25th November 2022
From CHARM, Communities For Accessible Rights based Mental Health
Concerns raised by CHARM, service users, their families, and staff, some of which have been presented through the media have led to NHS England commissioning an independent review into the services provided by GMMH. The Trust has also been placed in ‘intensive care’ through the NHS Recovery Support Programme. Yesterday the CQC also told Greater Manchester Mental Health NHS Foundation Trust to make significant improvements and have suspended their rating. Given these circumstance we call for roots and branch review of mental health support of people in crisis across Greater Manchester
CHARM identified serious concerns about the crisis in mental health care in Manchester two years ago. In our open letter to Andy Burnham and the Briefing notes and Evidence base we identified many of the failings that are now acknowledged by the CQC and the Trust.
As we argued at the time
‘Existing practices mean that Greater Manchester already has an unenviable record for: using physical restraint at higher levels than other parts of the UK (Mind, 2018); the worst record in the country for missing patients (625 patients in 2018 – 2019, NHS); too many Black people come into contact with mental health services through the criminal justice system than via a GP referral.”
We were not listened to, in fact the Trust continually denied there were problems and the failures identified have got worse. In Manchester our experience has been that the Trust has placed its professional reputation before openness and transparency.
CHARM has been tracking the failure and challenges facing services throughout Greater Manchester through Mental Health Trust Watch where we have recorded information on dozens of incidents. Our evidence highlights that failings are widespread, with public and private hospitals in the Greater Manchester who treat NHS patients.
As we have stated in previous statements, the failure of GMMH does not just lie in inpatient services. The neglect of vulnerable individuals across the city who were supposed to be served by community teams is widespread. We have been informed that 1000 people in the city of Manchester are waiting for a care coordinator and those who have care coordinators rarely see them because their case loads are unmanageable. The impact on families and carers, mainly women has led to the deterioration of physical and mental health.
‘Nothing was put in place to help me, apart from a carers assessment and talking to the CMHT carer support worker. My mental and physical heath was so bad, I had told them I was suicidal and couldn’t see a way out, but they had no power to help me to change the situation. I knew one of us was going to die in this house, either her or me and I told them this.
The disintegration of services has gathered pace over the last few years. Senior management have ignored concerns raised by the Union regarding safe staffing. There has been complicity by senior managers who have covered up the failings of community services, ignoring complaints until they have been taken to external authorities or failing to address severe carer breakdowns.
The lack of a functioning community service has meant that often the only available treatment has been hospital admission which as has been revealed is unsafe and has failed to protect people’s basic human rights.
‘My son was put in isolation for two weeks. It was traumatic and there was no consistent psychiatrist, and each psychiatrist had a different approach. Many of the staff felt it was not appropriate for him to be in isolation and thought I should complain. There were serious breaches of his human rights and his right to privacy (Jan)
‘My daughter ended up in hospital for nearly three years on her second admission. There was no clear plan – they didn’t listen and no psychological intervention and little attempt to engage her in any purposeful activity. She was neglected. She ended up putting on 40kg in weight, became diabetic and at one point had to be admitted to a heart ward. When we finally decided it was best to just get her out of hospital and asked the doctor what his opinion would be if we requested a nearest relative discharge, he threatened us with removing our rights as nearest relative. The system creates this kind of oppressive response.’ (Ana)
The management of the service has not just taken its toll on service users but staff who have been dehumanised by the way in which they have been forced to work creating a lack of humanity due to their need to desensitise themselves in order to survive, creating wide spread Moral injury.
The failures that have been exposed today are also a result of a wider structural failure to recognise the unique health and social care needs of Manchester. The concerns of families and the workforce were taken to the Manchester Health scrutiny committee before the Panorama programme but they failed the act and chose to accept the reports from GMMH. Commissioners in the combined authority have also accepted plans for health and social care without considering the impact on the most vulnerable. Joint Strategic Needs Assessments were not adequately carried out. Most recently the community transformation model adopted in Manchester which has focused on extended provision in primary care, has led to an exodus of staff providing vital services to the most vulnerable in community mental health teams. The service has collapsed.
We believe Greater Manchester Mental Health Trust through its culture, size and location will remain remote, separated and unaccountable to the communities it serves unless there is a root and branch review of how to meet the mental health needs of its diverse communities. This must be co-produced with the community.
To begin this process of creating a service fit for purpose we must first listen to the stories of those with lived experience. CHARM and Mental Health Charter Alliance are working together to launch a Story Bank of experiences which we will use to support our campaign to improve mental health support in Manchester. We call for anyone to share their stories with us by contacting email@example.com
Join us in our campaign for a mental health service that protects human rights at our public meeting on 10 December 2-4pm, Central Methodist Hall, Manchester. Speakers include Danius Puras, psychiatrist, former UN Special Rapporteur on Human Rights and Mental Health and Roberto Mezzina, psychiatrist, Vice President of the World Federation for Mental Health, retired director of Trieste Mental Health Department to support us to envision a different future.
‘our common goal is to liberate global mental healthcare from coercive practices…. If we do not move in this direction, arguments for coercion will continue to be used and misused.’ Dainius Pūras
For interviews and further information contact:
firstname.lastname@example.org Tel: 07932 639 757