Monthly Archives: May 2010
Probably not the most in-depth review as I haven’t had a lot of time to process the programme shown on BBC 4 on Wednesday called ‘Sectioned’ as a part of the ‘Out of Mind’ season about mental illness.
The programme’s aim was to allow a greater insight into some (in this case three) patients who had or were being detained in hospital under a compulsory section of the Mental Health Act (known as being ‘sectioned’).
They followed three men – Anthony, Richard and Andrew and looked at the challenges they have and continue to face and the way they have experienced mental health services – particularly and exclusively (because of the nature of the scope of the programme) in-patient services.
Between them, they had experienced a number of hospital admissions and the programme certainly picked up on the cyclical nature of some of the experiences of mental illness. There isn’t necessarily a beginning and an end but more different ways of seeing things and different places along the scale of wellness and illness.
Rather than recount the experiences that were highlighted in the film, I think at least the film succeeded in presenting the stories of three individuals rather than three ‘patients’.
We had an understanding of who the subjects were and the effect that their illnesses had on them and their closest family.
The story was one of experiences rather than processes quite rightly and I think there is scope for programmes such as these to increase appreciation and understanding of the reality of mental health inpatient wards. There was no indication that any kind of support or process existed outside the wards but I suppose that wasn’t the point of the programme. There was a helplessness though that I was almost left with when I wanted to justify a little more hope than was presented but perhaps that wasn’t within the bounds of the programme makers remit.
One of the most striking things was the declaration that hospitalisation is and was crueller than imprisonment. There is no sentence though, just a revolving door and no crime that has been committed to lead to the sentence and the natural cycle of right and wrong.
It was a decent and sympathetic programme covering an aspect of mental health services that is often ignored. I wonder if Janet Street-Porter would benefit from a little time watching programmes such as these and coming to visit a psychiatric ward..
But then, as I explained to my tearful foster child last night, so long away from her family with no idea when or if she might be going home at all, life isn’t about being fair.
The new coalition government published some of the details about their plans for the next five (gulp) years yesterday. I had a brief glance at the issues as they relate to social care in particular.
I feel distinctly underwhelmed, I have to say. I’m glad the Tories’ ‘insurance scheme’ has hit a road-block at least. It made no sense at all to me and didn’t really address a lot of the more widespread issues relating to social care funding. The Lib Dems seems to have dragged them back to the idea of negotiations and discussions.
Negotiations and discussions and commissions. That’s a bit of a drag. Haven’t we been here before? A few times. I know realistically there wasn’t another way forward but it feels like there is constant ploughing over the same paths again and again with more consultation documents about the same things. I wonder if the government really are serious about saving money when they just repeat the same consultations endlessly. At least the document mentioned the Wanless Report (which, incidently, I have a lot of time for). I wonder what difference the consultation will bring from consultations raised over the last few years and it seems like just another chance to delay the decision making even more.
All the other policies presented, apart from the completely unsurprising trashing of the ‘Personal Care at Home Bill’ which to be honest, didn’t make a whole lot of sense to me anyway, are just progressions of the ways things were moving in social care anyway.
Today’s coalition announcement sets out how the Government will push forward reform of social care. The Government will:
• establish an independent commission on the funding of long-term care, to report within a year;
Unsurprising – see above
• break down barriers between health and social care funding to incentivise preventative action;
More preventative action can’t really be argued against. Preventative work has been completely neglected in the face of cost-cutting in the short term and meeting performance indicators. I’ll be keeping a close eye on this one.
• extend the greater roll-out of personal budgets to both older and disabled people and carers to give more control and purchasing power; and
This was always going to happen regardless of which government was in power.
• increase direct payments to carers and better community-based provision to improve access to respite care.
Nice words – actually there has been a massive increase in respite provisions over the past few years and increasing it can only be a good thing.
The government has also promised to increase and prioritise funding into dementia research which is very positive. I wonder how much funding will be spared the scythe of government cuts in general though.
Burstow has been appointed as the Care Services Minister. He has, I understand, a fairly positive background in speaking up on social care matters. It could have been a lot worse, I guess and we’ll see if he has the power to battle it out with the Chief Secretary to the Treasury in order to secure funds for the department and the sector.
So I remain a little ambivalent. It’s hard to argue against any of the provisions made but where the difference will be made is in the amount of money that can be argued away from the Treasury by the Department of Health in the coming months.
I know I shouldn’t go to the Daily Mail website. It is a form of morbid curiosity but I saw this article headlined and couldn’t resist
Chief Constable Peter Fahy of Greater Manchester Police says that he needs ‘more mental health nurses as much as officers’ because, and I quote
‘there were so many disturbed patients being let out onto the streets by the NHS that officers were having to ‘pick up the slack’.
‘Let out by the NHS’ – I wonder if that’s the new term for a hospital discharge. .
I don’t even know where to start with this. Of course, I don’t have the figures to hand and don’t know what the time spent on s135 and s136 is on Greater Manchester’s police force but it’s a valid use of police time.
s135 is the part of the Mental Health Act that allows an AMHP (who would have a warrant) with a police officer to enter a property to remove someone who is mentally unwell to a place of safety for an assessment to take place.
s136 allows the police to remove someone who they believe to have a mental disorder to a place of safety for an assessment to take place.
And the use of s135 and s136 powers is not about ‘apprehending criminals or ensuring no crimes are committed’ but rather an act taken for the safety of the patients and the general public to ensure that an assessment can take place.
Public safety, I thought that was what we were to expect from the police as much as ‘apprehending common criminals’.
I ponder at his comment that
‘We have to train our staff to a professional level of someone like a mental health nurse to enable them to deal with these cases.’
Seriously? He thinks he is training his staff to the level of a mental health nurse? I have to say I am fortunate to work in an area with some really wonderful police officers but it’s a bit like MPs saying they are social workers because they deal with a bit of paperwork every now and then. It denigrates the work that is done by professionals and that it should be acceptable to make an issue of it is a surprise. If it is acceptable.
The article goes on
He said: ‘Officers are very good at being able to detect the burglars, the car thieves, the hoodies, basically your common criminal.
‘But what we are talking about is a particular type of disturbed individual whose irrational behaviour is outside of the norm.’
He told the conference: ‘I really feel for my own staff who are sent to domestic violence or mental health cases, dealing with vulnerable people when that officer is trying to do his best and then a tragedy occurs.
‘Even if they have done their best, the Independent Police Complaints Commission will treat the officer as if they are responsible.’
Mr Fahy also called on magistrates to lock up suspects until proper risk assessments could be carried out.
So much to pull apart in those sentences. Firstly, I think he is underplaying the skill of his own officers. He distinguishes between ‘common criminals’ and somehow manages to put mental disorder as ‘outside of the norm’. I’d love to know what his idea of normal is. .. oh wait, I think it is very clear. The fact that he refers to ‘hoodies’ says it all really.
I wonder how much he is just riding on the crest of Daily Mail readership but there’s some serious problems with what he says. The assumptions that he draws that mental illness = danger. That domestic violence is ‘just a drag’.
The police should be dealing with ‘common criminals’ rather than ‘domestic violence or mental health cases’. Interesting interpretation when he wants to pick and choose what help to give.
I would feel very sorry for any mental health nurses he did want to employ but I think it was just a matter of rabble rousing.
In the meantime it does nothing for the cause of working together and combatting assumptions and stigma against those who suffer from mental illnesses and need the support of services, including the police force, at some of the most difficult moments.
I mentioned last week a programme ‘Sectioned’ which is on this coming Wednesday. This is part of a season which is starting tonight on BBC4 related to mental health.
It started with a rerun of Stephen Fry’s ‘Secret Life of a Manic Depressive’ with the first part being shown tonight and the second part on Wednesday.
At 9pm tonight, there’s a showing of ‘Mental : A History of the Madhouse’ which looks at the history of the ‘asylums’ through the words of people who worked in them and lived in them. A few of my colleagues worked in some of the larger longer stay hospitals. I’ve heard some of the stories but I think it’s useful to put mental health policy and practice in a historical context and I am actually really looking forward to watching this one.
At 10pm there’s a drama by Poliakoff ‘She’s Been Away’. It is about a woman who had been ‘away’ for many decades in a psychiatric hospital/home and a friendship she develops with another woman. In what was Dame Peggy Ashcroft’s final performance, it is summarized as
‘an agonizing depiction of medical bureaucracy ruining one life and nearly killing two others’
Although it was originally aired in 1991, it offers a great opportunity to see what was a very well-received television play. I’m also hoping to catch this although whether I’ll actually watch it tonight or not, depends on today’s workload!
Wednesday has the airing of ‘Sectioned’ which I wrote about briefly last week. It should be a chance to see a different side of the world in which I work and try to explore it as an outsider. Sometimes we become so used to the types of worlds we work it that seeing it from the outside is both refreshing and thought-provoking.
I think these seasons can do a lot to challenge thoughts and assumptions about mental health services and the people who use and need them. I hope to be challenged about my own assumptions and perceptions as well. I’m sure some reviews will be posted over the next week or so!
The Open University have a tie-in which looks at the documentaries (Mental : A History of the Madhouse and Sectioned) and also looks at how Mental Health can be explored through different art forms. It’s definitely worth checking. They also have a free CD to give away which connects with the programme series and has five artists explaining how their personal experiences have impacted on their creativity.
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- BBC4 to screen mental health documentary on sectioning (guardian.co.uk)
I had a lump in my throat when I watched Brown’s resignation speech. I thought he spoke with an enormous dignity. But within the hour a new tenant of 10 Downing Street had staked his claim.
My one sadness and this is a very personal one is that my father was always a Liberal/Liberal Democrat. My grandfather stood for Parliament (in a completely unwinnable seat) as a Liberal and my mother stood as a councillor (again, I think it was not a particular winnable seat) for the Liberals. My uncle was a Liberal councillor for decades. Although I’ve veered at times further to the left, my father who was brought up very much in that political culture and environment would have been so excited to watch the games as they have unfolded. He loved politics. How much he would have enjoyed this process. I’m not sure about the result as he was very bitter about Thatcher’s legacy but nonetheless I’m sad he didn’t live to see it.
So what might a Conservative/LibDem coalition look like? Wow, I just shuddered even typing those words.
There will be a lot more coming out through the day but so far but the National Care Service is dead. Will there be another consultation on funding for Adult Care? Probably.. Eventually.. but the costs will be a factor and costs are going to be a heavy theme for this Parliament.
For the moment the focus will be heartily on cuts. It is a frightening time to work in the public sector although in our team and our Trust, the cuts have been coming hard and fast in any case. Just yesterday, we were told that some of the advertised vacancies which had been covered by now dismissed agency staff, have been retracted and that there will be a recruitment freeze – regardless of current vacancy levels. Not Good.
Incidently, I was talking to the other AMHP in my team earlier in the week and she muttered how we should be reassured that as AMHPs we were in a better position than most regarding job security as there is a big shortage of AMHPs in the Trust and people haven’t been rushing forward to train. Maybe that will change but I don’t take a lot of comfort in it to be honest. There will definitely be more than a few lean years. I can’t say I’m want to be graduating imminently..
On a broader level, I worry about where the Personalisation Agenda will move and how much it will be a transformation into lower costs and scrounging around agencies paying minimum wages at awful conditions for an hour here or there.
I am pleased the income tax allowance will rise to £10,000, helping the lowest paid workers, and the Tories plan to raise the inheritance tax will be shelved.
I was also heartened to see a proposed end to child detention immigration controls.
I’m glad they’ll be a referendum on the Alternative Vote system.
I expect we’ll know a lot more about the way things will fall together when we know who is in charge of Care Services and pushing these agendas that are specifically relevant to social care through. I hope that the Tories ‘insurance’ scheme against costs of entering residential care is considered and dismissed as the idiocy that it is.
As I mentioned to a colleague at work yesterday, a coalition government is better than a Conservative government. I have to say I am trying to be hopeful but I have just a little trepidation moving forward.
But I’ll get back to that over the next few days no doubt.
In other news, The Guardian highlights that a documentary called ‘Sectioned’ will show on BBC4 next week – May 19. It will follow three people ‘as they pass through the UK mental health system’. I think it sounds fascinating and will, no doubt, pick up on it when it shows – but something to highlight in advance.