Myles’ Blog: SEPT need to accept responsibilties

“As many of my regular readers will know, I am a mental health service user, having been afflicted with depression for 33 years and rather opinionated when it comes to the quality of the mental health provision in Thurrock; it will come as no surprise then that I am covering that topic once again.

Back in April, I highlighted the deplorable state of the provision at Grays Hall Outpatients Department and one would expect that the situation would be well on the way to being resolved by now but it has not. In fact, nothing seems to have been done about the situation at all. The posters declaring that service users are “seeing the same doctor as usual” are still on display in the waiting area and yet, in the last four appointments I have had there in the last year or so, I have seen four separate doctors – all members of the same consultant’s team to be sure but not really the continuity of provision that the posters make the bold claims of. Worse still is the fact that only one of the four doctors seemed to have read the notes that their colleagues had written about my case, leaving me with the trauma of cataloguing the circumstances of my previous and current problems before being rushed out of the consulting room as if there was a fire in the building.

The issue of the high staff turnover at Grays Hall was brought to the attention of the Chief Executive of South Essex Partnership Trust (SEPT) about a year ago by my very self and yet, despite being given assurance that the matter would be looked into personally, there has still been no hint of an investigation, let alone any findings. This is hardly a satisfactory state of affairs for an organisation that proclaims that it is “providing services that are in tune with you”. Neither is the fact that some service users from Thurrock have to go all the way to the Mental Health Unit in Basildon Hospital to access some of the services they rely on. A trip to Basildon may be alright for those with concessionary bus passes or their own transport but is a costly affair for those of us who have to pay the bus fare, bearing in mind it is a weekly expense at a time of financial uncertainty. There is also the matter of the extra stress of the bus trip for those of us who suffer with varying degrees of social phobias. My own problem is rather mild but a trip on public transport is still a stressful affair even for me.

Another issue for me is that my appointment at the Mental Health Unit is at 8:30am in the Community Resource Centre. This would not be a problem normally but, if the bus gets me to the hospital late, I cannot get into the building as the door is kept locked until 9am when the receptionist arrives and that is hardly helpful especially in the rapidly approaching cold weather. Even if things are running on schedule, some of my fellow service users and I are left standing outside the building for minutes, waiting for the therapist to open the door for us. Hardly “providing services that are in tune with you”.

I have been accused by my current therapist of having a problem with mental health staff, which is something I strenuously deny. I hold my previous therapist in the highest regard and my current therapist is reasonably good. I believe that most members of staff in SEPT are trying to do a difficult job under increasingly difficult circumstances. I have got a problem with SEPT as an organisation though. I believe that SEPT is suffering from Sick Organisation Syndrome (SOS). SOS is where an organisation is completely oblivious to the fact that, while they may believe they are wonderful, they are actually falling down on the job in a big way. In Thurrock, SEPT is the epitome of a sick organisation. What makes matters worse is that the Trust’s public governors seem to be completely oblivious to the problems with the quality of provision in this area. During a public member’s meeting earlier this year, a Trust governor for Thurrock admitted that she was unaware of the high staff turnover at Grays Hall when I brought it up. I was amazed, as I would have thought that it was her responsibility as a governor to know all the important issues in the area she represents. How else can SEPT let down their service users?

It would seem to be impossible to be let down any further but SEPT manages to do just that. Bearing in mind that the Trust is supposed to be a South Essex organisation, they seem to spend more time thinking about their newly acquired areas of Luton and Bedfordshire rather than fixing the problems with their provision for South Essex. The Trust, in true empire building style, has also acquired some community (physical) health services to provide as well. Where, however, does that leave the poor mental health service user in Thurrock? Left at the bottom of the agenda as a mere afterthought, apparently.

I could go on SEPT bashing for ages but the bad aspects of the Trust are endemic of a deeper problem at the heart of mental health provision in general, a darker and more damaging problem for the service users who rely on the services provided. The problem of which I speak is the apparent push by mental health trusts towards service user dependency on their services, thanks to the new Payment By Results (PBR) method of funding. PBR means that service users may be discharged having achieved a short-term stability in their condition but before they are truly ready for discharge simply so that they can be re-referred later. Each new referral nets the trusts a significant additional payment, more than if a service user is kept in the service. It makes financial sense for the trusts to keep their service users dependent on their services but it does little to help the poor service user.

The problem with building a dependency on statutory mental health services is the fact that service users will never be able to become fully productive members of society because getting work will be almost impossible and they will be unable to contribute to the public coffers. It also means that the types of services that would really help the service users are not available through the trusts because they will not be funded to provide them. Peer support opportunities that would be the most beneficial for people with mental health issues will struggle to find independent funding on their own and the service users will be left, unaided and dependent on statutory services that have little or no incentive to heal their service users. During a conversation, a fellow service user said to me that “the commissioners should just give us the flamin’ money and we’ll run our own services” and, for the good of the mental health service users, I have to say that I agree with him.”

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