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“Unless similar units cease to receive public money, such lethal outcomes will persist” says independent report into deaths of adults with learning disabilities at hospital

An independent report into the deaths of King, Nicholas Briant, 33, and 36-year-old Joanna Bailey, who all died at Cawston Park, said their relatives described “indifferent and harmful hospital practices”.

The report, published on Thursday, makes reference to “excessive use of restraint and seclusion by unqualified staff” and a “high tolerance of inactivity”.

“Unless this hospital and similar units cease to receive public money, such lethal outcomes will persist,” the report said.

How many people from Greater Manchester are living in Units like this?

The report into the deaths at Cawston Park has made 13 recommendations to a series of agencies including the Law Commission, suggesting a review of the law around private companies caring for adults with learning disabilities and autism.

“Given the clear public interest in ensuring the wellbeing and safety of patients, and the public sponsorship involved, the Law Commission may wish to consider whether corporate responsibility should be based on corporate conduct, in addition to that of individuals, for example,” the report said.

Flynn, who was commissioned by Norfolk Safeguarding Adults Board (NSAB) to write the report, said the report highlighted “failures of governance, commissioning, oversight, planning for individuals and professional practice”.

See full article here

Source: The Guardian, 9th September 2021

Nutrition Diet and Mental Health Evidence-Based Approaches for the 21st Century

Saturday 16th. October 2021 for 9.00am – 13.15 pm

With covid 19 and other health issues, there are many more people experiencing psychological and mental health problems.

Chy-Sawel a mental health charity is holding a morning online event to bring the latest Evidence-Based Approaches for the 21st Century on Nutrition, Diet, and Mental Health.

Good nutrition is fundamental to mental as well as physical health and wellbeing, and
scientific evidence shows that diet is an important modifiable factor in the prevention and
treatment of mental illness.

Nutritional psychiatry is now a growing discipline, considering food and diet (and the use of supplements if needed) as part of an integrated and complementary approach to the
management of mental health disorders.
Importantly, this approach can also help to alleviate many of the physical conditions or
symptoms associated with psychiatric disorders, and to minimise possible side-effects of
some standard treatments.

At this event, Chy Sawel brings you the chance to hear from two of the leading experts in
this field.

Dr Alex Richardson, Founder Director of Food and Behaviour (FAB) Research, and Visiting Senior Research Scientist at the University of Oxford
Dr Kevin Williamson, Head of Research and Senior Nutritionist, Rotherham Doncaster and South Humber NHS Foundation Trust

Chy-Sawel proposes to use as the main treatments alongside therapies like ‘Open Dialogue’ and other various therapies at their Therapeutic Centre.

Please see below the ‘Eventbrite’ link to book your tickets to join the event.

There is a small cost of ten pounds for the event to cover their costs.

 We look forward to seeing you on the morning. 

Mental Health Service Users are experiencing difficulties when applying for Transport Passes from Transport For Greater Manchester

Alan Hartman from North Manchester Service User Group reports on the impact of “Stepping Down” and the high case loads of mental health staff on people with severe and enduring mental health issues. This is especially hitting people in the pocket and leaving people with little or no mobility.

Patients with Severe and Enduring Mental Illness are being discharged back to their GPs, further caseloads of Greater Manchester Mental Health NHS Foundation Trust are extremely high with a very high employee turnover.

This means patients have to rely on their GPs for medical evidence of the application form when applying for a transport pass.

This can cause a serious domino effect, lack of mobility, causes you stopping attending therapies and hospital appointments, also keeps people longer in hospital and being isolated in your home can trigger a serious episode of mental illness.

For example a female Service User, was very upset because her GP charged her £35 to produce and sign the form required to get the bus pass. This is because GPs say they are not contracted by NHS commissioners or Transport for Greater Manchester TfGM to do this work.

Another Service User also very upset say she asked to see the nurse employed by TfGM, and told they were working from home and when she asked for an assessment over the phone she was told this is not possible.

A male Service User (who did not know whether he was still under the Trust or not) went to his GP, but was told he would have to wait weeks for the form to be completed, this hasc left him very anxious and stressed.

We need several meetings to sort these problems out, with the attendance of Councillor Emma Taylor, Assistance Executive Member (Transport).

We feel either the yearly extension should be brought back till we can sort out these problems that are putting many people with Severe & enduring Mental Illness at risk.

Current situation

My concerns and questions of the situation were not answered.

GPs are still charging some patients as much £35 (GPs have always been private businesses) to fill in a form for a bus pass.

TfGM have ignored the current guidance for disabled people from the Department of Transport for local Authorities, that the applicant should not pay the cost of the administration for isonly a paper medical assessment, which is totally superfluous.

My advice to Service Users that are charged by their GPs is send the receipt to Eamonn Boylan, Chief Executive, Transport for Greater Manchester, 2, piccadilly place, Manchester M1 3BG and asked for reimbursement.

Also, if your bus pass does not come in time, which is the fault of TfGM keep your tickets and send for reimbursement.

It was agreed we write to Cllr Taylor and Eamonn Boylan, Chief Executive of TfGM, with everybody name on the letter.

Alan Hartman, North Manchester Service Users Group, September 2021

Seni’s law: Use of Force (Mental Health Units) Act 2018

This event is a contribution to the current debate on race, the experience of mental health and mental health services, on detention and deaths in custody. It is open to, everyone including stakeholders, people with lived experience, carers, healthcare, mental health and social care professionals, ‘ activists, members of the legal profession and emergency services.

Use of Force (Mental Health Units) Act 2018 – known as Seni’s Law – and the implementation guidance are the focus of this day.

Seni Lewis died under police restraint in a mental health unit at the Bethlem Royal Hospital in 2010.

His mother, a key collaborator in developing this event, campaigned for the Act and we are now working with her to support its implementation.

Aji and Marcia Rigg, the sister of Sean Rigg who died in 2008, are central voices in the day.

More information and booking details here

Hosted by Maudsley Learning whose vision is to enhance the mental health and wellbeing of all through education and training. Part of South London and Maudsley Mental Health Trust.

Black History Month & Mental Health

October is Black History Month. The event recognises the contribution and achievements of those with African or Caribbean heritage. It’s also an opportunity for people to learn more about the effects of racism and how to challenge negative stereotypes.

Here we list events in Manchester and online with a focus on well-being and mental health.

Hashtag BLAK is proud to present a special Black History Month event with Being Amani author Annabelle Steele, hosted by Hashtag BLAK Co-Director Abiola Bello.

Join them at the start of Black History Month for a lively and interactive discussion on the important themes in Being Amani including Black Love, Black Joy and Black Mental Health.

More information and to book your place for this online event here

Health Inequalities: Build Back Better
At the School of Health Sciences on October 20th for an event to celebrate Black History Month, with speakers from across UoM, followed by a Q&A and social.

The speakers will be:
Oyebanji (Banji) Adewumi (University Director of EDI) – “Black History Month – A Time for Change “
Adam Danquah (FBMH AD for Inclusive Education and Engagement) – “A Hair Out of Place: The Psychological Impact of a Black Body in White Space”
Hema Radhakrishnan (FBMH Associate Dean for Social Responsibility)

More information here


Celebrating Black History Month at HOME from October – December with a curated season of events alongside their core programme. See more here

Michelle Ayavoro & Recovery Pathways: Inspired, Uplifted and Proud
Part of Black History Month 2021 at HOME Friday 1 Oct 2021 – Wednesday 5 Jan 2022

More information here

Magical thinking and moral injury: exclusion culture in psychiatry

“This is an article about exclusion. We might not like to admit it – even fail to realise it – but National Health Service (NHS) mental health service structures have become increasingly focused on how to deny people care instead of help them to access it.

Clinicians learn the art of self-delusion, convincing ourselves we are not letting patients down but, instead, doing the clinically appropriate thing.

Well-meant initiatives become misappropriated to justify neglect. Are we trying to protect ourselves against the knowledge that we’re failing our patients, or is collusion simply the easiest option?

Problematic language endemic in psychiatry reveals a deeper issue: a culture of fear and falsehood, leading to iatrogenic harm. An excessively risk- averse and under-resourced system may drain its clinicians of compassion, losing sight of the human being behind each ‘protected’ bed and rejected referral.”

Dr Chloe Beale, British Journal of Psychiatry Bulletin, September 2021

Chloe Beale, is a consultant liaison psychiatrist at Homerton University Hospital, London, trust lead for suicide prevention for East London NHS Foundation Trust and an honorary clinical senior lecturer at Queen Mary, University of London, UK.

In this article Chloe calls for the “rehumanising of psychiatry”.

She says:

“Patients and carers have been speaking out about exclusion and iatrogenic harm for too long; psychiatrists complaining about blame culture similarly. It is time this was translated into action by those with most power to effect change. Consider this a call to arms: if the content resonates then ensure you do more than shout into your echo chamber.”

See full article here

“Build Back Fairer in Greater Manchester: Health, Equity and Dignified lives ” Mental Health Issues

Link to previous article published in July here

Background:

The report was published in July 2021, commissioned by the Greater Manchester Health and Social Care Partnership.

Entitled ‘Build Back Fairer in Greater Manchester: Health Equity and Dignified Lives’, it includes recommendations on how to reduce health inequities and build back fairer from the COVID-19 pandemic for future generations.

Here, we have identified the references to mental health in the report.

Our objective is to ensure the recommendations contained within the report are brought to the attention of Mental Health Service Providers in Greater Manchester.

Introduction

Marmot calls for doubling of healthcare spending in the region over the next five years, as well as a refunding of local government, to tackle and prevent these inequalities and growing problems such as homelessness, low educational attainment, unemployment and poverty.

Future spending should prioritise children and young people, who had been disproportionately harmed by the impacts of Covid restrictions and lockdowns, and had experienced the most rapid increases in unemployment and deteriorating levels of mental health.

As well as damaging communities and harming health prior to the pandemic, funding cuts had “harmed local governments’ capacity to prepare for and respond to the pandemic and have left local authorities in a perilous condition to manage rising demand and in the aftermath of the pandemic”, the report said.

Key Social Determinants and Mental Health issues identified in the report

1. Education: As with inequalities in the early years, inequalities experienced during school years have lifelong impacts – in terms of income, quality of work and a range of other social and economic outcomes including physical and mental health.

Socioeconomic inequalities in educational attainment have persisted since 2010 entrenching trajectories of inequality which begin in the early years.

Young people living in more deprived areas continue to have significantly lower levels of attainment during secondary school, measured by GCSE results and attainment 8 scores, which measures pupils’ performance in eight GCSE-level qualifications.

2. Unemployment and poor quality work: are major drivers of inequalities in physical and mental health. Being in poverty and working in poor quality employment have marked effects on physical and mental health, including on children in the families concerned.

3. Poverty is associated with poor long-term physical and mental health and low life expectancy.

Living in poor quality housing, being exposed to poor quality environmental conditions, poor quality work and unemployment, not being able to afford nutritious food and sufficient heating for example all impact on health.

Poverty is also stressful. Coping with day-to- day shortages, facing inconveniences and adversity and perceptions of loss of status all affect physical and mental health in negative ways

Nearly half of those in poverty in the UK in 2018 – 6.9 million people – were from families in which someone had a disability.

Some ethnic groups also face much higher rates of poverty than others, particularly those who are Black and Bangladeshi and Pakistani origin where rates of poverty after housing costs are as high as 50 percent.

Persistent poverty refers to someone who has been in poverty in three of the past four years.

People in persistent poverty are at particularly high risk of having poor physical or mental health.

Rates have stayed roughly the same since 2010, at about 13 percent. Lone parents with children have the highest risk of being in persistent poverty

4. Empowering and sustaining communities was central to the 2010 Marmot Review, an overarching theme was to ‘create an enabling society that maximises individual and community potential.’

The Review described the importance of communities and places in shaping physical and mental health and wellbeing and described how inequalities among communities are related to inequalities in health.

Since 2010 these community inequalities have, in many ways, widened.

5. Poor quality housing, particularly damp and cold homes, directly harm physical and mental health and poor housing conditions continue to harm health in England and widen health inequalities. Unaffordable housing also damages health, 21 percent of adults in England said a housing issue had negatively impacted their mental health, even when they had no previous mental health issues, and housing affordability was most frequently stated as the reason. The stress levels resulting from falling into arrears with housing payments are comparable to unemployment.

7. Covid – 19: The City Region has also experienced particularly damaging longer-term economic, social and health effects from a combination of local and national lockdowns during the autumn of 2020 and through the first half of 2021.

Impacts include deteriorating community and environmental conditions as the public purse is further strained, widening inequalities during children’s early years and in educational engagement and attainment, increasing poverty and income inequality, rising unemployment, particularly for young people, and deteriorating mental health for all age groups but again particularly for young people.

All of these negative impacts will damage health and widen health inequalities in Greater Manchester. This report assesses these unequal impacts and makes proposals about how to take urgent, remedial action.

There has been an increase in poor mental health among children and young people from already concerning levels before the pandemic. A significant acceleration is needed in the provision of mental health services for young people and in programmes to support mental health in schools, further education and workplaces.

8. Community assets are important to health directly and indirectly: directly through the services and opportunities they offer that support physical and mental health, and indirectly through a sense of control and empowerment, levels of community cohesion and social interaction, all of which support good health.

9. Climate Change: Most residents noted the importance of green environments and local events and facilities to good wellbeing, which are highly supportive of good physical and mental health and help reduce inequalities.

10. The direct and indirect impacts of climate change are a threat to health and health inequalities in Greater Manchester, as globally. Immediate action to reduce greenhouse gas emissions can also improve health and reduce existing health inequalities.

The direct impacts of climate change on physical and mental health include: greater exposure to extreme heat/cold and UV radiation, more pollen, emerging infections, flooding and associated water-borne diseases, and impacts of extreme weather.

Action to reduce air pollution, by reducing the burning of fossil fuels, will not only have immediate health benefits, but will also contribute to achieving net-zero greenhouse gas emissions.

The indirect impacts of climate change on health and inequalities include increases in the price of food, water and domestic energy and increased poverty, unemployment and anxiety (34).

12. Homelessness: In Greater Manchester, huge strides have been made in reducing rough sleeping and further plans made for eliminating it (60).

Greater Manchester’s A Bed Every Night scheme and Housing First policy provide accommodation for people who sleep rough and offer support to improve their physical and mental health.

The NHS provides funding for the scheme as it is viewed as a form of prevention, reducing need for NHS services. The Mayor’s Homelessness Fund enables businesses and individuals to donate towards supporting local services to support homelessness reduction, too (61).

The Let Us ethical lettings agency in Greater Manchester provides management services to private landlords through the services of housing association partners, aiming to improve the private rental sector (62).

In March 2021 the Better Homes, Better Neighbourhoods, Better Health ‘Tripartite Agreement’ between Greater Manchester Housing Providers, Health and Social Care Partnership and the Combined Authority was launched.

The partnership aims to plan new housing and communities to enhance health, support more vulnerable households, support homeless people and those sleeping rough, and expand the ethical lettings agency to make an additional 800 homes available to those who are homeless or sleeping rough by 2024 (63).

The Greater Manchester Good Landlord Scheme, approved in March 2021, could help to address some of the issues by placing the onus on landlords and agents to improve and maintain standards in the private rental sector. The Scheme addresses some of the issues by: strengthening and focussing enforcement capacity in a co-produced model with districts; targeting capacity building for landlords (and agents) to help them better support their tenants, particularly those on low incomes; working with districts and key stakeholders to ensure tenants and landlords have access to accurate and up-to-date information and advice; and promoting the active growth of ethical/social investors in the sector (54).

Greater Manchester’s 2019–2024 Housing Strategy has two key priorities: to provide a safe, healthy and accessible home for all and to deliver the new homes Greater Manchester needs (45). It commits to providing 50,000 affordable homes, of which 30,000 will be for social rent, by 2037 (45).

However, this is too few and too slow to meet the demands for affordable housing, and given the impacts of the pandemic, the Strategy’s priorities are unlikely to be met in the 2019–24 timeframe. 

Fifteen new mental health workers to be recruited as ‘crisis’ looms for service in Bury

More than £750,000 per year has been allocated to recruit new mental health professionals in Bury.

Fifteen new mental health professionals are to be recruited in Bury in a bid to avert ‘significant patient risk’ as waiting lists grow and demand increases.

Health chiefs in Bury heard this week that unless there was investment as the borough emerges from the pandemic there was a risk that mental health services for children and adults would become ‘non-operational’ and the service could reach ‘crisis’.

At a meeting of Bury’s Strategic Health Board on Monday, September 6, members were presented with a report from Will Blandamer, executive director of strategic commissioning on the need for investment in community mental health services.

Mr Blandamer, said: “This relates to the service pressures and impact of Covid on emotional health and wellbeing and mental health for our Bury population.

“It initialises a step change in how we will move to redesign our mental health adults and children and young people pathways moving forward as we build back better from Covid.”

The three year plan details an ‘enhanced staffing options proposal’ to allow the recruitment of six mental health practitioner posts in the remainder of the 2021/22 year.

An additional nine staff would need to recruited in the year after that to make the service safe.

Mr Blandamer added that there was also a need to recognise the expansion of the service with the redesign of mental health services.

Once fully recruited, the cost of the extra staff per is calculated at £663,000 in 2022/23 and £764,000 per year after that.

Mr Blandamer asked the board members to be aware of the risks to the service if the investment was not agreed.

Will Blandamer said the recruitment of 15 new staff was needed to avoid a possible ‘crisis’ in Bury’s mental health service

He said: “If staffing is not increased there is a significant risk of a number of patients being on the waiting list without an allocated care coordinator.

“There is a risk of patient conditions deteriorating and reaching crisis with a potential to have an impact on other services and the wider system.

“Staff well-being is a concern as managers may see staff requesting a reduction in working hours due to the pressure and demand of the
work which may impact on staff moral and staff resilience.

“There is a possible risk for the service to become non-operational and a risk of adverse publicity and regulatory scrutiny if the service does not mitigate emerging pressures.”

The board approved the plans at the meeting.

See full article here

Source: Manchester Evening News, 8th September 2021

Greater Manchester Mental Health receive approval for New £105m Park House Psychiatric Hospital Unit

Greater Manchester Mental Health NHS FT (GMMH) have received Full Business Case (FBC) approval from the trust board and Manchester Health & Care Commissioning, for a development to deliver a new adult mental health unit. It intends to support Manchester patients at North Manchester General Hospital (NMGH) and will replace current dormitory type accommodation with limited outdoor space.

The development forms part of a project for NMGH, aimed at improving health and well-being for people in the local area over the next 10 to 15 years.

The adult mental health unit is predicted to cost £105.9m. GMMH are expecting to receive £91.3m government funding, with the remaining £14.6m funded by the trust.

The FBC will now be formally submitted to NHS England/Improvement who will review the FBC for a final investment decision, which will allow construction to commence.

Neil Thwaite, Chief Executive of GMMH, said: “We passionately believe this investment will greatly improve the quality of specialist inpatient mental health care and will enable us to build a therapeutic, modern environment for patients and workplace for staff.
“It is excellent news for people needing in-patient mental health services in Manchester and forms part of exciting regeneration plans being developed for the North Manchester hospital site.”

The development will include the replacement of the current Park House inpatient mental health unit at NMGH, which will be completely rebuilt on the hospital site, but in an alternative location. It will mean that the unit can be completely constructed without disturbing current patients, with the day-to-day operation of services still being able to continue.

The current plans include:

  • 150 single en-suite bedrooms to be provided over nine single sex wards, including a purpose built Psychiatric Intensive Care Unit (PICU), seven adult acute wards for female and male adults, and one older adults’ ward.
  • An assessment suite (specifically for people needing a place of safety and assessment under Section 136 of the Mental Health Act).
  • A variety of internal activity areas and multiple outside garden spaces specifically designed to enhance the environment and aid recovery.

During the development of the FBC GMMH discussed their plans with key stakeholders, as well gaining support from the wider health and care system, including commissioners. GMMH will continue to engage with the community to hear feedback, test thinking, and develop the design proposals further.

The local planning authority and Manchester City Council gave full planning approval in January 2021.

The construction on the new building site is expected to start in 2022, with the new facility anticipated to be built and operational by 2024.

See Full article here

Source: National Health Executive, 11th August 2021

Kind, caring and ‘totally devoted’ dad of three found dead at home

A “popular, fun loving, kind and caring” dad of three who was described as being “totally devoted” to his children took his own life, an inquest heard.

Zowie David Hesford, 38, was discovered dead at his home in Hebden Court in Bolton on July 22 last year.

Bolton Coroner’s Court heard how Zowie had suffered mental health issues for the past three years and had been diagnosed with psychosis but had been making plans for the future at the time of his death.

His brother, Bradley Hesford, said Zowie had been looking for work, had moved into a new flat and started up his social life again, spending time with family and buying a darts board.

He described how Zowie had been looking forward to the easing of lockdown restrictions and being able to see more of his children.

Zowie had two young children with former partner Bernadette Hesford, known as Bernie.

He also had an 18-year-old daughter, Leah, from an earlier relationship.

Giving evidence in the hearing, Bernie described how following the death of his aunt in 2017, Zowie’s mental health began to suffer.

After the couple separated in July 2018, Bernie said Zowie lived with his dad before choosing to live in what was described as a ‘hut’ on Mortfield Fishing lodge in Halliwell.

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Dr Hannah Cappleman, Consultant Psychiatrist for Bolton Early Intervention Service, whose care Zowie was under, said he had taken some advice in relation to benefits and was happy with his living arrangement, despite their concerns.

She said he liked living there, despite having other options, preferred to just be in his own company and did not want to be around other people.

Despite this, the court heard how Zowie loved having face time conversations with his children as well as seeing as much of them as he could in person.

Occupational therapist Rory Bradshaw described how Zowie’s mood had been flat for three years but said: “He really, really valued these conversations.”

The court heard how Zowie eventually moved to a flat at Hebden Court but, after receiving no response to texts from his children on July 22, Bernie and Leah went to this address to check on him.

When they got no response, Bernie says she took Leah home before returning and noticing Zowie’s phone, wallet and keys in the front room. She contacted the early intervention team who contacted the police.

His body was then found by his family in the utility room.

HM Area Coroner Professor Dr Walsh said a post mortem had shown Zowie to not be under the influence of drugs or alcohol at the time of his death and there was no evidence of a third party intervention.

He gave a conclusion of suicide.

He said: “Zowie was passionate, popular, fun loving and caring.

“He was devoted to his children.

“He had had some mental health problems because of his aunt and the break up of his relationship.

“Sadly relationships end – some people can cope and others can’t.

Full article here

Source: Manchester Evening News, 9th August 2021