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"?]

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