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A humbling NHS experience, a media row and a good GB speech

Posted on 12 June 2009 | 10:06am

What a truly
inspiring and humbling time I had at the new Psychiatric Intensive Care Unit at
Rathbone hospital in Liverpool yesterday. 

It was not just the evident quality of care being provided for a small number
of seriously ill men. It was also the clear emphasis that was put on making
sure the views of service users and carers were taken into account in the way
the place was run. Mersey Care NHS Trust should be really proud of what they
have there.

I first knew of the Liverpool PICU when Anne Evans, who
herself has mental health problems, contacted me asking for a letter with good
wishes for the unit.

I was not alone. Dotted around the walls are framed messages, photos and
letters from dozens of people as varied as Roger Moore, Kevin Spacey, Liz Taylor,
Carla Lane and the pop group Madness. She had even managed to get one from chef
Raymond Blanc for the dining room. 

Service users and families had been involved in the design, (and even won an
award for the windows,) the colours on the walls, some of the layout.

What I saw and heard gave me plenty to talk about in my speech on stigma and
discrimination to the NHS Confederation in Liverpool later in the day. I gave
the NHS plenty of praise, not least because of what I had just seen, but also a
bit of a kicking because only 12 per cent of the NHS has signed up to the Time
to Change campaign aimed at changing attitudes to mental illness. And I read
out a comment posted on yesterday’s blog from an NHS employee who said the NHS
as an employer needed to do more to tackle stigma in its own back yard.

It was a bigger audience than I had been expecting and it is always
interesting for a speaker to see which bits go down better than others.

The three occasions on which my remarks were interrupted by unexpected applause
were first, when I said that whatever the pressures there should be more
investment not less in psychiatric services because it would also help the
government’s goals on crime, education, family policy. Second, when I
criticised the media for the constant linking of mental illness and violence
when the mentally ill are more likely to be victims of violence than
perpetrators. And third, in the q and a moderated by Sarah Montague of the
Today programme, when I said the media did not paint an accurate portrayal of
any part of our national life.

Sarah did that very defensive thing journalists tend to do, saying I was
‘blaming the media’. I wasn’t. I was simply saying that if the media only
covered what they deemed to be bad about politics and public life, we should
not be surprised if people got a skewed vision of the world. I think – and I
hope – that she was somewhat taken aback by the evident support for the notion
that the culture of negativity had gone too far.

I also criticised David Cameron (lots
of nods but no spontaneous applause for this one) for the way he slapped down
Tory MP Nadine Dorries when she expressed worries that the MPs’ expenses furore
would lead someone to suicide. She was right to express concern at the way the
witchhunt was going.

One of the event’s sponsors had very kindly bought hundreds of copies of my
novel, All In The Mind, to hand out to delegates so thanks for that.

Good day, saw a lot, learned a lot, hopefully helped a bit in the anti-stigma
fight.

Then back to London for a Labour fundraiser at Stamford Bridge.
Good venue. Sneaked a look in the away dressing rooms to see where Burnley
would be changing. Met a woman called Helen who said she once snogged Wade
Elliott whose goal at Wembley secured promotion.

GB spoke really well
about four preconditions for electoral success – sorting the economy, sorting
politics post expenses, showing we have the right policy agenda for the future
and setting out the contrast offered by the choice of the Tories.

I took both my mother
and Fiona’s mother with me, to add a little glamour to the evening, and both
said Gordon’s speech was as good as they had heard. While nobody was in any
doubt how hard the task ahead is going to be, there was definitely a bit of
hope in the air.

  • Peter

    Thank you for coming to the conference … I almost fell off my chair when you read out my comment on your website. I have to tell you the buzz after you left was great. People felt really inspired and moved by what you said about your own experience, and also your challenge to the NHS to do more. I think there was an acceptance that as employers NHS trusts do not set a good example in this field. But it was also great to hear you evangelise about the work of the NHS people you spent the morning with.

  • Jenni G

    I absolutely loved the look on Sarah Montague’s face when she saw that the audience was backing you not her in the argument about media and politics. Why can’t more people in politics and public services stand up for themselves like that? We spend all our time having to apologise for ourselves when as you said the work going on in the NHS is fantastic, yet the public never hear of that through the media, who spend all their time saying everything is terrible. Well done too for standing up for MPs in general whilst not defending the expense abuses. I can honestly say people left the session you did invigorated and inspired. I know I did, and the comments all around me said the same. Please keep up the work you do on mental health. If anyone can break down the walls of stigma you talked of, you can

  • Alan Macrae

    I will take your word for it that mum and mum in law were impressed by GB speech. But why can’t he come over like that to the public?

  • Fran Elliot

    I had never heard of Psychiatric intensive care units till now. Interested in the use of carers and families in designing services. Wish there was more of that. I have a daughter who requires regular hospital visits and while obviously the patient is the most important person, I sometimes feel there is little regard for the families who have to live with the illness all the time, inside and outside the hospital environment

  • Peter Farley

    Alastair – You really have to drop the link between increased budgets and improved services. There is absolutely no correlation in the NHS (or anywhere else) that this has occurred, and in many instances the opposite – as endorsed by the reactions of many within the NHS itself. Please take on board this extract from comment in The Times this morning: “We all know that the money has run out. We know that Britain is at the limits of borrowing, that taxes must be raised or spending reduced. We know that Labour’s spending spree was poor value for money. Perhaps the biggest lesson of the new Labour experiment is that throwing money at public services is not always a panacea. If it makes them bigger rather than smarter, the new complexity and bureaucracy can undermine the benefits of hiring, for example, 41,000 more doctors and 85,000 more nurses. Money has not solved the NHS’s morale problems: the Department of Health has stopped asking NHS staff if they would be happy to be treated in their own hospital, because the annual survey answers had become so shocking.

    In a devastating report this week, the Office for National Statistics (ONS) said that NHS productivity fell by 4.3 per cent between 1998 and 2007, and that improvements could have been achieved with far less money.”

    Need I say more. Let’s chop out all the waste. It cannot be difficult to save at least 5% from the current NHS budget without impacting services – and that number would now be more than £5 billion, still a drop in the ocean against the debt we now have to repay given the government’s lurch into the red to supporting its unfunded spending sprees. Gordon needs to stop both kidding the electorate and himself that any government can look to the next 5 years without making significant cuts across the board in public spending.

  • christine higginbottom

    Dear Alistair, The fact remains that for the severely mentally ill in the community there is a woefully low provision of care and support. It is now seen as the ‘ideal’ to treat and care for people in the community,and this ‘idea’ will only increase in the years to come. However, no one will acknowledge that plenty of the mentally ill just CANNOT manage to look after themselves, their illnesses prevent them from coping. I believe it is just another form of cruelty to expect them to do so when the support and resources are not out there in the community.

    Thank you, Christine.

  • Lindsey Dyer

    The Psychiatric Intensive Care Unit at Mersey Care is a small service where up to 8 men stay for a few days or weeks whilst in an acute stage of mental distress. We have some fantastic staff who spend lots of time with patients and there are lots of interesting and therapeutic activities. Every single aspect of the PICU was designed with and by people who use mental health services and carers. They were involved in the appointment of/and choosing the staff who work there and in deciding all the activities that are offered.They are valued and respected for their knowledge and experience and paid for their time (£12 an hour plus expenses). There are over 300 people like Anne who have experience of mental health services involved in Mersey Care and the PICU is a great example of the difference she and others are making. Thanks so much for coming to see us Alastair!

  • Anne Evans

    Thank you so much for visiting us yesterday and for the acknowledgment of both staff and service user/carers, who have all worked hard together to establish The PICU. The unit itself, the staff, and Touchstone are very dear to my heart. It is no longer just a project for me, it is an ongoing process of change and development, as PICU’S values are about staff, service users and carers working together, collaboratively, not critically, in order to provide not just a more positive, healthier in-patient experience, but to ensure that in the future mental health units are healthier and supportive environments for staff also. I can see positive changes in mental health health services from when I was admitted into a psychiatric unit in 1994, however, I recognise it will take time to change the attitudes and values surrounding mental health. MerseyCare has given me the opportunity to challenge some of the negative attitudes and values and to have meaningful, active involvement in shaping future mental health services. Thank you again Alastair for your support for PICU.

  • gary Enefer

    The NHS has always been an expensive but wonderful idea and we should be proud. The country needed to bale out the Banks to stay afloat and we’ll just have to pay it off over time.

    Labour still has better values than the Conservatives.God knows what they will do if they get in – last time round they stole our school children’s milk.

  • Brian Hughes

    “Posh” Sarah, like many in her trade, tends to get defensive very quickly when anyone points out to her what a distorting mirror their belovéd media hold up to reality.

    There must be thousands of examples of well equipped NHS units staffed by dedicated professionals providing first rate services to patients. But we hardly ever hear about any of them.

    An issue that everyone in the service needs to think long and hard about, however, is the experience of the service that the infrequent user receives.

    Managers, doctors, nurses and administrators should be encouraged to exercise their imaginations and critically examine their units from a patient’s perspective. Then perhaps, for example, people like my ninety year old mother wouldn’t end up wandering through long, inadequately signposted hospital corridors between confusingly named departments whilst getting (otherwise excellent) treatment…

  • Em

    I don’t have much to add except to register gratitude and thank you for keeping the NHS and mental health issues front and centre.

  • Jane A

    This survey, published today, highlights how people’s attitudes to mental health changes from year to year.
    I tried to post it earlier, possibly it failed because of length, so this is briefer.

    * Almost three quarters (73%) agreed that people with mental health problems should have the same rights to a job as anyone else – up from 66% in 2008.

    * 79% agreed that mental health services should be provided through community based facilities – up from 72% in 2008.

    * 79% agreed that people with mental illness should not be excluded from their neighbourhood – up from 74% in 2008.

    Levels of fear of mental illness also demonstrate signs of improvement:

    * 61% of people agree that people with a mental illness are far less of a danger than most people suppose – compared to 57% in 2008.

    * Only 15% of respondents feel frightened by people with mental health problems living in residential neighbourhoods.

    (Attitudes to Mental Illness 2009, Department of Health)

  • PrimeMinisterTension

    Dear Alastair. I think mental and emotional bullying in a learning and workplace environment can lead to serious mental health problems such as clinical depression. Do you agree? Tim Fields covers these subjects matters in a thorough and intelligent way. Worth checking his website out.

  • BasketWeaver

    Apart from high profile media players such as yourself not many intelligent loonies get the opportunity to reach their potential. Most are exploited as cheap labour or worse patronised into working in a charity shop.

  • Alina Palimaru

    I second Em on this one. You rule!

  • Randle P McMurphy

    This care in the community is a shambolic. What are we looking at ya bams? Labels, stigma and exploitation of vulnerable people. There are a lot of ignorant individuals out there who who sweet fa about mental health issues. Some are on this blog. The individuals who put the interest of New Labour over above gaining true understanding of real problems in the real world. Campbell I hope you reply to the points Chrissy makes.She is someone who needs serious answers to serious questions.

  • Dorcas

    No-one can force the mentally ill to take their drugs, pursue a non-destructive lifestyle or accept help. My near neighbour – and the rest of us – live in a never-ending cycle. He stops taking his anti-psychotics, he smokes copious skunk, lives in filth, is sectioned; comes home, stops taking his anti-psychotics etc. He becomes frustrated, throws things (once a fridge down two flights of communal stairs), his dog (and who would dare suggest he shouldn’t have one?) craps and pees everywhere and jumps at my visitors. Often he has no money to feed it (see Skunk). Many different organisations brave the stench to tap on his door offering support but he won’t talk to them or read their letters.

    Sorry, but I don’t have a romantic view of mental illness; it can be incurable, smelly, anti-social and stubbornly selfish. This intelligent man with a high disposable income in benefits intends to have his own way at everyone else’s expense. I am sick of living near him and his mental illness. I hope he falls down a deep well.

  • Phil Spector

    Can I get a free wig on the NHS?