Welcome to my February update of my Carers forum for Lewisham by former mental health carer Matthew McKenzie FRSA. This forum allows those who care for someone suffering mental illness to get togther, network, gather information and get engagement from Health & social care services. I also allow for particular speakers on carer empowerment, carer’s rights, advocacy, campaigning and discussions.

For february our speakers were

• Charolette from Healthwatch Lewisham
• Cath Collins from South London & Maudsley
• The new Lewisham service user network
• Plus Wendy Dewhurst who is the General Manager for Lewisham Community Services (SLaM)

Charlotte Bradford from Healthwatch Lewisham presents

As you can probably tell from my previous blog posts, Healthwatch tends to listen and engage with my carer groups every so often. I am thankful for healthwatch to also help promote my carer groups to spread the word. Charlotte who is a project officer from Healthwatch Lewisham remembered attending one of my carer groups before Christmas, and this is her first into 2022. Charlotte oversees a number of different reports that healthwatch Lewisham produce on a yearly basis.

The most recent one that they published on their website is the digital exclusion report. Healthwath Lewisham spoke to a number of residents to hear more about their experiences over the past 18 months with accessing health and social care services. This will help Healthwatch Lewisham look at what their priorities will be for this year. Plus they will be focusing on the next report where they will be conducting a number of interviews on visits to care homes.

• Cath Collins – carers social worker updates the group

Where ever I go and engage mental health carers I often ask if their mental health trust have a focus on unpaid carers. It really helps if there is a designated person whose role it is to focus on unpaid mental health carers. Over in Lewisham, we have a social worker whose job it is to focus and support unpaid carers. Cath Collins is employed by Lewisham council, but works closely with South London & Maudsley NHS trust.

I am glad we have Cath to update our carer members over in Lewisham. Cath mentioned that as of this moment for inpatient mental health services for Lewisham particularly on the wards they are going through a process called the “Triangle of Care” audit, which is a very good practice when it comes to supporting the mental health carers.

In a nutshell, it was put together by a carer (Alan Worthington). The triangle of care policy is kind of like a checklist. So you have the six key areas to check whether you are mental health carer friendly on your inpatient NHS wards in your services.

All five wards at the (SLaM) ladywell unit are going through their submitted assessments, these being the home treatment team assessment, although she is still waiting on the psychiatric liaison team to submit theirs. Basically it is all about making them think on how they support carers. These things could be : –

• How do they evidence that?
• How can we how can they prove that they do that?
• What information do they give people?
• How do they involve people in the assessment of the person who needs support.
• If the staff are carer aware and that they know about the needs of carers and the impact of caring?
• Do they have a lead in their team who supports carers?

So the triangle of care audit is really thorough and even though it seems like an exercise it’s been really good. Cath mentioned it’s really sort of good practice on going on some of the wards and in some of the teams it’s helped them to highlight and really think about visitors be it the mothers, partners, brothers and sisters who come to the wards who support someone in hospital.

Cath also reminded my carers group about the carers support session that evening, which is run in conjunction with Carers Lewisham.

• Linda from Lewisham service user network presents

Our next speaker to the carers forum was Linda Amoakohene who is the Sun Project Lead and Senior Occupational Therapist. Linda works for the Lewisham personality disorder service. She is also leading on the Lewisham service User network which is part of the Lewisham personality disorder service.

Linda was here to tell us a little bit about a new project. Even though it is new it actually was launched in October 2021. So they are still relatively new. The project is open to really anyone in the community of Lewisham who may be having some mental health difficulties. It doesn’t have any particular mental health labels even though the service Linda is providing is sitting within a specific service the personality disorder service, the project is actually available to anyone in the community in Lewisham. So whether you identify yourself as a carer or a patient of South London and Maudsley or just a patient of a GP or a member of the community. It is open access.

The Service User network is a peer support group. So people who attend the group come to get support when they’re in crisis, or perhaps they are struggling with things that impact on their mental health. So people end up self referring where they can come as often or as little as they like. Linda also mentioned that they don’t have to be under the South London and Maudsley NHS services to access the project, they could just be under the GP. There are also leaflets about the project or people email the team, and then they will send you the link to self refer to the project. So once the person self refers, they then make contact with the person on the phone, to find out a little bit more about them.

At the team they then complete something called a “Crisis and support plan”, which is basically applied to help someone think and plan, especially when things are really tricky. This can lead to questions on what sorts of things help or don’t help. This is so people basically go away with something that they can sort of use in a dynamic way, whenever they need it.

As of this moment, the project has got three groups a week, and they’re happening online. They might launch a face to face group since the COVID situation is obviously changing, and the government rules are relaxing, but they may still maintain some of the health requirements because COVID hasn’t gone away, and they still want to protect lives.

I thought to ask Linda a Carer question : Where I was happy about the new project and service, but I was interested in what support will be provided to unpaid carers.

Linda responded at length that this group is for anybody, they don’t identify carers or service users

• Wendy Dewhurst from South London & Maudsley presents

Wendy apologised for being a little late due to just catching up from coming off another online meeting. Wendy introduced herself as the general manager for community services in Lewisham, which essentially means that she has the day to day oversight and operational management for all of the services in the community. So that’s the primary care teams, community mental health teams, early intervention, low intensity and the personality disorder. Wendy has been in the role about a year and a half and during that time, She has taken all services through the transformation into the new model, which they are now trying to embed an implement, which is an ongoing process and is not going to happen overnight. However they have certainly seen some good results, particularly at the front end.

Wendy answered a few questions from group, where she fed back concerns about access to mental health services. Currently, the access is by the GP, although she is in the process of setting up a mental health advice line which should be operational, hopefully in the next month, where people that have any sort of concerns can talk about a mental health crisis. The service will be manned by the mental health charity MIND.

So if following a conversation with someone who mans that line and they feel that the person needs a service then they can put you directly into that team. So it will be a sort of option for self referral. Wendy thinks that there will be some people that maybe don’t want to engage with statutory services like GPS and maybe don’t trust particular services, so it’s another option to get that much needed support and they very keen on being able to process self referrals. This so SLaMs (South London & Maudsley) primary care mental health teams have something in Lewisham, which is where they can provide the most appropriate treatment that’s the least intrusive.

So it’s an intervention that services which involve psychology, Occuptional therapy and mental health advisors from MIND. Where they will work in an alliance, SLaM will work with the local authority and Bromley, Lewisham & Greenwich Mind.

Wendy mentioned they have an enhanced multidisciplinary team, where they work very closely with the GPS in the primary care team, and the GP tends to remain as the responsible doctor. The enhanced multidisciplinary team and the consultant will focus more on serious mental illness and longer care term needs where maybe patient might be subject to CPA (care Programme approach), still the move is that CPA is going to not exist going forward.

Wendy gave a talk describing the CPA where it has certain sorts of conditions with it. This is where you have to review every six months, you have a care coordinator, social worker and psychiatrist. Although what they found is that so often people that were on CPA, all the care was focused on that, and people that didn’t have CPA might not have got the same level of care. So what they want is for everybody to have the same level of care, irrespective of of what what that is, so has the same rights.

• Final update from Cath Collins

Cath reminded us that our mental health NHS trust has a carer’s strategy called the family and care strategy. This is what they are doing in Lewisham and are trying to make it Lewisham specific. So things that are in the carer strategy as a whole will be relevant. So making sure the wards and the crisis services adhere to that good practice of the triangle of care. There’s another priority about young carers, identifying those 18 and under who are caring for their parents or brothers and sisters. Other things like making that SLaM’s carer information is up to date and relevant for mental health carers.