Are We Going To Do This, Or Not?

I think I’m becoming a bit report weary, especially now I have to make sure I’ve read every one of them cover to cover and several, like the new one this week from Her Majesty’s Inspectorate of Constabulary, are hundreds of pages long.  Two hundred and twelve pages long, to be precise.

I’ve printed off this latest report and have put it on top of —

I could go on with other reports and yet more reports.  Then there is this list of statutory guidelines, many parts of which are routinely disregarded.   Only yesterday I heard a person from the Department of Health lamenting that no-one really knows about the new Code of Practice to the Mental Health Act that is coming in to play in two weeks’ time!

So rather than provide you with a running commentary on this new report, I’d refer you to the excellent summary coverage of it by @NathanConstable who blogged before I got the chance and said exactly what I think about it – rather than bore you in a similar way, I’d just encourage you to read his post and see it against the background set out above.  I’d just ask whether anything else needs to be happen before we accept that there is a serious human cost to our ongoing inability to get this right, a serious lack of strategic vision about what we’re trying to do and no remaining excuses for the interia because we can’t look grieving families and vulnerable adults in the eye and claim to be getting this right.  

Perhaps if we had children being detained in custody for days because a £100bn a year organisation can’t sort a quite, ligature proof room somewhere for them to wait safely until we get a plan in place we would realise we have to do something – but hang on, we’ve already had that, haven’t we?  Perhaps if we had hundreds of unnatural deaths a year across our coercive systems we the police and mental health services often interface in a range of complex ways, we’d have to do something – but wait:  we’ve already had that, haven’t we?  Perhaps if we had vulnerable adults detained in cells whilst extremely psychotic, covered in their own faeces, smearing bodily fluids all over the walls after drinking from the toilet and banging their heads repeatedly off concrete walls for protracted periods of time – but wait: we’ve already had that, haven’t we?!

I can think of just a few more shocking things that could happen but I’m just too appalled at the idea that we’d need to see ourselves reflected so badly and that it took such events to make us see that before the end of this century my grandchildren’s generation are going to look at us and wonder how on earth these things weren’t viewed as the outrages they are and more importantly, why we kept letting it happen.

Are we going to do this properly, or not?!

We should just decide and be honest with people – at least we can all get on with our lives knowing where we stand.  I know that change is happening at last and I know we can see various versions of furious activity all around us – it’s not good enough, it’s not fast enough and we should be ashamed that we are perfectly capable today of repeating the disasters that struck vulnerable people and their families a decade or more ago.

IMG_0053IMG_0052Winner of the President’s Medal from
the Royal College of Psychiatrists.

Winner of the Mind Digital Media Award.

11 thoughts on “Are We Going To Do This, Or Not?

  1. Thank you for writing this.
    Thank you for the mention and thank you for saying exactly what many of us on the front line – from across the services involved – are thinking and feeling.

    1. Officers – wise & considered words & I thank u for your ongoing efforts.

      But I fear it is not going to get much better anytime soon. Just this afternoon I have had oversight of a situation that could & should have been managed so much better & has me emailing – “It is not ok or anywhere near how we should be doing this stuff.”

      1. I share your sense of pessimism. The pace of change, as Michael says, is glacially slow. Lots of talk of huge steps forward which really are no such thing. We will all have to continue to manage things as best we can in the meantime. Not an easy thing to do. Thank you for your kind words 🙂

  2. I shudder at the thought that vulnerable people and their families are STILL at risk of serious consequences as a result of a system that is all to often failing. How long do we have to read report after report after tragedy after inquiry, until our loved ones are receiving the care they deserve? Thank you Inspector and others for the work that you do, lets not stop banging that drum.

  3. If the numbers are considerable and there’s no money in the pot should we be diverting big bucks from frontline policing and employing thousands of mental health nurses instead?

    1. If there is “no money in the pot” then we have a responsibility to campaign for better funding! Its not an either or situation…police or mental heath staff…. we need to redistribute the wealth in this country, a few bankers bonuses would be a start ….

      1. Back in the real world that’s very unlikely. The systematic decline of secondary mental health services with resources diverted – not increased- to those with mild to moderate needs (IAPT,primary care) at the expense of the most severely unwell is evidence of that. Ppl who need urgent assessments via police usually will fall in the former category but in order to manage acute disturbance and aggression in some, assessments have to be undertaken in secondary care. So I head into work today with 40% fewer beds than 10 years ago, merged and squashed crisis team covering large inner city area, expanded caseloads in community teams and an Early Intervention Team in name only (due to caseload size). Any Attempt to take on work that others have done diverts resource from severely unwell eg. Taking on welfare checks and potentially increases risks to all. The shambles of s136 in London where MH units will accept everyone is proof or that. May sound good in meetings but has led to staff assaults ++ and unsafe environments for patients ( no 1:1 special like in custody).
        Much of this will be and already is hidden , especially as frontline MH staff do not, for various reasons , speak out like police ( witness twitter accounts).

  4. Thank you Jo for that insight and the work you do. I was being rather simplistic in my comments, guess that comes from constantly experiencing the appalling CAMHs “care” my son received in Devon. Why don’t mental health staff speak out?? As a parent/career I am angered that I hear lots of comments from police/care groups/charities/media but very little from the services employees! Jo I am so very tired of years of carrying/caring for a very vulnerable young man and having to beg/demand for care and support that we desperately needed by didn’t receive. In fact I would go as far as to say that the mental health intervention he received did more harm (26 hours in police cell as place of safety, 2oomile round trip for in patient care) than good. I am tired of fighting . Thankfully our experience now in the adult service is better and I am cautiously optimistic this will continue 🙂 However much damage has been done and my son has lost years of healing/recovery that he should have had support with.

    1. My experience has been that Custody is far safer than a 136 suite, the people involved in providing servcies should look at what they are actually providing.

      1. Laura I can assure you that lots of frontline line staff do speak out & remember that they to are users & parents, sons, sisters, brothers, partners etc of users & everyday have to try to do there best within a system that does/cannot do what our politicians & big bosses tells you/us it does. They are also employees & have contratcts of employment & again have commitments & moragages/rents & again have sons, daughters, lovers & lives outside work that require £s.

        Me working on a theroy – “Delusion of Boss Theroy”. In that, those incharge of all this & with the real power to bring about change, have to believe & say out loud that it works, even when there is clear evidence that it is not working as it should/could! Otherwise why would they not use the power to bring about the change required? It is not all about money & some of the solutions are complicated – but then only because of the way it has been set up (evolved).

        Anyway you take care of u & yours.

  5. It’s not about the money, It’s about getting all your ducks in a row.
    An extract from a CQC inspection report published in Late February 2015, about the MH provision provided by a health trust overseeing part of my local area concluded:
    There was confusion as to which team provided crisis support. Community mental health teams (CMHTs) were thought to provide crisis support during core hours but staff in CMHTs said they couldn’t provide a crisis service out of hours. Staff in acute mental health teams said they thought there were plans for them to provide crisis services in future but were unsure who provided them at present.
    The CQC considered that the facility in question required Improvement.

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