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!

Co-producing the Annual Report for Mental Health

L-R: Aled Davies (Powys County Councillor), Sophia Bird (Powys Public Health), Meriel Richards (individual rep National Forum for Service Users & Carers), Seamus O'Doherty (Welsh Ambulance Service), Louisa Kerr (Powys teaching Health Board), Clare Lines (Strategic Lead Mental Health - PtHB), Michelle Forkings (Aneurin Bevan Health Board), Jackie Davies (Children & Young People's Partnership), Steve Pearce (Powys Youth Justice).

Following development of the new Powys mental health strategy – Hearts and Minds: Together for Mental Health – the first annual report was produced by the Powys Mental Health Planning and Development Partnership Board for 2012-13 (you can read it here). This reports on which key elements of the delivery plan had been achieved during that year. As far as I am aware, it was written primarily by staff working for Powys teaching Health Board.

At a recent meeting of the National Partnership Board (minutes available here) the individual representative who is based in Powys, Rhydian Parry, gave feedback from the National Forum for Service Users and Carers. One of the points he made was:

“Service user and carer views need to be clearly and accurately embedded in annual reports.”

“The Chair (of the NPB) responded saying all Local Health Boards and Trusts have been informed of this requirement. A small amount of financial support has been made available to each Partnership Board to support this process. Sian Richards (Welsh Government Mental Health Strategy Lead) will be meeting the Service User and Carer members immediately after this to discuss how they can play an active role in the development of the Welsh Government report.”

I knew that an event had taken place in late September this year, pulling together the members of the Powys Mental Health Planning and Development Partnership (PMHP&DP), including those using mental health services and those close to them, to look at production of this year’s annual report. The work was being described as “co-production” – a word which can mean so many different things to different people. It is defined by the New Economics Foundation “as delivering public services in an equal and reciprocal relationship between professionals, people using services, their families and their neighbours”.

So, I asked my colleague Freda Lacey for an update about last week’s event.

Freda told me that four of the individual reps – Rhydian Parry, Meriel Richards, Kate Van Ende and Michelle Willingham – had contributed along with people working to provide statutory mental health services, Powys Public Health, a Powys county councillor, Powys Youth Justice Service and the Welsh Ambulance Service. Prior to the event the four individual reps had given feedback first on the structure of the event, and then about the way their contribution would be included in the Annual Report.

The idea of a “timeline” was developed – the journey of an individual’s life from cradle to grave – along which mental health services could be accessed. Feedback was then given about these services.

The completed Annual Report will be signed off by Powys teaching Health Board (PtHB) in October before being passed to the Welsh Minister for Health & Social Services – Mark Drakeford. It comprises two parts – a written section, where the reps have made detailed feedback on the delivery plan and overall report, and an audio version containing real life voices. The voices will include contributions from an all age perspective, including children from the Sparks Project run by Tros Gynnal, an interview with an older couple relating to dementia, and excerpts from the DIY Futures book of stories – it’s the inside that matters, covering adults’ and older adults’ perspectives. Additionally, partners have been asked to give their feedback on how the voices of people in contact with services have helped shape their services. There will be contributions from Dyfed-Powys Police and the Children and Adolescent Mental Health Services team (CAMHS).

Clare Lines, Strategic Lead for Mental Health at PtHB, and chair of the Powys Mental Health Planning and Delivery Partnership, will also speak about the positive impact that the individual reps have made on her work and that of the Partnership.

We will let you know as soon as the Annual Report for 2013 - 14 is published. Watch this space!

National Mental Health Partnership Board update

In early November Freda updated us in her post Citizen Power, Active Participation about the process for selecting representatives for the National Mental Health Partnership Board – along with details of the National Forum for Service Users & Carers and the local groups that feed into this board, and representation on those.

 

As stated on the Welsh Government website, the National Mental Health Partnership Board (NPB) will “oversee the delivery and implementation of Together for Mental Health – A Strategy for Mental Health and Wellbeing in Wales and its Delivery Plan; guiding and monitoring progress, and facilitating co-ordination of the cross-cutting approach required across Welsh Government, Statutory agencies, the Third and Independent Sectors.”

Together for Mental Health is the Welsh Government 10 year strategy for improving the lives of people using mental health services, their carers and their families. At the Shaping Services Together conference, which took place on 19 September in Llandrindod Wells, we were introduced to several members of the NPB, see photo below.

We have now received further updates from David Crepaz-Keay, Mental Health National Forum for Service Users & Carers and Sian Richards, Strategy Lead, Mental Health & Vulnerable Groups Division, Welsh Government. 

Let’s start with David:

“Back in the spring the Wales Alliance for Mental Health was asked by 
Welsh Government to oversee the process to identify two service users and two carers to become members of the National Mental Health Partnership Board (NPB) in time for the December meeting. I’m proud to report that we have achieved this.

Junaid Iqbal, Jane Treharne-Davies, Carina Edwards and Rhydian Parry have become members of the NPB; we also have a team of skilled deputies to support them in these roles and to step onto the board when needed. Alan Meudell, Julie Murray, Tracy Elliott and Steve Hails have been selected deputies. All eight people will become members of the Forum and met the other Forum members at the Forum meeting in Swansea (in late November).

The eight people were chosen following an open recruitment process by a panel of Forum members following interviews (in mid November). The process has been a long and challenging one and has only been made possible by the hard work of a few and the good will and support of many.

We now have Forum members from Betsi Cadwaladr, Hywel Dda, Cardiff and Vale, Powys and ABMU. We have also completed selection of the ten national members of the Forum, but this will be revisited once all Local Partnership Board service user and carer members are in place as we already have a number of vacancies.”

And over to Sian:

"I would like to take this opportunity to thank you all for the roles that you have played in establishing service user and carer arrangements for the National Mental Health Partnership Board.

The importance of strong service user and carer engagement at both an individual care level and strategically in the planning and monitoring of services is one of the underpinning goals of Together for Mental Health. The need for a national forum bringing together service users and carers who are active across Wales and the establishment of an open and transparent mechanism to appoint service users and carers on to the new National Partnership Board were clear recommendations from last year’s service user conferences. Earlier in the year Welsh Government asked the Wales Alliance for Mental Health to co-ordinate the process to respond to these requirements. David took on the lead role and has done absolutely sterling work to get us to a position this week where the recruitment process is now complete for the Partnership Board and we had over 40 people from across Wales attending our National Forum meeting in late November.

Every one of you has had a key role in this process and I would very much like to thank you for the energy and enthusiasm that you have shown in helping us to deliver this, and for the time commitment that you have been prepared to put in to it, often at short notice and on top of many other demands.

I think that we are now in a very exciting place in terms of the development of this approach in Wales and it would not have happened without your input.

Many, many thanks and I look forward to meeting with many of you over the coming months.”

Rhydian Parry, one of four people recruited from across Wales to the NPB, is from Powys, as is one of the reserves, Steve Hails. Congratulations to them!

5 of the 9 representatives from Powys attended the first Powys Mental Health Planning and Development partnership as new members of the group on December 5th 2013. 

Over to Freda:

“Wow, what a week it's been! I was really in awe yesterday as we sat around the table at the first Powys Local Partnership Board meeting where we had individuals in contact with services around the table. Laura and I were speaking afterwards and we felt it was the best Local Partnership Board meeting we'd attended. The atmosphere and energy in the room was very different, it really felt like we were coming together, management were listening and your contribution was really valued.”

We’ll keep you updated about how the National Mental Health Partnership Board and National Forum for Service Users & Carers are going. Meanwhile, if you have any questions just get in touch with us or leave a comment below. You can email pamhinfo@pavo.org.uk