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GRIFFITHS AWARDS £1 1/4 MILLION TO HELP PEOPLE WITH MENTAL HEALTH CONDITIONS BECOME ENTREPRENEURS

Thirteen new projects to encourage enterprise among people with mental health conditions will be set up with £1.25 million of DTI funding, Minister for Small Business and Enterprise Nigel Griffiths announced today.

The projects, based throughout England, will help people with mental health conditions become self-employed, start a small business or social enterprise through mentoring, training, advice and hands-on support. Some will also help those already in business where illness is putting it at risk.

They will be funded by the Phoenix Fund, the £177 million DTI programme set up to help tackle social exclusion by encouraging entrepreneurship.

Nigel Griffiths is meeting with project representatives at a celebratory event this morning. He said:

"I am delighted to award these grants to 13 projects which aim to stimulate and sustain entrepreneurship among those affected by mental health conditions.

"A high number of people with mental health issues aspire to work, but many fear that employers will have little understanding of their situation. We believe that, for some, setting up their own business would be a viable alternative. It is clear from the sheer volume of interest we received in this programme that those working in the field agree."

Health Minister Rosie Winterton will also congratulate the winners at the event. She said:

"The projects being launched today are an excellent example of promoting social inclusion by giving people with mental health problems a real chance to develop their skills and experience through self-employment and allowing people to fulfil their potential within society."

The recipients, who between them initially plan to help more than 1,000 people, are:
The Tarka Foundation, Devon
Futuretrend Technologies Ltd, London
Impact Initiatives, East Sussex
Fredericks Foundation, London
Granby Toxteth Development Trust, Liverpool
CSV Avon Training, Bristol
St Helens Chamber, St Helens
Burnley Enterprise, Burnley
Northern Pinetree Trust, Durham
Business Link Milton Keynes, Milton Keynes
Partnership WTPO Ltd (Laughing Buddha), West Yorkshire
Rochdale & District Mind, Rochdale
mind, in partnership with NFEA and The Telework Association

For further details, including contacts, see the end of this release.

The winning bids were chosen by a panel which included representatives from the Sainsbury Centre for Mental Health, Mental Health Foundation, Sainsbury Family Charitable Trust, the National Federation of Enterprise Agencies and consultants Equalities.

Panel member Dr Bob Grove, the Sainsbury Centre for Mental Health's Employment Programme Director, said:

"As with the rest of the population, a small but significant number of mental health service users have entrepreneurial skills and prefer self employment because of the control it gives them over their working lives. This Phoenix Fund initiative gives them the opportunity to test out these ambitions with the support of experienced business advisers who understand the particular issues they face.

"The projects selected will not only benefit the people who use them, but will also provide valuable learning for all those organisations involved in combatting the discrimination and social exclusion experienced by those who suffer the stigma of mental illness."

Research shows that at any one time, around one in six people of working age suffer from poor mental health with between two and four per cent having a severe mental illness. A significant number will have had professional careers interrupted or aborted by the onset of their condition.

Data suggests that up to 50 per cent of individuals with mental health conditions, even those with severe problems, can be helped to obtain paid employment. Recent research commissioned by the DTI's Small Business Service has emphasised the relevance of self-employment for some people with mental health conditions but also found few current examples of support focused on helping individuals pursue such opportunities.

Notes to Editors

1. The Phoenix Fund was established by the Secretary of State for Trade and Industry in 1999 to help promote enterprise in disadvantaged areas and groups under-represented in terms of business ownership. Some £177 million of Government money will be paid out through the fund by 2008. Further information on the Phoenix Fund can be found on the Small Business Service (SBS) website at .http://www.sbs.gov.uk/phoenix

2. Enterprise Week, 15-21 November, is a series of events to promote entrepreneurship, particularly among young people. It is part of the Make Your Mark Campaign being run by Enterprise Insight. For more details see http://www.starttalkingideas.org.

3. A social enterprise is a business with primarily social objectives whose surpluses are principally reinvested for that purpose in the business or in the community, rather than being driven by the need to maximise profit for shareholders and owners.

4. Research is from the Department for Health's National Service Framework for Mental Health (1999) and Drake, R.E., McHugo, G.J., Becker, D.R., Anthony, W.A, & Clark, R.E. (1996) `The New Hampshire Study of Supported Employment for People With Severe Mental Illness'. The report `Tackling Mental Health Issues Through Enterprise' commissioned by the SBS from MIND and Social Firms UK is available on the SBS website:www.sbs.gov.uk/analytical

Grant recipients
The Tarka Foundation, Devon
Title: Holistic Opportunities for Progressive Enterprises (HOPE) - Receiving £109,850

This project will provide enterprise support to those with mental health conditions, and change people's perceptions about mental health and enterprise. It aims to help people with mental health conditions and their families. It will establish business mentoring support; establish and manage a facility to bring together finance providers, business people and mental health clients; provide support in the promotion of the businesses formed; and look at ways of creating employment supported self-employment and social enterprise opportunities. The initial target number for first stage support is 350 clients.
Contact: John Hardy - 01271 344823
john.hardy@tarka.org.uk

Futuretrend Technologies Ltd, London
Title: Positive Minds - Receiving £124,050

This project is designed to encourage and support people suffering from mental health conditions who wish to become self-employed. It will provide a one-stop shop for professional business advice and training, ICT training, business planning with mentoring, assistance with raising finance, and hot desks. A particular focus of the project will be the effective use of e-business and the project will provide training in this area and develop website/e-commerce sites as part of the project services. A trained psychologist will be part of the team. The aim is to help men and women, including a large proportion from the black and ethnic community, women, and refugees, whether employed or unemployed. Around 75 people will be supported overall.

Contact: Mukesh Gohil - 0208 443 2888
mukesh@futuretrend.co.uk

Impact Initiatives, East Sussex
Title: Pathways To Enterprise - Receiving £100,869

This project will produce a model to help people with mental health needs explore the option of becoming self-employed or involved in business/enterprise. The objective is to increase the number of people with mental health needs becoming self-employed or involved in social enterprise, by providing a combination of business/enterprise and mental health support within a network, to reduce isolation. Some 60 people will be helped, including both employed and unemployed, those with substance abuse issues, offending history, the homeless, or BME groups.

Contact: Chris Peters - 01273 821914
chris.peters@impact-initiatives.org.uk

Fredericks Foundation, London
Title: Fredericks Foundation Business Ability - Receiving £121,354

This project will focus specifically on unemployed people with mental health conditions wishing to become self-employed. The service will be provided in South West London, focussing initially on Wandsworth and the areas covered by South West London & St George's Mental Health NHS Trust. The aim is to work with 54 clients, of whom 18 will start up new businesses. Others will achieve positive outcomes such as paid employment, or take up other vocational training, or will continue working towards self-employment through a successor or complementary project.

Contact: Joe Michel - 01276 472722
joe@fredericksfoundation.net

Granby Toxteth Development Trust, Liverpool
Title: Business For All - Receiving £110,266

The project will build strong links between the mental healthcare network and the business support network, facilitating the movement of users and survivors of the mental healthcare system into meaningful business and self-employment. It will initially seek to help those with mental health problems who have some level of aspiration to start their own business but who are held back from doing so by their illness. It will help up to 40 people, with 10 going on to start their own business.

Contact: Chris Starkey - 0151 734 4925
chris.starkey@talk21.com

CSV Avon Training, Bristol
Title: Enterprising People - Receiving £101,412

This project will help people with mental health conditions in Bristol and South Gloucestershire to explore the possibilities of becoming self-employed or setting up a small business or social enterprise. Those for whom it seems a viable option will take part in a personal development programme prior to receiving training and intensive support to achieve their goals. CSV Avon and Mental Health Matters will work together, using their respective experience of helping people to start their own business and supporting people with mental health problems to return to employment. Around 100 clients will be supported overall.

Contact: Paula Cannings - 0117 908 2266
paula@csvavon.org.uk

St Helens Chamber, St Helens
Title: INSPIRE - Receiving £103,614

This project will deliver a targeted and focused programme that promotes entrepreneurial awareness for people with mental health conditions by promoting initiatives and activities that give them the confidence and skills to consider self-employment. It will encourage the development of social enterprises that can contribute to the local economy and facilitate social inclusion, as well as supporting people in existing businesses where illness puts the business at risk. Clients will be individuals from the Care Programme at St Helens Mental Health Trust, MIND, and the Shaw Trust. Around 200 clients will be helped overall.

Contact: Ann Holcroft - 01744 742003
ann.holcroft@sthelenschamber.com

Burnley Enterprise, Burnley
Title: The Bees Knees - Receiving £67,564

This project is a partnership approach run by The Hive, with the Lancashire Care NHS Trust, Greenspace, a charitable horticultural therapy service, and Burnley Enterprise, to help people with mental health conditions develop business and technical skills. The aim is to create two social enterprises providing 14 service users with self-employment. All 31 users of the The Hive and Greenspace will be helped by assessing their needs, exploring the business issues faced, and piloting the social enterprises with test-trading.

Contact: Jo Royle - 01282 411320
jo.royle@burnleyenterprise.co.uk

Northern Pinetree Trust, Durham
Title: Northern Pinetree Trust - Receiving £117,990

This project will bring together the work of a number of key agencies to design and deliver enterprise awareness; deliver training, counselling and support; advise on access to finance issues; support existing businesses where illness puts the business at risk, help test business ideas; provide on-going support; and create a business forum to secure peer group support. Delivery will be across the North East of England. The aim is to initially support 120 clients, and to signpost a further 40.

Contact: Gill Robinson - 0191 492 8215/Michael Leithrow - 0191 492 8200
manager@pinetree-centre.co.uk

Business Link Milton Keynes, Milton Keynes
Title: Snakes and Ladders project - Receiving £123,828

This project will help employed and unemployed people with mental health conditions in Milton Keynes, Oxfordshire and Buckinghamshire to consider self-employment. It aims to improve the understanding of a range of partner organisations to develop mechanisms to overcome barriers that hold back individuals. Knowledge-based skills will be transferred between organisations, and diagnostics will be developed to assess participants' needs. Flexible provision and on-going support will help clients through their "journey". Around 50 people will be helped.

Contact: Catherine Harries - 0845 606 4466
catherine.harries@businesslinksolutions.co.uk

Partnership WTP Ltd (Laughing Buddha), West Yorkshire
Title: Laughing Buddha Bubble Incubator project - Receiving £97,637

This project will introduce people with mental health conditions to enterprise and reinforce those opportunities with a supportive mentoring structure to enable successful small businesses to be established. It builds on an incubator model developed with Manchester Business School. It is a multi-partner venture, with Kirklees Mental Health Partnership Board helping with the initial exploration phase, but rolling out opportunities across the region. Individuals will be able to test their business ideas while working in a safe environment that will be attuned to their specific support needs. 40 people will be supported initially.

Contact: Louise Pinfold - 0161 236 4464 or 07947 131254
LP@partnershipWTP.co.uk

Rochdale & District Mind, Rochdale
Title: Business Ideas In Mind - Receiving £91,730

This project will provide a tailored enterprising programme for people with mental health problems through start-up and beyond. It will stimulate and develop business ideas; provide business advice, mentoring, support and training; and provide specialist support for coping with health issues. It will also create an enterprise network and provide business services to new entrepreneurs. Up to 30 people will be helped initially, including some from ethnic minorities, with a range of mental health conditions.

Contact: Hazel Curran - 01706 345264
Rochdale mind@aol.com

mind, in partnership with NFEA and The Telework Association
Title: Mental Health Service User Consultancy - Costs still in negotiation

This project will provide training to mental health service users and enable them to use their experiences to become consultants: around 50 people will be directly helped. It will also help inform business support providers about mental health issues and, through them, the wider business community.
Contact: Kathleen Miles - 0208 519 2122
k.miles@mind.org.uk

Health agency to reform inspection procedures

Inspection of services for children, older people and the mentally ill will be done jointly and take into account wider measures of satisfaction and progress, the Healthcare Commission has announced.

The new measures of inspection, which will replace the current star ratings system for healthcare organisations, are being consulted on before being implemented next year.

Inspections will then be on a broader range of seven core standards including the care environment and patient focus.

The Commission says it recognises that mental health and learning disability organisations, and primary care trusts with their responsibility for commissioning, need to have standards and targets interpreted in ways that matter to patients.

Mental Health Foundation chief executive Dr Andrew McCullough said the new system was likely to address criticisms of the way services for the mentally ill have been assessed.

He said: ‘They are acknowledging precisely the sorts of criticisms which have been made – not being sensitive to quality and not being sensitive to the patient’s view.

It feels like it is moving to a system that is locally sensitive.’

Improvement reviews of adult community mental health services are currently being piloted with the Commission for Social Care Inspection, and of older people’s services with CSCI and the Audit Commission.

A Healthcare Commission spokesperson said the Commission and CSCI had very similar views of the way forward for inspection. She said: "We share quite a similar vision and are moving towards a more risk based and proportionate method of assessment."

communitycare.co.uk 29 Nov

More abuse of older people in residential homes, finds charity poll

Abuse of older people is more likely in residential care than in other settings, according to an analysis of calls to charity Action on Elder Abuse.

Although two thirds of the 7,000 calls analysed related to abuse in the victim’s home, nearly a quarter of callers complained of abuse in residential care, where less than five per cent of older people actually live.

Several abusers were in collusion in one third of cases, and this was most likely to happen in institutional care.

Government legislation designed to protect whistleblowers has not been effective, the charity said.

Paid carers made almost a fifth of helpline calls, but relatives and victims were still much more likely to sound the alarm.

The charity urged professional bodies to make failure to report abuse a breach of their contract.

One third of the abuse reported was psychological, a fifth was financial and another fifth was physical; there was neglect in 12 per cent of cases and sexual abuse in three per cent.

Almost half of all cases included multiple abuses.

Sexual abuse was the only type of abuse where reporting rates have increased, and the report said this may be due to abusers seeking softer targets due to more rigorous protection of children recently.

In 46 per cent of cases, the abuser was related to their victim – commonly a son, daughter or partner – but relatives working as informal carers were implicated in less than one per cent of cases.

Paid workers were blamed in a third of calls.

Victims were most likely to be female and in their 80s. In 16 per cent of cases, the victim was over 90 years old.

The report urged the government to set up a taskforce to study elder abuse and to launch an advertising campaign to highlight the problem.

communitycare.co.uk 29 Nov

MPs highlight key failure of Mental Capacity Bill

The government is under growing pressure by MPs to introduce safeguards into the Mental Capacity Bill to to prevent the unlawful detention of people who lack the capacity to resist.

The bill does not meet requirements under European human rights law, the Joint Committee on Human Rights concluded a report published this week.

Failure to include safeguards for "compliant incapacitated" people such as access to tribunals and advocates meant it was “established beyond doubt” that the bill was incompatible with the European Court of Human Rights, said the report.

Its findings follow victory in the European court in October for an autistic man, HL, who was detained unlawfully at Bournewood Hospital, in Surrey, for five months because he was not able discharge himself.

Judges ruled that HL was deprived of his liberty, which contravened article five of the human rights convention.

Health minister Rosie Winterton told parliament at the time of the ruling that all aspects of the Bournewood judgment would be considered and the government would “deliver the appropriate safeguards as soon as possible”.

But the committee said it was concerned at the “apparent postponement of a remedial measure following the judgment in HL v UK” and said it had written to a parliamentary under secretary at the Department for Constitutional affairs for an update.

“It is obviously undesirable for the present Bill to proceed to enactment on its original assumption that there was no Bournewood gap to be filled", said the report.

Communitycare.co.uk 29 Nov.

NOTE: The full report, Joint Committee On Human Rights - Twenty-Third Report, which also contains consideration of other Bills can be downloaded here: Download file

A browsable (HTML) version can be found here

Racist prison murderer was diagnosed psychopath

The young offender who killed his Asian cellmate Zahid Mubarek, 19, was diagnosed as a ‘pyschopath’ four months before the murder took place, but no further action was taken, an inquiry heard.

On the first day of the public inquiry into Mubarek’s death, Nigel Giffin QC said no risk assessment had been made of Robert Stewart, then 19, despite a diagnosis of a “long standing deep seated personality disorder”.

Stewart went on to batter Mubarek to death with a table leg in their shared cell at Feltham Young Offender Institution in March 2000. He was sentenced to life imprisonment

Giffin told the inquiry there had been five “potential missed opportunities” to recognise the risk posed by Stewart and a further nine “critical turning points” at Feltham where the tragedy could have been averted.

Inquiry chair Mr Justice Keith said he hoped the inquiry “would get to the truth of how Mubarek came to be murdered”.

He added: "We know how much it means to Zahid’s family who fought so long and hard to get it. Zahid’s family will at least have the satisfaction of knowing that such lessons as can be learnt from his tragic death may make our prisons a safer place in which to be."

The Mubarek family held a rememberance service for their son before the inquiry began.

communitycare.co.uk 18 Nov

Mental health reform a priority

Pushing forward reforms to mental health laws will be a priority in the coming year, the Queen promised in her annual speech on Tuesday. The Mental Capacity Bill will provide rules on caring for people who lack capacity through mental illness or disability.

Proposals to allow patients to make advance decisions to refuse treatment
have been criticised by some. Opponents are concerned the creation of 'living wills' may lead the way to legalised euthanasia. The Bill would set out a clear test for assessing whether a person lacks capacity to take a particular decision at a particular time.

Under the Bill, which would apply in England and Wales, patients would be able to nominate a person as their designated carer to make decisions about their treatment and welfare. Everything that was done for a person who lacked capacity would have to be in that person's best interests.

It would also be a criminal offence, with a maximum sentence of five years, for anyone who wilfully neglected or ill-treated a person who lacked capacity. The Queen also said progress would also continue on the draft Mental Health Bill, which includes measures to allow the enforced treatment of potentially dangerous mental health patients. It is being reviewed by a pre-legislative committee which should report in March.

The Queen's Speech also promised hospital superbug infection rates would be
lowered, NHS capacity would be increased and patients would be given more
choice about their care. There will be an even stronger emphasis on disease prevention as the Public Health White Paper proposals come in to force, said the Queen. This will include making smoke-free environments the norm, curbing the
promotion of unhealthy foods to children and providing clear nutritional labelling for packaged food.

Commenting on the draft Mental Health Bill, Liberal Democrat health spokesman Paul Burstow said: "This is a Bill which does nothing to tackle the stigma attached to mental health problems. It is focused on a Home Office security agenda, not improving mental health services. A new Mental Health Act is desperately needed, but it must be a law to protect and improve services for patients, not a means to demonise those with mental health problems."

Richard Brook, chief executive of the mental health charity Mind, said his organisation would campaign for fundamental changes to the Mental Health Bill. He said: "We believe the proposed legislation does not move us towards a compassionate and effective mental healthcare system."

Shadow Health Secretary Andrew Lansley said: "Labour say the NHS is their priority, but the Queen's Speech shows that is all talk. Action is required on health to cut bureaucracy, reduce the costs of inspection, to strengthen public health and mental health services and to ensure patients are treated in clean and safe hospitals."

bbc.co.uk 23 Nov

Newsletter for Mental Health Officers in Scotland #7

this issue includes:

Welfare guardianship - protection and empowerment
MHO and police services in Fife

Mental Health Officers and the problematics of gender

Has the AWIA been met by an indifference to rights on the basis of expediency?

Human rights journey at the State Hospital

How many Mental Health Officers do we need in Scotland?

Download file

Ruling angers dead man's family

The family of a mentally ill man have expressed their anger after an inquest verdict that he was unlawfully killed by police was overturned by a judge. Roger Sylvester, 30, from Tottenham, north London, died in January 1999 after being restrained by officers in a padded room at a psychiatric hospital. His family said they felt let down after a High Court judge replaced the previous verdict with an open verdict. Eight Metropolitan Police officers had challenged the original verdict. The judge said on Friday that the unlawful killing verdict had to be quashed to ensure justice for both the officers involved and for Mr Sylvester. Mr Justice Collins said the way the coroner had summed up at the inquest in October 2003 had "confused" the jury. The judge said he would not order another inquest, and said no jury in any criminal case would be likely to convict any officer of manslaughter. The Metropolitan Police officers welcomed the reversal of what they had called an "irrational" ruling. The officers were suspended following the unlawful killing verdict but have now been reinstated.

Mr Sylvester's brother Bernard Renwick said the family was withdrawing from the legal process "with a bitter taste in our mouth", after nearly six years of campaigning.

He said: "From day one we were told to expect openness, accountability and transparency. We merely wanted truth and, where necessary, justice. Instead we have had obstacles, delays, anguish, smoke and mirrors and 'justice'. Where is the justice?" Mr Sylvester's 70-year-old mother Sheila said: "Did Roger kill anybody?"

Outside the court, Metropolitan Police Federation chairman Glen Smyth made a statement saying the officers involved had been subjected to "wholly unfair public vilification". He also called for "fundamental reform" of the inquest system and accused pressure groups and MPs of attaching themselves to campaigns such as this to "promote their own interests".

Mr Sylvester had suffered from mental health and drug problems, and was detained after being found naked and banging on his own front door. Mr Sylvester, who weighed 18 stone, later collapsed after being held down by a number of officers for 20 minutes in a padded room at a psychiatric hospital. He was in a coma for seven days before being pronounced dead on 18 January, 1999. The inquest jury returned a verdict that he died from brain damage and cardiac arrest due to breathing difficulties caused by restraint.

In reaching its verdict, the inquest jury concluded Mr Sylvester had been restrained for too long, in the wrong position, and was not given sufficient medical attention. Lawyers for the officers had argued that the inquest was wrongly allowed to be turned into a surrogate criminal trial, in which the police involved stood convicted of manslaughter. There was no evidence to support the decision Mr Sylvester was killed unlawfully, they maintained.

Speaking after Friday's hearing, Annette Pedder, whose partner Simon Creevy was one of the suspended police officers, called for an overhaul of the inquest and coroners' court systems "to stop people having the heartache of a judicial review".

She told BBC News: "We have had extra security measures fitted at home, as have all the families involved, because threats have been made by people in the past towards the officers. I certainly wouldn't want anybody to go through what we have had to go through for the past few years."

bbc.co.uk 26 Nov

Full Transcript

Mental health Bill is to be delayed

21 November 2004

Campaigners for better treatment for people suffering from mental illness, including The Independent on Sunday, will be able to claim a victory this week.

The long-awaited Mental Health Bill will be one of eight "draft" Bills that will have to wait until after the next general election before they are enacted. This will allow more time to devise a compromise between ministers who want the public protected from potentially violent patients, and those who fear that the mentally ill could be turned into the only people who can be punished for crimes they have not yet committed.

The Bill contains a measure first proposed by Jack Straw five years ago, when he was home secretary, after the former psychiatric patient Michael Stone was convicted of murdering Lin and Megan Russell. In its original form, in October 2002, the Bill proposed that psychopaths labelled untreatable should be detained indefinitely, even if they had committed no crime.

The Mental Health Alliance, whose members include the Law Society and Mind, condemned the move and this newspaper has opposed it in a two-year campaign.

A new draft of the Bill has offered extra protection for the mentally ill.

news.independent.co.uk 21 Nov

Bartram (Stephen) v Southend Magistrates' Court

22 Oct

The background, so far as material, is as follows. On 13th January 2003 the claimant stabbed his dog and killed it. The reason why he did it was, it would seem, because he believed that the dog was harbouring an evil spirit and it was necessary to stab the dog in order to enable the evil spirit to escape. It will be apparent from what I have said that this claimant suffered from mental illness. That mental illness is paranoid schizophrenia. The condition is, as will become apparent, susceptible to medication and at the relevant time, for whatever reason, the claimant was not taking the medication which he should have been taking and as a result was moved to stab and so kill his dog. ...
They then purported to make what is described as an interim hospital order and that records that having heard the written evidence of two medical practitioners and complying with the provisions of the relevant section of the Mental Health Act, the accused was suffering from the mental disorder. They do not specify which precise form of mental disorder was the one from which he was suffering, but as I have said the medical practitioners spoke with one voice so far as that was concerned. Being satisfied that the conditions under section 37 of the Mental Health Act which were required to be satisfied for the making of a hospital order were satisfied, and that arrangements had been made for his admission, they ordered that he be detained in hospital in the meantime. As I say, that purported to be an interim hospital order, although it does not refer specifically to section 38 of the Mental Health Act 1983 which is the section which gives power to make interim hospital orders. It is perhaps fortunate that it did not refer specifically to section 38 because the magistrates had no power to make an interim hospital order under section 38.

Full Transcript

Results from the second survey of public opinions concerning people with mental illnesses

Conducted by the Office for National Statistics on behalf of the Royal College of Psychiatrists’ anti-stigma campaign. July 2003

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Royal College of Psychiatrists' response to Public Health White Paper

Mental illness is different from physical illness

The Public Health White Paper is welcomed by the Royal College as an important and timely new commitment to prevention and public health interventions.

Research shows that such interventions can be effective. Self-determination, partnership and choice are all important facets of a coherent approach to improving health, and involving the population in this is clearly desirable.

The College has concerns, however, that the most appropriate models of public health intervention for physical illness are not necessarily appropriate for mental illness. The risk of mental illness may not be a matter of individual choice. As a result, we have doubts about how easily the recommendations in the Public Health White Paper can be applied effectively in the area of mental health. We recommend, therefore, that a complementary - but separate - public health strategy is considered for mental health.

Nov 04

People can make lifestyle choices, such as whether to smoke and the kinds of foods they eat, and government does have an important role in helping to change behaviour. Whilst the College supports the need for a smoke-free ban in public and work places, banning smoking in psychiatric environments may be counter-therapeutic. For example, psychiatric patients often use smoking as a coping mechanism, and research has indicated that nicotine can help some brain illnesses.

We know that improving physical illness will impact on mental illness; rates of chronic illness, with loss of function, are associated with higher rates of mental illness. If the results of the recommendations in the White Paper were to decrease morbidity and mortality in physical illness, this would reduce rates of mental illness.

For further information,- contact Deborah Hart or Thomas Kennedy in the External Affairs Department. Tel: 020 7235 2351 exts. 127 or 154. E-mail: dhart@rcpsych.ac.uk.

Key issues for the Royal College of Psychiatrists

The risk of mental illness may not be a matter of choice

The risk of mental illness may not be a matter of individual choice. It can be argued that an individual's risk of heart disease is in part a culmination of lifestyle and dietary choices. It is difficult to make the same argument for depression, schizophrenia, agoraphobia, obsessive-compulsive disorder and most other mental health problems, apart perhaps some due to substance misuse.

The emphasis in the White Paper that individuals are responsible for their own health, rather than the NHS, Government and other institutions, does not apply to the area of mental health. The balance between individual and societal responsibility for people with mental health problems may be significantly different from the balance of equally preventable physical problems.

Increased stigma

The individualisation of risk and the impression that mental health is a matter of choice could lead to further stigmatisation of mental illness. The White Paper's emphasis on choice and self-help can further increase the guilt, shame and stigma felt by patients, carers and their families.

We agree that changing behaviour is an important lever for improving health, but it is also important to recognise that the vast majority of mental illness cannot be improved by lifestyles choices only. Other contexts, such as societal and macro-economic decisions, which are outside individual and community control, also impact importantly on mental health.

Employers' role in improving the heath of the workforce

Job insecurity, lack of autonomy in the workplace, poorly managed workplaces, racial and other forms of discrimination and bullying have all been associated with higher rate of common mental disorder, such as anxiety and depression.

This has not been helped by increased scrutiny of public bodies by outside agencies. For example, school inspections by Ofsted, have been linked to anxiety and depression in teachers.

The Department of Health is the largest employer in the UK, but its workforce has been characterised as having low morale and is under continual pressure due to its high level of responsibility, relatively low pay and constant change.

The College would support effective strategies to improve the work environment and would welcome plans to attempt to make the public sector a less stressful place to work. A focus on improving the working lives of all its staff, and management strategies based on developing and enabling staff, may pay dividends.

Healthy lives

People with mental health problems may have fewer choices for healthier lifestyles. Smoking is a case in point. People with mental illness are more likely to smoke and it would be inappropriate to withdraw something that is used by patients as a 'coping mechanism' when they are very upset and distressed. It is not always practical to enforce a smoking ban in secure or 'semi secure' or closed environments, such as prisons, when people cannot go outside to smoke. Moreover, research has also shown that nicotine can help some symptoms of brain illness.

Healthier lifestyle choices can also be limited by the prevailing social and economic climate and by education.

There are a number of possible interventions that can improve an individual's capacity to deal with psychological problems. In depression, for example, cognitive behavioural psychological techniques, coping skills strategies, personal growth classes, stress management classes, are techniques that can improve outcome.

The role of education and early intervention

It is possible to teach people in schools about mental illness, increasing emotional literacy, social skills, competence and coping skills. Such skills can help decrease depressive symptoms and improve psychological health in children. The National Curriculum has an important role in this area.

Research has shown that getting help earlier, rather than later, is important in addressing psychological problems in young people. A campaign to improve the knowledge of an individual, and information about the support network of routes to care and resources available, is a viable option for helping people to get effective early treatment.

Some individual measures may decrease the risk of mental illness or decrease morbidity by earlier treatment, but there may be greater impacts from environmental manipulation rather than initiatives geared towards the individual.

What can be done to create an environment that encourages healthy lifestyle choices?

Changing environments may not encourage healthy lifestyle choices.
For example:

Income inequality, financial insecurity, low social efficacy and low social cohesion, poorer built environments, some forms of social housing, law autonomy in the working environment are all associated with higher rates of common mental disorders.

For ethnic minorities, the level of racism in an area and the density of ethnic minority population are associated with rates of common mental disorder and psychosis.

Other factors associated with an increased risk of psychosis include poor antenatal care, lower birth weight, being born and raised in a city and the use of drugs such as cannabis and cocaine.

Ethnic density is also important for refugees and asylum seekers, making dispersal injurious to mental health. In addition, the process of applying for asylum in the UK acts as a 'secondary trauma', often increasing existing difficulties due to difficult migration experiences, and sometimes persecution and torture in their countries of origin.

Increased maternal support, either postnatally or through proper support networks and financial incentives, and refocusing of professional help on the psychological needs of the new mother would be practical health interventions.

By increasing social cohesion and social capital in terms of residential stability, community-based organisations and facilities, community groups and appropriate use of public spaces would contribute to lower rates of crime, substance misuse and teenage pregnancy, which are all risk factors for mental illness.

Dixon (Simon Nicholas) (By his Mother & Litigation Friend Pauline Dixon) v Were (John) (2004)

26 Oct

In this action, the Claimant, Simon Dixon, claims damages from the Defendant for personal injuries and related losses sustained following a road traffic accident on the 5th July, 1997 ("the accident").
2. The Claimant was born on the 17th February, 1976. He attended Crosfields Preparatory School and, thereafter, Radley College ("Radley"). In September 1994, he commenced his studies at Newcastle University and was still a student at that university at the time of the accident.
3. In July 1997, the Claimant was enjoying his summer holidays. He was staying at his parents' home in Shiplake. On the 4th July, he went with friends to a party at Goring Heath. In the early hours of Saturday 5th July, the Claimant, with five other friends went for a drive; the Defendant was the driver. All concerned had had a good deal to drink. Seat belts were not worn. Tragically, the car collided with a tree. Two passengers were killed. The Defendant was subsequently convicted of causing death by careless driving and was sentenced to a period of imprisonment. The Claimant, on any view, was gravely injured; he suffered severe physical injuries and, in addition, sustained brain damage, resulting in lasting mental health consequences....At the commencement of the trial, a causation issue formed part of the Defendant's case. In a nutshell, the Defendant contended that a psychiatric disorder from which the Claimant continued to suffer (bipolar affective disorder) was not caused by the accident; this disorder was instead the result of a pre-existing genetic predisposition, albeit that it had been brought forward in time by the accident. Manifestly, this defence faced a number of objections; it is only necessary to mention one. The foundation of the Defendant's factual case rested on the assumption that a relative of the Claimant (whom it is unnecessary to identify), suffered from a psychiatric disorder.

Full Transcript

H (through his litigation friend the Official Solicitor) (R on the application of) v (1) Brighton & Hove Council (2) Brighton & Hove NHS Primary Care Trust (Interested Party) (2004)

Two applications from a consent order made by Gage J: one by a mentally disabled person (H) seeking its enforcement, and the other by Brighton and Hove Council (the Council) seeking to discharge it. H had been admitted to a private hospital for treatment and had been detained there under s. 3 of the Mental Health Act 1983 (the 1983 Act). When the Council proposed to transfer H to another care home, he commenced proceedings against the Council to prevent the transfer. Based on negotiations between H and the Council, a consent order was made. The Council had agreed to provide H with suitable accommodation to meet his needs, and had proposed a timescale for implementation of that care plan. The Council was also required to pay the assessed costs of the proceedings to H. When the Council did not comply with the consent order, H applied for its enforcement. The Council applied for the discharge of the consent order on the ground that the accommodation referred to in the care plan was no longer suitable to H's needs, as his health had improved sufficiently to require his discharge from hospital. H argued that in the consent order the Council had agreed to provide him with a care home even if he was discharged from hospital. He contended that under s.17 of the 1983 Act, the Council was obliged to place him in the accommodation referred to in the care plan. The court was required to determine: (1) whether the consent order had to be discharged; and (2) whether the accommodation referred to in the care plan could appropriately meet H's current and future needs.

(1) The Council was required to advance compelling reasons as to why the consent order should be discharged. It had failed to do so and had not provided clear and sufficiently detailed evidence to establish a cogent case for the discharge of the consent order. (2) Based on the assessment of H's condition by various medical professionals, he was required to be detained in a hospital to facilitate and ensure his treatment under the 1983 Act. Placing him in a community care home that was not governed by the 1983 Act would be undesirable and unsettling to his health; H could not be placed in the accommodation referred to in the care plan.

Both applications adjourned for further directions. Outcome: Proceedings Adjourned

Full Transcript

An Evaluation of Appropriate Adult Schemes in Scotland

This research evaluated the operation of appropriate adult schemes throughout Scotland in 2002. The role of an appropriate adult is to provide support and reassurance to any person being interviewed by the Police as a victim, witness or accused and to ease communication with the Police. Although not established on a statutory basis in Scotland, the use, or failure to use, an appropriate adult has had legal implications. This study examined the effectiveness of appropriate adult schemes and makes a series of recommendations to improve the operation of the schemes in Scotland.

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OFFICER IS PRAISED FOR SUICIDE SAVE ATTEMPT

A Totnes police officer who plunged into the River Dart in the pitch dark to save an elderly woman, has been praised by a coroner as he heard how the woman fought to kill herself.

thisissouthdevon.co.uk 18 Nov

Joan Wallace threw herself into the Dart at Steamer Quay, Totnes, and then tried to fight off her rescuers as they battled for more than 20 minutes to get the 80-year-old depressed pensioner out of the water, the inquest heard.

PC Charles Goodman, a former soldier in the Royal Signals Corps, stripped off his uniform and then plunged into the River Dart to swim to the woman who was being held in place by a boathook held by a yachtsman who was struggling to stop her from being washed downstream by the ebbing tide, the coroner was told.

PC Goodman, 44, managed to put a strap around the woman before pulling her in to a set of steps where she was hauled to safety.

Mrs Wallace, a retired nurse, was unconscious by the time she was rescued and she died two days later in Torbay Hospital.

Torbay Coroner Ian Arrow praised PC Goodman's efforts to save the woman as he told him at a Totnes Inquest: "I publicly thank you for the efforts that you went to that night."

Recording a verdict of suicide he told the inquest that Mrs Wallace had left a note saying she intended to go to the river and that she could no longer cope.

"I am satisfied that she intended to take her own life," he said.

Mrs Wallace, of Weston Road, Totnes, had been born in Preston, Paignton. She had suffered from depression and had attempted to kill herself by taking overdoses of tablets on two or three occasions in the past, her daughter, Lesley Lyon of Totnes, told the inquest.

Just after 10pm on June 22 she went to the River Dart at Steamer Quay, Totnes, where Michael and Margaret Wilkins from Southampton, were on board their 30-foot yacht preparing to go to bed.

They came out on deck after hearing a splash and spotted Mrs Wallace floating in the water.

As Mr Wilkins held her by her coat with the boathook he could see her still trying to put her head under the water, he told the inquest.

As she struggled to free herself from the boathook she told Mr Wilkins: "Please let me go."

Then she managed to get out of the coat she was wearing but Mr Wilkins managed to snare her again by her T-shirt with the boat hook.

She continued to try to put her head under water but "I held her and I didn't let go," Mr Wilkins said.

Mrs Wilkins called the police and when PC Goodman arrived he stripped off his uniform, put a life belt around himself and then waded into the water to rescue Mrs Wallace.

The Totnes-based police officer who has been 18 years in the force, told the inquest: "I placed a strap around her body. I kept her head above water and we pulled her to the steps."

After the rescue PC Goodman went to Mrs Wallace's home where he found the note on her kitchen table.

Pathologist Dr Consuelo Garrido said the cause of death has been immersion in cold water leading to cardiac respiratory arrest and brain injury.

Apology to family of suicide man

The prison service has made an apology to the family of a paranoid schizophrenic man who killed himself while in custody.
Keita Craig, 22, the son of Culture Club bass player Mikey Craig, used his shoelaces to hang himself at Wandsworth Prison in February 2000.

A second inquest found the prison's neglect contributed to his death.

A letter of apology from Prisons Minister Paul Goggins was handed to the family at HMP Wandsworth on Tuesday.

The family have been working with the prison to improve conditions to ensure similar deaths do not happen in the future.

Mr Craig's grandmother Erin Pizzey received the open letter as she said his mother Cleo Scott felt unable to attend the prison.

Ms Pizzey said: "I think the most historic thing which has happened today is Paul Goggins has made what I asked for in the beginning, a public apology.

"Without that apology there is no closure.

"There is a huge feeling of injustice. Your child has been taken away and given back to you in a coffin.

"I feel that we have achieved a fruitful death for Keita.

"I was determined that he would not die without changes being made for everyone, especially the many young fragile people out there who have no place in prison."

Unique settlement

Mr Craig had been sent to Wandsworth Prison, south-west London, after appearing at Richmond Magistrates' Court on a robbery charge.

Warders at the court confiscated his shoe laces but they were returned to him by prison staff.

He was then put in a cell in the hospital wing without regular check ups and subsequently committed suicide.

The first inquest found Mr Craig killed himself while the balance of his mind was disturbed.

Right to life
The second agreed but also said the cause of death was contributed to by neglect.

Governor of Wandsworth, Jim Heavens, said deaths at the prison fell in the past three years although attempted suicides were a weekly occurance.

The apology was part of an uncontested settlement in which the family are being paid £20,000 compensation.

The Prison Service also accepted that Mr Craig's death violated Article Two of the European Convention on Human Rights, the right to life.

The letter of apology was given to Ms Pizzey by Mr Goggins' private secretary Phil RiIley.

bbc.co.uk 16 Nov

Sale of 'suicide book' criticised

A coroner is asking the online retailer Amazon to stop selling a book about suicide after the death of a 19-year-old Lancashire woman.
Preston coroner Howard McCann made the appeal after the death of Sarah Cherry, from Penwortham, who killed herself after reading it, an inquest was told.

"I was shocked that such a book should be readily available," said Mr McCann.

But Amazon said removing the book because its message was "repugnant" amounted to censorship.

A spokesman for the company said: "Our goal is to support freedom of expression and to provide customers with the broadest selection possible so they can find, discover, and buy any title they might be seeking.

Not promoted

"We leave it up to our customers to decide what they wish to read.

"While we do not censor items from our web site, Amazon.co.uk does not promote these kinds of titles.

"If a title is banned we would of course immediately remove it from the Amazon.co.uk website."

Mr McCann said the book would provoke more complaints if it were displayed elsewhere.

"I would strongly suspect that if you were to see this book on display, let's say in high street retailer, there would be objections from the majority of members of the public that such a book should be on display and indeed sold," he said.

bbc.co.uk 18 Nov

Woman saved from car park plunge

A detective saved a suicidal woman's life by pulling her from the edge of a multi-storey car park's top floor.
The woman, who is in her 30s, had both legs hanging from the edge of the 19th floor when police arrived at Garrard Street car park in Reading, Berkshire.

Det Sgt Ian Winson offered her a cigarette and as he stood behind her to light it, was able to drag her to safety from the narrow parapet.

The woman is now being given psychiatric care at a local hospital.

'Both feet dangling'

Det Sgt Winson told the BBC: "When I found the lady, she was already over the edge of the roof, sitting on a parapet which was no more than a foot wide, with both feet dangling.

"She was talking about her family and how things had gone wrong in her life and said she was intent on taking her own life.

"I tried to keep her calm and we spoke for about 10 minutes, during which time she asked for a cigarette, which I arranged for a colleague to bring us.

"It took a while to try to light it as it was very windy that high up. I was able to use this moment as my chance to drag her back onto the roof.

"She was unhurt and we escorted her to a waiting ambulance."

bbc.co.uk 15 Nov

Woman recovers from 40-year depression

When Mary Stephenson began suffering depression shortly after giving birth to her first child, it was the start of four decades of mental anguish.
Every anti-depressant and therapy was tried, with no effect, and her condition became steadily worse.

When she began to harm herself two years ago she was sectioned under the Mental Health Act and taken into a secure unit.

Doctors were baffled by her condition, labelling her "a conundrum".

It was a chance remark by a family friend that finally led to an unusual course of treatment, and the one which Mary believes has cured her.

Her family are convinced she was suffering mercury poisoning from the fillings in her teeth.
But the Department of Health says billions of such fillings have been used worldwide.

"The DoH has no evidence to suggest that mercury-based dental fillings pose a serious hazard to health," said Chief Dental Officer Prof Raman Bedi.

'Ups and downs'

Like many women, Mary's first pregnancy led to calcium deficiency and she needed 19 mercury amalgam fillings.

Shortly after her son was born she entered a spiral of depression.

"I put it down to what was happening in my life with the ups and downs I was having that I would feel a little depressed," she said.

"There were times that I really wanted to end it all because life was so awful and hopeless."

Her husband John said she gradually changed into a different person, one he did not recognise.

"She couldn't relate to young people and didn't really want them around her," he said.

"It was very hard because it wasn't her as I knew her."

Fillings replaced

After hearing about mercury poisoning, the family persuaded the hospital to allow her to visit a dentist in January 2004.

Over three months he removed the mercury fillings and replaced them with plastic composite.

At the same time she began a course of detoxification, taking 45 tablets a day to remove all the mercury from her body.

At first nothing happened, but then she started to get better.
By August she was able to leave the hospital for shopping trips and she was formally discharged back home on 21 October.

"The day I got out of the unit we went to the theatre," she said.

"In the interval I went to the toilet and as I was walking up and down the stairs I thought - I'm a free person - and that was lovely."

Mercury fillings have already been banned elsewhere in Europe, and the UK government advises that they should not be given to pregnant women as a precaution.

But they add that there have been billions of such fillings fitted and there is no evidence to show that they are a hazard to health.

'Open-minded'

A British Dental Association spokeswoman said only a tiny number of people have proved to be allergic to mercury and that a mercury sensitivity test could be requested from GPs.

The head of the Hampshire NHS trust treating Mary, Martin Barkley, said they were keeping an open mind over the case.

"We agreed to her family's suggestion that she took mercury detoxification tables. It is true that over a period of time her illness remitted," he said.

"The consultant psychiatrist has done a presentation of this case at one of the Trust's medical staff teaching forums in which he said that we need to open minded about this possibility."

bbc.co.uk 18 Nov

Child antidepressant use 'rising'

The UK has seen the fastest rise in the prescribing of antidepressants and other mind-altering drugs to children, a study of nine countries shows.
University of London researchers compared prescribing rates between 2000 and 2002 in countries in Europe, South America and North America.

During that period, the UK saw a 68% rise in children being prescribed drugs to stimulate or calm the brain.

The research is published in Archives of Disease in Childhood.

bbc.co.uk 18 Nov

Some common antidepressants were withdrawn from UK paediatric use last year, but the researchers say doctors are likely to move to others.

The team, from the School of Pharmacy at the University of London looked at prescribing of antidepressants, stimulants, antipsychotics, tranquilisers and medications to treat anxiety.

They examined prescription data for children up to 17 in the UK, France, Germany, Spain, Argentina, Brazil, Mexico, Canada and the US.

The information came from an international database (IMS MIDAS), which draws on data from a representative sample of medical practitioners in each country.

It was found children are generally being prescribed more antidepressants and other drugs designed to calm or stimulate the brain.

The highest increase of 68% was recorded in the UK. Many of the prescriptions were for medications used in the treatment of Attention Deficit Hyperactive Disorder.

Significant rises in the number of prescriptions for these drugs were evident in all countries, except Canada and Germany where the increase in prescriptions over the period was just 13%.

Bed-wetting

A second study by researchers at the centre looked at the rise in paediatric antidepressant prescribing to UK children under 18 between 1992 and 2001 using data from the General Practice Research Database.

Almost 25,000 children and adolescents were given 93,000 prescriptions, of which over half (55%) were for the older-style tricyclic antidepressants.

Tricyclics are licensed for the treatment of depression and night time bedwetting. Most of the prescriptions for children under 10 mentioned nocturnal enuresis, and not depression.

Four out of 10 prescriptions were for SSRIs such as Prozac (fluoxetine) and Seroxat (paroxetine)

The rate of antidepressant prescriptions for children rose by 70% in a decade. While the rate for tricyclics fell by 30%, that for SSRIs rose 10-fold from 0.5 children treated out of 1,000 to 4.6.

The researchers say almost half of adolescents with clinical depression had been prescribed tricyclics, despite the fact that these drugs are considered only moderately effective in this age group.

Dr Ian Wong, director of the centre said: "There is an element of better recognition of child and adolescent mental ill health."

Last year, the UK Medicines and Healthcare Products Regulatory Agency recommended most SSRIs should not be given to children.

While Dr Wong says this will impact on prescribing rates, he said doctors would simply use other antidepressant medications because of the lack of availability of other options, such as psychotherapy.

"We will see some sort of fall in prescribing rates, but we can't stop it all.

"Prozac can still be used, so we expect to see a drop but I'm not sure how big. And there are other types of antidepressants that could be used."

Dr Wong said more research was needed into how drugs affected children, rather than using data drawn from adult usage.

Alternatives

Lee Miller, from the charity Young Minds, said the prescribing figures would have changed since the new guidance on SSRIs.

He said: "We need to think about alternatives to medication for children with depression."

But he added: "There isn't enough funding going into providing other therapies for depressed children, such as cognitive or talking therapies.

Paul Burstow, Liberal Democrat health spokesman, said: "While it is good that the existence of mental health problems in children and teenagers is becoming more recognised, it is still disturbing to see such a large increase in prescriptions for children."

Marjorie Wallace, chief executive of the mental health charity SANE, said: "What we need is more research into the effects of medications on the developing brain, so that safer medical treatments can be offered, as well as an urgent increase in the numbers of therapists for young people who are ill and their families."

The government has published its long-awaited white paper on public health

BBC News Online looks at mental health - one of the five key issues covered in the government's long-awaited white paper on public health.

What does the government plan to do?

Introduce measures through the SureStart programme to improve the mental health of children and young people.

Publish an action plan to ensure equality of access to mental health services for ethnic minorities.

Publish guidelines on how mild to moderate mental health should be managed in the workplace.

What are mental health problems?

The term mental health covers a wide spectrum.

The main disorders include anxiety, Alzheimer's disease, depression, eating disorders, obsessive compulsive disorder, post-traumatic stress disorder, schizophrenia and self-harm

Mental health disorders can be sub-divided into two types - neurotic and psychotic.

Neurosis describes mental health problems which are severe forms of normal experiences, such as anxiety or depression.

Whereas psychosis is more severe and involved the distortion of a person's perception of reality, for example schizophrenia.

But not all diagnoses of mental health can be classified as either neurosis or psychosis.

For example, personality disorder falls outside the two categories.

And for some conditions, such as post-traumatic stress disorder, there is an overlap.

What are consequences?

The consequences of mental health problems vary depending on the severity of the condition.

People with depression or who have panic attacks can struggle with certain aspects of everyday life but can still learn to live with them and live fulfilling lives.

But mental health problems can lead to self harm and suicidal depression.
About 142,000 hospital admissions each year in England and Wales are the result of deliberate self-harm.

While self-harm is more common in women, three quarters of suicides are by men.

Mental health problems also have wider implications for society.

The total cost of mental health problems in England has been estimated at £77.4bn, according the Sainsbury Centre for Mental Health.

More than a third of this cost is attributed to lost employment and productivity related to schizophrenia, depression and stress. More than 90m workings days are lost each year.

How many people are affected?

One in six adults at any one time has a mental health problem - maybe as many as 9 million are affected.

Workplace stress affects around one in five workers, around 5m people. And stress-related conditions are the most commonly reported cause of sickness absence. Around 895,900 adults on Incapacity Benefit report their primary condition to be mental ill health.

Depression is the most common form of mental health problem with one in six people having it at some point during their life. It is most common in the 25 to 44-year-old age group.

One in 100 have more severe forms of problems such as manic depression and schizophrenia.

Women are more likely to have neurotic disorder such as anxiety or depression than men. But men are three times more likely to be alcohol dependent and twice as likely to be drug dependent.

One in 10 children under 16 has a mental health problem. Among 11 to 15-year-olds, 13% of boys and 10% of girls have a mental health problem.

Among the elderly, dementia is one of the most common problems. Some 5% of over 65s and up to one in five over 80s have dementia.

Is it getting worse?

Most reports that have been published recently suggest levels of mental health problems are on the rise.

Self-harm is said to be increasing, particularly among children. Childline reports that the number of self-harm calls has been rising for the past decade and in the last 12 months jumped by nearly a third to 4,300 calls a year.

Dementia is set to increase also with the predicted trebling of the number of over 85s in the next 40 years, Friends of the Elderly says.

Anxiety and depression have also shown consistent year-on-year rises. By 2020, depression is expected to become the most common illness worldwide, according to US research.

Although schizophrenia is said to have remained fairly constant over recent years with about one in 100 having the condition.

However, those working in mental health often claim it is not so simple, arguing more openness and better diagnosing is leading to increased numbers being reported.

What did health campaigners want?

While much of the public health debate has surrounded obesity and drinking, campaigners believe there is much to be done to help people with mental health professionals.

The Mental Health Foundation said there needs to be a dramatic rethink on the way mental health is perceived.

Chief executive Dr Andrew McCulloch said people needed to be encouraged to look after their mental health as they do physical health.

"An overall approach is needed to promote mental well-being rather than managing mental illness in a reactive way."

Marjorie Wallace, Sane's chief executive, said mental health had to be made a priority.

"There needs to be greater awareness and understanding by the public and health professionals.

"Doctors need to intervene when they see a patient in the early stages of depression. The lead must come from the government."

She said she would like to see leaflets about mental health placed in all GP surgeries.

Rethink wants to see mental health discrimination further incorporated into disability discrimination legislation.

And Mind said mental health should be treated with the same importance as slimming, smoking and exercise.

The charity said social and economic factors often played a role in poor mental health and the government needed to address these, not focus solely on "personal health planning".

'Suicide pact' couple left note

An elderly couple, believed to have had a suicide pact, wrote a letter to a newspaper detailing their plans.
Bill and Wendy Ainscow, formerly of Wirral, walked into the sea off Tenerife after saying their mentally ill daughter had not had enough care.

Mr Ainscow, 75, died, and his 64-year-old wife is in hospital.

The pair wrote to the Liverpool Daily Post, saying their daughter, Lisa, 33, an Asperger's Syndrome sufferer, was "too much" for them to cope with.

Mr and Mrs Ainscow, who had been living in Birmingham, were picked up by a fishing boat from the sea last week. It is thought they had taken a cocktail of drugs.

The "suicide note" to the newspaper was posted only hours before the pair walked into the sea.

The condition suffered by Mr and Mrs Ainscow's daughter causes her to make demands for money, and she has racked up huge debts.
Last year Mr Ainscow, a former sub-postmaster, was jailed for stealing £50,000 in benefit books to help fund his daughter's addiction.

He was freed by the Court of Appeal when it heard about his circumstances.

In their letter the couple claims the NHS, to which they made an official complaint, failed to help them look after their daughter, who is "spending money faster than I can earn it".

The letter reads: "We realise now that this is an impossible task which we have had to abandon as she (Lisa) is proving to be too much for us to cope with.

Daughter sectioned

"There is still no attempt to provide any form of help, therefore we have chosen that the only way out is to end our lives.

"...We came to Tenerife on a cheap one-way flight and have been sleeping on the beach for the last three nights while we pondered the situation, but we realise that we will have to end our lives as there is no help whatsoever."

The couple said they were pleased when their daughter was sectioned under the Mental Health Act in 2003, but devastated when she was discharged 10 months later.

Lisa Ainscow's solicitor, Richard Nicholas, stressed that she was not responsible for her parents' suicide bid.
He said that she faces a potential backlash from "adverse publicity and reports which have virtually placed responsibility for her parent's death upon her".

"Lisa is an extremely vulnerable individual and such reports place her at great risk. "

Kevin Miller, director of Wirral social services, said: "We have had involvement with the family over an extended period and have worked hard to put measures in place which could help.

"We will of course review in detail, with our colleagues in health, what actions have been taken, and see what lessons can be learned."

'Years of torment'

Marjorie Wallace, chief executive of the mental health charity SANE, said: "One can only imagine the despair that drove Bill and Wendy Ainscow to their suicide pact and we feel overwhelming sympathy for Wendy and her daughter Lisa.

"We have been very aware of the family's distressing situation for some time.

"It is truly shocking that this couple had to fight for so many years to get their daughter treatment and that, when she was discharged from hospital by a tribunal, they were not informed, let alone given support.

"We believe that the mental health system has a duty to protect not only the life and health of the individual with mental health problems, but the family on whose lonely shoulders the burden of care so often falls.

"SANE is campaigning for the new Mental Health Act to give families like the Ainscows rights which could prevent years of torment."

bbc.co.uk 10 Nov

Women's wing of mental health campaigning group to launch

A women's wing of the mental health campaigning group Mad Pride is to launch later this month.

The group, called Mad Chicks, describes itself as "the girly section" of Mad Pride, mental health's equivalent to Gay Pride.

Mad Chicks, which aims to campaign on issues effecting women psychiatric patients and 'survivors', is backed by, among others, feminist scholar Lynne Segal, professor of psychology & gender studies at the University of London

The group said it will be campaigning on concerns around mixed wards, and childcare provision and sexism in the NHS.

"Mad Chicks gives a voice to those who are not listened to, or have had their voices taken away - a theft perpetuated in the much-hated new mental health bill, which further demonises an already alienated section of society," said Mad Chicks member Melanie Clifford.

"Mad Chicks gives that voice back with a scream. We say listen to the voices you're hearing, don't take these voices away with forced drugs."

Mad Chicks is to mark its launch with a day of events - open to women only - in Highbury, north London on Saturday, November 27. In characteristic Mad Pride style, there will be workshops on "creative subversion" and video screenings by "mad women artists".

Speakers include Segal and representatives from the London Disability Arts Forum.

In the evening there will be rock, dance, stand-up comedy and poetry performances. This event is open to men and women.

Clifford said: "This many mad women together can only change the world… or at least have the best fun in London."

psychminded.co.uk 16 Nov

Mental illness, drug abuse soars

The number of people who have a mental illness and are abusing drugs is rising sharply in England and Wales, according to research.
A study by Keele University researchers suggested that between 1993 and 1998, the numbers rose from 23,624 to 37,361 - an increase of 62%.

They looked at figures from doctors on the General Practice Research Database.

The link between drugs and depression, psychosis and schizophrenia has been highlighted by anti-drugs campaigners.

Illegal drugs

Researchers writing in the Journal of Epidemiology and Community Health found the rate of mental illness and substance abuse was up by 62% at 230 general practices between 1993 and 1998.

Men were much more likely to be affected, with their rates up 79%, compared with 44% in women.

Patients aged 16-84 were included in the study, which looked at the abuse of prescription and illegal drugs, but not alcohol and tobacco.

The study looked at about 3 per cent of people in England and Wales.

The average age of someone affected fell from 38 to 34, and the number of cases in the 25-34 age group more than doubled, from 6,874 to 13,240.

Certain types of mental illness saw a bigger growth. Psychosis and drug abuse was up 147%, paranoia 144% and schizophrenia 128%.

Cliff Prior, chief executive of the mental health charity Rethink said: "There is a rapidly growing body of evidence showing that drug use can trigger mental illness in people already at risk.

"However the mental health risks associated with drugs are not widely understood by most young people and more resources need to be put into mental health warnings on the use of drugs.

"A long-term, well-funded, innovative campaign aimed at publicising the real mental health risks associated with drugs including cannabis needs to be in place as soon as possible."

bbc.co.uk 16 Nov

Report slams mental health chiefs

A SERIES of blunders by health bosses led to a psychotic teenager launching a frenzied knife attack on a frail pensioner.

A damning report concludes a series of mistakes were made by mental health experts, allowing paranoid schizophrenic Sean Dunbar to burst into the Fen Ditton home of 80-year-old Jim Tyler and stabbed him repeatedly.

Mr Tyler survived the attack - but suffered serious stab wounds requiring 150 stitches. He is now permanently disabled.

The report states:

FAILED - There was no record of Dunbar's mental state being assessed for a six-week period immediately before he was released into the community from Fulbourn Hospital;

FAILED - Dunbar and his mother did not receive sufficient support after his release;

FAILED - An assessment of the teenager carried out four months after his discharge failed to identify him as a risk to the public;

FAILED - Dunbar stopped picking up medication from his GP several months before the attack - and although there were clear signs that he was having a relapse "none of these triggered an urgent response from services".

Richard Taylor, the chief executive of Cambridgeshire and Peterborough Mental Health Partnership NHS Trust, the body responsible for Dunbar's treatment, has admitted that crucial blunders had been made.

He said: "On behalf of the trust I would like to express our deep regret about this incident and to assure local people that we are firmly committed to doing everything we can to reduce the risks of something like this happening again.

"We acknowledge that there were shortcomings in Sean's care, and we have already taken action on the report's recommendations to tighten and improve our arrangements to make sure that risks of a similar incident in the future are eliminated as far as is humanly possible."

Dunbar, then 18, carried out the savage attack in October 2002. He slashed Mr Tyler in the face and upper body, screaming "I am going to kill you". The pensioner suffered wounds to his head and chest.

Seven months before the attack Dunbar had been a patient at Fulbourn Hospital.

He was discharged from there in March of that year so he could live with his mother.

But his condition quickly deteriorated - he was delusional and believed aliens were living inside his body, trying to take over his brain.

A court later found Dunbar guilty of attempted murder and he was sentenced to permanent hospitalisation.

w3.cambridge-news.co.uk 15 Nov

Mental health trusts to bank over £1million for run-down hospital environments

Mental health hospital facilities all over England are to be transformed for the benefit of patients, relatives and front-line staff in a new phase of the King’s Fund’s Enhancing the Healing Environment scheme, it was announced today.

There will be new projects in each of the 23 strategic health authorities outside London with the aim of improving the environment in which they deliver care to patients. The projects, which are being funded by NHS Estates and the Department of Health, will be led by nurses and will range from refurbishing corridors, waiting areas and wards to the creation of gardens, artworks and quiet spaces. They are expected to be completed by Spring 2005.

kingsfund.org.uk 15 Nov

Speaking today at a conference to mark the launch of the new scheme, Health Minister Lord Warner said: “Last November I announced that we were making this creative initiative available to Trusts nationally, with funding for one scheme per Strategic Health Authority. When we asked for volunteers, we were inundated and Trusts are still asking if they can be included. Mental Health is one of our priority areas, and we and the King’s Fund are both agreed that we should focus a further wave on this crucial area.

“I am delighted to have another chance to see the fruits of the labour of the schemes already being funded. We have seen the benefits that Enhancing the Healing Environment is bringing to these schemes, and I am very pleased to be announcing that more than £1million will be invested in raising the standards of the environment in mental health. I look forward to seeing the results and I believe they will be every bit as outstanding as the schemes on display at our conference today.”

Health Minister Rosie Winterton said: “Investing in better healing environments is an important part of
improving the overall healthcare experience for patients. There is robust evidence to show that better working environments for staff and better environments for care promote recovery and enhance the healing process. Focusing on mental health will extend the, already very apparent, benefits of the initiative to yet more Trusts – and of course to many more patients.”

The scheme has had a dramatic impact on patients and professionals since it started in 2001. An evaluation of the scheme jointly commissioned by NHS Estates and the King’s Fund revealed significant long-term benefits including:
• the potential to reduce aggressive behaviour by patients and relatives towards staff
• improvements in staff recruitment and retention rates
• faster recuperation rates for patients
• reductions in vandalism.

King’s Fund chief executive Niall Dickson said: “The physical environment in which people with mental health problems receive care is often uninspiring and dull. This scheme has already had a stunning impact not only on the environment, but also on those who use services and the staff who have taken part. All the projects are locally driven - patients and staff decide how best to spend the money, whether it be used to build a garden, refurbish a waiting area in A&E or simply create a quiet space. Put simply, they have made a huge difference.”

NHS Estates chairman Bill Murray added: “NHS Estates is delighted with the success of the Enhancing the Healing Environment Initiative and we are delighted to continue our support of the King’s Fund and the excellent work it has carried out since the initiative began.”

Each project has to physically improve an area used by patients and must be run by a nurse-led, multi-disciplinary team, which must also include service users. As well as a £35,000 grant, each nurse-led team receives a place on a King's Fund programme to develop their leadership skills and give them the practical knowledge they will need to make their project a success. The programme explores practical ways in which health care environments can be improved by the use of colour, light, art and design.

National Director for Mental Health Louis Appleby said: “We are delighted to contribute to this important initiative. A therapeutic in-patient environment is an essential part of modern health care. We have already seen how mental health schemes such as at Hillingdon PCT have benefited from the King’s Fund initiative. There were even unexpected benefits, such as an increase in visitors. These schemes prove what staff and patients can achieve when they are given the opportunity.”

Newly appointed Chief Nursing Officer Chris Beasley added: “I have been keenly involved with the Enhancing the Healing Environment initiative since its inception, when I was Regional Director of Nursing in the London region. I have seen for myself what a transformation it can bring – not only to the physical environment, but to the confidence and joint working between nurses, estates and facilities professionals, patients, users and carers. I am delighted to be taking the baton from Sarah Mullally, who I know was a very committed supporter of this programme.”
The following mental health trusts are taking part in the scheme:
Avon and Wiltshire Mental Health Partnership NHS Trust; Beds and Luton Community NHS Trust; Birmingham and Solihull Mental Health NHS Trust; Buckinghamshire Mental Health NHS Trust; Cornwall Partnership Trust; County Durham & Darlington Priority Services NHS Trust; Dorset Healthcare NHS Trust; East Kent NHS & Social Care Partnership Trust; Humber Mental Health NHS Teaching Trust; Isle of Wight Healthcare NHS Trust; Lancashire Care NHS Trust; Leicestershire Partnership NHS Trust; Lincolnshire Partnership NHS Trust; Manchester Mental Health & Social Care Trust; Mersey Care NHS Trust; Newcastle, North Tyneside and Northumberland Mental Health NHS Trust; North Essex Mental Health Partnership NHS Trust; North West Surrey Partnership NHS Trust; Sheffield Care Trust; South Staffordshire Healthcare NHS Trust; South West Yorkshire Mental Health NHS Trust; Suffolk Mental Health Partnership NHS Trust; Worcestershire Mental Health Partnership NHS Trust.

New mental unit sparks concerns

PROTESTS are expected over plans to turn the former naval training base at Forest Moor into a mental hospital.
There has been alarm over a planning application to turn HMS Forest Moor, close to the Menwith Hill military base, into a 64-bed medium secure hospital for people suffering from mental illnesses, personality disorders or learning difficulties.
A public meeting about the plans will take place on November 27 at 3pm in Darley Memorial Hall, set up by Menwith Hill with Darley Parish Council, for residents to view and discuss the plans.
Under the plans, the 20-acre site – formerly a radio communications base – would become a 48- bed hospital with a 16-bed rehabilitation unit.
The company behind the plans, Partnerships-in-Care (PiC), is applying for planning permission before buying the site from the Ministry of Defence.
The company, which runs a similar centre at Stockton Hall near York, said the centre would provide accommodation classed 'between high security psychiatric hospitals and local open units', easing a shortfall of mental health beds in the region.
The existing CO's accommodation will be demolished and replaced with three V-shaped wings connected to the main building, each with 16 beds, group rooms and a lounge. A separate rehabilitation wing will initially have eight beds, with a further eight added later.

nidderdaletoday.co.uk 12 Nov

The existing block will be turned into offices, meeting areas, occupational therapy rooms and a dining area with kitchens. There will also be a sports hall, fenced football pitch and tennis courts - all surrounded by a high fence. It is expected an initial 155 jobs will be created, with a further 18.
PiC stressed the level of security at the centre would not be suitable for 'patients that present a serious, grave or immediate danger to the public, nor the detention of persistent or determined absconders' and added patients would never leave the site without 'appropriate supervision'.
It also said the base, decommissioned last year, was not in close proximity to residential accommodation.
Menwith Hill with Darley Parish Council clerk Bridget Verity said people living near Forest Moor had been "alarmed" by the news. She said the council was 'keeping an open mind' until the meeting.
"I have had one or two calls from people living nearby who are quite alarmed," she said. "There's quite a bit of alarm and it needs explaining to the whole village without scaremongering. The meeting gives PiC the chance to explain fully what it entails."
PiC executive director David Ackroyd said he would be attending the meeting later this month to answer residents' questions.
He said they would provide services similar to those at Stockton Hall but the exact nature of patients at Forest Moor 'hasn't been absolutely decided'.
"I can assure you there will not be patients who require higher levels of care than at Stockton Hall," he said. "They'll be patients who are not considered by anyone, including the Home Office, to pose a danger to anyone."
"It is not a prison. It's a hospital in every sense of the word and we would not be getting anyone who posed an immediate danger to anyone."
He said Stockton Hall, opened in 1989, had "integrated" itself into the middle of a rural village similar to Darley. A protest led by members of the British National Party is also expected at the meeting.

Draft Mental Health Bill "unworkable" in Wales

The draft Mental Health bill is “unworkable” in Wales because services are not sufficiently equipped to deliver the legislation, Welsh organisations have warned, writes Maria Ahmed.

Giving evidence to the joint committee on the bill this week, Hafal, a service user-led group, said Welsh services “lacked the infrastructure” to support the bill.

Vicky Yates, a carer representing Hafal, told the committee implementation of the national service framework for mental health in Wales remained “patchy” and said the bill would not work without “radical” change.

The group were particularly concerned that there was no clear timetable for implementing the NSF, leaving Wales “falling behind” England.

Hafal also raised concerns over workforce problems including an “acute shortage” of psychiatrists in Wales.

The bill’s requirement of an increase in tribunals would lead to a diversion of “already scant resources” away from health services to the management of the legal process, the group warned.

“This in turn would mean more people deteriorating to the point where compulsion was necessary,” Hafal representatives said.

communitycare.co.uk 12 Nov

Proposed Mental Health Bill may breach human rights, says Law Society

Proposals in the draft Mental Health Bill to forcibly treat people with mental health problems in the community could breach patients’ human rights, the Law Society warned last week.

The warning came as the society, representing solicitors in England and Wales, gave evidence to the parliamentary committee scrutinising the draft bill.

The bill would allow compulsory treatment to be imposed on patients living in the community as well as those in hospital.

Mental health staff could also impose conditions banning patients from engaging in "specified conduct," such as going to a pub or socialising with certain people. Breaches could lead to their detention in hospital.

Russell Wallman, the society’s strategic policy director, said: "The introduction of community mental health orders will create the equivalent of psychiatric antisocial behaviour orders to be imposed on people with mental health problems."

He said the society believed the provision of well resourced community services would reduce the need for compulsion against people with mental health problems and that community treatment orders would be "unworkable and impractical."

Mr Wallman added: "We are concerned that people with mental health problems will be stigmatised as being a danger to the community when what they need is proper care rather than being made into criminals."

The society’s comments echo those from the Royal College of Psychiatrists, which described the draft bill’s proposals in written evidence to the committee as "extremely complex, confusing and, some would say, incomprehensible."

It said the college believed the bill as drafted was "unworkable" and the impact of the proposals overall would "damage safety for both the patient and society."

The college added: "It is essential that prospective patients are not deterred from seeking help. Indeed, because suicide and other risks are largely assessed from information given by the patient, it is necessary for the person to feel able to talk freely.

"Fear that being open will lead to loss of liberty does not aid this process. Hence if mental health law is seen to be overly coercive it will lead to patient avoidance of mental health services and, paradoxically, an increase in risk both to the individual and the public."

The proposed legislation was "extremely unlikely to have any impact on suicide or homicide rates," it said.

"The Government has rightly stated, in our view, that it has no intention of increasing the number of people subject to compulsion," said the college. "But the proposals in the Bill (the combination of a very broad definition of mental disorder combined with wide conditions for compulsion and the absence of exclusions) will lead to a marked increase in compulsory orders."

bmj.com 13 Nov

GP commissioning ‘should not apply to mental health’

The initiative giving GP practices the power to commission care for their patients should not extend to mental health services, a leading charity said this week.

The Sainsbury Centre for Mental Health said practices could make decisions on mental health services that were based on cost rather than on individual patient’s needs.

Mental health has been omitted from the new payment by results (PBR) NHS funding system because of the complexity of the services. Standard tariffs will not be applied to mental health until it is included in PBR.

Since service providers will be able to compete on prices, and GP practices will have incentives to make savings on their budgets, the charity said practices might choose the cheapest option, which might not be the most appropriate.

It also warned that the information technology needed to help GPs and patients make informed choices about treatment was not available.

Dr Alan Cohen, the SCMH’s director of primary care, said that practices could commission ‘talking therapies’ for common mental health problems such as depression but that primary care trusts should commission most mental health services for the time being.

‘Practice-based commissioning is the logical conclusion of the government’s NHS reforms. But it will not work for patients unless we can be sure that all services are of sufficient quality, that choices are supported by good information and that cost considerations do not distort decision-making,’ he added.

cipfa.org.uk 12 Nov

£375,000 damages for mental patient

A mental patient who was brain damaged when he was hit by a car in a possible suicide bid has been awarded £375,000 damages.
Stephen Grainger was admitted to Suttons Manor Clinic, London Road, Stapleford Tawney, Romford, Essex, in November 1996, suffering from severe depression.

Eleven days later, Mr Grainger sustained "life threatening and permanently damaging" injuries when he was hit by a car nearby.

QC Margaret Bowron told Mr Justice Jack at London's High Court that the driver, who was deeply traumatised, thought that Mr Grainger was attempting suicide.
Hospital staff maintained that he was trying to flag the car down.

"Sadly, we'll never be able to find out from the only person who really knows," she said.

Mr Grainger's claim against Speciality Care Ltd - which runs the clinic and which denied liability - centred on whether his medication and monitoring were sufficient.

Its QC, Benjamin Browne, paid tribute to the "remarkable devotion" shown by Mr Grainger's wife, Dawn, to her 45-year-old husband since the tragedy.

Approving the damages settlement, the judge echoed his remarks, saying: "I don't know what marriage vow, if any, Mrs Grainger took, but if she took the old-fashioned one, she has certainly stuck by it."

dailymail.co.uk 11 Nov

Mental patient killed family

A man with a history of mental illness walked into a hospital and announced that he had murdered his wife and her two children.

The man was being interviewed by detectives today after police went to his home and found the bodies of his wife and her six-year-old son and 15-year-old daughter.

The woman and her son had been stabbed to death and the teenage girl strangled in their flat in Wembley. Their bodies were found on Monday. Sources said he had a history of mental illness.

Detectives investigating the murders who visited the scene were said to be shocked.

The family were living under the care of Brent social services, which classed the family as "vulnerable", a spokeswoman for Stadium Housing Association said. The 86-flat block in Northwick Road housed several people with mental-problems. The spokeswoman said: " The woman and her two children were under the care of Brent social services. They moved into the block in 1999."

The murders come amid mounting concern over killings by "care in the community" patients.

In September Daniel Gonzalez, who suffered from paranoid schizophrenia, was charged with committing four murders in 48 hours in London and the South-East.

One in 10 murders in London were attributed to mental care patients last year. The mental health charity Sane estimates that about 15 to 20 killings every year are carried out by mentally ill patients.

thisislondon.co.uk 11 Nov

Minister rejects attempt to insert advocacy role in Mental Capacity Bill

Health minister Rosie Winterton has rejected amendments to the Mental Capacity Bill that would have seen independent consultees replaced by advocates, promising critics the existing proposal would be an “advocacy plus” role.

Under the draft bill, unbefriended people who lack capacity will have an independent consultee to advise them on decisions such as medical treatment and accommodation.

But campaigners, including learning difficulty and disability groups, believe the role should be advocate focused, which would guarantee the wishes of the individual were better represented.

But Winterton told MPs at a debate on the bill last week that the independent consultee would be a statutory role, given a strong voice and underpinned by national training and £6.5 million funding for England and £0.4 million for Wales.

She added that people who made decisions about a person lacking capacity who did not correspond with advice given by an independent consultee would be expected to explain why.

“We have always seen the role of the independent consultee as being “on the side” of P [person without capacity]. That is the whole idea,” said Winterton.

But Liberal Democrat spokesperson for older people Paul Burstow said he was unconvinced about the role, warning that it could become known as “advocacy-lite”.

“There may well be a role for a consultee, perhaps like that of the guardian ad litem in the child protection system, but it is a separate and distinct role from that of the advocate,” he said.

“I am not yet convinced by what the minister says. There is a tension in conflating an advocacy role – being the person on P’s side, his friend – with a role on which one has to step back and give advice in a detached way to the decision maker…I genuinely do not see how those two roles can sit together comfortable and effectively,” added Burstow.

www.communitycare.co.uk 10 Nov

Charities urge earlier mental health intervention

Mental health law must be reformed to ensure that people receive care and support at the earliest opportunity rather than only when they reach crisis point, MPs and peers heard today.

The law must be changed to give patients the right to have a psychiatric assessment when they first experience mental ill health, according to mental health campaigners.

The campaigners warned that the government's controversial draft mental health bill would lead to more resources being invested in secure mental health services at the expense of early intervention services - which could prevent people reaching the stage where they require compulsory treatment.

Cliff Prior, the chief executive of the mental health charity Rethink, told the joint committee on the draft mental health bill that the proposed legislation risked exacerbating existing funding inequalities.

He said: "All the resources have gone on compulsion, on secure beds, very little has gone on early intervention. A more balanced bill could drive resources where they are most needed."

He predicted that resources would continue to be channelled into secure services unless the bill gave people a statutory right for a mental health assessment when they first experience mental distress.

"The reason why mental health care is so distorted towards dealing with failure is because the legal powers are focused on that end," he said.

The committee heard further complaints about the draft bill's proposal to extend compulsory treatment into the community.

Kay Sheldon, a mental health service user from Wales, said she would have withdrawn from community care had she been subject to compulsory powers.

The bill would allow mental health staff to impose a condition that a patient subject to compulsory treatment in the community must not engage in "specified conduct", such as not being allowed to go to the pub or socialise with certain people.

If they breach the code of conduct they could be forcibly detained in hospital. Carers would be responsible for ensuring that patients did not break the code of conduct.

Mrs Sheldon said: "I'd be very concerned of the impact on my family. I would be very anxious if my husband was put in the role of having to police me."

society.guardian.co.uk 10 Nov

Warning of mental health crisis

Pressure on the number of hospital beds is leading to a crisis in care for people who are mentally ill in the West, an expert has said.
The MIND mental health charity says a shortage of beds means there is no space for people who need urgent help.

The claim has been backed by a woman whose mentally-ill mother was sent home after a suicide attempt - although the family still fear for her life.

The Strategic Health Authority has denied there is a shortage of beds.

Jeff Walker, of the Bristol branch of Mind, said: "A lot of beds have closed over the years and it does mean that there is not enough supply when people reach a point of crisis."

Emma Osborne's mother was examined by Casualty at the Royal United Hospital in Bath and sent home with a home help for one hour a day.

Ms Osborne, who has to look after her four-year-old daughter as well as her mother, said: "She has gone from being an active caring mum to this very insular person, someone who really struggles from day to day.

"I am really not hopeful for the future. I just see this spiralling."

The Bath NHS Trust admitted there was pressure on beds, but said no-one would be turned away unless it was safe.

bbc.co.uk 10 Nov

‘Voodoo curse’ mental patient killed herself

A WOMAN who felt she was plagued by a voodoo curse killed herself after being allowed out of a secure psychiatric unit.

Walthamstow Coroners Court also heard how Elizabeth Hart had taken two drugs overdoses in the weeks leading up to her death and felt TV programmes were "plotting against her".

Ms Hart,42, had taken an overdose of valium earlier this year at her home in Osprey Court, Walthamstow. She had also taken an overdose of tablets prescribed for her mother while on a trip to Scotland just a month before her death. She visited a hospital in Glasgow while on the trip, and then on her return to east London visited the Mascalls Park unit in Brentwood as a voluntary patient.

She told doctors she felt a voodoo curse was operating against her and showed signs of suicidal thoughts.

She spent one week at the Mascalls Park unit from March 22 where she was given increased levels of valium. Tranquillisers were also prescribed for anxiety.

In an assessment, Ms Hart told doctors her previous overdoses had been "impulsive and irrational", and although she was persuaded against returning home on March 29, she was allowed to go the following day.

Ms Day was then told to return on April 2 and gradually became more depressed. On April 2 she mentioned that she felt TV programmes were plotting against her. She returned again for another check-up on April 6 but was allowed home again.

Doctors said that as a voluntary patient, they did not feel at the time that her mindset was in such a state as to keep her in.

During the night of April 6 Ms Day sliced major arteries in her arms, which later led to her death.

The inquest was told how Ms Hart's father had a history of attempted self-harm dating back to her childhood.

Legal representative Meurig Horton asked the consultant pshychiatrist: "Given the history of Ms Day's childhood, that she was admitted to hospital in Glasgow, that she had previously taken two overdoses, that her drug levels had been doubled and that she was showing psychotic symptoms, do you think the assessment to release her was secure?"

The doctor told the inquest he felt that the correct procedures had been carried out and it was right to release Ms Day.

Coroner Dr Elizabeth Stearns recorded a verdict of suicide.

walthamforestguardian.co.uk 8 Nov

Elderly mental health warning

MENTAL health services for the elderly in Wales are lagging behind as more people living longer suffer from dementia and depression.

Financial watchdogs warn today despite some improvements, many problems with services identified two years ago remain unsolved.

A report by the Audit Commission in Wales said local health boards need to increase the priority given to older people's mental health if significant progress is to be achieved.

Some 41,000 people living in Wales have dementia while depression is more common among older people than in any other age group.

Action spelled out by the commission includes more support for GPs in making an early diagnosis of problems. It also wants extra support for carers. Early help and assessment have been slow to develop, says the report.

Care, whether at home, day and respite centres or via specialist services varies significantly, and the recruitment and retention of staff is still a "significant challenge" in these service areas.

Clive Grace, director general of the Audit Commission in Wales, said: "This report addresses a significant and growing concern. Mental health problems are common among older people, and more people are living to old age." "Progress in some areas is encouraging but many challenges continue to face those involved in providing services. The conclusions and recommendations should help public services in Wales to prioritise actions and investment."

icnorthwales.icnetwork.co.uk 5 Nov