Sunday, 29 May 2011

The 'Dark Side' that shames us all

Is it possible that anything more damning or incriminating could be written about the Cardiff & Vale University Health Board, or our governement, that is a greater condemnation of our Mental Health Service, and the manner in which service user concerns and dealt with ????  My co-writer is a highly intelligent concscientous citizen with the same passion as mine for correcting these gross injustices, in order to assure better services for the Mentally ill.  More than that , we are both totally honest and credible people - outside of the circle of waggons that is the bureaucracry protecting the providers of our  Mental Health  services, that is.  In areas such as Southhampton, Liverpool, Birmingham and Bristol such blatant corruption would never be tolerated, yet, in the Autocracy that is our Welsh Government it has become 'Standard' or 'Best practice' throughout NHS Wales. It has to be verging on criminal negligence that such incompetents, who perpetrate these unilateral malpractises, are allowed to continue with apparent impunity

Unfortunately, the Media do not consider 'Mental Health' matters to be 'sexy' enough to warrant their attention, and the general public still treat the subject as 'taboo', and not to be spoken about in case entire familes become stigmatised by the mere mention of the word 'Mental'.  Be assured - all of you - that Gillian and I will continue to battle these injustices until the day comes when only competent individuals are allowed any say in our Mental Health Services.  Perhaps the Royal College of Psychiatrists and the Mental Health Act Commission may be able to have their criticisms implemented for thr first time in over10 years ?  We can only hope that our new Minister will ensure probity in the control of our £1billion Health Budget for Cardiff and the Vale.

Friday, 20 May 2011

Care in the Community

Many young readers ( anyone below 60 ) may recall the famous Health Secretary, Frank Dobson MP.  He was a gritty, ‘tell it as it is’ bureaucrat who thought that Care in the Community was too expensive and hopelessly ineffective and, generally, unmanageable.  There were also concerns about the streets being terrorised by ‘mentally ill patients’, that would be hell-bent on causing problems for themselves and, of course, other so-called ‘sane’ citizens.  Quite simply, it was a mess, caused by a lamentable lack of planning by the Mandarins of the health service, who appeared to be ignorant, well-paid, graduates in suits who, in reality, had little idea how to run any organisation, let alone one as large and complex as the National Health Service.

Twenty plus years later, nothing has changed, except that the administration of the behemoth has become more unmanageable by an increasing number of University graduates, who expect large salaries, because their degrees were in subjects such as ‘60s Pop Music’ or  Stage Lighting’.  In common with their older colleagues they wrote in the type of gobbledegook that provoked Churchill to say “Up with this, I will not put”.  In other words ‘Bureacrats talking Bureaucrap’. Which brings me neatly to the, ‘Technical Outline and Financial Business Case’ entitled, “Development of the Adult Mental Health Inpatient Unit”, or, as I would call it ‘How to say absolutely nothing that could be interpreted as; meaningful, traceable by any evidence, incriminating or remotely factual, – in only 400+ pages' ( I couldn’t be bothered to count the pages of this 2” thick document ).  This entire document is full of empty rhetoric, construed financial information intended on misleading any poor reader, with totally vacuous summaries and – inevitably - a truckload of  B.S. ( business statistics, of course – what did you think I meant ?).

I am speaking from some considerable experience and, if there is anyone wishing to know ANYTHING about the construction and detailed model of the new unit, they should avoid trying to understand this document.  The only conclusion I am able to make is that there can be no genuine intention to build this unit, where the plan seeks only to hide all other capital costs of hospital alterations being made now, and over the next five years.  They truly believe that we are stupid enough to believe that this is a document fit to justify the expenditure of £80m+ of public money ( OUR money ) on a 125 bed Mental Health unit ( ca£700k per bed, as compared with £123K per bed for the recently built 57 bed Llanfair unit).

Reverting to Care in the Community, this document gives no ‘Who, What, How, Where, or When.  However it gives thousands of words in answer to the question ‘Why’ but not one them is understandable or reasonable to the bemused and confused service users.  Needless to say, the details of - or the money required to put - ‘bed-equivalent’ services in the community is completely ignored.  There isn’t even a clue as to what resources will be increased in order to cope with the increasing number of patients, being denied inpatient care.  Here, let me assure you that anybody subject to being sectioned under the revised 1983 Mental Health Act, is defined to be in need of inpatient care at times of crisis. Of course, we do have a 'Crisis Team' already operating from a remote corner of Cardiff and the Vale, however this resource is as inadequate as a sugar-paper umbrella in a monsoon.

There is some good news for those needing Care in the Community, and that is that some Community Mental Health Teams provide an excellent service, at current high case loads.  The finest and most efficient one of these is, unquestionably, Hafan Dawel in Penarth, where the psychiatrists, psychologist , Community Mental Health Nurses and administrators epitomise how proper mental health care should be implemented ( as I am sure is the same in all CMHTs ). So, as with the Health Board's rhetoric on inpatient care, nothing about Care in the Community is clarified, in a way that could possibly be of comfort to those poor vulnerable souls who will be expected to suffer from this lamentable lack of planning.  There is no Epidemiology Study or any Needs Assessment that would show the therapeutic care necessary for mental ( or physical ) health now, or in the future.  Be sure of one thing that is absolutely certain, the effects of this negligence will be felt most by the Elderly and the young – the Elderly Mentally Infirm or the desperate teenagers who lack the support that would enable them to cope with too much pressure, too early in life. Frankly, as long as politicians and incompetent bureaucrats have controlling influence of our health service, we are condemned to an inadequate, less accessible, and financially wasteful service. We must keep in mind that a One Billion Pound budget is in that hands of people who have repeatedly demonstrated their incompetence for decades, and this has to end – soon !  

( Next week 'Sullygate - the Cover-up exposed' )

Sunday, 15 May 2011

Bad Behaviour...

It was reported in the 'Western Mail ' that a mental health nurse denied the assault of, "punching two elderly patients" at Montgomery Infirmary on a night shift in February 2008 at a Disciplinary Tribunal in Cardiff last week. It will be interesting to see the result of the case that is continuing.

Here is a link to an article on the case:

Mental Health Bad Behaviour

Friday, 13 May 2011

How Can You Confront the Hydra ?

Having learned from bitter experience that the Cardiff and Vale University Health Board and the Community Health Councils are as sincere and trustworthy as a Taliban peace negotiator, we service users need an alternative source of help.  If you have recently become ill, you will learn that there is a layer below the venemous statutory authorities that are ( unsurprisingly ) classed  as non-statutory bodies that were established - mostly as 'Charities' - all promising to provide sanctuary and help for the mentally ill, albeit at a price.  Membership is supposed to be free, but some discriminate against the more disturbed patients ( who may be subject to 'an episode' that might upset others, including the staff ). This is done by some so-called charitable groups by having the Trustees vet every application, before granting membership for a nominal sum ( eg £1 ). One of these where I used to be a Trustee even went to the extent of searching certain male sufferers for knives or other sharp objects, thereby instilling groundless fear into all service users, whilst posing as virtuous protectors of the vulnerable ( themselves, of course ).

These self-made 'drop-in' centres do, however, offer a place of temporary respite where patients may mix freely with fellow sufferers and, hopefully, form a self-help group that will eventually become confident enough to return to a normal life of useful employment. Help is provided by staff and a plethora of literature that can be obtained, at a price, as is the case with all refreshments and meals, which all runs contrary to the remit of a 'charitable' organisation.  Creating a mirage of sanctuary, these ( supposedly user-led ) charitable centres are funded by grants from; the Government, the Health Boards, Local Authorities, European Social Funds, and quangos such as the incompetent Wales Council for Voluntary Action.  Herein lies their greatest shortcoming, in that their first duty is to themselves - self-preservation and ( often ) Empire building - which places their loyalties to their fund providers first, with the mental health service user coming a distant second in priority.  This basic conflict of interest - applicable to all non-statutory bodies - results in their giving uncritical support for the majority of changes to mental health services, which have resulted in the depletion of services ( e.g. the loss of 422 inpatient beds since July 2002 - from the Trust's own published figures ).

All of these publicly-funded non-statutory bodies have sat on their thumbs, watching the systematic destruction of successful mental health Day and Inpatient units, in abject silence.  In truth, they are the dreaded Hydra - many 'heads' all joined to the same body, with one aim only-survival.  Millions of pounds ( in total ) are given to these so-called Charities, specifically for the help of the mentally ill, yet most of this money is spent on bricks and mortar, maintenance and service charges, as well as wages and expenses for staff.  Who monitors this waste of public funds ? - nobody.  You will find poor monitoring of funds, no government accountability, and worst of all - no punishment for the abusers, who unite impenetrably against any and all challengers.

So, in addition to having to deal with the nest of vipers and other ( equally repugnant ) reptilian statutory bodies, we must - somehow - confront and tame the Hydra that is the non-statutory bodies, unarmed and with only each other for support.

  [ Explanation ( from Robin ):  I have been asked to be more specific about the terms Statutory and non-statutory bodies as those readers, not involved with Mental Health Services, may not understand the distinction between the two.
Statutory Bodies are, basically , the Wales Government plus all subordinate organisations or Quangos that are accountable to them.  These include, NHS Wales, Cardiff & Vale University Health Board and other health Boards in Wales, Health Inspectorate Wales, the Ombudsman, the Wales Audit Office, Older people's Commission, All Local Authorities and Councils, the Community Health Councils and other similarly useless and untrustwothy bodies that the government and the NHS choose to use to ensure that the public and patients in Wales are properly 'managed' (e.g. The Wales Council for Volutnary Action ).  This involves keeping us all in total ignorance of their plans by not involving us - meaningfully, genuinely, sincerely, or at all - on any changes to our Health Services.  Their motto is "We Know What's Best for You, so shut up, don't bother us, and 'Keep taking the tablets'.

Non - statutary bodies are none of the above, although misunderstandings are easily made, when they all give uncritical support to their masters and other fund providers.  These organisations include such charitable, or quasi-charitable organisations such as Mind Cymru, Mind Cardiff, Mind in the Vale. The Four Winds in Cathays Terrace, Awetu in  Roath , Depression Alliance Wales, MDF - Bi-Polar Association, Hafal, and especially the principle organisation  that is used by the Health Boards as being 'representative' of the 6700+ service users in Cardiff and the Vale - The Cardiff and Vale Mental Health Project.  This particular organisation has a database of a 150 or so service users ( which hasn't grown in number in 13 years ), and they facilitate 'presentations' and agree with every 'proposal' put forward by  the health board without exception.  So, having revealed this last self-serving, 'friend' of the mentally ill, it is only fair to point out that, in my opinion, the finest of these bodies is Hafal, whose services to the acutely mentally ill ( and their carers ) are, without doubt, the best in Wales. However, sadly - when 'push comes to shove' - they will not openly contradict their paymasters.

If I've left anyone out, please write to me and set me straight.  Alternatively, you may choose to dismiss me out of hand as our government departments do whenever I have the temerity to challenge any policy/protocol/procedure that I feel is immoral and ( sometimes) illegal.]

Wednesday, 4 May 2011

Avoiding Snake Bites and Looking After our Own

The lovely dry weather that we have been enjoying lately reminded me of the times when I was young and living in Canada.  When the sun was at its' hottest my daft brother and I used to go hunting snakes, in order to get a bounty payment from the laboratory that used to 'milk' the rattlers of their venom.  At $2.50 per snake, we could make some serious cash for spending on day-to-day essentials such as popcorn, candy, root beer and going to the movies.  Of course, it's like the recipe for Rabbit stew says - "First catch a rabbit".  It's the same thing with snakes.  Finding them is the easy part, catching them is quite another feat, and avoiding getting bitten is an absolute imperative.  Let me assure you that a snake bite isn't any fun at all, and - if you're lucky enough to find help - you can benefit from the product of your labours by getting the antidote from the same laboratory, at $10 a shot, that is, which can oft times make it hard to end up with a profit.  So, why am I telling you this stupid anecdote, when we're supposed to all be involved in getting a better Mental Health service.

Apart from the fact that hunting snakes could make you subject to being 'sectioned' as someone who is 'not of sound mind', there is a lesson for all service users, hidden somewhere in this story.  That is - If you get bitten by a ruddy rattlesnake - avoid going anywhere near the sods again, unless they're in a Zoo behind 1/2" thick glass !
In our case, we have all been bitten by the venemous 'Nest of Vipers' that is the University Health Board, provoked by our totally insincere and dishonest government, aided and abetted by the totally dishonest community Health Council. That means that we should all see them for the deceivers they are and avoid them at all costs, in case we get bitten again !  If we get asked to attend meetings - go, by all means - but be sure to treat everything they tell us with a huge pinch of salt because, although the snake can shed its skin, there's still a damned venemous reptile underneath afterwards.  So, it would seem prudent to avoid close contact with the UHB whilst seeking help elsewhere.  But where ?

If we can't trust the statutory bodies, the next layer of 'help' lies with the non-statutory bodies.  These are usually privately run 'charities', established to provide support and help to the mentally ill by providing them with refuges - or drop-in centres, as they are known.  Most of us will have 'enjoyed' having to pay for cups of tea and for a mediocre lunch there, when we are at our lowest ebb, and feeling totally disillusioned with life altogether.  At these times of utter despair, I myself have gone crying through the doors of such places, hoping to find solace amongst fellow-sufferers.  I was welcomed as all service users are at these oasis, with a sympathetic smile and a cup of milky tea which cost me 20p. I was seated amongst fellow-sufferers, looking distraught and feeling like death.  Looking around me made me feel even worse, as everyone looked the same or worse. I was on the point of running into the street screaming when a lovely bountiful lady, named Vicky, asked me if I wanted a private chat 'upstairs', where I imagined lay the cattle prods and skull vices.

Vicky Edwards was a psychiatric nurse and had been a patient herself.  I felt more comfortable and opened my heart to her, tears pouring down my face but feeling all the while that - somehow - she understood and genuinely wanted to help me.  Eventually, I returned downstairs where lunch was being served by the volunteer cooks who were ill themselves.  This was when I realised that fellow sufferers offered the best possible form of help because they suffered too, just like me, and understood.  I had recently been a patient in Sully Hospital, where I received a mixture of institutional care and friendships that remain to this day.  I wasn't aware of any problems with this kind of inpatient care, but I didn't like the locked doors or the screaming of frightened and confused patients at night.  I learned quickly that these patients were quickly and firmly dealt with by nurses administering large doses of sedation - some by injections with the patient being pinned to the bed or the floor.  I became afraid to sleep and soon became more introverted, reluctant to speak out or doing anything more than stand silently in line waiting for my meal and, perhaps, a dessert.

The problem with my treatment was that not one of my doctors had ever experienced mental illness themselves, which made being taken into a private room for a 'chat' leaving me feeling more like an extraterrestial alien being questioned about his peculiar way of life.  I saw ( and still see ) myself as 'normal' - whatever that is - with no self-esteem or confidence.  I moved like a Zombie, completely under the control of the anti psychotic drugs and other strange tablets.  I didn't dare ask what they were, although I quickly became chemically castrated as well as having my identity, or any dignity, stripped from me.  Eventually, I was classified as non-acute, with reduced medication and more freedom to interact with the other patients.
It didn't take me long to get to know everyone in the ward - male and female - and having regular conversations with me, often telling me more than they told their psychiatrist.  They trusted me and I became their friend, and we all enjoyed a lovely Christmas together, even though we were without our families.

Two weeks later I was discharged, feeling very frightened and suddenly alone.  My family treated me with scorn, as though I had become ill in order to get sympathy.  "You're lucky you're not some peop le who are really ill...." and, "You need to pull yourself together and stop being so selfish...." and "Don't you DARE tell anyone else that you were in a psychiatric ward - people will think we're all 'loopy' like you....".  You have no idea how much I wanted to be back in hospital with my friends.  And so it went on, being stigmatised by my family and even my own GP, "Don't worry....." he told my then wife, "....those who threaten suicide never do it."

The stress of living was killing me and, two years later, I had to have a quadruple heart bypass, which provided me with the greatest revelation of my life.  Shortly afterwards I decided to dedicate what time I had left to helping others, particularly the mentally ill.  I became involved in the 'Save Sully Hospital' campaign, then began reading as much of the existing legislation governing the care of the mentally ill, experiencing my first crooked 'consultation'.  Service users were cheated and the hospital sold to crooks by other crooks in bureaucratic suits. This was the time I decided to fight this corrupt bureaucracy, regardless of the personal cost to me.

Anyway, to return to the snake-pit, I quickly realised that the best help available to service users was to be obtained from fellow sufferers, and to hell with the statutory bodies !!!! ( be continued )