Dyfed Powys Police - Mental Health : Working Together - Part 2

We found out in Part 1 of this post last week how Dyfed Powys Police has been rolling out mental health awareness training sessions for the force's staff and partner organisations over the past few months. I was lucky enough to be able to attend the May session as the PAVO representative. These sessions have focused specifically on Section 136 of the Mental Health Act 1983, and the collaborative nature of the approach to this 72 hour detention which can be instigated by the police. 

The first half of our training covered a look at our needs and expectations, an introduction from the police mental health lead Inspector Brian Jones, setting of context by Lousia Kerr who is Powys Mental Health Partnership and Project Manager, and a consideration of "what is mental health?" by Powys psychiatrist Stephen Novick. Kath Arnold, manager of the Integrated Community Mental Health Team in Brecon, was next up before we ran out of space. In Part 2 we complete the picture. 

Approved Mental Health Professional – Helen Kiteley, Social Worker PCC

Helen described the very specific role of the Approved Mental Health Professional – a social worker who is specially trained to consider when someone may need compulsory admission under the Mental Health Act. “The AMHP is tasked with balancing care v control in the context of managing risk and the Human Rights Act 1998”.

This does not necessarily mean that someone ends up in hospital. They could be managed by the Home Treatment Team (more below) and able to stay at home. The “least restrictive intervention” is the one which has to be used.

Helen also covered a Section 135, the role of the “nearest relative”, and a AMHP’s duty to complete Mental Health Act assessments when required.

Crisis Resolution Home Treatment Teams – Andrew Williams (South), Graham Batha (North)

Andrew Williams

Andrew explained that he was a man with two hats! With his Welsh Government hat on it is his statutory responsibility to gate-keep admissions to hospital, to respond to crisis referrals in 4 hours and review out-of-hours referrals in 24 hours. With his practical hat on Andrew and his team are providing individuals with intensive support in their own homes. Staff work closely with family members and friends to maximise levels of support, and provide psychological and practical help. “Crisis prevention is really key.”

Graham’s view from the North of the county was not dissimilar. He said “we bring many aspects of hospital care to the patient’s home. Currently we have 300 patient contacts per month.”

Both teams work out of hours, though not 24/7. You can read more about the work of the North Powys HTT here.

Brian highlighted the fact that the police are operating in a different place to that of just 2 years ago. “As soon as we are facing a S136 we go out to someone who may harm themselves. But the HTT now arrive and say the police can leave”.

Graham Batha

Felindre Ward, Bronllys Hospital – Richard Rudge, Deputy Ward Manager

Felindre Ward is the designated Place of Safety for Mid and South Powys (except Ystradgynlais) where people can be taken by the police on a S136 for a mental health assessment. Richard talked us through the 12 bedded In-Patient Unit, the specific roles of staff based there, the admissions procedure and then in more detail the role of the nurse in the S136 process.

The team at Felindre works very closely with CMHT teams at Brecon and Llandrindod Wells, as well as the South Powys CRHTT.

Some interesting questions emerged during this session, such as what happens when someone is visiting Powys and is detained on a S136. It was clarified that they are then brought to a Place of Safety within Powys to be assessed, rather than being transported back to where they originally came from.

Emergency Duty Team – Debbie Everett, Social Worker & Michael Dalladay Senior Practitioner EDT

“It is the responsibility of the EDT to respond to social care emergencies where the urgency of the situation requires action at a time when mainstream services are not available.” The team has many varied duties, including undertaking mental health assessments.

Experience of someone in contact with mental health services – Jan Rogers

Regular readers of this blog will no doubt be familiar with Jan Rogers (volunteer and trustee at Ponthafren Association, and now MBE!) who then told her personal story. Jan included her experience of being detained under a Section 136 over 30 times, and her subsequent role in 2014 as a member of the Expert Reference Group which reviewed the Mental Health Act 1983 Code of Practice ( in England).

Jan concluded by saying: "things are not always what they seem. Think before making a decision or acting."

Brian rounded off the day with a number of typical scenarios, some of which we addressed in groups. There was some really useful discussion with partners from all sectors contributing and it was clear that the awareness raising had been of genuine benefit to all concerned. My feeling is that everyone working or volunteering in the field of mental health in Powys would find this session invaluable - long may it remain available to enhance our knowledge and encourage enthusiastic partnership working!

Janet Rogers is awarded an MBE in the Queen's birthday honours list

It's almost two years ago now since Jan Rogers wrote about her experience as a member of the Expert Reference Group reviewing the Mental Health Act (1983) - Code of Practice in England.

This weekend I was delighted to discover that Jan had been awarded an MBE in the Queen's Birthday Honours List 2016 (page 78 of the Prime Minister's List) for her contribution as a member of this Expert Reference Group and to mental health generally. 

Nicky Morris, Ponthafren Association Manager, tells us more:

Janet Rogers is a volunteer and trustee at Ponthafren Association.

Ponthafren provides a unique blend of services to address the mental health needs of its members and the citizens of Montgomeryshire in North Powys. 

Within the core funded service, Ponthafren has developed two main centres in Montgomeryshire, at Newtown and Welshpool, with a satellite provision in Llanidloes in the form of a group which meets weekly on a Thursday. The centres provide a drop-in facility that gives people experiencing mental health difficulties opportunities to find: a ‘safe place’, peer support, crisis support, and access to a wide range of learning and work related opportunities. 

The service provides a Wellness, Learning and Recovery Centre which enables people with mental health problems, families, carers, staff from mental health service providers and people from partner agencies to attend courses. The ethos of these centres is that they are open to everyone and we do not turn away anyone who has an interest in attending. Mental health issues can affect us all at any time; it’s about being able to support people in whatever way they want, at whatever stage of their recovery journey they are at.

In addition to the core service, Ponthafren has developed a range of services including: counselling, outreach support, 1:1 personal support & planning scheme, health and wellbeing, and a young persons' initiative.

Jan Rogers said: “I must admit it was completely unexpected! I’m honoured to be getting an MBE and very grateful to the person who nominated me. I’m passionate about mental health and getting people's voices heard, because it allows me to make a positive difference to people’s lives. The MBE is for the work I did on The Expert Reference Group, headed by Dr Nicola Guy. We met at the head office of the Department of Health in London, this was over a period of about 14 months. The group consisted of people who used services and carers. We reviewed parts of the Mental Health Code of Practice of England. 

"Having experienced mental health issues for a long time, it was a journey within my recovery that I will never forget. I was very honoured to have been chosen to sit on the group. The way that it came about was -  I started volunteering at Ponthafren Association, with the PR group, took an information stall along to a Powys Association of Voluntary Organisations event, from there gave talks to Dyfed Powys Police and other front line services and PAVO put my name forward for the EXPERT REFERENCE GROUP’’.

Peter Bayliss, Chairperson of the Association said: “We are all immensely proud of Jan, her contribution to Ponthafren Association, and the success and significance of her charitable work is inspiring. Importantly, she is a fantastic role model for the next generation, showing clearly how what we do can have a tangible impact on people’s lives.”

Huge congratulations to Jan from all of us here in the mental health team at PAVO!

Glorious Gardens From Above: BBC TV @ Ponthafren

This Autumn the glorious terraced garden which is managed by a team of devoted volunteers at the mental health charity Ponthafren Association, Newtown, will feature on a new BBC TV programme called Glorious Gardens From Above. 

TV/radio gardener and horticulturist Christine Walkden spent the summer journeying across the British Isles in a hot air balloon. From this striking new perspective she flew across the country calling in at some of the most beautiful gardens on her way. The new programme is not just about gardens, but people's relationships with gardens. Ponthafren's garden was chosen to represent the community garden category in the episode focusing on Mid Wales.

I met the BBC producer/director Will Ridgeon and his colleague Helen Shields as they spent the day filming interviews of staff and volunteers at Ponthafren and touring the garden to find some of the best viewpoints. That was not difficult in a stunning garden cut into the steep hillside alongside the River Severn, with views overlooking not just the riverbank, but the town of Newtown opposite.

Nicky Morris (Centre Co-ordinator) began her interview by describing the layout of the garden. Starting at the top, there is a large fruit and veg patch, from which leads a long drystone wall. This is topped with herbs all the way down the sloping path to the sensory gazebo - one of several outdoor seating areas. Next is the sensory garden itself, which is stuffed full of different textured plants and grasses, and then alongside the riverbank is the wildlife walk. This incorporates a pond with a solar powered fountain and mass plantings of shasta daisies which blend perfectly with the natural vegetation of the riverbank. 

Each area has its own features, included topiary figures and sculptures made out of all manner of materials, including a recycled bath and washing machine innards! Iolo Williams opened the garden once the wildlife walk was complete and said it was ideal for wildlife - the dragonfly larvae had moved into the pond already!

Helen and Will then moved on to interview Ponthafren garden volunteer Jan Rogers – who is turning into something of a regular guest on this blog (she recently wrote – Volunteering whilst getting benefits and Mental Health Act 1983 – Code of Practice: the review (in England)). As Jan picked apples from a loaded tree, before moving into the greenhouse for tomatoes and cucumbers, she answered questions about how her involvement as a volunteer gardener at Ponthafren had impacted on her own wellbeing. She also spoke passionately about what she had gained from her experience – including increased confidence, new qualifications and the opportunity to work outside.

She explained that a variety of funders had contributed to the garden improvements over the years, including work to make the garden more accessible to all. In the last few years new raised beds and an extra greenhouse have been added, and also new seating areas. These projects are often planned, costed and built by the garden volunteers themselves, and there is a sense of huge achievement as each idea is brought to life.

Volunteers have been able to attend Coleg Harlech (now WEA Cymru) courses in Drystone Walling, Art & Design in the Garden, and Landscape Design, whilst completing various projects. Jan said "some of us were lucky enough to complete a 12 month Diploma in Horticultural based Progression (14 units including a wide range of topics from herbs, grafting, and seed collecting to writing business plans, to name a few). I personally would have never taken part in this type of course if it had not run at Ponthafren."

Jan heads up the team of garden volunteers at the Centre. Each volunteer chooses what area they want to work in, "one lady can't stand for long but she loves to sit and pot things on. We take a lot of cuttings, and the plants are put in our yard for people to buy which is our money to buy seeds, compost and tools for next year. This is the great thing with our garden, there is something for everyone. The only thing that I do insist on is that everyone enjoys it!"

Jan arrives with a basket full of veggies for an outdoor cookery demonstration.

Julia Gorman (Newtown Resource Centre Facilitator at Ponthafren) was then filmed with Ponthafren members preparing the vegetables Jan had gathered. Julia runs regular nutrition sessions at the Centre for members to attend and learn about food preparation and diet - she and some of the volunteers prepare healthy and tasty food for all to enjoy at the end of a session. 

Contrast this image with one taken about 15 years ago when volunteers started work at Ponthafren to transform the garden.

All in all everyone had a thoroughly enjoyable day - though obviously Will and Helen were working non-stop throughout to film the best shots for the programme! We all noticed during the filming how often noises intrude to interrupt a session. Ponthafren garden always seems very peaceful, but on the day the BBC arrived a whole host of sounds came and went, including: squealing seagulls, bottle bank emptying across the river, workmen building a shed next door, motorbikes roaring along Milford Road, dogs barking and planes soaring high overhead. A tip for anyone wanting to get into the TV business: learn and practice patience as a key skill!

The new series Glorious Gardens From Above will now start broadcasting on Monday 10 November on BBC 1 at 3.45pm daily (please note change of broadcast date!)

There are 15 episodes in total. The Mid Wales episode, in which Ponthafren Association features, will transmit on Wednesday 12 November. It will also feature Powis Castle Gardens, and the Dingle Garden near Welshpool.

You can join a Drop-in Gardening session with Jan at Ponthafren Association 

every Wednesday and Friday 11am - 2.30pm.

Julia runs Foodwise sessions at Ponthafren Association every Thursday 2 - 3pm.

You can find out more here.

Powys voices count at the top

   

We are often asked how people can use their own experiences to influence change – whether that be in the way mental health services are provided in Powys or indeed the laws which govern how people experiencing mental distress are treated in Wales and even the UK as a whole.

Recently, two perfect examples of exactly how this is happening came to light, and we thought it would be useful to share these with a wider audience. Hopefully the experiences of these two Powys residents will not only influence future change, but also inspire others to come forward and volunteer to contribute. The more voices we hear the better!

Our role in the mental health team at PAVO is to ensure that these voices are well and truly heard by people in the position to do something with what they hear. Powys Teaching Health Board fund PAVO to do this participation work and my colleague Freda Lacey, Participation Officer in our team, has played a pivotal role in this work.

So, to the two local people concerned, Jan and Rhydian. Freda updated me about their two ground-breaking roles:

“Jan Rogers and Rhydian Parry gained membership on two key executive committees linked to Welsh and English government movements for change.

Jan is the only Welsh member reviewing the Mental Health Code of Practice in England. This work is being led by the Department of Health and backed by the Minister for Health, Norman Lamb.

Rhydian is the youngest Welsh speaking member of the prestigious National Mental Health Partnership Board, implementing the Mental Health (Wales) Measure. This engagement work is endorsed by Mark Drakeford, Minister for Health and Social Care.

The changes being proposed will have wide reaching impact for other citizens across both countries.”

Jan Rogers - Newtown

Jan has been a trustee at Ponthafren Association for many years and has won awards for her extensive volunteering contribution. Her work as a member of the Expert Reference Group reviewing the Mental Health Code of Practice has enabled her to meet with people directly affected by the “Winterbourne View” which is an underlying part of the review. In helping shape the new code of practice, which will be published shortly, Jan has voiced her views on the following areas:

• Restraint. 
• “Sectioning” by the Police and how detention takes place. 
• How the Mental Health Act could work better with the Mental Health Capacity Act around deprivation of liberty issues. 

Dr. Nicola Guy, Department of Health, said:
“I was really interested and impressed by Jan’s contributions in the meetings and very grateful that she was prepared to be so open about her experiences. Her cross border insights have been particularly useful as a Powys resident, who sometimes has had to receive services in Shropshire.”

Rhydian Parry - Brecon

Rhydian recently wrote about his experience volunteering with Powys Patients Council – Life on the ward: the patient’s voice. He underwent a rigorous selection process to be chosen as one of only four individuals (with lived experience of mental distress) to sit on both the National Mental Health Partnership Board, and the Local Mental Health Partnership Board in Powys. You can read more about the process of his selection last Autumn in Freda’s post Citizen Power, Active Participation.

The National Mental Health Partnership Board is responsible for implementing the “Together for Mental Health” strategy across Wales. It is multi-agency, multi-disciplinary and involves a range of public bodies and voluntary sector services, for instance, housing, education, health and social care. Its aim is to drive an holistic strategy for mental health for the citizens of Wales over the next three years.

Siân Richards, Strategy Lead for Mental Health and Vulnerable Groups Division of the Welsh Government said:
“We are delighted to have Rhydian as a crucial member of the Board, particularly with his unique insights as a young person having to transition into adult mental health services, his Welsh speaking skills, and his experiences of being detained and restrained under the Mental Health Act. He clearly has a strong desire to represent the voice of people who are in receipt of mental health services and his contribution to the Board is invaluable”.

Carol Shillabeer, Chair of the Powys Partnership Board, said:
“It is really valuable to have Rhydian and the other individual representatives on our local partnership board as their insights, guidance and critiques are helping us drive changes in Powys Mental Health Services which ensure that “service users and carers” are at the very heart of the services we commission.”

Some of the immediate results of Jan and Rhydian’s active participation:

• PAVO has been invited to help ensure that Jan and others are invited to be part of the Welsh Mental Health Code of Practice Review that Minister Mark Drakeford has recently announced. 
• Rhydian is being invited to participate in key National and Regional Police initiatives looking at how people are handled by the Police whilst experiencing mental distress. 

Want to know more about these initiatives and citizen engagement? Just ask your question below, or contact Freda by emailing Freda.Lacey@pavo.org.uk or call 01597 822191.