Stop forcing mental health workers ‘help’ police criminalise Muslim communities

Reframing Self by Sarbjit Johal

Sarbjit Johal reveals GMMH Trust’s involvement in the development of Vulnerability Support Hubs (VSHubs) funded by the NHS, Home Office and the counter-terrorism police

A recent Medact report  (’Racism, Mental health and pre-crime policing, the ethics of Vulnerability Support Hubs’ May 2021) has highlighted the increasing securitization in mental health provision. Vulnerablity Support Hubs (VSHs) are being developed in three areas of the UK. These Hubs are ‘a secretive mental health – related project run by UK counter-terrorism police that disproportionately targets, impacts and ultimately harms racialised communities.’

Greater Manchester Mental Health Trust is involved in the Northern hub.

Thousands of individuals suspected of potential ‘extremism’ – a vague and racialised term which the government itself has tried and failed to legally define – have been assessed by the hubs, in which mental health professionals collude with counterterrorism police officers. Using a series of Freedom of Information requests the report highlights the increasing blurring of boundaries between security and care. The activities of the Hubs push mental health professionals into work that is beyond the health remit and encourage health workers to ‘monitor’ patients, and help conduct ‘combined’ mental health and terrorism risk assessments.

Muslims are at least 23 times more likely to be referred to a VSH for “Islamism” than a white British individual is for ‘Far Right’ extremism. Once referred to a VSH, based on the health officials gut instincts, suspicions or observations of what they perceive as odd behaviour in the patient, VSHs are places where the individual is now under pressure to consent to whatever is being suggested. They might have to agree to a mental health diagnosis or say yes to increased surveillance of their activities. Or they may have to agree to have their behaviour and speech observed and assessed or be questioned about their medication compliance if they are already a mental health patient. This is all to see if the person who has already been identified as showing ‘signs of extremism’ is now showing ‘signs of future criminal activity’.

These Hubs are an extension of the Prevent agenda. Activists have shown that Prevent is a surveillance programme targeting and monitoring people primarily in the Muslim community. They could be people who are demanding their democratic rights for equality and justice, they may be people speaking out against government domestic, trade and foreign polices (upholding right wing regimes with leaders like India’s Modi, Brazil’s Bolsonaro, or Israel’s Netanyahu) or they maybe people organising against the racist scapegoating of migrants, refugees and asylum seekers. They could also just be  Muslim people resisting the welfare cuts to Nurseries, Youth centres and etc their communities or people just practicing their faith.

Vulnerability Support Hubs (VSHubs) started off as a pilot project funded by the NHS, Home Office and the counter-terrorism police.  Now we find this pilot project has become a national scheme and is being rolled out by the police via ‘Project Cicero’.

Altogether, there are three VSHubs. They are in Manchester (North), Birmingham (Central) and London (South). Greater Manchester Mental Health is involved in the northern hub.

In 2016, Vulnerability Support Hubs were just ‘helping’ the police in pre-criminal stages of the Prevent programme. But now they’ve become ‘spaces’ for health professionals to help police with their live investigations and prosecutions. This Medact report refers to a case study from the North Hubs which show that Hubs are now effectively ‘tools of intelligence gathering’ for active police investigations.

by Felicia Chand, reproduced from Inqilab, South Asia Solidarity Group’s  magazine, 1991

So, VSHs are not actually supposed to provide health care for people suffering mental health issues. They are designed to be centres for the police to gather information on people and especially from young Muslims, some as young as 6 years old and others are teenagers. The Hubs promote a mental health diagnosis and treatment within a conventional medical model. This encourages police and mental health workers to see Muslim communities through a ‘criminal lens’ rather than provide health care and address their health needs as ‘patients’. 

In 2015 the government made the Prevent programme a statutory duty for all public bodies including NHS trusts. Health workers were expected to report people they thought were showing signs of being “ vulnerable to radicalisation”. These signs can be anything from expressing a need for an identity or status, being excited or showing comradeship or just having a desire for adventure.  In 2020, Medact research found that Muslims were at least eight times more likely than non- Muslims – and Asians at least four times more likely than non-Asians – to be referred to Prevent.

These VSHubs also get referrals for the Prevent counter-terrorism programme from people living in precarious social and economic conditions. They maybe homeless and unemployed because they cannot access public funds. They are pathologised and criminalised. In the current racist hostile environment, as migrants with insecure immigration status, they are likely to be passed on to detention centres and face the threat of deportations. (Medact report, P41)

Sumayyah Ashrab, Humayara Tasnim, Tahyhba Ahmed, students suspended organising against the racism of Prevent policies, Newham <https://www.huffingtonpost.co.uk/2015/06/12/newvic-islamophobia-_n_7567992.html>  2015

Resistance movements have always highlighted the role of unequal power structures in the scapegoating of Muslim, Black, migrant and vulnerable communities.  Present government policies from health and welfare cuts, to foreign and domestic immigration policies and the erosion of workers rights have led to increasing anger at the social and economic conditions being inflicted on BAME communities. The criminalisation of protest can be seen from a school  student  in Manchester who was suspended recently for shouting ‘Free Palestine”. These VSHubs are part of the current government strategy to criminalise all those who dare to demand their rights and speak out against injustice.

Let’s not forget the racism experienced by students and teachers in Birmingham under the governments Islamophobic Trojan Horse operation. These Hubs are going to deter vulnerable communities from accessing Health and Care services through the distrust that they create. As these VSHubs are not designed to meet our health, welfare or caring needs, we have no choice but to support the campaign to close them down. With support from the 1.2 million workers in the NHS of whom 248 400 (20.7%) are from BAME backgrounds, I am sure we can win!

Health Services NOT Control and Criminalisation!

Stop state repression, Stop silencing of dissent!

Close down all Vulnerable Support Hubs! 

Fighting for an alternative by Sarbjit Johal

GMMHT receives 30,000 calls to 24/7 Helpline since March 2020

Mental health phonelines run by the NHS have answered around three million calls during the pandemic since being fast-tracked a year ago.

The dedicated 24/7 NHS mental health crisis helplines were fast-tracked four years earlier than planned to ensure support could be provided during the pandemic.

The lines are staffed by mental health professionals who can refer people to local urgent, acute and routine mental health services. This may include phone and video consultations, as well as urgent face-to-face assessments where necessary.

Most callers are able to receive treatment over the phone or can be referred to a face to face assessment and fewer than 2% of the calls have resulted in an A&E attendance or a blue light response from ambulance or police.

The helplines have been set up by the 54 mental health trusts across England and some have now been running for over a year, with three million calls between May 2020 and May this year.

At the start of the pandemic Greater Manchester Mental Health NHS Foundation Trust (GMMH) set up a 24/7, all-ages helpline within a week, staffed by experienced mental health practitioners from a range of services, many of whom were shielding themselves but supported to work from home.

In their first ten days, over 1,500 calls were received, and during the height of the pandemic the call handlers received almost 550 calls per day.

Since 20 March 2020, they have handled almost 30,000 calls and since its expansion in May, have supported the Greater Manchester Clinical Assessment Service (CAS) and NHS 111 service by streaming their calls and supporting the caller to a solution which helps relieve pressure on other services, including ambulance call outs and attendances at A&E.

It has undoubtedly prevented many service users and families from experiencing a crisis in isolation with no support. The main outcomes have resulted in callers being supported with crisis intervention to prevent self-harm, including suicide prevention and safety planning with the service user so they continue to be cared for at home.

One caller, who would like to remain anonymous, said: “I turned to the helpline in the middle of the night when I was feeling very low. I would like to express my gratitude to the helpline team for helping me reach my birthday. I would have not got this far without your support.”

The service has been able to intervene at a critical point in the crisis pathway and divert people, who do not need urgent physical health care or require assessment under the Mental Health Act, from attending A&E departments and potentially being admitted to an acute mental health bed.

This resulted in reduced pressure on the local urgent care systems across Greater Manchester and the provision of a more timely and appropriate care pathway for people in mental health distress.

See full story here

Source: Rochdale News, 15th July 2021

NHS is failing half of young people with mental health issues

Up to half of all children and teenagers referred to mental health, learning disability and autism services in the run-up to the pandemic were left without proper support, with parents telling the Observer of children waiting years for treatment and a seven-year-old girl denied support as she was not suicidal.

Data published by NHS Digital shows that in 2019-20 – the most recent figures available – 23% of the 547,590 under-18s referred to NHS mental health, learning disability and autism services had no contact from health workers to deliver care, nor meetings between health workers to support their care. Another 26% – 144,384 people – had their referrals closed without receiving treatment. Some were told they needed social care instead, or passed on to charities, with others simply refused care as local services lacked sufficient capacity.

The pandemic has seen a rise in demand for young people’s mental health services. It was revealed last week that referrals rose by a third in 2020-21 compared to 2019-20.

Mental health minister Nadine Dorries recently tweeted that “we lead the world in the delivery of [mental health] services” and “we are not in the middle of a MH crisis” after a deluge of parents described their negative experiences of CAMHS.

See full article here

Source: The Observer, 18th July 2021

Pennine Care sign staff health and wellbeing pledge

Pennine Care NHS Foundation Trust has become the latest NHS provider to sign a pledge supporting the principles of the Nursing Times Covid-19: Are You OK? campaign.

The trust signed up to support the campaign, after its Clare Parker, its executive director of nursing, responded to a call made by Nursing Times to NHS providers across the UK.

Pennine Care, which employs around 4,000 staff, provides mental health and learning disability services to people across Greater Manchester.

It runs a range of mental health and learning disability services for children and adults from sites in Bury, Oldham and Rochdale, Tameside and Glossop, and Stockport.

The trust highlighted that it had already taken a range of steps to protect staff mental health and wellbeing.

These include a dedicated staff wellbeing service offering support, counselling or therapy. Staff can self-refer or a referral can be made by a line manager.

It also offers wellbeing screening and support for our staff and their families through the Greater Manchester Resilience Hub, and a comprehensive staff wellbeing hub on its intranet.

In addition, ‘wellbeing and work’ sessions have provided an opportunity for staff to share personal experiences, connect with other colleagues and support their own wellbeing.

Meanwhile, there are blended Schwartz Rounds, Freedom to Speak Up Guardians, links to free wellbeing and mindfulness apps, and health and wellbeing ‘wobble rooms’ across the trust.

Nursing Times launched the Covid-19: Are You OK? campaign in April 2020 to first raise awareness of the mental health pressures and wellbeing needs of nurses during and after the coronavirus pandemic.

They are now in the second phase of the campaign, which involves actively asking employers from the health and care sector to back the aims of the campaign.

“We have been doing everything we can to support them, in a practical and holistic way”

Clare Parker

As a result, they aim to contact the majority of NHS acute, specialist, community and mental health providers, as well as independents, in the coming weeks to see if they will sign the campaign pledge.

In signing up to support the campaign, employers are pledging to provide easily accessible formal mental health and wellbeing support to staff for as long as it is needed.

They are also agreeing to foster a culture of mutual support, in which staff are alert to the possibility that colleagues may be experiencing problems as a result of their work during the pandemic.

In addition, they are pledging to ensure staff experiencing problems know they will receive a positive, supportive response by disclosing them and that it will not be viewed as a sign of weakness.

Go here for full article,

Source: Nursing Times, July 2021

High volumes of staff absences at GMMHT due to Covid-19 and poor communication between teams delayed help for Trauma Survivor who subsequently died

A beloved daughter and sister ‘took shelter in drugs’ following a ‘horrendous rape’, sparking an addiction which ultimately led to her death, say her family.

Catherine Devitt was 56-years-old when she was found unresponsive at her home in Richardson Street, Eccles, on November 16 of last year. 

In the months before her death, Catherine presented at Salford Royal Hospital’s accident emergency department.

Doctors on the ward assessed her and observed that she was behaving ‘erratically’, was visibly ‘unkempt’ and not taking care of herself, as well as being concerned that she was suffering a ‘physical illness’.

Catherine was sectioned under the Mental Health Act and transferred onto a psychiatric ward – treatment she had been through in previous years – between July 16 and July 27, 2020.

At first, medics believed she was showing ‘psychotic symptoms’ but, as the drugs left her system, Catherine became ‘pleasant’.

She told doctors she ‘wanted to work in the community with her social worker to stop using drugs’ following her discharge from hospital.

Catherine continued to live in supported accommodation for vulnerable people in Richardson Street, where she would often be visited by her social worker, according to staff at the complex.

But despite the insight Catherine appeared to have into her drug habit, and desire to stop using, attempts to get in touch with her by Greater Manchester Mental Health (GMMH) teams failed.

Catherine did not answer calls from mental health practitioners and missed appointments. However, internal investigations done by GMMH found that communications between mental health liaison teams based at Salford Royal and home treatment teams were lacking. 

Attempts to reach Catherine and start work to help her reduce her drug intake were delayed as liaison staff believed she had been discharged, while home treatment staff believed she was still in hospital.

In addition, high volumes of staff absences due to Covid-19 gave way to long waiting lists for appointments also delayed Catherine being able to get help, said Michael Hartley, who led the report by GMMH’s governance body.

Yet, the investigation found that there may not have been a different outcome in Catherine’s case had improved measures been taken given her history of unsustained engagement with mental health services.

Mr Hartley apologies to Catherine’s family on behalf of GMMH and said the learning will be implemented across the service’s operations.

Full article here

Source: Manchester Evening News, 16th July 2021

New treatment significantly improves mental health in heart disease patients, Manchester led study finds

A study, led by Greater Manchester Mental Health NHS Foundation Trust (GMMH) and the University of Manchester (UoM), and funded by the National Institute for Healthcare Research (NIHR), has found that a mental health treatment called Metacognitive Therapy significantly improves symptoms of anxiety and depression for heart disease patients.

These findings, published in the American Heart Association journal, Circulation, are a huge step towards better informed and well-rounded care for heart disease patients, with the potential to improve not only mental health, but also the physical health of those recovering from heart disease.

Whilst CR services do have an educational component and an exercise component, they don’t currently include any specific mental health treatment to support patients with symptoms of anxiety and depression. 

Added to this, mainstream mental health treatments, such as Cognitive Behavioural Therapy (CBT), are not very effective at improving the mental health of heart disease patients. One of the reasons for this is that CBT focuses on challenging negative thoughts and beliefs, which can be completely valid and realistic in people suffering from chronic and life-threatening heart conditions. 

In response to this, Professor Adrian Wells, Consultant Clinical Psychologist at GMMH and Professor of Clinical and Experimental Psychopathology at UoM, who had developed a mental health treatment called Metacognitive Therapy (MCT), adapted this treatment for cardiac patients.

MCT helps people to manage worries and low mood through reducing unhelpful styles of thinking, such as rumination (dwelling on the past) and worry (concerns about the future). It helps people to discover new and more helpful ways to react to negative or distressing thoughts so they are less likely to dwell on them, resulting in improved anxiety and mood. 

This took place at Manchester University NHS Foundation Trust, East Cheshire NHS Trust, Stockport NHS Foundation Trust and Pennine Acute Hospitals NHS Trust. 

Findings showed for the first time ever that MCT plus CR is significantly more effective in improving symptoms of anxiety and depression in heart disease patients. 

It also proved to be more effective in helping patients reduce unhelpful thinking patterns and trauma symptoms. 

See full article here

Source: About Manchester, 22nd June 2021

Grandad desperate for help took his own life after being passed from ‘pillar to post’ by Greater Manchester Mental Health NHS Foundation Trust

Coroner Chris Morris concluded Stephen Myers committed suicide following an inquest at Stockport Coroners’ Court (Image: Manchester Evening News)

Inquest heard man left ‘very upset’ when he learned from his GP, just a few days before he took his own life, that he had been discharged by the mental health team.

Manchester Evening News, 15th June 2021

Steven Myers, 49, from Wythenshawe, was found dead in room 222 at The Amblehurst Hotel in Sale on December 2 last year.

Previously homeless, he had been living in the ‘chaotic’ temporary hotel accommodation on Washway Road for eights months up until his death, the inquest heard.

An inquest into his death heard Mr Myers had been left ‘very upset’ when he learned from his GP, just a few days before he took his own life, that he had been discharged by the mental health team.

His GP referred him a second time but the inquest heard Greater Manchester’s mental health trust arranged an appointment for December 7, five days after his death.

Detectives who were called to Mr Myers’ death found no evidence of any third party involvement, police coroners officer Andrew Stevenson told the inquest in Stockport on Monday.

A post mortem examination revealed marks on his groin and lower legs suggesting he had injected himself with drugs while toxicological tests revealed evidence of heroin, codeine, cocaine and an anti-psychotic drug, quetiapine, in his body.

His GP, Fiona Greenslade, told the inquest she had a telephone consultation with Mr Myers on October 8 last year and saw from his medical notes he had a long history of mental health problems and drug use.

The witness said the patient reported his ‘psychosis’ was deteriorating, and that he was hearing ‘whispers outside his door’ although he went on that he would not take his own life because of how much he loved his grandchildren

The doctor referred Mr Myers to the mental health team.

Mr Myers spoke to a consultant psychiatrist on October 19 but he was discharged following a telephone consultation on November 23, the inquest heard.

Dr Greenslade said the decision left the patient ‘very upset’ as he felt he needed ‘psychological input’ and she agreed to ‘re-refer him’.

On December 2 the GP practice received a letter offering Mr Myers an appointment with mental health services. while the suggested appointment date was December 7, five days after his death.

Christopher Ranson, a senior social worker at Greater Manchester Mental Health NHS Foundation Trust, told the inquest it first received a referral for Mr Myers in June 2020 following an ‘episode’.

He underwent cognitive behaviour therapy years earlier which he found to be successful but he declined it on this occasion and he was discharged back into the care of his GP, Mr Ranson told the inquest.

Mr Ranson, giving evidence on behalf of a colleague who had carried out the assessment, agreed with the coroner that Mr Myers felt as if he had been ‘pushed from pillar to post’.

The witness also agreed the patient should have been referred on to the mental health primary care team.

Recording a verdict of suicide, coroner Chris Morris concluded Mr Myers had died of a ‘mixed drugs overdose having recently been discharged from mental health services’.

He also had a ‘long history of substance misuse’ and reported using illicit drugs to ‘to help him deal with some of the symptoms’.

He was staying at The Amblehurst Hotel in Sale which was ‘not an ideal situation for him’, said the coroner, who noted the accommodation had been described as ‘chaotic’.

“He regarded himself as as experiencing worsening psychosis that he associated with mental health problems during that time,” said Mr Morris.

It had been difficult for Mr Myers to distinguish between a psychotic episode and ‘noise from the living environment’, said the coroner.

Mr Myers was assessed but it had been concluded any treatment was unlikely to benefit him and he was referred back to his GP who then re-referred him, he said.

He went on that ‘tragically’ Mr Myers was found dead in his hotel room on December 2, leaving behind two notes which he said he regarded as notice of his intent to end his own life.

Following the hearing, Mr Myers’ mother Hazel said her son, who was known as Benny, had been ‘failed’. “He was passed from pillar to post,” she said.

Gill Green, Director of Nursing and Governance at Greater Manchester Mental Health NHS Foundation Trust (GMMH) said: “We offer our deepest condolences to Steven’s family, friends, and all those who cared for them at this sad time.

“Though the Coroner ruled that the care provided by the Trust did not contribute to Steven’s death, there are always things to be learned from tragic incidents such as this, and actions to be taken to ensure we provide the best possible care to our service users.

“Since the incident, following a comprehensive review into the care Steven received, we have delivered thorough staff training and education regarding the referral process into other services within GMMH, and best practice for clearly documenting patient information. 

See full article here

Death could have been prevented: Greater Manchester’s mental health trust ‘lost oversight’

A heartbroken mum says she feels her daughter’s death could have been prevented if she had received the mental health treatment she desperately needed. 

Olivia Garvey was found ‘collapsed and unresponsive’ at the White Lodge Hotel, in Salford, last September – six months after her last involvement with mental health services. 

An inquest into the 24-year-old’s death heard Greater Manchester’s mental health trust had ‘lost oversight’ of her due to staff sicknesses during the pandemic.

Olivia’s mother, Louise Garvey, told the hearing her daughter had a history of mental health issues and said she had tried desperately to help her access the right support, believing she required treatment at an inpatient facility.

After Olivia, from Eccles, cancelled an appointment in February of last year, a follow-up was never rearranged.

See full article here

Source: Manchester Evening News, 19th June 2021

Bed occupancy levels at Greater Manchester Mental Health Trust continue to exceed full capacity.”

Papers discussed by Greater Manchester Mental Health Trust’s board show that whilst demand for services dropped during the pandemic, community mental health services then saw a 26pc increase on pre-Covid levels in March – ‘suppressed demand that is now coming through’.

Trafford clinical commissioning group noted a similar pattern. “Referrals to specialist child and adolescent mental health services have increased, with more children presenting in crisis and with increased complexities,” its papers noted, adding that the lockdown measures have also hit access to psychological therapy and dementia diagnosis rates.

The signs were already appearing a month ago, when Manchester Health and Care Commissioning – the joint NHS and council body that buys health and social care services in the city – raised concerns about long mental health inpatient stays at its last meeting. Too many people were being sent to mental health beds out of the area alongside ‘increases in referrals to eating disorder and child and adolescent mental health services’.

Meanwhile most people with learning disabilities had not been having their annual check-ups and most vulnerable children had not had their assessments carried out in the month after being taken into care, a further health and social crisis looming in the background as a result of lockdown.

At the same time the system was already, at that point, seeing a rise in walk-ins to A&E. Sarah Price, a spokesperson admits the system had hoped, last month, that the surge in these overall pressures would be short-lived. But there now is an expectation it will carry through towards the winter. “I think a month ago when we were thinking is this a blip, or is this something to be sustained – and we do think it’s going to be sustained for a while yet,” she says.

Source: Manchester Evening News, 27th June 2021

The £1.8m project helping Salford patients feel at home again after hospital care

Salford patients delayed on hospital wards are being helped to return to the community with a fresh start in a new home as part of a £1.8 million project.

Progressive landlord ForHousing has joined forces with Greater Manchester Mental Health NHS Foundation to tackle the long delays in people being discharged due to a lack of suitable properties.

A number of patients who have received mental health inpatient treatment in hospital or temporary mental health supported accommodation are affected and, according to NHS data, more than 40% of patients currently in mental health hospitals do not actually need to be there.

See full article here

Source: Manchester Evening News, 9th July 2021

Children six times more likely to be restrained than adults

Children in mental health units are almost six times more likely to be restrained compared to adults, according to the findings of an unpublished NHS England review.

Several sources who have been briefed, during presentations, on the unpublished review of inpatient child and adolescent mental health services undertaken by NHS England’s Getting it Right First Time team confirmed its findings to the Health Service Journal (12/07/2021)

The findings included:

  • The average length of stay for children on more than a third of general mental health wards was longer than two months, although lengths of stay across units varied significantly;
  • There is no clear and preferable inpatient model for CAMHS units nationally;
  • NHS benchmarking data, used in the report, revealed average staffing vacancy rates of 19 per cent, with one service reportedly having 70 per cent vacancy rates. The national average for mental health services generally is 14 per cent;
  • Children’s crisis and intensive community support services are inconsistent across the country, with significant variation in terms of out of hours offers, interventions and staffing levels. Young people were too often admitted to an inpatient unit because of a lack of alternative community services;
  • That more than three-quarters of children accessed mental health support through accident and emergency departments or paediatric wards six months prior to their admission; and
  • There was evidence some children’s mental health had deteriorated because of their experiences on units.
  • The report recommends restraint levels for children are no higher than adults and that providers should be benchmarked against their peers over plans to reduce restrictive practices.