1in4 imminent closure response

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  • #10314
    JK
    Participant

    We’re getting going!… and our current immediate efforts are to try to get a piece about the imminent closure of 1in4 people in the Weston Mercury. A lot of people in Weston and Clevedon use these centres for support day-to-day to prevent what starts as a manageable distress growing into a full blown crisis where lives can be at risk. Personally I think all across mental health services as well as GPs there will be more need for crisis provision with these centres closures.

    #10321
    Admin
    Keymaster

    I believe the letter was printed in the Mercury? I haven’t been able to get hold of a copy to check but a colleague mentioned it was.

    #10323
    Ben
    Participant

    Clarity letter in Mercury.

    Here is the letter in last week’s mercury.

    • This reply was modified 1 year, 7 months ago by Ben.
    • This reply was modified 1 year, 7 months ago by Ben.
    • This reply was modified 1 year, 7 months ago by Ben.
    • This reply was modified 1 year, 7 months ago by Ben.
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    #10327
    JK
    Participant

    Thanks Ben. Have with help aquired a hard copy of the relevant Mercury. Will try to scan it in and see if can do the same for Lord Cotter’s letter on the same page. Have hopefully agreed with Lord Cotter to assist him with tech of a press release (PC and printer) re lack of parity of esteem despite the government saying it’s funding mental health sufficiently and to the same degree as physical health. He has just cited the closure of 1in4 people in a debate in the House of Lords.

    #10328
    Ben
    Participant

    I attached a copy of the Mercury article in my post above although it wasn’t that obvious, hopefully it shows up better now.

    I’m not sure how useful a press release about the national politics side of the funding debate will be to the plight of services in NS in the short term, as it shifts the focus and responsibility off the council and ccg and onto national government. That said, it’s still a very important point overall, and if Lord Cotter can combine it with a call for local authorities to uphold their responsibilities then that would be really helpful.

    • This reply was modified 1 year, 7 months ago by Ben.
    #10334
    JK
    Participant

    <p style=”text-align: left;”>Agree with you dont want it hi-jacked for political point scoring! Its 2 important to service users in WsM and Clevedon. The point I am (if people agree???) hoping to get across is with lack of parity of esteem of mental health care and support services they are cut earlier and harder than those for physical health. This leaves Second Step gone, VANS severely cut. And the council and CCG are doing the further mental health care and support cuts here in North Somereset without informing (at the very least) the public and service users what they are doing with ALL of the money recouped. It might be very soon the time to do an FOI request to ask??? What do people think?</p>
    Tc and bw, J

    #10335
    Ben
    Participant

    It’s not really a matter of what they’re using the money for, they aren’t because there is no money. Local authority funding from central government has been slashed over the past 6 years and local authorities are having to make lots of cuts to balance their books. There is no recouped money. The problem in NS is that vulnerable people are bearing the brunt of those cuts, and there’s been no real impact studies, public consultation, or even any notice given over the closures for residents to have a chance to have their say.

    I’m not sure how much use FOI requests would be, plus all of the budgetary info is in the public domain already.

    The other thing that muddies the water slightly is that parity of esteem refers to treatment options within the NHS. It doesn’t really carry over to non statutory local authority services, which are the bulk of what have been cut. They’re two different (but equally important) arguments.

    • This reply was modified 1 year, 7 months ago by Ben.
    #10337
    JK
    Participant

    I think people with mental health conditions receiving the drastic and earlier cuts before physical ill health – given something has to go – would be relatively popular amongst reasonably large sections of the WsM community. That’s the issue of parity of esteem…It’s not what particular budget it comes from, it’s that mental health conditions are not anywhere near a priority for many people. Impact studies etc cost money in themselves which the council might well baulk at spending…. we can by all means campaign that we believe the impact on those with mental health conditions is disproportionate but without a study we can’t prove it…..could this be a proposal for a funding bid for a study/survey monkey – style survey? If anyone thinks yes I’d need people to join me and may to ask for support from IMHN which could be too slow????? J.

    #10338
    JK
    Participant

    Hi Ben,

    Just found a post of yours I missed for an open letter and am very happy with your thoughts. Yes they need sequencing and structuring and they will then make some v strong points.

    In particular I missed of yours:

    “There was a low level equality impact study done by the council for the social support budget cuts. This study acknowledged that the cuts would disproportionately effect vulnerable groups and recommended a full equality impact study be done by Jan 18. This was never carried out, but the cuts were done anyway.”

    There is potentially a case I’d have thought for getting in a baseline survey done now/asap as things ‘may’ get worse and there’d be something to compare it with. Is there anyone joined up to these forums who would like to post some potential topics or questions to construct a survey around current mental health / mental health social care support, current levels of social isolation? Please correct me Ben if we should only be pushing  NS council to do this?

    #10339
    JK
    Participant

    Some questions / thoughts / SOS?

    I raised the 1in4 closing issue (in the ‘wrong’ place – as there is no ‘right’ place) in a meeting that included Angela Kell lead mental health commissioner in NS part of BNSSG commissioning group. It’s about all NS service users as the services are so thin. So please can we write a joint relatively fast email to Angela Kell re 1in4?     – after discussion at next Clarity if soon enough and anyone reading these posts please submit points to raise and volunteers to construct an email to Angela Kell with me and ideas who to copy in? I’d suggest copying in Glenn Townsend Patient Involvement etc BNSSG CCG and anyone else we can think of please?

    The topic is immediate and important. A support worker said to me after seeing Julie’s/ Clarity’s letter in the Mercury that it’s hard to describe what’s good about 1in4 but it can just be someone going there at a drop in making and drinking a coffee and leaving without any conversation. Just safety.

    #10340
    Ben
    Participant

    Local authorities have a duty to carry out impact studies on significant changes in their policies and services. They did cursory ones when they proposed the current budget which recommended that in depth impact studies were done before the budget was passed, however they weren’t carried out. I have the original documents on my laptop.

    I personally do not believe that the parity of esteem argument is the right one to use in relation to local authority provided social care services. It’s a different wider issue which carries no weight with the council who were the major funder. They will say that they’re fulfilling their statutory obligations, and they will also say that existing services (Alliance etc) cater for everyone. Not to mention the fact that the majority of the cuts effect vulnerable people across the board, including those with physical problems, there are a number of orgs such as Vision the sight impairment support people, and Gemini the domstic violence org who are also likely to close this year due to lack of funding, so it’s a much wider issue than just mental health in NS.

    Also, comparing one thing to another (in this case mental health services with physical ones) is a dangerous game to play and risks alienating those who support or have physical problems as they try and defend what they’ve got and it’s a very problematic route to go down, it’s more likely to be divisive than uniting as things stand. Like I said earlier, the parity route leads to very murky and difficult waters. It also means almost nothing to your average person, it’s not an engaging hook for people to buy into, it’s a mainly political issue and is an argument that needs to be had on a national political level and trickle down from there I think personally.

    However, if you say that the cuts to services remove vital lifelines from vulnerable people which has major implications, and use our experience with mental health as the core example, that’s something concrete and personal that people can instantly understand and get behind, and will mobilise the majority rather than just those with personal interests. Also it’s much harder to argue against as we can demonstrate the effects, we can use people’s personal stories, talk about real needs etc.

    I don’t know if that makes sense?

    #10341
    Ben
    Participant

    All of the services cut were NSC funded services so yes they’re the right people to push. We can’t really do an impact assessment ourselves, it’s a technical document which needs a specialist who has access to the Council figures and numbers. However I think doing a survey about how people feel about the cuts, and how it impacts their life is a great idea, so would asking people to tell us their stories about how they used the services which have closed. That would give us some really valuable material to use.

    I’m not sure Angela / Glenn are really the right people to be talking to right now? We could talk to them in vague terms about our concerns, but I feel this needs to go bigger than them really. Don’t they already know exactly what the issues are? If not why do they exist?! I feel them wanting to field our concerns is lip service at the moment. I could be mistaken and be misunderstanding their roles.

    #10342
    JK
    Participant

    How about this as an attempt to square the circle in case Lord Cotter turns up at my flat tomorrow? Any changes would be welcome but I may end up opening the file in front of him…..

     

    The cuts to Council and some NHS Clinical Commissioning Group funded services in North Somerset remove vital lifelines from vulnerable people. This has major implications for those with mental health conditions, from our Clarity-North Somerset Independent Mental Health Network experiences. The services for vulnerable adults, including those with mental health issues, have already been severely cut e.g. Citizens’ Advice. Further, individuals and groups using 1in4 Peoples’ mental health service are already increasingly struggling with their mental health with the insecurity of it closing and when it closes it will leave a huge void in many of their lives and contribute to even greater social isolation. A support worker from another agency mentioned that during the 1in4 drop ins people come in make a mug of tea etc. sit without necessarily speaking, drink their tea and leave in a visibly calmer state than when they arrived. On the other hand there can be lively conversations on a variety of topics – again helping peoples’ mental health, social inclusion and general welbeing; this just scratches the surface with lots of more structured activities and counselling at a low cost also available.

    Mental and physical health need parity of esteem at national and local levels so that the NHS delivers equitable services under these two broad headings. The government have a narrative that they are investing in mental health nationally; it just sadly also seems to have major cuts planned and falling in North Somerset at this time and social services and voluntary organisations cannot be there to fill the gaps as they too like 1in4 and Second Step are going or gone.

    #10343
    JK
    Participant

    Glenn is an allay….. though may not be relevant to this particular area – he will always do his best so that service users are heard.

    I need to reply to Angela asking eg about deteriorating social inclusion and the CCG’s bit of the 1in4 funding and if there is nothing else put in place the increasing social isolation where a support worker who was the once a week person someone saw – as they were discharged from secondary services without methods to cope – is now withdrawn through social services reviews of someone too afraid to articulate their needs. So health and social care are meant to be working more closely but as neither has any money it’s a case of passing individuals to and fro without any coherent service. And IAPT re-tendering at the moment will change that service markedly too.

    #10344
    Ben
    Participant

    The letter draft is a good starting point and raises all the points we need to make, let’s see what Lord Cotter makes of it and where he wants to go with it. For me, so long as he makes these points, his press release will be useful:

    • All specialist mental health support services in NS have been or are being cut with no consultation or discernable plan to put anything else in place.
    • The few support services that remain do not work for people with mental health conditions as they do not meet their complex needs, nor do the staff have the knowledge to effectively work with them.
    • People with mental health conditions rely on these services in many different ways to help them manage their independence and health.
    • Without these services, more people will lead difficult and unfulfilled lives, go into crisis, and potentially even die bye suicide.
    • Not only is this an immoral and unacceptable human cost, it puts significant additional pressure on other services, greatly increasing their costs.

    Does that sound like a fair summary?

    Now that you’ve explain where you’re coming from with Angela I totally agree.

    This is where statutory duty comes in too. Could we argue that the cuts seriously hamper the ability to carry out Section 117 of the Mental Health Act and make effective aftercare practically impossible? I believe the CCGs part is to give you access to a psychologist, psychiatrist and care coordinator who will coordinate your care and treatment, but a) care coordinators are as rare as unicorn horns in NS, and b) their job is untennable with so few services to work with. 117 also clearly gives social services responsibility too, which means NSC have to do more than they are, as the services we’re left with have no specialist knowledge and will not be able to work effectively with people with poor mental health. There are other aspects of the MHA that we could use to argue too, as there’s numerous parts of it that refer to the requirement for person centred social care that is co-produced.

    Now that Second Step (and rethink too I believe?) floating support has gone – Alliance will be doing all the independent living support, which will be time limited and solution focused. The only way person centred and co-produced support will happen now is if you have the perfect combination of care co-ordinator and social worker who will give you a good care package / personal budget and support you in managing it, which is very very rare. Even then, there’s not enough capacity within care providers with specialist mental health knowledge to provide that care, and there are people who have been waiting in brokerage for months for their care package to be fulfilled. As with trying to get secondary care treatment in NS, it’s an all or nothing thing and only the people with the most severe conditions get it. That’s my experience of it anyway.

    Two other slightly unrelated things I would suggest might be useful to raise with Angela are the lack of a 136 place of safety in NS, and you can refer to the website article I wrote? Closely linked to this which is something else which I’ve had on my mind for a while, is that apart from IST there is no out of hours crisis support at all in NS, so people end up in hospital, in a 136 suite, or potentially dead through suicide. I would like to see crisis support improved. At the very least they could put a CPN (or whatever their title is now as it’s recently changed) into 168 Locking Road overnight along with the out of hours GPs.

    Good to hear Glenn is an ally.

    • This reply was modified 1 year, 7 months ago by Ben.
    • This reply was modified 1 year, 7 months ago by Ben.
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