Shaping mental health services: a Powys update

AKA my “Mental Health Awareness Week” blog post! 

At two PAVO events, (in Brecon and Newtown) a couple of weeks ago we invited people in contact with mental health services and those close to them to join us. It was billed as “your opportunity to come and meet your individual representatives, learn what’s new with mental health services across Powys and give your opinions.” I went along to the event in the North and enjoyed a day of debate and information sharing (not to mention some amazing art exhibits and a Laughter Workshop) at the Maesmawr Arts Centre in Caersws.

Freda Lacey, PAVO’s Participation Officer, introduced the day and gave an overview of the mechanisms through which people can feed in their views about mental health services in Powys. Feedback is taken to the Powys Mental Health Planning & Development Partnership run by the health board, also to the National Service Users & Carers Forum, and finally to the National Partnership Board. You can read more about the structure here.

Freda went on to explain that there are currently 5 vacancies on the National Service Users & Carers Forum – opportunities for people in Powys to get involved and help shape future mental health services. If you are interested then please get in touch.

National Partnership Board - behind the scenes

Rhydian Parry from Powys, who has previously written on this blog about his experience as a volunteer on Patients’ Council, is one of four people with lived experience sitting on the National Partnership Board. He spoke enthusiastically to us next about what it’s really like to be a rep at that level.

At a recent NPB meeting Rhydian gave a presentation about a questionnaire around crisis services. He received a good reaction, and crisis services were subsequently discussed at each of the local partnership meetings. Rhydian described this as: “A step forward. Progress.” He and the other reps are often invited to do other things. They recently attended a talking therapies conference in Cardiff. “We are able to speak to reps from all the health board areas and find out the waiting times across Wales. If someone is now waiting 6 months to see a psychotherapist that is good – it used to be a 2 year wait.” Rhydian also spoke about his work with the police around detaining people under a Section 136.

Meriel Richards and Kate van den Ende, the two other Powys reps on the NSUCF, also contributed to the update. Meriel said that “at the last meeting it really felt as if we were part of the forum. It’s chipping away.” Kate added: “It states in legislature that they have to listen to us.” She described the slow process of winning influence. “There is now a good chance to say that this is the way it should be.”

Issues that are raised by the reps can be taken by mental health commissioners at Powys teaching Local Health Board to service providers and further information requested. The reps are clearly making a difference. Even so, it was identified that the task is huge. Someone from the audience said: “like trying to move a mountain with a wheelbarrow and a hand shovel”.

Not everyone likes to attend meetings to have their voice heard. Other suggestions for encouraging people to contribute their opinions included using social media and email, encouraging feedback in GP surgeries, and putting up posters on school noticeboards.

Freda opened up the discussion to ask people attending to tell us what they believed to be the current gaps in services. The key areas were well familiar to us all, and included the long waiting lists for psychological therapies, and the failure of Children & Adolescent Mental Health Services (CAMHS) to meet all young people’s needs. It seemed as if some agencies struggled to signpost people to support services in the voluntary sector. One carer of a young person said: “I would feel empowered if I had the information I need – not completely on my own having to deal with things.”

There was also a real appetite for finding out more and trying alternative approaches (what we have called Beyond Medical) such as the Soteria House promoted by the Soteria Network and the Finnish Open Dialogue approach.

Louisa Kerr updates us

Louisa Kerr, Partnership & Project Support Officer for the Powys Mental Health Planning & Development Partnership, was next welcomed to the event to speak about upcoming priorities for the health board. These include:

- Enhanced Primary Care services;

- Acute Care in the community;

- Repositioning for older people;

- Integration of services.

Louisa is also working on rolling out two other projects – updating the health board website with more information about mental health services, and developing a crisis house in Powys.

Recommissioning of voluntary sector mental health services in Powys

Louisa spoke at length about this process. The Hearts & Minds Strategic Plan – vision for mental health services, commits the voluntary and statutory sectors to work together to achieve the best outcome for individuals. All services are being looked at in line with the strategy. The health board is now seeking equity of services across Powys, which means that to be fair a commissioning process will take place (see the “commissioning cycle” for a diagram showing the nuts and bolts of the process). Formal events are being arranged in the near future, and the health board will engage with "all ages" around services to make them the best that can be commissioned.

In response to questions from the audience, Louisa clarified that “price is not the driver. It is having the best service in place.” The Welsh Government guidelines on tendering will be followed.

Those present went on to express concern about the process which can cause stress for both volunteers and people in receipt of their service. This was acknowledged, and Louisa said she would be going back to speak to the procurement team for clarification on any questions raised. It was also made clear that PAVO (Powys Association of Voluntary Organisations) can be called upon to provide support to voluntary sector agencies around commissioning.

How to be a Two-headed monster
 in Owen's Laughter Workshop!

The discussion could have gone on all day, but a delicious Maesmawr Arts Centre lunch beckoned, followed by a tour of the grounds and the sculpture trail, and an amazing Laughter Workshop with Owen Griffkin. All in all a brilliant day.

Jill Ball (Powys Befrienders) & Glynis Luke
 (PAVO mental health team) on the tour
at Maesmawr Arts Centre, Caersws

What do you think? Would you be interested in finding out more about becoming a “service user & carer rep” for the National Forum? Let us know! Your voice needs to be heard!