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Lack of service user involvement in mental health services

Posted By Miss Button

"Lack of service user involvement in mental health services"

About: Community Mental Health Services / Mental Health Acute Assessment and Treatment Service (MHAATS) Falkirk Community Hospital / Woodlands Resource Centre

(as a service user),

I have searched over the last few weeks for evidence of service user involvement within Forth Valley mental health services (specifically Falkirk area) and there seems to have been a complete lack of service user involvement for some time. It would be encouraging to know that this activity is somehow not that easily accessible rather than it not existing however that also presents the issue of the great difficulty it is to locate even a contact name and number to enquire about such involvement. In the event that this activity does exist perhaps some of my questions could be answered if such issues have risen at service user involvement meetings or alternatively perhaps, they could be answered by a member of the mental health team.

I appreciate the pandemic puts constraints on staffing level and also limitations around in person situations however I feel this is a time when service user involvement could be crucial. In these unprecedented times, should this not be when professionals should be assessing the impact of the change of delivery on service users? Could this not be done through the use of technology such as video conferencing/email/social media?

I do not usually believe in dwelling on the past as improvement lies in the future however, I feel it is important to mention this lack of service user involvement seems to have been the case for many years in Forth Valley, or again it is not an area that many people are aware of existing. The last I remember this being an active area was when the recovery approach was at its peak around 10/12 years ago or thereabouts.

The recovery approach which mental health services claim to practice, seem to lack any real recovery principles. Yes, the terminology is used in some literature relating to your services but I feel there is a lack of recovery concepts being practiced consistently. ‘Person-centred’ practice is often referred to as your approach to care/treatment of service users yet I am unable to locate any documentation that tells me which philosophy or framework your person-centred approach is informed by. I fear this is a term that is used in a tokenistic manner, as it has existed for around 20 years and commonly used but I fail to see it happening. This is not to say I have not experienced some effective treatment from your services but for me ‘some’ is not acceptable and standards of treatment should be consistent and reliable for all.

I have been on NHS Forth Valley website and done many internet searches to find out how to become involved but have come up against a complete block. I find this extremely disappointing and wonder why this health board seems to be behind others in the country in this practice and can only presume service uses views on what makes quality healthcare seem to have little value to the mental health system in this area, for how treatment could be improved.

I have looked at the Improvement Strategy 2017 – 2021 for Forth Valley where mental health is highlighted as one of the priority areas particularly for children and young people and I believe early intervention is crucial as a way of attempting to prevent severe and enduring mental health problems, thus I would advocate for this plan however I cannot locate much information about the future plans for those already living with severe and enduring mental health issues. I would hope recovery is not seen as unattainable for those within your service but as aforesaid I struggle to find any evidence of this being carried out in delivery, certainly not from a service user perspective.

I have expressed these views on care opinion as I have been unable to locate anyone who knows who could answer these questions and telephone calls to Woodlands Resource Centre have not been returned when I have made enquiries!

I hope the concerns I raise within this letter are something that will not only be taken to the staff team but to the wider community of people who use your services.

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Responses

Response from Julia Ferrari, Service Manager, Community Mental Health Services, NHS Forth Valley 4 years ago
Julia Ferrari
Service Manager, Community Mental Health Services,
NHS Forth Valley

Submitted on 26/03/2021 at 10:32
Published on Care Opinion at 13:27

Many Thanks for taking the time to submit this information, we are grateful for your input and apologise if you have had difficulties in contacting someone to discuss further.

We have now had a preliminary discussion on the telephone which was really helpful in understanding your concerns a little more. I explained that there have very recent discussions around patient participation in NHS Forth Valley and that I would keep you up to date on developments in this area. You explained you would be keen to be involved as and when these developments come to fruition.

Many thanks again.

Kindest Regards

Julia Ferrari

Integrated Mental Health Manager

Woodlands Resource Centre

01324 624111

  • {{helpful}} {{helpful == 1 ? "person thinks" : "people think"}} this response is helpful

Update posted by Miss Button (a service user)

Thank you for your response and for providing information on the person centred philosophy your service claims to practice. I have had no contact from anyone in NHS Forth Valley regarding patient participation and I am still unable to find this anywhere online. I did have an email from HSCP informing me there are opportunities to become involved in the Forth Valley mental health strategy planning yet having replied to the email and leaving 2 voicemails to register my interest and enquire further I have not had any response.

Although we had a telephone discussion which seemed hopeful the questions/concerns I originally raised in regards to recovery principles and those labelled with a severe and enduring mental health diagnosis, have had no response or answers.

Unless detained under the mental health act, no service user has any access to advocacy to discuss issues relating to this or anything at all so no one really has their voice heard or any access to patient representation. Again this is something other health boards have. Why not in Forth Valley?

Again, it seems as if the response to this post 2 months ago was merely tokenistic which does make me wonder if this was simply because it was on care opinion.

Service users deserve a voice, and not just as a tick box exercise through obligatory evaluation forms/telephone calls, but opinions and suggestions from service users informing change at practice level, and further providing evidence of this to service users.

Response from Jim Crabb, Consultant Psychiatrist & Associate Medical Director, Mental health services, NHS Forth Valley 3 years ago
Jim Crabb
Consultant Psychiatrist & Associate Medical Director, Mental health services,
NHS Forth Valley

Submitted on 09/06/2021 at 11:00
Published on Care Opinion at 16:12

Thank you for this message.

We agree entirely with your view that those individuals that use mental health services deserve a voice.

Like all health and social care systems around the world, our mental health services have faced unprecedented challenges responding to the global covid-19 pandemic. Ensuring that we continue to provide care to the most at need, and that we respond to the increased numbers in distress as a result of the pandemic, has had to be our number one priority. This has sadly had to take precedence over other priority projects, such as developing greater user involvement in our services.

We remain absolutely committed to developing a patient participation group. We will take this and other service development work forward as soon as we can.

best wishes

Dr Jim Crabb

Associate Medical Director for Mental Health, NHS Forth Valley

  • {{helpful}} {{helpful == 1 ? "person thinks" : "people think"}} this response is helpful

Update posted by Miss Button (a service user)

Thank you for your response Dr. Crabb. I am delighted to hear that you share my views on service users having a voice and I can appreciate the restraints that the pandemic has had on services. I think it is great that you recognize that those most in need through this challenging time should be prioritized. This could be an interesting area for exploration when you do have the time and resources to engage service users in participation as this could be a wonderful opportunity to hear how those experiencing mental distress through the pandemic have experienced you services and whether there is any opinions on how 'need' has been prioritized by your service.

Can I draw your attention back to my original comment however, in that there are many more unanswered questions from myself in this, which have existed for a long time before the pandemic was here although perhaps the answers to these are too complex to type in a response here while you are so busy so I look forward to hearing these responses when you do find yourself with adequate time to respond.

Now that the pandemic seems to have reached a level of containment, I imagine plans are being drawn up for how you will proceed with engaging service users. I am keen to hear when you will be in a position to share these plans with myself or others receiving treatment from your services.

Perhaps engaging service users and 'allowing' them to take some control in service user participation could reduce the time professionals would have to invest in this and could be an empowering experience for some service users.

Thank you

Update posted by Miss Button (a service user)

I am sure you will be up to date with all relevant WHO guidance however just incase the pandemic has made it difficult for this to reach Forth Valley services, I thought I would add the link to the much needed guidance on community mental health services that the WHO has published for your convenience.

https://www.who.int/publications/I/item/9789240025707

I find it interesting to read some professionals reflections on this; http://https://twitter.com/ClinpsychLucy/status/1405974970509967372?s=20

As you are not in a position to engage service users in participation at present, I will continue to use my voice here in the meantime.

I fully understand that you cannot respond to all my comments and do not expect this at this time however, as you agree service users should have a voice, I hope you will find me using my voice in this way is useful for me and others and this is the only available platform that we have to share our opinions with your service and to have my voice heard that I know of, where NHS Forth Valley are directed to.

For some of us, recovery would have been far easier and quicker if we had a voice that was heard rather than everything we say and do resulting in diagnostic overshadow (as my comments here will likely be too) as this results in many of us having been silenced and stripped of our true identity.

If 'care opinion' does not see this as an appropriate use of their website, I will happily discontinue from engaging with this thread in line with their wishes.

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