Sunday, 24 November 2013

Mental Health Advocacy in Fife – an Opinion, July 2011

[statement from July 2011, Emailed to Fife Council social work and NHS Fife managers, after I resigned from the Fife Mental Health Strategy Implementation Group]

"Independent advocacy is a way to help you to make your voice stronger and to have as much control as possible over your own life. It is called "independent" because it is not tied to the people who provide other types of services.
The New Mental Health Act: A guide to independent advocacy: Information for Service Users and their Carers

"Independent advocacy is a way to help people have a stronger voice and to have as much control as possible over their own lives. Independent Advocacy organisations are separate from organisations that provide other types of services."  
Scottish Independent Advocacy Alliance 'What is Independent Advocacy?'
(bolding is mine)

In Fife we had independent mental health advocacy services through Fife Advocacy and the TODAY Group, until there was a tendering process for these mental health advocacy services in 2009.  Unfortunately the local user led mental health advocacy groups lost out in the tendering process to the Circles Network, the only other organisation that put in a tendering bid.  Now we are in the position of having had Circles Network managing all the mental health advocacy in Fife since April 2009.  SIAA maintains that Circles Network is not independent, as they are a service provider, and I am in agreement with this.

I have been involved in mental health activism locally since 2008 through the setting up of Peer Support Fife, to promote the PS model in Fife because we did not have one of the PSW pilots.  I did engage with some mental health groups in 2003-6 while recovering from mental ill health, hospitalisation and the subsequent treatment - LINK Befriending Project, NEFAMH, FEAT, Energi, The Cottage, Express Group - being a volunteer with some of them, on the committee of others.  This helped in my recovery and in May 2006 I was offered a FT post at Adam Smith College, Employability Co-ordinator and PT Lecturer, gaining another postgrad qualification, in FE lecturing, at Stirling University in 2008.   

I was never involved in the local advocacy groups, wasn't on their committees or even knew who were on their committees but I did know some of the workers in the TODAY Group, because I live in the Cupar area.  But I have worked in advocacy in the Perth area, 2000-2, managing advocacy volunteers, facilitating self advocacy groups and doing one-to-one advocacy with different partners. 

I understand the concept of 'independent advocacy' from the standpoint of being a survivor of mental ill health and the psychiatric system.  And as a carer I know the importance of the person I care for having someone who is separate from services helping them to have a voice.  This will mean that the person receiving mental health advocacy can be sure of an independent service, not aligned with any other type of service, and with an expertise in mental health matters - not learning disability matters or physical disability matters which are different from the mental health perspective.  For people with mental ill health can and do recover.  

People with a learning disability or physical disability do not often recover, depending on the disability eg a person with cerebral palsy or Down's syndrome will not recover although they can and should have a good quality of life and the appropriate services.  A person with a diagnosis of schizophrenia often recovers, statistics have shown this.  Most members of my family have experienced serious mental ill health, hospitalisation, drug treatment and they have mostly all recovered, got back to work and on with their lives.

I have always expressed concern about Circles Network being awarded the mental health advocacy contract by Fife Council and NHS Fife.  My stance on this has not changed.  I am concerned for a number of reasons.  Firstly I did not think that the advocacy tendering process was fair or transparent.  I raised a concern about this on the Fife Council website (see previous blog post) and had a subsequent meeting with Fife Council Social Work staff Roseanne Fearon, Bridget Barker and Marsha Vettesse in Rothesay House on 29 June 2009.  The meeting was conducted in a reasonable manner but I was not allowed to discuss the tendering process.  Roseanne Fearon made this very clear.  It was disappointing as this was the reason that I had requested a meeting.  However I had no option but to accept.

Another concern was the fact that Circles Network is not independent, it provides services in the main to people and children with learning disabilities.  When Circles Network were awarded the Fife mental health advocacy contract I did some research on their work, speaking to advocacy workers in Edinburgh who at that time were still managed by Circles and other service users who were involved.  The feedback given was that Circles Network governance was poor, subsequently the advocacy contract in Edinburgh went back to the local group Advocard. 

From the Circles Network website I can see that the organisation offers many different services to the families of, and people with learning disabilities.  Their website also says "This year we have begun to thread advocacy into our children and young people’s services. This is proving to be exceptionally valuable but also very challenging and we are quickly building our expertise".  This is all well and good, there are also organisations in Fife that will provide advocacy for their clients but this is not 'independent' advocacy and should not be replacing independent advocacy.  In Scotland there is a legal right to independent advocacy for anyone with a 'mental disorder'.

I am concerned that the Fife local user led mental health advocacy groups were not supported in their work to continue and to improve their services. If targets were not being met, and I have been told this by Fife Council staff, then it was up to these staff to put in place mechanisms to ensure that the targets were being made.  The development of mental health advocacy in Scotland has been down to local grassroots user groups all over the country setting up and helping their fellow service users to have a voice.  I think it's a great shame that the Fife local mental health advocacy groups were not supported by the Fife statutory agencies to continue and to improve their advocacy work.  We have lost the historical roots of mental health advocacy in Fife.  And the responsibility for this should not be laid at the door of these groups, in my opinion.

I stood with the TODAY Group as they campaigned at Scottish Parliament about the unfairness of the advocacy tendering process by Fife statutory agencies, and I would do it again.  There weren't many other folk with us on the day.  I know how difficult it has been for me to have a voice in the corridors of power to do with Fife mental health service planning and provision.  We're now more than 2yrs into the new advocacy regime and there seems to be very little meaningful mental health user carer involvement, participation or leadership. 
Peer Support Fife have been running events around user carer involvement since 2009, after the advocacy tendering, our United We Stand networking event in the October had over 80 participants and 14 workshops.  But our 2010 involvement events were not well attended by Fife MH users and carers, although we had many folks from other areas of Scotland.  Ironically our May 2010 Mary O'Hagan user involvement event had some Fife folk but mostly paid workers and the Dundee user participants challenged the workers as to why they hadn't brought any service users along with them.  

Our March 2011 Mary O'Hagan service user participation and leadership event, funded by Fife Council and NHS Fife, had only one carer from Fife (not me) and no service users, no voluntary sector worker representation, 7 NHS Fife and 6 Fife Council staff.  The Fife Council lead for mental health, Julie Paterson (who is now taking forward user involvement), did not even attend this event, something else work wise had come up that was more important. 

I have now resigned from the Fife MH SIG (strategy implementation group), after struggling for over 16 months to have a voice or make a difference.  It became increasingly difficult with the regular attendance at the SIG meetings of the Circles Network Chief Executive Officer Mandy Neville, the Circles Scotland Co-ordinator and a Circles volunteer.  It was becoming a bit like a Circles meeting where we could hear about how well they were doing, the speakers they were inviting over from America (on inclusion) and the many 'collective advocacy' groups that they had set up with referrals from NHS Fife staff, most of them in hospital settings where I suppose people can't get away. 

What is the future of mental health advocacy in Fife?  I hope that we can get back to independent advocacy as soon as possible.  We've got 45 people coming out of medium/long stay Fife psychiatric hospital wards in the next wee while.  I am concerned as to the quality of the advocacy they will receive, to help them in this important transition.  They are not people with learning disabilities (a local councillor recently described them as this in a Courier article, see below).  Some of them may have learning difficulties but they have had mental health problems, resulting in them being hospitalised and medicated.  Which might account for their seeming to have difficulties in learning.  

I know that when I was on psychotropic drugs I felt and probably looked like a zombie, lacked direction and had very little creative thinking abilities.  We surely don't want for them to be in another institution 'in the community'.  Doing the same activities but supervised by support staff on lower wages.  I think they deserve to be offered services with a recovery focus and independent advocacy to help them make choices.  As do all of us who experience mental ill health, want to speak out and take back control.

Courier article 2 June 2011

[it's now November 2013 and to date only 15 long-term patients have been "released" from Stratheden Hospital.  I wonder if they have received "first-class care"?]

Sunday, 17 November 2013

Fife Council news item 28 May 2009 'Mental health advocacy services will expand across Fife' and my online response

[Archived news: published on Thursday 28 May 2009 by Fife Council]

"Mental health advocacy services will expand across Fife

FIFE Council and NHS Fife are committed to improving services to vulnerable adults with mental health problems in Fife.

That was the message given today to Fife Health and Social Care Partnership, a joint Fife Council and NHS Fife Board group. A report has been presented to partnership members to update them on the improvements being made to Mental Health Advocacy services Fife- wide.  

George Cunningham, an NHS Fife General Manager, said: “We are committed to improving services to vulnerable adults with mental health problems in Fife. Social work and health services together recognised that there was a need to improve the services offered to vulnerable people with mental health problems. There was a need to ensure greater access to services for all who needed them. 

“Following a fair and transparent process involving representatives from NHS Fife, Fife Council Social Work Service and Procurement Service, as well as service user representation the contract for mental health advocacy services in Fife was awarded to Circles Network following our standard tendering process.”

Circles Fife, a group with a proven track record who deliver a range of advocacy projects in Glasgow and Edinburgh, will be setting up an office base in Fife as soon as possible.  

A key task for Circles Fife is to improve and enhance the opportunities for service users to be more actively involved in planning and designing services. As one of their first tasks Circles Fife is setting up a stakeholder event (planned for late summer) with this as the key objective. One of the main outcomes of this event will be to identify service user and carer representatives for the Mental Health Strategy Implementation Group (SIG) to ensure that service users are more actively involved in this key aspect of service planning.

Mr Cunningham continued: “We are confident that the new arrangements for advocacy will improve, expand and enhance services to vulnerable people across Fife with mental health difficulties, who are often excluded and marginalised.

“The agreements we had in place previously with two different advocacy groups ended on 31 March, but both have agreed to continue working with us for 12 weeks to support the transition. This will ensure that people receiving advocacy services see a smooth handover and that there’s no confusion or inconvenience for them.

(bolding is mine)

My online response:

">>> chrysmuirhead 05/28/09 23:23 >>> 

Enquiry Details : Dear Ms Fearon

I am responding to the article dated 28 May 2009 on the Fife Council website News page which I have just read.  A bit of background - I am a recovered mental health service user and also a carer of someone recovering from mental ill health so this topic is of great interest to me. And I have worked recently as an independent trainer, delivering WRAP and Peer Support training nationally to individuals and organisations. I was also invited to speak at the November08 Fife Council Social Inclusion conference as someone who had experienced mental ill health and the challenge of getting back into the community.

I am encouraged to read that there will be improved advocacy services for people with mental health problems but concerned that the previous advocacy projects, and service users involved with them, are feeling that there was no or very little stakeholder involvement in the tendering process.  They are groups who have been working with these 'vulnerable people' over many years and have established trusting relationships.  Mr Cunningham uses the words 'fair and transparent process', 'smooth handover' and 'no confusion or inconvenience'.  I am concerned that some service users might not share his opinion on the process.  If this is so then the handover will not be smooth and there is likely to be uncertainty and stress in the short term and a lack of confidence in the longer term.

Advocacy is all about helping people to have a voice, this relationship can take time to develop and be long lasting.  The tendering process appears to have occurred quickly and been a top-down process rather than a consultative engagement.

I would welcome the opportunity to discuss this with you further.

Chrys Muirhead"

Friday, 15 November 2013

18 May 2009, campaigning with the TODAY Group at Scottish Parliament

It was on 18 May 2009 that I attended the demonstration at Scottish Parliament against the advocacy tendering in Fife and ended up speaking, off the top of my head, to a group of fellow activists, about the council's tendering of advocacy services in Fife.  See video link.

18 May 2009 in solidarity
I remember calling Circles Network the Circles project, because at that time I didn't know anything about them and had only turned up at the parliament to support the TODAY Group and fellow protestors. 

It was the beginning of my campaigning and a very enjoyable experience.

From the video write up:
"The TODAY group (Together Overcoming Discrimination Against you and me) is a mental health advocacy group based in Cupar which serves the whole of Fife. It supports the rights, views and opinions of over 300 members and 12 member groups in Fife. The popular and much-needed group has been relied on by people with mental health issues and their carers for 16 years. However, Fife Council & Social Care Committee decided to put mental health advocacy out to tender and has awarded the contract to an English-based group which will deprive people of local based services, and take away local jobs and volunteering opportunities. It may also lead to the loss of a 5-year Big Lottery grant.

TODAY have been campaigning against Fife City Councils decision. On 14th May they went to Holyrood, Edinburgh to lobby the Scottish Parliament to try and win support for their cause. Many of the campaigners demonstrated outside the parliamentary building where they found themselves side by side with Save Our Schools campaigners from Glasgow who were also lobbying parliamentary MSPs in a quest to get Glasgow City Council to overturn its decision to close 22 schools and its plans to close a further 34. This shows how council cuts are affecting people throughout Scotland. The TODAY and SOS campaigners gave each other some support and solidarity."

first post new blog, the why of it

I'm an unpaid carer who is also a survivor of mental illness and psychiatric treatment.  

I believe in the importance of independent advocacy for people who have mental health problems or "disorders" and may be detained in psychiatric settings or in locked wards under the Mental Health Act.  

I also believe that in Fife we now don't have independent advocacy since Fife Council and NHS Fife brought tendering into play and awarded the advocacy contract to an English learning disability service provider Circles Network (CN), who are based in Rugby, Warwickshire.  And began to redefine what independent advocacy is, for the people of Fife.

Because we don't have independent advocacy I contend that the human rights of people with mental disorders in Fife, detained under the Mental Health Act, are at greater risk of abuse. 

This new blog will detail my contact with CN since first hearing of them in 2009 after they were awarded the Fife advocacy contract.  It will also include my contact with Fife Council who were usually my first port of call but who often couldn't answer my questions and passed me on to CN.  A never ending circle.

During this time my youngest son was a detained, locked-in psychiatric patient and was subject to a denial of his basic human rights.  Locked in a seclusion room.  No toilet or drinking water.  I had to advocate as well as care for him and for this I was put under pressure by psychiatric nurses and social workers alike.  In psychiatric notes and reports.  Labelled and misrepresented.

I decided to offer my services as a volunteer advocate with CN in Fife so as to help with collective advocacy.  The Fife local CN manager was supportive and explained the process at a meeting this August in Stratheden Hospital, just up the road from where I live. 

However I got an Email from the CN Warwickshire HR Officer to say that my offer was declined.  Without even sending me a volunteer application form.  I complained to Fife Council social work service about discrimination.  They said that CN would investigate.  How so, surely a conflict of interest?

Then yesterday I got a letter sent/Emailed (how did they get my home address?) warning me of "legal redress" because of my "continued negativity" towards them.

This blog is my response.  I have a right to tell my side of the story and to question the spending of public monies, the professionalism of council funded agencies and if advocacy in Fife is truly "independent".