations have very specific definitions. Essentially, a delusion is a false belief, it’s held with really strong conviction, despite the fact is evidence to the contrary. it’s out of keeping with the person’s cultural, personal, religious, familial background. Dr Shubulade continued with stating that a hallucination is when you have a perception in the absence of a stimulus, so you hear a voice, but there’s no one speaking.

There are different types of psychosis, you could get organic psychosis. So you’ve got a tumor sitting in your brain, and that affects a certain part of the brain, the limbic system, and that happens if you are taking drugs, and can lead to psychosis. Drugs can frequently cause many psychotic episodes and sometimes you can get a drug related psychosis or you get a persistent psychosis as a result of persistent.

You can have a schizophrenia type psychosis, that is psychosis characterized by particular types of conditions and particular types of divisions, you get manic psychosis when there’s a big mood component. So people are very high and elated and very grandiose can get depressive psychosis, where people are very, very sad and nihilistic and thinking that things are terrible, and everything’s going to just be horrible and die and they can become catatonic. You can get catatonia in schizophrenia and mania and depression as well.

The reason Dr Shubulade was just telling us this is because she thinks there’s often an assumption that psychosis is schizophrenia. It’s not just to say that the biggest risk for developing schizophrenia is a genetic one. In fact that if you have an identical twin, then you have an almost one in two chance risk of developing schizophrenia. Just in terms of prevalence, that means how frequently it occurs across the world.

RATES OF PSYCHOSIS IN BAME AROUND THE WORLD

Dr Shubulade mentioned we know that wherever you are in the world, where in white majority countries basically the prevalence of schizophrenia, psychosis certainly is 1%. Interestingly, that’s one in 100 people. And that doesn’t matter where you are. Interestingly, the lifetime risk in less developed countries is lower than it is in developed countries.

Dr Shubulade pointed out that very interestingly, it’s been found again and again and again, that the rates of psychosis in black people in white countries is much higher than you would expect. it’s higher than the majority white population. And it’s higher than this 1% prevalence and in the UK, for example, it is thought to be at about 4% to 5%. So one of the questions is, why is that? The problem is that people often say “Oh, This is schizophrenia.” But what we know, there’s been loads of debates about this over the years. And we know that unfortunately, those debates have kind of been so polarized, it’s either it’s been from one extreme to another, where it’s that people are being misdiagnosed full stop, and don’t have any mental health problems, any more than anybody else, to black people have schizophrenia, because they’ve got a genetically that they’re genetically predisposed to that.

Genetics and Schizophrenia

Dr Shubulade mentioned a study where they follow those people up for the next 10 years and what they found is that the rates of psychosis over time have changed. In fact, they’ve increased, but they sensibly looked at the rates of psychosis in different ethnic groups and the found was that there was a difference in the rate the change and in the rates of psychosis over time. So for the white patients the rates of psychosis have actually increased over time. Interestingly, the people of black Caribbean heritage, even though the rates of psychosis decreased, they’re still higher, but they had decreased over time. That was only a 10 year period. What that tells you is that that actually, these differences that we’re seeing cannot be genetic, because if it’s a genetic cause, then they couldn’t change in such a short period of time, because genes take hundreds and hundreds of years to change. They don’t change in a period of time in a short time together 10 years.

It’s likely that psychosis is heterogeneous which means it’s different types of conditions and number of conditions with similar features caused by different things. That means there’s a range of factors that combine to cause it, to push us into psychosis, there are different routes into psychosis, your genes might make you vulnerable. But just because you’re vulnerable to psychosis doesn’t mean it’s going to happen. If you’re born prematurely, it probably increases your risk. If you abuse drugs a lot probably increases the risk.

Dr Shubulade mentions something that relates to my mothers experiences

Dr Shubulade mentioned that we know now there’s a range of early social and psychological adversity, such as separation and parent being a migrant, growing up in a new difficult community. As the migrant grows up in a city being bullied or abused (think of 1960s racism). Basic equity and discrimination all seem to be associated with an increased risk of psychosis. As Dr Shubulade spoke of these terms, my attentioned turned to what my mother went through due to the above and how this could have contributed to her developing Schizophrenia in later life.

Dr Shubulade stated that for certain ethnic minority groups, it looks easy to go on to social media and chat boards, where you see people saying that they’re going to vote for sector services, because for help with eating disorders, it’s not that people aren’t attending mainstream services. E.g. For Attention deficit hyperactivity disorder (ADHD) those are higher rates and ADHD is something that is very commonly seen in people in prison. ADHD is the kind of thing that means that you can’t, stay on at school very well, and you have difficulties. But if you get help for it, when you’re young, you don’t end up being at the different school, you end up giving being given support. If it’s not recognized, you end up being labeled as a naughty kid and being expelled.

Where Racism fits in all of this?

So what about racism? Is that a risk factor for mental disorder, there of course are different types of racism such as individual racism which is personally mediated. We also have institutional and structural and is internalized, Dr Shubulade reminded us that individual racism is the overt or covert racism, it can be intentional or unintentional. Prejudice is based on the assumptions about the abilities, motivations and intentions of another person according to the race. Discrimination is the actions and behavior that you do against that person because of your negative assumptions about them. which can manifest as a lack of respect. So you know, shopkeepers watching you when you walk around the shop.

Dr Shubulade stated that as a senior doctor, it doesn’t matter when she goes to the shop, because of her race there can always be a situation where security follows her around because they think she will steal something. And that’s not, that’s simply because she a black female, devaluation being surprised at a person’s competence. This happens to her to a point of dehumanizing experiences, because people think that if you’re black, you must be super strong, like an animal or something.

Dr Shubulade reminded us that very recently, some really tragic instances that have happened in the nation, you know, what happened with Kevin Clark.

https://www.bbc.co.uk/news/uk-england-london-54709897#:~:text=Kevin%20Clarke%2C%20who%20had%20schizophrenia,as%20a%20%22fitting%20tribute%22.

COVID and Race

Dr Shubulade continued to point out that know lots more black and Asian people have been dying from COVID. And yet, we saw right at the beginning that that was kind of dismissed and not thought about why that might be. If it was thought, or maybe its genetic. I mean, I always like to use the term BAME, because I think that it kind of makes people forget that these are all different types of people, black people, Asian people, Filipino people, you know, do it Orthodox Jewish people have all had genetic differences. But there also was social factors. Dr Shubulade mentioned these are associated with an increased risk of developing mental health problems not just the COVID situation.

People can’t get access to health, work and social support, and if you get access to employment, it’s no employment or poor quality employment. Its difficult for BAME community to get access to the same medical services depending on the same environment that you live in. And very importantly, there’s a reduction in access to power. So there’s a difference in access to power, including access to information, the information about your own history, not just one part of it, and difference in access to resources that includes wealth and organizational infrastructure. And very importantly, access to voice your situation. Dr Shubulade felt that we have seen this very much in America in the leading up to the elections, where whole parts of electoral wards were discounted.

Not only just to say about social factors, but social structures that we have, which have been around for hundreds of years. People are used to them, they have become institutionalized.

QUESTIONS FROM MEMBERS

One carer member raised the point that it was an really interesting presentation, because there’s a number of factors in there that cross over into some of the work that they themselves had done previously. The carer was interested about the rates of psychosis that have decreased over that 10 year period. Is that drop those rates? Is that related to medication? Because medication has been changed? Or what was the reason for the drop?

Dr Shubulade responded stating that it is incident rates, so that what that means as in new cases of psychosis.

Another carer wanted to know what Dr Shubulade is doing to support the carers of the patient be it under psychosis or to stop carers from becoming the patient? And mostly, how is she showing that they’re being treated equally as carers?

Dr Shubulade pointed to The Patient Carer Race Equality Framework, she reminded us that the word “Carer” is in there. The way the patient care race policy framework works is that first step is you go out to the community to find out what their needs are. With SLaM there’s already work on partnership groups between each of the boroughs that SLaM serves. Those partnership groups consist of people who are people with lived experience for themselves as individuals, patients, but also carers as well. And in fact, there might be more carers than patients who are involved in each of the four groups. So already, there are carers who are involved in the engagement work. Some have been trained in some of the processes that you need to be able to understand how to make change. So quality improvement techniques, and committee work. and they are all involved in the different work streams. So one is about developing competencies. One is about engagement work. One is about dissemination.

The carer pressed the matter and felt the reason why they asked this question is that they never see many statistics on how carers are being supported. If you show them these great statistics regarding our service users when will there be statistics to show that carers are being treated equally?

Another carer member mentioned what she noticed in housing estates, going to school, seeing her peers, especially young black boys, who were extremely, highly clever, in the middle of their a levels, dropping out through mental health, getting schizophrenia, and committing suicide, it’s just unbelievable what she has witnessed. While this is going on, she mentioned the Dr’s evidence is based on percentages, so portion of people will have certain outcomes. And the problem is when you get the budget for this ever decreasing “moving” budgets, more equally of these different groups, what can happen, you’re actually moving smaller budgets. So your actual outcomes in numbers might actually even be less than. So people will then say to you, oh, well, you know, proportionately, you’re doing better. What’s your problem?

Another BAME member mentioned how they were heavily involved in SLaM’s PCREF meetings, but the crux of what came out today, for them is it’s never presented in the other PCREF presentations. There is not sufficient space for members to practice free speech, basically, because it’s very structured, because there are elements within these PCREF groups that still are being controlled. And still somebody having more power than the people that the measures are supposed to be impacting, or they’re supposed to be engaging with, which means decisions are made. And so we are not aware of because the system has an agenda. It is like SLaM has to get things done in a timely fashion. And if we as business people, other people, and other things don’t have the time, because it’s not a full time job. We’re not included.

The BAME member went on to conclude, that even as a community leader, the people are heading up and running, setting the agenda that disseminates the information. Because as if we don’t have the resources, because we’re all giving our time for free. What we’re hearing through these meetings is that they’re recruiting activists, there are forms that everyone has to sign up to, to say that we’re an activist, and that’s what they are hearing about a lot. When they asked for what’s their definition, Slam’s definition of an activist, there just does not seem to be a definiation

The forum member felt offended when they heard “join us” at the peak of activism thinking, a lot of us have been doing activism all of our lives. We’ve been doing this all of our lives and so to hear such a corporate organization say to them after so many years was offensive.

Dr Shubulade felt it was the community driving the PCREF project, but did insist that members of the PCREF group not give up on engaging with SLaM. Dr Shubulade felt PCREF is a competency framework and the idea for it, is that it is a how to make to make a difference that the BAME forum member mentioned was like building up assets in the community and having the community lead or work together with SLaM. Dr Shubulade felt there is some way to go, but we can all make a difference.

Dr Shublade concluded that she need to tell the group that right now, there has never been an opportunity like that is now to make a difference. And she would ask people to persevere. She feels it’s not a straightforward process and it is a new, although the idea aren’t new, but the process is different and it may be something that there’s always going to be someone who seems to be driving it and that someone isn’t always it ought to be. But gradually over time, things will change.

Danielle Perlman presents South London Listens

Danielle started her presentation by commenting on how she feels Dr Shubulade is amazing. And she was really taken aback by seeing her presentation and hearing all the engagement in questions. So in a way, she is very glad that we spent more time on on PCREF. And talking about it because she thinks it’s such an important piece of work.

Danielle wanted to engage the BAME carers group on the ‘South London listens’ project

Danielle also wanted to give a shout out to Brenda because she made a friend last year when Brenda did Mental Health First Aid training together. Since then they have kind of been each paths having crossed last time they met when in the Lewisham ‘South London lessons’ event which was held by local leaders in in collaboration with ‘CitizensUK’.

Daniele then described who are citizens UK, they are a community organizing, and national charity, and working on bringing people together to share stories and experiences to bring the change on what matters most. So what they are talking specifically in South London listens, which via the ongoing pandemic we are all experiencing and how that is impacting not only our physical health, but mental health within our communities.

Danielle wants to be asking key questions around what in relation to pandemic is putting pressure on communities mental health, and what can we do to support our communities. South London Listens came out of a number of sites that we that we held last year to work on engagement not within our SLaM services, but within communities. This is so when people are starting to experience a decline in the wellbeing, what can we do to be more supportive? Because that was on one of our psychological resilience. So far We’ve listened to 4000 people across the whole of South London, including SWLSTG NHS Trust and Oxleas NHS Trust. Essentially, when we say we’re listening, it means that people have been trained in the techniques of community organizing. So we’ve trained 350 people in the methodology of listening.

Normally, we’ve all been online, since usually we would be fully face to face, but it’s not in person or house meetings. Moving on Danille wanted to asktwo key questions where we give everyone in the group the same amount of time to contribute. The BAME carer forum moved on to a workshop where members contributed to the following questions.

The first question that was asked is in relation to the ongoing pandemic and lockdown that we’re experiencing and thinking about our well-being, what has been putting pressure on you, your family and your community?

The second question was what could really what could relieve the pressure and each of us would take a minute to contribute and to share something about our experience around the 2nd question.

Joint Southwark & Lambeth MH Carers forum February 2021

Welcome to february’s Southwark & Lambeth MH carers forum update. This forum is aimed at those who care for someone with a mental illness. The forum gives families and carers a chance to understand the complexities of mental health and social care services.

For February, we had the following speakers who were kind enough to have a chance and engage with carers, even if it ended up as a friendly debate. Although the forum represents Lambeth & Southwark carers, membership is open to many carers outside those boroughs, because I feel carers should network, connect and learn from each other.

The following speakers for February were.

  • Lee Roach who is the SLaM’s Occupational Therapist and carer lead for Lambeth inpatient wards
  • Rebecca Martland who is a PhD Researcher and Physio engaging with carers on the High intensity treatment exercise
  • Sam McGavin & Sophia Stevens from Southwark Council developing Southwark’s carers partnership
  • Annette Davies who is a carer working towards developing stronger networks to carers including a BAME carer group.
Continue reading

Lewisham BAME MH Carer Forum January 2021

Welcome to the first January Lewisham BAME carer forum for 2021. The BAME carer forum is one of the 6 carer forums I run once a month. The carer forum runs online to adhere to covid-19 restrictions and allows members to attend a lot more easily.

The BAME Mental Health carer forum is aimed at BAME carers who are caring for someone with a mental illness, especially for someone using the services of South London & Maudsley, although I am not super strict who attends the forum since carers from other forums and boroughs often attend.

On the January agenda were the following.

  • NHS England presenting on their National Patient Carer Race Equality Framework (PCREF)
  • SLaM presenting on their Local drives for PCREF
  • SLaM older adults diversity drive

We were joined by Staff from Oxleas as well as Manchester NHS Trust who are also seeking to engage and improve services for the BAME community.

A representative from Public Health Lewisham also attended as well as carers, black mental health activists and researchers.

NHS England & Improvement presents PCREF

Husnara Malik the Programme Manager for National Mental Health Team presented on “Improving Black, Asian and minority ethnic community experiences of mental health services”.

She spoke about the Advancing Mental Health Equalities Strategy which outlines the short and longer-term actions NHS England and NHS Improvement, which will advance equalities in access, experience and outcomes in mental health services. The Strategy builds on the 8 urgent actions health systems must take to advance equalities in the round, referenced in the Phase 3 COVID-19 response letter.

The Key objectives of the Advancing Mental Health Equality Strategy are

  • Developing the Patient and Carers Race Equality Framework (PCREF).
  • Investing in advancing mental health equalities via transformation/pilot sites.
  • Sharing evidence where it emerges.
  • Developing a Provider Collaboratives impact framework.
  • Improving the quality and flow of data to national NHS datasets.
  • Using headline measures of mental health equality to monitor change over time, at both national and local level.
  • Supporting the development of a representative workforce at all levels, equipped with the skills and knowledge to advance mental health equalities.

The aim of the PCREF is to improve the way organisations deliver mental health services so the experience of Black, Asian, Minority Ethnic patients and carers improves; to the end of making services more accessible, and to improve the health outcomes for Black, Asian, Minority Ethnic patient and carers.

But What is it?

The PCREF is an organisational competency framework that values the voices of racialised communities’ lived experience to help service improvement by providing more culturally appropriate care. It is a practical tool which helps organisations to understand what steps it can take to achieve practical improvements.

Components of the PCREF

  • Part 1: Statutory and Regulatory Obligations

An outline of the core statutory and regulatory obligations the PCREF will support Trusts to fulfil, including (but not limited to):
Human Rights Act 1998
Equality Act 2010
Workforce Race Equality Standard (WRES)
Use of Force Act 2018 (The Mental Health Units)
CQC Inspection Criteria well led

  • Part 2: Organisational Competencies

Core ‘competencies’ culturally-responsive services should demonstrate (see next slide)
Guidance on how to identify and additional, local competencies
Advice and support on how to build these competencies

  • Part 3: Assessment and Feedback Tool

A Patient and Carer Feedback Mechanism, to be supported by a benchmarking tool, which tracks progress over time

So far the Steering group formed, consisting of experts by experience and 4 PCREF Pilot Trust partners – Birmingham and Solihull, Greater Manchester, East London and South London and Maudsley Trust.

They Held deep-dives into differential BAME experiences within mental health service pathways

Building on the above, and the Mental Health Act review, identified 10 potential organisational competencies

Started engaging with patients and carers on these potential competencies, with further engagement in the pipeline

How can people with lived experiences including volunteers get more involved with mental health services to help improve the outcomes and experiences for BAME communities?

NHSE&I currently have a number of people with lived experience as patients/carers co-developing the PCREF. NHSE&I also believe it will be critical for the PCREF to be developed in partnership with local communities, with lived experience informing its development and ongoing evaluation. They expect ‘co-production’ will be one of the core competencies of the PCREF itself. This means we would expect Trusts to have clear and transparent ways of working with diverse communities to inform service improvements, and how they are evaluated

NHSE&I aim to achieve this by holding more engagement with specific groups i.e. older people, people with a disability and other groups in the development process (accounting for intersectionality). In addition, they will be rolling out a more targeted questionnaire on the competencies in the PCREF Pilot sites early in 2021. Our Pilot sites will be focusing on more ‘in-reach’ models of engagement like targeted workshops and focus-groups as part of this

Zoe Reed SLaM Non-Executive from the board presents

Zoe explained the key principles for developing reponse to the fact that we know that many black service users and carers don’t get equal access to mental health services. So the principles SLaM are using are the joint leadership SLaM and the BAME community between each program on PCREF that they were building towards their database

Zoe mentioned their will be joint chairs at every level between the community and SLaM on the new PCREF initative. So this is the program that SLaM are working towards at the beginning of phase one for this year. SLaM are now is really looking at the data and trying to get an understanding about what the data is, and how that might lead them to think where are the gaps for black people using their mental health services?

Carer questions

Some members were interested in attending the community PCREF events hosted by SLaM and the BAME community, so there were a few questions regarding this. Other question on if SLaM were going to involve the carer centres where BAME carers also use their services.

SLaM Older Adult services Presents

This was a shorter presentation on how Older Adult services were also looking to engage with the BAME community on memory services. There has been a lot of engagement with the organisation Black Thrive in Lambeth and Southwark, but there needs to be a way to engage in Lewisham.

This concludes the January BAME carer forum for 2021

The Fircroft Trust urgent appeal

The Fircroft Trust are devastated to have been informed by RBK, without consultation or notice, to vacate our beloved Mental Health Resource Centre on Ditton Road.

The Fircroft Trust has leased this building for over 40 years and provide a haven for over 75 people who have varying degrees of mental health challenges. At a time when there is a national crisis in mental health, withdrawing this essential support system, which has not only been shown to improve quality of life for the individuals who accessed it, but also reduce hospital admissions and suicide rates, has been devastating for our local community.

The Fircroft Trust has worked hard to minimise the impact of the pandemic on the people who rely on their service and have continued to support the community by maintaining daily contact with their most vulnerable service-users, either via telephone, outside group activities or ‘COVID-friendly’ garden work and meet-ups. However, the impact of the pandemic has meant The Fircroft Trust faced increasing demands for their service from vulnerable members of our community. This is something The Fircroft Trust can’t ignore and they urgently need your help.

How you can help

Services needed by our community:

The Fircroft Trust are urgently seeking new premises in the Chessington, Surbiton or Tolworth area that would be suitable for us to resume the face-to-face support services that is so missed by our service users.

If you can help, or know of a local building, please contact Kay Harris on the details below.  Please share this with your network and help us to continue supporting the people in our community who need us most.

The Fircroft Trust

Tel:         07885 771571

Email:     office@thefircrofttrust.org

http://www.thefircrofttrust.org

Black Thrive Employment Project: improving outcomes for Lambeth residents with long-term conditions

Black Thrive is a partnership between communities, statutory bodies, voluntary organisations and the private sector. We work together to reduce the inequalities and injustices experienced by Black people in Lambeth.

According to the GSTC “One to Many” report, more than 1 in 5 residents in Lambeth live with at least one long-term condition. Over 19,000 live with multiple long-term conditions (three or more). Even though Black communities make up 18% of Lambeth’s adult population, they account for 27% of people with multiple long-term conditions. Furthermore,

in Lambeth, Black residents are four times more likely to be unemployed than white residents. When they are employed, they are disproportionately engaged in insecure, low-paid and dangerous work, which harms mental and physical health. In addition, Black people can face racism and discrimination in the workplace, which negatively impacts mental well-being.

Therefore, we know that people of African and African Caribbean descent in Lambeth are more likely to be unemployed and more likely to have poor health. One of the key drivers of these inequalities is structural racism and the fact that our current healthcare and employment systems prevent Black people from thriving.

As a result, in collaboration with Guy’s and St. Thomas’ Charity (GSTC), Black Thrive’s Employment Project is developing community-led solutions for improving employment outcomes for Black people with long-term conditions. Our goal is to ensure that Black people in Lambeth with long-term conditions are as likely to be in and sustain, meaningful employment as equivalent white people.

To do this, Black Thrive is partnering with community members, statutory bodies and local organisations to achieve justice for the Black community through radical systems change. In September 2020, we launched our £300,000 grant fund to pilot projects that consider the lived experience of Black people with long-term conditions and have the potential to create systemic change. Projects should test and pilot new ideas that have the potential to shift the dial on employment outcomes and improve the evidence base around what works for Black people in Lambeth with long-term conditions.

The fund was managed and distributed by our Employment Working Group; a group of local Black residents with lived experience of managing one or multiple long-term conditions. We believe that prioritising community-power and lived experience is a radical way of funding new and exciting initiatives that may be overlooked by the traditional system. After receiving 84 applications, the Employment Working Group decided to fund 8 projects – the vast majority of which are led by Black and disabled people.

Funded projects include a radical self-care and wellness to work programme, the creation of a network of Black social entrepreneurs, supporting those recovering from mental illness and substance addiction back into employment through dog day-care traineeships and empowering Black people to develop employability skills through social action. To read more about all 8 projects please visit: https://employment.blackthrive.org.uk/our-grantees/

As the projects begin recruiting participants, it is important we ensure that the opportunities available reach the most marginalised people. This is a form of systems change in itself, as it will allow those people who fall outside of traditional referral pathways for services to still access support. 

Given that carers have an intimate and trusting relationship with their loved ones based on an acute understanding of their needs, interests and goals, they are a vital network which cannot be overlooked! We strongly encourage all Lambeth-based Black carers to review the projects on offer, share them widely within your networks and follow the sign-up process if you, or someone you know, is interested in taking part.

If you have any questions about the Black Thrive Employment Project, please email: employment@blackthrive.org.uk

Black Thrive Employment Project Grantees

Patient and Carer Race Equality Framework at SLaM

Welcome back and thanks for stopping by. Have you ever heard of PCREF? There was a blog about it in 2019 regarding mental health inequalities for black people. Mental Health outcomes for those from the Afro-Caribbean community has been very poor for a long time. So there has to be some form of change, but how can this go about? I think it starts with the community and a way for black people to come together and query how mental health services and support the community.

The blog about health inequalities from NHS England is below.

https://www.england.nhs.uk/blog/how-can-we-have-the-same-outcomes-when-were-not-having-the-same-experiences/

South London & Maudsley short for SLaM are one of the mental health trusts looking to work with the black community on ways to support wellbeing and close the inequalities gap.

I recently made a short video as an intro into black health inequalities, although its not going to be the only video I am working on.

They are looking for members of the Black community to attend a series of events SLaM call ‘Fit for Partnership’. These events well focus on four boroughs they run services.

  • Croydon’s Black Community:  Tuesday 19 January, 6pm – 8pm:  Register here
  • For more information email:  CroydonIAG@bmeforum.org  

There will also be a Black service users and carers event, where details are below:

Four borough Service User and Carer event:  Thursday 4 February, 1pm – 3pm:  Register here 

For more information email PCREFapproach@slam.nhs.uk 

Lewisham Mental Health Carers forum October 2020

Welcome to a brief update on the October Mental Health carers forum for Lewisham. I have been so busy of late, that I did not have much time to do any writing. For the carers forum, the guest presenters were Carol Burtt who is a Consultant Clinical Psychologist for Lewisham and she spoke more about IAPTs in Lewisham.

We also had Susan George from the CQC who inspects GP services in Lewisham engaging and updating carer members of the forum.

Going back to Carol, she spoke about how the service IAPTs provides are primary care where they essentially provide help for people with mild to moderate psychological difficulties such as mild to moderate depression and or anxiety. Anxiety might include panic attacks, or a state of worry. Carol talked the group through such symptoms like generalized anxiety disorder, social anxiety, health anxiety, some OCD, obsessive compulsive disorder, some relationship difficulties that might be leading to depression or anxiety.

Carol spoke about how mental health can cause some relationship difficulties that might be leading to depression or anxiety. So in fact, it might be more likely to be something that carers might experience themselves rather than the people that they are caring for. Carol then talked about how busy the service is, being that they had 880 referrals last month and they processed about 600 people who were seen last month.

For people to access IAPTs, you can get a telephone assessment within a few days, and this is what IAPTs is aiming for at the moment so that we can have a rapid response to people’s referrals. This is so people can get to speak to a clinician within a week, and a chance to talk about explaining the difficulties. People can get referred and then get directed to the most appropriate treatment.

Certainly last year, SLaM IAPTs did increase a lot of digital input so that people can actually have some treatments via online programs, which SLaM call computerized CBT, which could be an initial treatment. Carers can access that very quickly. So people can start such treatments within a week of having had your first telephone assessment with somebody. So that’s the benefit of that. Carol mentioned that IAPTs online is obviously not for everybody, some of the us know, that some people will want to have a direct face to face contact at the moment, obviously, with the COVID situation where SLaM working remotely.

Carol then explained more about the service as in how people are allocated to a psychological well being practitioner, SLaM have about 20 of those clinicians which Carol manages herself. These clinicians have had a training in a low intensity CBT cognitive behavioral therapy, so they’re trying to provide what we call Guided Self Help.

Carol then gave us an example of how people would have access to these different programs. One would be for depression. One would be for anxiety, one for social anxiety. The person would have some tasks and some information that they would have to deal with each week. Then each week, it finishes with checking in with person, either online or by telephone to see how you’re getting on.

Still, if people felt that their mental health was a bit more complicated, and SLaM felt that you need it, then any input with a psychologist or a cognitive behavioral therapist, or a counselor would be a three to four months, wait a moment.

Carol also explained that before the COVID situation, they were providing face to face workshops in groups where people actually attended their clinics, but since the pandemic has affected things, they are now looking at more online groups and workshops. Carol reminded us about our BAME forum where her colleague, Elaine presented and how she is leading on the development of some workshops, particularly for local communities in Lewisham.

QUESTIONS FROM THE CARER MEMBERS

A number of questions were asked of Carol from our members. One of the group members was interested in the following question on if the IAPTs service helps those with addictions when people have got the problems and they’re addicted smoking, drinking alcohol, or even taking illegal drugs?

Carol responded that they do is make an assessment as to whether addiction is a primary problem, or even if addiction is the biggest problem or there’s an element of depression and anxiety. For example, somebody who’s got a very serious drinking problem or significantly problem, then they would advise them to go to a specialist addiction service. Carol also repeated that they are trying to look at different ways in which people can access this help earlier, as soon as possible. They are looking at providing these online interventions, and online workshops as soon as possible so that people get some help. Very quickly, before I can say, for such problems develop further.

Another carer queried the struggles they have when the cared for has trouble accessing the service, especially from a mental health trust. The carer does not want to intervene, but notices how difficult it is for the caree to get lost in trying to access IAPT services. Carol mentioned that unfortunately, it’s the way things are organized. And they have a secondary care psychology that is very separate from primary care. So they don’t provide a service for people who’ve been admitted to secondary care psychology, which is a separate.

Another carer made a statement rather than a question and pointed out that she was referred to IAPTs on a series of six well-being workshops. She felt that the CBT there, she didn’t find that useful because it was too general.

CQC PRESENTS UPDATES

Susan from the CQC was listening closely to what carer members questioned or queried. Susan felt that its really important for representatives from CQC to hear our stories, and she really appreciates everything that was mentioned today. Susan continued that it’s also important because she is an inspector of GP Practices and part of her job is to ask providers what they’re doing in terms of providing care and support for carers. So it’s vitally important for her to hear carer members own experiences.

Susan mentioned that there was not too much time, but she would do just a quick summary of things she has been involved with, and what the CQC are doing at the moment. The CQC are looking around at communication with patients and patient populations, particularly with carers. The CQC are looking at a number of scenes of regarding the pandemic and how services have communicated with people.

Since the GP practices has started to shut their doors, the CQC are interested on what the GPs do to open up again, what are the GPs doing to tell people that they are open again, that they’re available for routine appointments? How are they telling people about the services that are available?

The CQC are also looking at sorts of communications, the CQC are looking at how GPS are maintaining equality of access or equity of access for people. There has been a huge change digitally in terms of the type of appointments and consultations that people will have. Not everybody is fluent in English or has access to digital means of equipment or resources.

Susan pointed out that some people who may find that trying to navigate their way through this new online world of appointments is baffling and terrifying. So the CQC are also looking at developing, how they talk to the GPs during inspections. The CQC are interested in what the GPs are doing to make sure that they’re communicating clearly with patient’s about the changes to appointments. Explaining to patients about the difference on treating for an emergency appointment, an urgent appointment, a routine appointment. There is a lot of assumptions that everybody knows all these phrases mean.

Susan updated us that the CQC have just published the “State of care 2019” for 2020. The report is available on the website, however Susan kindly sent us the link in the online zoom session.

The report is especially important because it pulls together some of the themes that the CQC have been looking at during COVID-19 and also pre COVID. The CQC are looking at some of the gaps in access to good quality care, especially mental health care. The CQC are also looking at the themes around system health inequalities around support and care for our better communities.

The CQC are also looking at communication and are interested in conflicting messages or conflicting nasty messages and guidance. It’s not always clear for patients and the CQC are interested in how GPs are engaging with their BAME communities.

Other things Susan pointed out was that the CQC have been working on questions about safe care and treatment and about the support for people living with mental health illness. The CQC are also asking providers specifically about how to be monitoring carers health and safety during the pandemic, have they been maintaining their registered unpaid carers and so what steps have the GPs taken to enhance the identification and management of the mental health issues of people living with mental health that includes people with dementia.

There were a lot of questions from the forum regarding the state of carer registers, some members are aware of the pressures GPs are under especially with new contracts, but others are keen to see where carers are being referred to and if social perscribers are doing their role.

HEALTHWATCH LEWISHAM ENGAGES WITH CARER MEMBERS

Healthwatch were there to listen to carer members regarding health services.

Healthwatch Lewisham are an independent charity. They are the patient champion for people who use health and social care services and so they listen to people on what’s going well on health services, what’s not going well.

Healthwatch Lewisham collect that feedback from patients and then at the end of every quarter they analyze and report back. Those reports are presented to sort of people in the borough of Lewisham that have the power to make change happen to like commissioners.

Healthwatch Lewisham also do project work and one of their recent projects was looking at the impact of the COVID-19 on Lewisham residents. That report has now been published. Healthwatch also has an advocacy service. So if anybody has complained about NHS service that they’ve used, and they can go through their advocacy service. So far healthwatch Lewisham have three advocates, and they basically help people through navigate the health system.

The reason Healthwatch Lewisham were at the forum was because they wanted to gather some feedback from people’s experiences with health and social care services. They were interested in feedback regarding GPs, hospitals, pharmacies, dentists, opticians, mental health services, Community Services, basically anything that carers and the person they care for has accessed.

Healthwatch Lewisham were kind enough to recognize that it’s a group environment and sometimes people don’t feel comfortable sharing their experiences. So even after the forum, members could feedback via the healthwatch email or site where they sent the link.

CARERS FEEDBACK TO HEALTHWATCH LEWISHAM.

Many of the group members fedback experiences on the following.

1) Lewisham Hospital
2) GP appointments
3) Positive aspects of using GPs
4) Dealing with receptionists
5) Dental appointments

This was the update for October at our Lewisham Mental Health carers forum.

Joint Southwark & Lambeth MH Carers forum October 2020

Here is the brief update of the October Joint Southwark & Lambeth Mental Health carer forum. This is one of the five carer groups that I run per month. The carer forum is an engagement & empowerment group for carers to learn more about mental health services and at least query what is on offer.

SOUTHWARK HEALTHWATCH UPDATE

As usualy the group is supported by the local mental health trust South London & Maudsley, we also had southwark healthwatch in attendance as well as both Southwark Carers and also Lambeth Carers. Lastly both the engagement leads of Lambeth & Southwark CCG were to be in attendance, although only Southwark CCG could make it, due to Zoom blocking Lambeth CCG. It must be noted that the 6 CCGs are now merged into NHS southeast London clinical commissioning group, so its not always clear who is from what (more on that later).

The forum was co-chaired by carers Ann Morgan (Lambeth) and Annette Davis (Southwark). Our first update was from Southwark Healthwatch who are interested in the experience of those waiting for hospital treatments, like for surgery or chemotherapy, anything in a hospital. Southwark Healthwatch are doing that through phone interviews or online chats in a group, whichever people feel the most comfortable with. They just want to hear from as many people about how waiting times in hospital has impacted them, and what could be improved. Southwark Healthwatch are also interested in how the waiting times affect mental health and I suspect on how badly covid-19 is affecting waiting times in hospitals.

Members are very interested to see the outcome on feedback from Kings Hospital trust and Guys & St Thomas hospital trust on waiting times.

LAMBETH CARERS UPDATE

Ann morgan then introduce Josh Simpkins from Carers Hub Lambeth to talk more about the Lambeth Carers Card, which came from the Lambeth carer’s strategy. Josh mentioned that they made a recording of the launch, which is on their website, YouTube channel and facebook. Although at the joint forum he was going to do a bit of an introduction and background on the scheme itself.

The card scheme itself helps with emergency planning for carers, which is especially prevalent today due to the covid-19 situation. Josh also talked about how the schemes template on how a carer can use the template as a process to quickly make use of resources if the usual carer resources were unaccessible.

Josh talked more about the carer’s strategy, but members are hoping to hear from Polly on any developments for carers in Lambeth. There is still a hint of jelously from myself as I feel Lewisham has a way to catch up in regards to a carers strategy, what impressed me futher is the strategy is taking shape even during covid-19 as the Lambeth carers care helps protect against dwindling resources. A governor at the forum actually asked if the card was either Southwark and or Lewisham, but unfortunately its only for carers in Lambeth. We can only hope the other boroughs can emulate the successes for carers in Lambeth.

Ann Morgan queried if there will be a card for young carers, which was an excellent question since young carers can be forgotten when it comes to developments and projects. I personally think due to the lack of young carer empowerment groups, its harder for young carers to get a voice, so its often older carers who may try and speak up for young carers. Josh from Lambeth carers hub mentioned they were brain storming ideas to help young carers in Lambeth and so we should watch this space.

Josh did mention another thing regarding young carers is that when he went in with, with his colleagues into Lambeth schools. They found that young carers wanted space to get away from their peers and connect with other young carers in a different space, rather than just the other pupils in the school. There was more to this than connection purposes, but it certainly was a start on the needs of young carers. Josh mentioned there certainly was discrimination on young carers at school, which many at the joint forum were aware of.

It was also mentioned from the Southwark Carers inpatient lead that what strikes them is that the carers card links everything together. Although there will be times when obviously, the carer is overloaded and might not know where to look, but its really impressive as the Lambeth carers card puts everything together. He hopes we could do something similar in southwark because he feels there are lots of pockets where carers cannot find resources, so it would be great to get everything under one avenue.

SOUTHWARK CCG – South East London Clinical Commissioning Group UPDATE

Next we had Bola Olatunde from the Southwark CCG group engage with carers on how they were working to support mental health and carers in the 2 boroughs. Bola first explained that there is no Southwark CCG anymore. They became NHS SE London CCG from the 1st of April 2020. So they were Southwark CCG up until the 31st of March, then six independent CCGs came together and then joined as one NHS southeast London CCG from the first of April. Those were Southwark CCG, Lambeth CCG, Lewisham CCG, Greenwich CCG, Bromley CCG and Bexley CCG. As of the summer, the South East London Clinical Commissioning Group has been heavily supporting the carers groups since I am active in Lewisham, Greenwich, Southwark & Lambeth, although there are plans to expand BAME carers in boroughs I am not active in, depends on my time.

Bola explained the to carer forum that they are now borough teams, but we don’t have six CCGs anymore. So they are the southeast London CCG. Bola was here to just to let us know that the team is still here and if any updates or developments are taking place then they will seek to engage with us. Bola posted some information in the chat box of ZOOM to raise awareness for the flu vaccination if people are eligible and to to remind them to book their appointments with a GP practice or local pharmacy.

There were a lot of questions from the group members on the nature of the new CCG structure and who does what within the new development.

SOUTHWARK CARERS UPDATE

We had an update from Mary Jacob who is the chair of trustees from Southwark Carers and also a carer, she updated the joint Southwark & Lambeth carers forum on what Southwark Carers is doing. Mary mentioned that at the moment, Southwark Carers at looking at their premises and how they are going to continue giving the best services that they can under the restricted funding they are having. Southwark carers still need to get confirmation with Southwark about how much funding they are to receive and when they are going to be funded till.

Southwark carers

Southwark carers are at least very grateful for the support they are getting so far. Currently Southwark carers are continuing with their services to all ranges of carers in the borough. Southwark carers are in partnership with a fair shares Co-Op, so they are still providing food parcels to the carers who win the most who are in the most need. Southwark carers are also still providing online activities, including exercise classes, salsa classes and also a film club. The last film that was shown during Black History Month, was the film Black Panther. The Film Club not only provides the film a source of entertainment and social contact for carers.

They are also going to continue with their cultural events right the way through the year, not just in October, they have a program of events that’s now being finalized, including sharing different recipes from different countries and different festivals including celebrating Diwali, celebrating Hanukkah, celebrating all the different cultural festivals.

Southwark carers are also going to have mindfulness classes online and they are looking at how to reach carers that may be find it difficult to get onto zoom.

Another Southwark Carer trustee present at the Joint Southwark & Lambeth forum mentioned that lots of carers aren’t IT proficient and it is documented that carers are to face real challenges in regards to finding time for self care.

So with self care being much of a priority and looking at the 360 overview of carers responsibilities, southwark carers are having to look at how they are revising their service to actually be more accessible in light of covid-19.

UPDATE FROM SOUTHWARK INPATIENT CARERS LEAD

We then had an update from David Meyrick the inpatient ward carer lead for Southwark under South London & Maudsley. Currently he mentioned they have taken steps regarding wards and have revisiting them such distance measures. They have found that there was different arrangements across the wards that were visited and they were just concerned that might be a little bit inconsistent, especially if you had a loved one readmitted and found it difficult to visit the ward. So SLaM have taken the steps forwards across the five wards that obviously needs to be booked in this way, it makes things a lot safer. So the staff can facilitate two visits a time but in the same bubble, is keep it safe that way. David thinks it’s been working well, so far.

David is aware that some inpatient wards are reluctant to do this, because its not always possible to just spontaneously support the patient and the visitor. however he feels it’s just in the best interest of all. So crisis support is working well. Plus they have set up virtual cave surgeries towards information provision, inside work, and, and running cameras to support carers and patients. They have a monthly, a weekly support group that runs and I’m sure and that’s providing emotional support and peer support that carers need.

Annette co-chair of the joint forum and carer herself mentioned that since she started working with David carers attend the group regularly every week. Annette felt she can actually see the difference and what the most significant things for carers is they want to be heard.

UPDATE FROM LAMBETH HEALTHWATCH

Lastly we had an update from Lambeth Healthwatch in what they have been doing since the last meeting.

Mental health of young people

Transition of young people with mental health needs and learning disability. We are looking into the transition pathway for three cohorts of young people: young people known to Children and Adolescents Mental Health Services (CAMHS); young people who have complex needs known to SEN team; and young people who have social and emotional issues not meeting the criteria for secondary care or not accessing service. We will interview young people, their carers/parents, and health and social care professionals. We will also hold focus group discussions with different groups of young people.

Young people’s mental health and emotional wellbeing needs assessemnt – We are in the task and finish group of Lambeth Made. The group will investigate and analyse mental health needs of young people in Lambeth. This assessment will go beyond reviewing existing need but will also look at the protective and risk factors that influence mental health, modelled on a life course approach from maternity through to young adulthood. The findings of this assessment will feed into an overarching strategy to transform the offer of mental health and emotional wellbeing support we provide to CYP and their families; focusing on promotion and prevention, right through to specialist provision, seeking to uncover and address any unmet need. This needs assessment will replace the joint needs assessment carried out by Lambeth and Southwark Public Health Team in 2013/14 and will be informed by The Young Lambeth Emotional Wellbeing and Mental Health Strategy and Plan 2015-20.

Campaigns regarding world mental health day

Lambeth Healthwatch hosted an event to mark World Mental Health Day 2020 on 7th October which was well attended. They will be hosting more of these regular online events which are open for anyone to attend.

There will be a Webinar next week on Wednesday 4th to mark National Stress Awareness Day.

I asked if they was any updates from Lambeth HW MH lead.

Lambeth Healthwatch responded that there is ongoing work with Lambeth Hospital to support staff and service users with the move to DBH. Planning some remote engagement sessions in November. The sessions will be aimed at understanding the views of hospital staff and service users on the development of Lambeth Hospital.

Lambeth Healthwatch are also involved in several projects looking at maternal mental health and the impact of Covid pandemic. In particular, they are working with King’s College Hospital and partners from different organisations to access women who are expecting or have given birth during the pandemic.

Lambeth Healthwatch are supporting the Adults Safeguarding Board in planning a workshop to mark Adult Safeguarding Week 2020 on 19th November 2020. The event’s theme is Safeguarding in our Community and will explore how we assess safeguarding issues in a digital world.

The last update from Lambeth Healthwatch is that they are supporting the Care Quality Commission to promote its campaign. They will interview six service users (2 people with learning disability, 2 older people, and 2 carers) from which they will write case studies and record a short video of each service user’s experience. They will also ascertain the success of the campaign after publishing the videos.

This is the October update from my Joint Southwark & Lambeth MH carers forum. If you are caring for someone with mental ill health in Lambeth or Southwark, check out the next dates of this carer forum at the following page.

https://caringmindblog.com/mental-health-events/

We Coproduce October forum 2020 – A Caring Mind book Section

If you have been a regular to visiting my blogsite then I am sure you have seen a few blog posts about the fantastic mental health forum over in West London. Taken from their website “We Coproduce CIC is an award winning social consultancy, owned and run by local people for people who care about the future of health care in the UK. They are commissioned to work with local communities to coproduce better and braver solutions to health and social care challenges.”

We Coproduce do a lot more than run their forums over in Hammersmith & Fulham, Hounslow and Ealing. Over many years they have worked closely with the mental health trust West London NHS trust on improving mental health for the community. For the October forum facilitated by both Jane McGrath and Natalie Louise there were many exciting speakers.

One of the speakers was myself where I talked about my new book “A Caring Mind”. You can see the talk I gave from the video below.

Matthew Mckenzie speaks about his new book – A Caring Mind

The book “A Caring Mind” shines the spotlight on the carer’s experience when caring for someone with a mental illness. Often carers stand in the background and carry on supporting their loved ones because of duty, love and just being there.

I felt it is about time I put my thoughts down in a book and We-Coproduce along with West London NHS Trust supported the work I was doing.

You can get hold of my book on Amazon either in Paperback or Ebook.