Latest: July 2004 Archives

Mental Health Bill Update- July 2004

At the start of the year, the second draft of the Mental Health Bill was forecast to emerge in March, then it was “possibly July” and now the Minister has said that it will be “early September”( but don’t hold your breath !) Optimists may hope that the delays are because the Bill Team is determined to get everything right, unlike last time, but the reality is that the fundamental problem which led to the appalling 2002 draft is still unresolved.

By Roger Hargreaves

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Blueprint sets out future of mental health nursing

A new mental health workforce strategy for England to be published next month by the Department of Health will recommend a radical overhaul of how nurses in the specialty work.

Roslyn Hope, workforce lead for the National Institute for Mental Health in England (NIMHE), revealed last week that one of the strategy’s aims will be to achieve the government’s target to recruit 3,000 extra mental health nurses by 2006.

It will also set out how mental health nurses can move into new roles and develop new ways of working to improve services.

Speaking at the national mental health nursing conference in Cambridge, Ms Hope said: ‘We need to maximise the role of nurses as advanced practitioners and help nurses to move into new roles as, for example, counsellors and health psychologists.’

She pointed out that the mental health nursing workforce has grown in recent years, and the vacancy rate is only 2.7 per cent, compared with 11.5 per cent for psychiatrists.

Work has already started on piloting new ways of working, such as the employment of advanced practitioners by the Avon and Wiltshire Mental Health Partnership NHS Trust, Ms Hope said. Primary care graduate workers – typically psychology graduates – are being employed at various general practices, working alongside GPs and practice nurses.

Guidance developed from these and other pilot projects is being distributed to other trusts. Ms Hope conceded that there are gaps in the training of mental health professionals that need to be addressed, especially in children’s and older people’s services. This problem is being addressed by NIMHE in partnership with the NHSU, she said.

Speaking from the audience, David Hyde, principal lecturer in health, social work and education at the University of Northumbria, said that better use of interprofessional education was one way of tackling this problem.

In his university the cohort of 400 nursing students that started last October trained alongside occupational therapists, social workers and physiotherapists. Feedback from the students was much better than from students in the cohort that started in March, who trained on their own.

• A guide for mental health professionals on how to improve services for refugees was launched last week by the Refugee Council and Birmingham and Solihull Mental Health NHS Trust.

Although targeted at the West Midlands, the trust hopes the guide will be of use in other regions. For copies call 0121 622 1515.

nursing-standard.co.uk 28 July

DWP officers are not covered by the Mental Capacity Bill

Hundreds of thousands of vulnerable benefit claimants could escape the protection of the Mental Capacity Bill, leaving them open to financial exploitation, campaigners warned.

The bill sets up a system of court-appointed deputies to look after the interests of people lacking mental capacity, and binds them to a set of principles and safeguards.

But the Making Decisions Alliance, a coalition of charities, is concerned that Department of Work and Pensions officers appointed to manage the benefits of anyone who is judged incapable, do not come under the bill’s powers.

MDA co-chairman Richard Kramer said: "Appointeeships should be brought within the scope of bill to ensure that people are safeguarded against abuse and exploitation - especially when their only income is from benefits and the appointee has total control over it.

"Appointees have more powers than court-appointed deputies. Our concern is they will not have to have to adhere to the principles of bill and their position is not revoked unless concerns are raised by third party."

Kramer said the DWP should apply the same tests for mental capacity that are set out in the bill, but feared two parallel systems emerging with different safeguards.

communitycare.co.uk 26 July

Self-harm: The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care

NICE and the National Collaborating Centre for Mental Health have published a guideline for the NHS in England and Wales on the short-term treatment and management of self harm.

Click Here

Doctors ordered to warn of antidepressant dangers

Doctors will be required to warn all patients under 30 of the suicide risk posed by the antidepressant Seroxat following an investigation into the drug by a European medical agency, it emerged today.

society.guardian.co.uk 27 July

The recommendation is expected to become law throughout the European Union (EU) in the autumn once the findings of the investigation are ratified by the European Commission.

The move responds to warnings about Seroxat made by the European Agency for the Evaluation of Medicinal Products (EMEA), which licenses drugs for use in the EU, in April.

The EMEA recommends that the antidepressant should be prescribed with extra caution to those aged between 18 and 29. It states that the drug can lead to an increased risk of "suicide-related behaviour in young adults", and calls for patients to be "monitored closely throughout treatment".

A significant number of patients prescribed Seroxat are under 30, according to the drug's manufacturer, GlaxoSmithKline.

The EMEA guidelines echo earlier warnings about the withdrawal symptoms experienced by patients on Seroxat, and backs the ban on prescribing the drug to those under 18, which came into force in the UK last year.

Mental health charity Mind called on the UK Medicines and Healthcare Regulatory Agency (MHRA) to order family doctors to warn all their depressed patients about the EMEA's findings immediately.

A Mind spokeswoman said: "The European ruling on Seroxat makes it very clear that the very real problems with this drug potentially go far beyond the groups already acknowledged to be at risk.

"When there are up to 800,000 people currently taking Seroxat in the UK, there is an urgent need for these risks to be made plainly known, and for GPs to be very aware of potential problems when they hand out prescriptions."

The MHRA launched its own investigation into Seroxat and other similar medicines, known selective serotonin re-uptake inhibitors, including Prozac, last year, but has yet to report its findings.

New figures reveal hidden epidemic of self-harm

Britain is facing a spiralling epidemic of self-harm, shocking new figures indicate. More than 170,000 people a year - most of them teenagers and young adults - seek hospital treatment after deliberately hurting themselves in apparent expressions of despair, research has found.

The disturbing trend is exposed by figures collated by the Government's drugs and treatment assessment body, the National Institute for Clinical Excellence (Nice). It is the first time such figures have been compiled and highlights mounting concern over the rising numbers of young people turning to self-harm, in which they cut, burn or mutilate themselves in an attempt to relieve mental anguish. When experts examined the number of total years of life lost due to different conditions, self-harm and suicide was third only to heart disease and cancer.

Experts warned that the true picture was much worse even than the figures indicated, and that many hundreds of thousands more may be self-harming but failing to seek treatment.

While the rise in suicide has been well documented, the growing problem of self-harm remains a taboo subject within the health service. In an attempt to break that taboo Nice is tomorrow to release new guidelines for the treatment of people who self-harm.

The figures emerged as a damning report was published into the death of 22-year-old Sarah Lawson, who had a history of severe mental health problems and self-harming. Sarah was given an overdose by her father, James, after she was thrown out of a psychiatric unit at the end of a week in which she had tried to kill herself three times.

Mr Lawson took the agonising decision to help his daughter die after the family was driven to the brink by the lack of help available to her. The independent review of her case condemned the mental health services as dysfunctional, fragmented and patchy and said Sarah had been failed by the system.

Mental health campaigners say the case highlights the alarming lack of care available to the hundreds of thousands of young people who harm themselves. Marjorie Wallace, chief executive of the mental health charity Sane, said: "This really has become an epidemic and the way in which people who self-harm are treated is a national scandal. These are people who are pushed to the bottom of the treatment queue, made to feel it is their own fault and denied any real understanding of their condition."

She added: "The problem is spreading. We are not just talking about young girls cutting themselves any more: we have heard of young men gauging their flesh, drinking acid, removing genitalia. These are people in desperate need of help and we are punishing rather than treating them."

Tomorrow's report is the first effort by Nice to estimate the scale of the self-harm problem in Britain. A recent survey found that 13 per cent of all 15 and 16 year-olds had self-harmed at some point in their lives, and that 7 per cent had done so in the past year.

Dr Tim Kendall, co-director of the National Collaborating Centre for Mental Health, which has helped to draw up the treatment guidelines, said: "The 170,000 a year who attend A&E are really the tip of the iceberg. They are probably mainly people who have taken overdoses, but there are many, many more who may be cutting themselves or harming in other ways who do not go to hospital but try to patch themselves up.

"Even the people who attend hospital are not being treated in the way they should be, because there is not enough understanding of their problems. In some parts of the country, the treatment they receive is appalling. We have heard of people who have turned up at A&E having cut themselves, and are stitched up without anaesthetic by nurses who tell them that they cut themselves without anaesthetic, so why should they get it now?"

Half of the people who attend A&E after self-harming are sent away without any psychological assessment or follow-up. "These are people who have often been abused or neglected and have very serious problems, yet we are just patching them up and sending them away," Dr Kendall said.

news.independent.co.uk

Mental health care 'failed' Sarah

A 22-year-old suicidal woman helped to die by her father was "failed" by mental health experts assigned to her case, a scathing report said.

dailymail.co.uk 26 July

The mental health team which treated Sarah Lawson was "dysfunctional", and there were "failings" in the supervision and management of clinicians, the report concluded.

Miss Lawson's parents, from Worthing, West Sussex, wanted their troubled daughter to be admitted to a secure psychiatric unit following a catalogue of suicide attempts. The day before she died, she was taken into the Homefields Psychiatric Hospital in Worthing but was ejected the following day for allegedly smoking cannabis.

Six hours after leaving the unit, Miss Lawson's father James Lawson helped her take a drugs overdose. When that failed, the 55-year-old suffocated her to death. Mr Lawson, himself diagnosed with depression in 1999, admitted manslaughter on the grounds of diminished responsibility in May 2001 at Maidstone Crown Court and was given a two-year suspended prison sentence and two years' probation. The judge told Lawson it was clear "no help was immediately available" for his mentally-ill daughter, who had suffered from manic depression for more than 10 years and had a long history of self-harm and trying to commit suicide.

The shocking case prompted an independent review into Miss Lawson's care, and the agencies responsible for the provision of mental health services in Worthing welcomed the report.

Speaking on behalf of all the agencies Lisa Rodrigues, Chief Executive of the West Sussex Health and Social Care NHS Trust, accepted the findings, saying: "We have learned the lessons arising from this review and have made substantial service changes over the past four years."

The review panel criticised a number of the services provided for Miss Lawson. Findings included failings in the supervision and management of clinicians in the Worthing Priority Care Trust particularly during the mid to late 1990s; The Worthing Community Mental Health Team was 'dysfunctional' in August 1997 when Ms Lawson was referred to it and information was not communicated to the Community Mental Health Team both at the time of the initial referral and subsequently.

The review found the needs of the Lawson family were not adequately assessed and as a result, steps were not taken to address the separate needs of Sarah Lawson and her parents as carers.

However, Miss Lawson's parents, James and Karen, 47, then a part-time charity worker, also came in for criticism in the report, which said: "On occasions, Sarah Lawson's mental health was influenced negatively by her parents, and especially by her mother, Karen Lawson. It was she who objected to, proposed, and rejected various treatments, some of which had, or had the potential to, help her daughter.

Health and social care in Worthing has undergone major reform since Sarah's death, a trust spokeswoman said, with the creation of new organisations, new management teams and new partnerships to deliver improved mental health services for the local community.

Calls for hospital mental health service review

AN MP has called for a shake-up of mental health provision at a hospital where two patients have walked out of the same ward and committedsuicide in the past six months.

Adam Price, MP for Carmarthen East and Dinefwr, said "underfunding and structural deficiencies" are ruining a service which is relied upon by up to 20% of people during their lifetimes.

icwales.co.uk 26 July

He wants a safety review at the hospital in Carmarthen, and for mental health to be put higher on the agenda by the Welsh Assembly.

Mr Price made the plea after an emotional meeting with the family of Roy Thomas, 54, who committed suicide after leaving a special psychiatric ward at the West Wales General Hospital.

And Mr Price said a number of other recent high-profile cases in the area highlighted concerns relating to mental health provision in West Wales.

William Rogers, 62, died in January after leaving the same ward. The body of the Llansawel man was found in the nearby River Gwili.

The mental health service in the county was also criticised at the inquest into the shooting of pub landlady Caroline Evans, and subsequentsuicide of the killer, mental outpatient Will Davies.

And a recent Commission for Health Improvement (CHI) report also emphasised a number of areas for improvement.

Mr Price said, "Mental health should not be a peripheral issue.

"It is expected that 20% of the population will experience mental health problems during their lifetime.

"We urgently need therefore to dismantle the stigma associated with mental health.

"Above all, the Government has a duty to ensure that mental health patients receive the aid and services they deserve.

"Mental health staff are both dedicated and committed. However, the service in West Wales is struggling from underfunding and some structural deficiencies."

A spokeswoman for the Welsh Assembly said that it was waiting for the outcome of an investigation into the suicides.

She said, "Mental health continues to be a key priority for the Welsh Assembly, and such is the importance, that a review of mental health services in Wales has been commissioned in order to ensure that service delivery is of the highest quality.

"The Assembly is determined to put mental health at the top of the health agenda and for it to remain there.

"We welcome the interest in mental health issues and feel it is an issue we all need to talk about and know more about."

Pembrokeshire and Derwen NHS Trust, which runs the mental health service in the area, has extended its condolences to the family of Mr Thomas in their loss.

A spokeswoman said thata redevelopment programme was ongoing to improve services.

Order of Business 20 July 2004: House of Commons

DRAFT MENTAL HEALTH BILL (JOINT COMMITTEE)

Mr Peter Hain

That the Lords Message of 15th July relating to a Joint Committee of both Houses to consider and report on any draft Mental Health Bill presented to both Houses by a Minister of the Crown, be now considered.

That this House concurs with the Lords that it is expedient that a Joint Committee of Lords and Commons be appointed to consider and report on any draft Mental Health Bill presented to both Houses by a Minister of the Crown, and that the Committee should report on the draft Bill by 31st March 2005.

That a Select Committee of 12 honourable Members be appointed to join with the Committee appointed by the Lords to consider the draft Mental Health Bill.

That the Committee shall have power—

(i) to send for persons, papers and records;

(ii) to sit notwithstanding any adjournment of the House;

(iii) to report from time to time;

(iv) to appoint specialist advisers;

(v) to adjourn from place to place within the United Kingdom.

That the quorum of the Committee shall be two; and

That Mrs Liz Blackman, Mrs Angela Browning, Mr David Hinchliffe, Mr George Howarth, Tim Loughton, Mr Paul Marsden, Laura Moffatt, Ms Meg Munn, Dr Doug Naysmith, Mr Gwyn Prosser, Dr Howard Stoate and Hywel Williams be members of the Committee.

Stigma's days are numbered

The time is right to change attitudes and behaviour towards mental illness, says Louis Appleby, the government's mental health tsar

society.guardian.co.uk 16 July

My first exposure to mental health services was when I worked as a nursing assistant between school and medical school. This was in a long-stay hospital in Scotland, outside an old mining village on the edge of farmland. Every now and then the ward had a day out, and on the way back we would stop off (briefly) in a local pub.

Here was a clear message about people who suffered from mental ill-health. They were not part of the community - they were even separated from the rest of the NHS. Not that the pub customers were unkind - on the contrary - but they did look at us with unmistakable "them and us" expressions.

But there is no "them and us" with mental ill-health, as the figures on how common it is clearly show. On any day, one in six of the adult population has a mental health problem, often depression or anxiety.

That translates into several people sitting with us in a railway carriage or restaurant, several thousand in a Premiership crowd or parliamentary constituency. It means doctors, nursing assistants and pub customers. It means neighbours, friends, family, ourselves.

Yet stigma and discrimination are among the main complaints of people with mental health problems. The recent Social Exclusion Unit (SEU) report on mental health told us that 85% of respondents had experienced stigma because of their mental ill-health - for some, this was worse than the illness itself.

The SEU reported that fewer than four in every 10 employers would appoint someone with previous mental illness. And stigma is alive and well in the NHS - the SEU quoted a study in which 44% of people with mental health problems reported discrimination by their GP - often that their physical symptoms were not taken seriously.

The challenge then is to change attitudes and behaviour towards mental illness. Yet people don't change just because you tell them they should. The evidence suggests that increasing awareness on its own is insufficient - practical steps are required, as is time.

A few weeks ago, a new five-year programme - From Here to Equality - was launched by the government to reduce the stigma and discrimination associated with mental ill-health. It will be delivered by the National Institute for Mental Health in England (NIMHE), working in partnership with the Disability Rights Commission, several government departments and the voluntary sector.

It will target young people, public services including the NHS, and the media, establishing a speakers' bureau so that people with mental health problems can tell their own stories to those who need to hear them. It will encourage the public to complain about poor media coverage on mental health.

The time is right. A public outcry forced The Sun to change the tone of its coverage of Frank Bruno's admission to hospital last year. The next step is for the media and others to treat derogatory terms for mental illness as no less unacceptable than abusive racial terms. When that happens, the days of stigma really will be numbered.

Royal College of Psychiatrists pledges mandatory involvement of patients and carers in psychiatrists' training

Annual meeting of the Royal College of Psychiatrists
6th – 9th July, Harrogate International Conference Centre
The Royal College of Psychiatrists will pledge today to make mandatory the involvement of patients and carers in psychiatric
education.

"Although there are already some areas of the country where the input of patients and carers into the training of psychiatrists is successfully in place", says Dr Mike Shooter, President of the Royal College of Psychiatrists, the College is committed to ensuring that their involvement
in psychiatric training becomes mandatory. We are very keen to take this initiative forward, ahead of possible forthcoming external national requirements.

"The proposal to involve carers in the training of psychiatrists is a major component of this year's joint campaign with The Princess Royal Trust for Carers, Partners in Care: working together to make a real difference*. This proposal has been universally welcomed at the many carers' meetings which I have attended over the last year or so", continued Dr Shooter.

There is already expertise available in many parts of the country. However, the College's commitment to bring this practice into routine psychiatric training will present services with a number of challenges and difficulties in some places. We are therefore planning, in collaboration with The Princess Royal Trust for Carers, a number of training activities and the development of other resources to support this initiative.

For further information or a press copy of the full article, contact Deborah Hart or Thomas Kennedy in the External Affairs Department. Tel: 020 7235 2351 exts. 127 or 154.

Friday 9th July 2004

Watchdog concerned by mental health performance

The number of mental health trusts to receive the poorest performance rating has more than doubled in the past year, according to an NHS watchdog.

Seven mental health trusts received the worst score of zero stars this year compared to three last year.

Of the 83 trusts in England, more than a third (30) still received only one star or less.

The number of top rated three-star trusts rose by just one to 15 from last year. Nearly half (38) of the trusts received two stars, while 23 received one star.

The Healthcare Commission, the independent healthcare watchdog which rated the trusts, said the performance of mental health trusts remained "a cause for concern".

More than a fifth (16) of the trusts have poor suicide rates. More than a third (29) have failed to set up satisfactory assertive outreach teams, which provide support for difficult to treat patients, such as those with mental health and drug problems, while 31 failed to record decent information about their patients' care and case history.

Sir Ian Kennedy, chairman of the commission, said: "The information which the NHS collects about the care of people who use mental health services is simply not good enough. It must be improved to ensure the better care of patients."

Cliff Prior, chief executive of the mental health charity Rethink, said the results reflected the poor quality of care experienced by many patients.

Mr Prior claimed that primary care trusts (PCTs) were denying mental health trusts the funding they required to improve care services. "Progress is too slow, too patchy, and held back by lack of funds," he said.

Rethink also criticised the star rating targets which mental health trusts are judged against as unambitious.

Mr Prior said it seemed unlikely that early intervention teams - to support people in the early stages of psychosis - and crisis resolution teams would be in place across England by the end of 2004, in breach of the targets set in the national service framework for mental health.

Guide to NHS star ratings 2004: mental health trusts

society.guardian.co.uk 21 July

Watchdog concerned by mental health performance

The number of mental health trusts to receive the poorest performance rating has more than doubled in the past year, according to an NHS watchdog.

Seven mental health trusts received the worst score of zero stars this year compared to three last year.

Of the 83 trusts in England, more than a third (30) still received only one star or less.

The number of top rated three-star trusts rose by just one to 15 from last year. Nearly half (38) of the trusts received two stars, while 23 received one star.

The Healthcare Commission, the independent healthcare watchdog which rated the trusts, said the performance of mental health trusts remained "a cause for concern".

Cliff Prior, chief executive of the mental health charity Rethink, said the results reflected the poor quality of care experienced by many patients.

Rethink also criticised the star rating targets which mental health trusts are judged against as unambitious.

Guide to NHS star ratings 2004: mental health trusts

society.guardian.co.uk 21 July

Ministers act to help people with mental illness find work

Research shows only 24 per cent of adults with long-term mental health problems are in work

The government has launched an action plan to help people with mental illness back to work.

The announcement comes just weeks after a parliamentary committee recommended changes in the draft Disability Discrimination Bill to make it easier for those with mental illness to benefit from anti-discrimination legislation in the workplace.

The scrutiny committee said the current requirement for a mental illness to be "clinically well recognised" was difficult to prove and could discriminate against sufferers.

It recommended that the bill be changed to make clear that a person suffering mental-health problems would be protected by the bill if their illness affected their day-to-day activities.

Eliminating discrimination was also a focus of a government report aimed at helping those with mental-health problems back into employment. It was published earlier this month as part of a report - Mental Health and Social Exclusion - from the Office for the Deputy Prime Minister.

It found that only 24 per cent of adults with long-term mental health problems in England are working. Yet research in the US found that up to 58 per cent of adults with enduring mental health problems were able to work if given effective support.

Launching the report, health minister Rosie Winterton said: "Our aim is to ensure that people with mental-health problems can get access to ordinary mainstream opportunities."

She pointed to Pathways to Work, a pilot based at Jobcentre Plus, as an example of work underway to help people back to work. The initiative includes six monthly work-focused meetings and a team of expert advisers to help those with mental-health problems. It has been so far been piloted in seven areas.

peoplemanagement.co.uk 19 July

MENTAL HEALTH CHIEF'S VISION

The new head of cash-strapped mental health services in Exeter and East Devon has acknowledged his staff are having an "incredibly difficult time".

Medwyn Williams, of the Devon Partnership NHS Trust, made his comments ahead of a restructuring of the service which could see up to 160 jobs lost in a bid to shave £3m off its budget next year.

He said: "I'm really delighted to be here and to have this opportunity to work alongside people in helping to take forward the service.

"The financial situation that the trust is facing is not unusual for mental heath services. It's an underlying issue that needs to be resolved.

"It's an incredibly difficult time for everybody concerned, not just for our staff, but for our users and carers."

However, Mr Williams said there was a strong sense of commitment among staff to improve the service. He added: "We are slowly starting to take away some of the stigma associated with mental health but have still got a long way to go."

Mr Williams' appointment comes in the wake of a call by Exeter and Greater Devon coroner Dr Elizabeth Earland for a review of supervision levels at the Cedars unit, part of Wonford House psychiatric hospital, Exeter.

In May an inquest jury returned two verdicts of suicide and an open verdict on three patients who died in a 200ft cliff top plunge in June 2002.

Afterwards, the trust said 'significant changes and improvements' had been made since the deaths.

Mr Williams, a father of two young children, took over the role last month. He has worked in a variety of mental health roles for more than 20 years - most recently as assistant director for mental health at Hertfordshire Partnership NHS Trust.

He replaces George O'Neill, who has left the trust and returned to Devon County Council to work on mental health issues.

The Government has just announced massive changes in its approach to mental health with a view to helping people in their own homes.

thisisexeter.co.uk July

Forum Brief: Mental Health

Depression is to be officially recognised as a disability and covered by anti-discrimination legislation for the first time.

Andrew Smith, the secretary of state for work and pensions, said that the groundbreaking legislation, to be included in a new Disability Discrimination Bill, would make Britain a world leader in the field.

Government Response: Department for Work and Pensions

Andrew Smith, the secretary of state for work and pensions, said : "In years to come, the treatment of disabled people typical of the 19th century - and still too often the case today - will be seen as an affront to their humanity. It is the last great cause of emancipation of our time.

"The reform aims to strengthen the Draft Disability Discrimination Act, published in December 2003, and in particular to ensure that people with mental illnesses are properly protected.

"We don’t have the ‘clinically well recognised’ requirement to other conditions, so why should we apply it to mental health.

"Instead, consideration will be given to how long a person has been suffering mental ill- health. The general rule is that the person must have suffered the condition for at least 12 months."

epolitix.com 16 July

Forum Response: Disability Rights Commission

Bert Massie, chairman of the Disability Rights Commission, said: "The move would end the “perverse injustice” of the current Act, which deprives people with mental health problems of the same protection under law as other disabled people."

Forum Response: Disabilities Trust

A spokesman for the Disabilities Trust said: "The Disabilities Trust welcomes news that the government has agreed to accept most of the recommendations made by the joint parliamentary committee on the draft Disability Discrimination Bill and to include mental health problems within its remit.

"In particular we're glad the Minister has recognised that depression does not need to be 'clinically well recognised' in order for people to be covered against discrimination.

"Our only disappointment is that the government still appears to regard twelve months, rather than six, as the minimum length of time a persons' mental health problem has to have been acknowledged.

"The Trust itself is a member of the New Spirit Coalition which comprises a wide cross-section of disability groups that have come together to campaign on the Bill.

"The NSC has been determined to ensure that mental health problems (and particularly depression) are included in the Bill.

"Although mental health problems can be difficult to detect, it is important to ensure that individuals with this often hidden condition receive the same protection under the law as other disabled people.

"The next step now is for the government to try to ensure there is enough parliamentary time to get the legislation onto the statute book before the next general election."

Forum Response: Depression Alliance
Jim Thomson, chief executive, Depression Alliance said: "People affected by depression have, at long-last, official recognition that their illness is a disability. This is something to be celebrated as those who are discriminated against on the grounds of their mental health issues now have a legal right to reply. Unfortunately, depression isn’t a tidy illness, it often comes in unpredictable bouts, so whilst Depression Alliance welcomes the new legislation as a move in the right direction, we still have concerns that the general 12 month rule will preclude many people from accessing benefits and other support."

Mental illness to be a listed disability

DEPRESSION is to be officially recognised as a disability and covered by anti-discrimination legislation for the first time.

Andrew Smith, the Secretary of State for Work and Pensions, said that the groundbreaking legislation, to be included in a new Disability Discrimination Bill, would make Britain a world leader in the field.

“In years to come, the treatment of disabled people typical of the 19th century — and still too often the case today — will be seen as an affront to their humanity. It is the last great cause of emancipation of our time,” he said.

The reform aims to strengthen the Draft Disability Discrimination Act, published in December 2003, and in particular to ensure that people with mental illnesses are properly protected.

It will remove the stipulation that mental illnesses must be “clinically well recognised” before they count as disabilities.

“We don’t have the ‘clinically well recognised’ requirement to other conditions, so why should we apply it to mental health?” Mr Smith said.

Instead, consideration will be given to how long a person has been suffering mental ill- health.

“The general rule is that the person must have suffered the condition for at least 12 months,” he added.

Bert Massie, chairman of the Disability Rights Commission, said that the move would end the “perverse injustice” of the current Act, which deprives people with mental health problems of the same protection under law as other disabled people.

The protection of disability legislation will also be extended to cover people with progressive illnesses, such as cancer, multiple sclerosis and HIV/Aids, in a move that will benefit an estimated 175,000 people, Mr Smith said.

timesonline.co.uk 16 July

Dispute intensifies over Government Mental Capacity Bill

Disagreement over whether the Government's new Mental Capacity Bill would introduce euthanasia in the UK has intensified, with a group of influential Catholics writing to a Catholic newspaper warning of 'dangers' they believe are inherent in the bill.

ekklesia.co.uk 16 July

The letter, signed by the Master of the Guild of Catholic Doctors, five other doctors, a medical student and two barristers, one of whom is chairman of the Catholic Union, argues: "The Mental Capacity Bill permits 'slow euthanasia' a form of homicide by omission and sets up a pathway by which routine lethal injection will inevitably become desirable."

At the beginning of the month however, Lord Alton of Liverpool, a well know pro-life campaigner on the issue, wrote in the Universe newspaper that it is "completely untrue" that the Bill would legalise euthanasia.

He pointed out that pro-Life parliamentarians, working with Archbishop Peter Smith, had been successful in having a clause included on the face of the Bill which "specifically prohibits assisted suicide by act or omission." Lord Filkin, the Government Minister responsible for the Bill had, according to the Peer, "put their position in black and white."

But John Smeaton, national director of the Society for Protection of Unborn Children (SPUC) said that the position of Catholic doctors and lawyers should cause both Catholic politicians and the bishops to 'rethink their position.'

Date set for long-awaited mental health bill

A revised version of the controversial draft mental health bill will be published in September, the government confirmed today.

The bill will then be subject to pre-legislative scrutiny by an expert parliamentary committee, according to the Department of Health.

The move was welcomed by mental health campaign groups, which condemned the original draft bill's measures to extend compulsory treatment as too draconian.

But they do not believe there will now be enough time to bring forward a complete bill before the expected general election next year because of limited parliamentary time.

The Mental Health Alliance (MHA), a coalition of 60 organisations including the Royal College of Psychiatrists and the charity Mind, said it hoped that the new draft bill would be a significant improvement on its predecessor.

Paul Farmer, chairman of the MHA, said: "The government's first draft mental health bill was universally condemned for excessive focus on public safety and its extension of compulsory treatment. We strongly hope that the next draft bill, when it is published, will be significantly improved and a real advance on the current Mental Health Act.

"Pre-legislative scrutiny should allow mental health service users, carers, workers and voluntary organisations to have a real say in the creation of a new mental health act. All of our members look forward to working with the committee to put forward recommendations for a bill fit for the 21st century."

Niall Dickson, the chief executive of healthcare thinktank the King's Fund, said: "It is over five years since the government started to look at a new mental health act.

"The proposals put forward in that time have caused much uncertainty and anxiety, in particular among mental health service users and their carers. We hope the government has taken on board the serious concerns expressed by service users, carers and mental health professionals."

society.guardian.co.uk 14 July

Health chiefs committed to improve mental care

HEALTH chiefs have reaffirmed their commitment to mental health services following the news that several are under threat of closure.

The News reported how financial pressures meant the Cambridgeshire and Peterborough Mental Health Trust partnership was recommending cutting services in a bid to save £800,000 so it can meet its legal requirement to deliver a break-even budget at the end of the financial year.

w3.cambridge-news.co.uk 12 July

The partnership's board agreed recently to endorse a draft strategy suggesting reducing day services in Cambridge, reducing staff levels in adult community teams, closing a ward at either Wisbech's North Cambridgeshire Hospital or Doddington Hospital and closing an eight-bed intensive rehabilitation centre and Springbank Ward, both at Fulbourn.

However, bosses at Cambridge City and South Cambridgeshire Primary Care Trusts (PCTs), which commission the health services locally, say they are still in discussions with the mental health partnership about funding for the rest of the year.

Sally Hind, South Cambridgeshire PCT chief executive, said: "South Cambridgeshire and Cambridge City PCTs have a strong commitment to improving mental health services."

"Last year we purchased around £21 million of mental health services from the trust, and already this year we have committed an additional £2.8 million. This is above the national average.

"I would like to reassure people no decisions have been made about what, if any, service reductions will be made.

"Discussions are continuing with the mental health trust with a focus on making the best use of available resources."

She said community support schemes could be developed which would enable a reduction in expensive inpatient beds.

Richard Taylor, chief executive of the trust, said: "Despite increases in resources, there remain significant pressures within the mental health trust.

"I am confident however that by continuing to work with the PCTs and local service users and carers we can provide the level and quality of service residents of Cambridge and south Cambridgeshire expect."

Concerns have already been raised about the potential cuts.

Lifecraft, a self-help mental health charity, based in Gwydir Street, Petersfield, Cambridge, said: "Lifecraft members are concerned their care and support will be directly affected, especially as there are current difficulties getting support from services already pushed to capacity. This could have extremely negative implications people's health."

In a letter to the News, Margaret Missing, of Stretten Avenue, Newmarket, said: "I realise the Trust Board is in a very difficult position but the local PCTs must come to some financial agreement with it and not make this vulnerable group of patients suffer further."

Mental illness cases wait 16 months for aid

PATIENTS in the Lothians suffering from debilitating mental illnesses are having to wait more than 16 months to see clinical psychologists.

NHS chiefs today blamed the massive waiting time - which is affecting adults battling depression, eating disorders and other ailments - on a national shortage of qualified professionals.

news.scotsman.com 10 July

Campaigners attacked the delays for treatment, calling for radical changes to training regimes for the specialist role.

Health officials stressed most patients were having to wait significantly less than 16 months - with emergency cases deemed as "high priority" by GPs usually getting appointments with clinical psychologists within a matter of a few weeks.

But the crisis is understood to be most acute in East Lothian - where patients not deemed to be at serious risk have been warned that they will wait an average of 16 months before seeing a specialist.

Irene Matthews, 53, from Longniddry, today hit out after being told she would have to wait well over a year before she could get an appointment at Edenhall Hospital in Musselburgh. Earlier this week, the row over excessive waiting times was re-ignited when it emerged a former soldier was told he would have to wait 70 weeks to see a consultant neurologist.

In the latest case, Mrs Matthews was sent a letter from the hospital informing her of the long wait after being referred by her GP.

It read: "Unfortunately, we have a lengthy waiting list at the moment and this means there will be a delay before we can offer you an appointment. The average waiting time is approximately 16 months. We very much regret this situation and we will be sending you an appointment as soon as possible."

Mrs Matthews today said: "It is not acceptable, not just for me but for other people who are waiting for appointments. When I first read the letter I thought it was 16 weeks, but when I looked again it was 16 months."

Mrs Matthews has long suffered from back pain and sciatica, which led her to become depressed.

"The GP had already been advised of the delay," she added. "The doctor suggested I see a psychologist after I ended up on anti-depressants." She said there was nothing she could do but wait the 16 months until a specialist was free to see her. Despite Scottish Executive pledges to cut excessively long waits, clinical psychology is just one of several areas in which patients can wait months or years for appointments.

In the Lothians, some waiting lists for dermatology, ear, nose and throat and ophthalmology stand at over a year.

SNP health spokeswoman Shona Robison said: "This case puts a human face to the misery of those who have to wait far too long to see a clinician. Clearly in this case there are mental health concerns and to have to wait nearly a year and a half to see a clinical psychologist is unacceptable."

A spokeswoman for the Mental Health Foundation claimed more needed to be done to get the next generation of experts working on the front line. She added: "Graduate psychologists are having huge problems in getting training posts in Scotland.

"There’s so few training opportunities so it’s very difficult for trainee psychologists to become clinical psychologists. We would like to see more training posts established."

A spokeswoman with Lothian Health Council added: "We sympathise with this woman, but there is a shortage of clinical psychologists nationally. We hope the problem is going to be addressed."

Murray Duncanson, chief executive of the NHS Lothian Primary and Community Division, stressed steps were being taken to tackle the issues. He said:

"We are planning to increase the number of clinical psychologists in East Lothian and have also established enhanced counselling services within the East Lothian GP practices. In addition, we have increased the number of training places we have available, in recognition of the national shortage of clinical psychologists."

STRESS, HUMILIATION, DISGUST, ANGUISH, DEPRESSION

RAPIST DEMANDS PAYOUT OVER 'BORING' JAIL

A PAEDOPHILE and triple rapist is demanding £15,000 compensation for being bored in jail and having to slop out.

Gavin Davidson says slopping out is 'disgusting'. At most, his three young victims can expect £15,000 between them in compensation for the horrific abuse he put them through.

Davidson, 44, is one of seven prisoners who have joined forces to sue the Executive. Taxpayers will foot the bill for their case.

The inmates want a total of £87,000 for 'loss of self-esteem, stress, depression, disgust, embarrassment, humiliation and mental anguish'.

Scores more cons are expected to follow them into court.

Tory justice spokeswoman Annabel Goldie condemned the case. She said: 'This is a deplorable state of affairs.

'The public will have no sympathy for those who have created so much suffering. We must never lose sight of the misery that victims have to go through.'

It did not take Davidson long to kick up a stink about slopping out. Hehas served only four months of his 10-year sentence.

Two other child molesters are among the seven inmates at Saughton jail in Edinburgh who have been granted Legal Aid to fight their cases.

Paul Nicol, 39, got five years in May for filming himself abusing a 12-year-old girl in the bath. He wants £7000 compensation for his living conditions in the prison.

Fellow pervert Thomas Connor, 77, was convicted of preying on two young girls over aseven--year period.He believes he deserves £18,000 compensation for slopping out.

The other prisoners involved are Nigel McKenzie, 36 (claiming £12,000), Graeme Turnbull, 40, (£12,000),Angus McPherson, 28, (£18,000) and Walter Allan, 44, (£5000).

All claim their health has suffered because their shared cells don't have proper toilets and they have to empty their potties in the morning.

They also complain about their 'monotonous existence' in Saughton, where they are locked in their cells for long periods.

The case is the first major attempt to exploit the £2450 damages award won by armed robber Robert Napier in May.

He claimed his human rights were being breached because he had to slop out at Glasgow's Barlinnie jail.

Davidson and the others were not at the Court of Session yesterday as Lord Carloway heard legal arguments in their cases.

Lice They want the judge to rule that they can't be forced to slop out until a full hearing of their claims has been held.

The prisoners say slopping out is unhygienic and puts them at extra risk from infection.

Turnbull claims his asthma has worsened because of the conditions in Saughton. The others complain of ailments including acne, lice and conjunctivitis.

The seven are all demanding to be moved to cells with toilets.They also argue that the jail doesn't offer enough work, recreation and education for prisoners.

Mungo Bovey, QC, representing the seven, told the judge: 'Given the hardships imposed on these individuals, it is encumbent on ministers to secure that this state of conditions doesn't continue.

'These problems have been well known for a decade in terms of their unacceptability by international standards.

'There is nothing that could justify these conditions in a modern society.'

Around 1200 male prisoners still haveto slop out in Scots jails. Parts of Edinburgh,Perth, Polmont and Barlinnie and the whole of Peterhead jail are affected.

The Scottish Prison Service says it is getting rid of the practice. But the Executive have been criticised for moving too slowly.

SNP justice spokeswoman Nicola Sturgeon said: 'These new cases were inevitable.

'The Executive were told to end slopping out but they have not acted quickly enough.

'We are now faced with a situation were more and more convicted criminals could be in line for compensation payments at the taxpayer's expense.

'This has turned into a total farce. The people entrusted with running our justice system look grossly incompetent, and faith in that system is totally undermined as a result.'

Goldie added:'The flood of cases over slopping out were to be expected.

'But they were entirely avoidable if the Scottish government had got its act together and not cancelled the programme to end the practice.'

She added: 'Prisoners suing because their life in prison is boring is ridiculous.

'The public will have no sympathy. 'These men are in prison for agood reason. It is not supposed to be a picnic or a holiday camp.'

dailyrecord.co.uk 9 July

BMA annual representative meeting: Wishes of patients who have lost mental capacity must be respected

Patients who have lost their mental capacity but have previously indicated that they wish to receive artificial hydration and nutrition should have their wishes respected. This proposal from the Worcestershire division was endorsed at the annual meeting by 59 votes to 56.

Dr Anthony Cole, a consultant paediatrician at the Worcester Royal Infirmary, said that guidelines from the BMA about the withdrawal of hydration and nutrition had made some doctors uncomfortable and he had told his family that he did not wish to die from lack of food or water.

The Mental Capacity Bill would enable people to spell out what medical care they would want if they became seriously ill and were unable to make their own decisions (26 June, p 1516).

The bill would give legal force to an advance refusal for treatment but not to a request for treatment, although it did specify that patients’ wishes should be taken into account. Dr Cole said that he had made a declaration about the appropriate treatment that he would wish to receive and that the motion said that such requests should he respected. The proposal would not be binding on the profession, he said.

Speaking against the motion, Dr Lewis Morrison, a geriatrician from Lothian, said that it implied that the decision to treat would be in the hands of the patient regardless of the opinion of the responsible clinician. "The best clinical decisions," he said, "are made by clinicians and their teams in discussion with patients and their families or carers to achieve consensus."

But sometimes geriatricians had to take difficult decisions that were not in accordance with others’ wishes. For some patients at the end of life artificial hydration and nutrition would not change the prognosis or improve the quality of life but would increase distress. Rejecting the decision was not condoning euthanasia by the back door but would leave difficult decisions in the hands of the people best able to make them.

BMJ.com 10 July

MENTAL WARDS ‘NOT FOR KIDS’

Jul 8 2004

AN MSP is calling for a stop to children being placed in adult psychiatric wards.

This week, Scottish Socialist MSP Rosemary Byrne lashed out during a parliamentary debate and said youngsters were at risk.

She said: “The news that young people continue to be placed in adult psychiatric wards is to say the least extremely disturbing.

“Recent reports have revealed that, over the past year, 144 under 18s, including 28 under 16s have been placed in wards where many have been subjected to “verbal aggression, violence and inappropriate sexual behaviour.”

“This is extremely worrying with major implications for young people with mental health or other social problems.

“During the progress of the Additional Support for Learning Bill in the Scottish Parliament I made clear my concerns over the shortage of clinical psychologists and mental health workers in child and adult mental health services.

“The number of suitable in-patient beds in Scotland for children with psychiatric illnesses has fallen from 58 to nine over the past nine years with the beds concentrated in just one hospital. The number of beds for adolescents has fallen from 67 to 48 over the same period. This trend must be reversed.

“Mental health services for young people must be increased in every health board area or the expectations implicit in the Additional Support for Learning Bill will not be fulfilled and our children will continue to suffer.”

icayrshire.co.uk

Mental Health Bill and Pre-Legislative Scrutiny

Letter from Rosie Winterton and Paul Goggins to Paul Farmer, Chair of the Mental Health Alliance.

Download file

Elderly patients 'illegally doped'

Elderly Welsh patients' lives are being cut short because they are being prescribed drugs unnecessarily and without their consent, a shocking investigation today reveals.

Researchers claim that doctors are unwittingly speeding up some elderly patients' deaths as increasing numbers of powerful anti-psychotic drugs are prescribed.

icwales.co.uk

A study by the Public Interest Research Unit today claims that elderly patients in West Wales have been prescribed the drugs without them giving their consent. And the charity said that in other cases anti-psychotic drugs appear to have been given without good clinical reason.

The charity's damning dossier today condemned the practice, saying if a patient was injured as a result of being prescribed these drugs it could amount to a criminal charge of battery and, in other cases, clinical negligence.

Its concerns echo warnings by the charity Action on Elder Abuse that the "illegal doping" of elderly people is reaching crisis point.

Report author Rupert Harwood said, "It is clear that some doctors are not providing appropriate treatment and in a number of cases the treatment is so inappropriate that it may amount to abuse.

"Some GPs appeared to be prescribing powerful anti- psychotics to the elderly with a frightening lack of caution.

"Whether through lack of knowledge or lack of proper consideration, there is little doubt that some elderly patients are being hastened on their way by the inappropriate use of anti-psychotic medication.

"While we are not saying that anyone has hastened the onset of death in any patient, we are saying that in cases where patients have pre-existing medical conditions, such as diabetes or respiratory illnesses, anti-psychotics will tend to shorten their lives."

But GPs accused the report authors of playing the blame game, saying they were being placed in a no-win situation as they attempted to fill the gaps in services for elderly people. They said more investment was needed to improve access to community-based geriatric psychiatrists.

Dr Andrew Dearden, chairman of the Welsh GP Committee said, "We must have same-day responses with a consultant psycho-geriatrician who can see these patients, arrange hospital or community care, arrange medication which he feels is appropriate and arrange the follow-ups.

"This sounds like the ideal system but it happens in very few places in Wales because the elderly do not rate very high on the Government's list of priorities."

The Trick And Treat report by the Public Interest Research Unit, a charity which primarily provides advocacy for health and social-care issues, found that, in many cases, doctors were not following guidelines which cover the use of anti-psychotic drugs; that patients and their families were not made aware of alternative "talking therapies"; and the side-effects of the drugs were not explained.

It also said that anti- psychotic drugs - which are used to quieten disturbed patients - had been prescribed in cases where they could have caused a serious reaction with other medications or to patients with pre-existing serious illnesses.

The relative of one 81-year- old patient interviewed for the report, said, "He was quite shocked when we found he'd been given an anti-psychotic. We could find ... no record of him having agreed to it."

And a patient in a West Wales community unit added, "I hid it in my top pocket so I didn't have to take it - I wasn't losing my marbles."

The report is based on interviews with 30 patients in Carmarthenshire, Ceredigion and Pembrokeshire, being treated in hospitals, nursing homes or as outpatients.

GARY FITZGERALD, chief executive of Action on Elder Abuse, said, "We strongly welcome the report as it adds to other evidence in connection with the misuse of medication."

He blamed attitudes to the aged.

"This is a societal thing and somehow we feel we can do things to the elderly that we wouldn't contemplate in other people."

And a spokesman for Age Concern Cymru said, "Older people need to be given adequate information about their treatment so that they can give their informed consent."

Life for Britain's 'worst stalker'

A deranged scientist branded by police as "Britain's worst stalker" has been jailed for life after targeting 200 victims.

For more than seven years Richard Jan, a 37-year-old "devious and manipulative bully", carried out what he called World War 3 against health officials, solicitors and others he believed were part of "a grand coalition" trying to section him under the Mental Health Act.

Divided into "First and Second Orders of Culpability", he "terrified" victims such as local councillor Liz Brookes, who was among those at the top of his hate list.

Sentencing him at London's Middlesex Guildhall Crown Court, Judge Henry Blacksell said she and her family were lucky to escape with their lives when he fire-bombed their home.

Another victim, Shauna Bailey, a social worker he particularly detested, was twice taken to hospital after late night attacks outside her front door.

He also torched her car.

Others suffered his "trademark" car tyre slashings, as well as round-the-clock phone calls.

In addition, some of the biochemist's victims were followed home or sent unwanted pizzas and taxis, and, on occasion, even a pest control officer.

Altogether he was linked to a staggering 4,500 "crank calls", a figure detectives dismissed as "the tip of the iceberg".

icwales.icnetwork.co.uk 9 July

Police review patient's death

POLICE are to re-investigate the death of a patient at Swansea's Cefn Coed psychiatric hospital.

Kurt Howard, 32, of Langland Bay, Swansea, died at Cefn Coed on June 29, 2002. Staff at the hospital were interviewed by police following the death which occurred "during an episode of restraint". But no charges were brought.

"South Wales Police can confirm that a number of staff at Cefn Coed are to be re-interviewed to clarify issues raised in connection with the death of Kurt Howard. No date has been fixed for an inquest and it would be inappropriate to comment further," said a spokesman yesterday.

Mr Howard's stepfather, Bon York, who now lives in Dorset said he was pleased the police were taking a second look. The inquiry is being overseen by Det Chief Supt Martyn Lloyd Evans, who headed the investigation into the Clydach murders.

Last month, an inspection team from the Mental Health Act Commission claimed the safety of patients and staff appeared to be at risk at Cefn Coed. Inspectors noted "with anxiety" shortages of staff.

After Mr Howard's death Swansea NHS Trust held an internal investigation, reviewing policy, procedures and training. A spokesman for Swansea NHS Trust said yesterday, "We can confirm South Wales Police are re-interviewing a small number of staff in connection with the death of a patient at Cefn Coed in 2002. We are co-operating fully with the police."

icwales.icnetwork.co.uk