mental health care changes

“Poor consultation” on mental health care changes 10/9/11

"Sirs,

“Modernisation" - isn't it strange that in almost all cases, the use of the M-word is used instead of the dreaded C-word, i.e. "Cutbacks."

Cynical? - No! Realistic? - Yes!

All public bodies, and some private companies like the sound of the M-word, because it puts forward the pretence that the result will be an improvement, whereas, should the press release use the C-word, there would be no wool to pull over the people's eyes and they would get upset.

Let's consider the 3 options being put forward by the Health Board.

Option 1 retains the status quo but is "considered to be an out-dated mode of service, concentrated around the in-patient facility, creating a culture of dependency, going against the way staff, service users and partners want to see the service delivered." Mmm?

Option 2 "would result in increased community capacity, but would also mean that acutely ill patients would have to travel to the mainland to access in-patient facilities" Mmm?

Option 3 "is based on recommendations in previous mental health reports, would increase capacity in the community "shifting the balance of care" but would still retain an inpatient facility for acutely-ill patients.

These options "were as a result of extensive consultation exercises over the past four years" and a "formal option appraisal process should now take place within the next two months...which will enable members of the public, staff, other agencies etc to get involved..."

Given that the options were based on four years worth of consultation, it is quite insulting to expect those outwith the process to come up with potential ideas within two months!

Excuse my cynical head again, but two months to carry out a formal appraisal is not realistic, unless of course you do not wish to allow others sufficient time to consider the pros & cons and put forward other potential ideas for consideration.

According to Health Service statistics, three out of every four people will suffer from some form of mental health issue during their life - on that basis, surely any "formal appraisal" should look to increase the availability of mental health care, rather than "modernise" the current setup?

Over the years and along with many others in the Western Isles, I have personal experience of the current and previous setups and can express nothing but praise for the staff who have to deal with issues and situations outwith my and many others understanding, day and night.

We had excellent support from staff in the community, but without the in-patient facility, I do not believe we could have coped - the additional strain placed on families who have to travel to a mainland facility to visit loved ones would be enormous.

The current setup has also removed the stigma that used to be attached to patients who were sent "across the water" - do we really want to return to that scenario which placed patients and families under more pressure - now that is most definitely not what we should wish for vulnerable members of our community.

To quote Dr Jim Ward's statement - " NHS Western Isles is focused on the strategic development of services for people with mental health problems, and providing local support within the community to reduce the likelihood of individuals requiring in-patient care"

Mental health care is not something that can be planned due to the infinite variables involved, so to set an objective of "reducing the likelihood of individuals requiring in-patient care" is not as easy as it sounds. Dr Ward continues "what is also fundamental to any considerations is that where in-patient care is required, it must be provided in appropriate surroundings"

These fundamental issues should effectively rule out transfer of patients to a mainland facility, should it not?

So what should we hope to achieve from this "modernisation"?

1. An improved service provision for mental health patients and their families.

2. Continued in-patient facility at Ospadal nan Eilean.

This should mean more community support for patients and families, not "an increased community capacity" which translates to "reduce in-patient numbers by any means."

A "continued in-patient facility" should not translate to a sharing of facilities within Clisham Ward as is rumoured. The current separate Acute Psychiatric Unit next to Clisham Ward should be maintained.

Mental health care is part of NHS Eilean Siar's provision to the population of the Western Isles via Ospadal nan Eilean. A true public consultation process would offer the populace a copy of the various options, with a choice to be selected by the majority which the Board could use as part of their appraisal. I doubt this could be completed within two months.

Should the option to transfer in-patients to a mainland facility be selected, each transfer would be accompanied by a qualified member of staff, the same would apply for the return journey. Family would wish to visit the patient, incurring further costs not to mention stress to family members.

There is no guarantee of a place being available at the nearest mainland facility - how far afield should patients and their families be expected to travel? The nearest mainland facility to the northern part of the Western Isles would be Inverness whereas Glasgow becomes the option as you move further south. Certain patients could also sign themselves out of the facility, in what could be unfamiliar surroundings - what then?

I would urge all Western Isles residents to submit their views on these proposals as recent "public consultations" have been somewhat lacking in their "public" input.

Norman Graham Smith

7 Gress

IIsle of Lewis

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