Tuesday, 23 June 2015

meeting with the @nhsfife Patients Relations Manager 22 June 2015

selfie taken after meeting, St Catherine St, Cupar
Here are some notes from and reflections on my meeting yesterday, 22 June 2015, with the NHS Fife Patients Relations Manager in the County Buildings Cupar.

Firstly, we met for over two hours and I would say that we were on the same page, regarding complaints in psychiatric settings, and about many other topics.  We agreed that there weren't many people coming forward with issues about mental health services, from the statistics, and the risks of retaliation are real if being critical about psychiatric treatment.

[However I am looking for action and not just managers agreeing with what I'm saying]

I spoke about how people are coming to me with their complaints eg the mother whose son was being locked in the IPCU seclusion room last September 2014.  He had 2 acquired brain injuries and the drug regime was over-sedating him.  This mother said in her second Email to me: 

"To answer your question re the seclusion room - YES it is still currently being used - my son has been in it on a few occasions during the past week!!!"

5 October article Scottish Sunday Express
I have since heard that from October 2014 the seclusion room has ceased to be in use.  I presume this happened after my successful Ombudsman case, decision came in end of September 2014, where my complaint against NHS Fife was upheld, regarding my son's "unreasonable treatment" in Stratheden Hospital:

If people are coming to me and complaining it means that concerns and complaints in psychiatric settings are not being listened to.  

The Manager told me about 3 initiatives ongoing in NHS Fife to try and encourage more feedback:
And she will send me more information about these so that I can be informed and also give my opinion.  I already know about and have used Patient Opinion.  It was useful, up to a point, but I believe it is more of a health board tool than a means of empowerment for a patient who has received sub-standard treatment.

I spoke in some detail about particular staff at Stratheden Hospital involved in practices that were risky and inappropriate, in 2010 and 2012, that I had witnessed, naming the nurses.  Some of whom had family members working in the hospital, also involved in the mistreatment of my son eg father and son nurses in Lomond Ward, husband and wife nurses in Lomond/IPCU, Feb12.  (blog post: keeping it in the family)  I remember writing an Email to the Acting General Manager about this.  

I am not happy that the Senior Charge Nurse who was in charge of the Stratheden IPCU in February 2012, when my son had his basic human rights denied, is still in the same position.  I heard this recently at the information session about the new build IPCU.  This SCN told me on 2Feb12 over the phone that her ward was all about "relationships".  

[I believed her.  Until I found out on 4Feb12 what the true state of affairs was.  She hadn't mentioned locking my son in the seclusion room overnight, in the dark, for hours on end, unobserved, at risk to his life.  She hadn't told me about my son's broken hand.  She hadn't arranged for an X-ray.  I had to instruct the ward Junior Dr Chan to do this.  I asked if they had a portable X-ray, was told no.  My son got an X-ray on 6Feb12 which confirmed the breaks in his hand.  I was there as a witness.

I mentioned the word "fear" to the Patient Relations Manager, as being one of the main reasons as to why patients and carers in psychiatric settings will not want to give negative feedback.  Fear of retaliation.  Fear of not getting a good service in the future.  Fear of what it might mean to the person they care for.  I raised concerns about Stratheden nursing practice in 2010 and believe that this impacted negatively on my son's care in 2012. 

I spoke to the Manager about Fife Council Social Workers who I also had to make complaints about in Feb12.  And the Adult Protection Investigation Report led by a Mental Health Officer, which tried to put the blame on me for causing psychological harm to my son when he was being locked in the seclusion room and being subject to psychiatric abuse.  Their investigation, I contend, was biased towards the psychiatric service and against a carer and her son.  Unbalanced reporting. 

We discussed other matters to do with NHS Fife, the health board meetings which I spectate at, and something of our personal stories, shared experiences.

I suggested to the Manager that we might collaborate on a joint event, a workshop or seminar for mental health staff in Fife.  I offered to co-present and faciliate, free of charge, no expenses.  I am an experienced, qualified community education worker and trainer since 1980, and have organised many events through my voluntary work with Peer Support Fife.  Not sure if my offer will be taken up.  But I have left it on the table.

I also gave a copy of a recent blog post to the Manager: here is the challenge: making it safe to complain in psychiatric settings.  Which had a list of proposals regarding meaningful involvement of experts by experience:

"Here are some ways in which I think the pathway to complaining can be made straighter:
  • putting Experts by Experience (EbE) at the heart of the process
  • safeguards in place which are safe 
  • confidentiality scrupulously adhered to
  • management ensuring regular training of staff in responding to complaints, involving EbE who may be service users, psychiatric survivors, carers or family members with a range of views
  • de-personalising the procedure, taking away any "blame" aspect
  • training of managers in how to write letters of response to complaints which are neutral and blameless
I believe that the meaningful involvement of EbE, in staff training programmes and debriefing sessions, is paramount in bringing about cultural change in psychiatric settings where people are not free to speak out without fear of retribution.  A range of experiences, from those who welcomed compulsory treatment to those who resisted with all their might."

Although I found the meeting with the NHS Fife Patient Relations Manager to be useful it does not mean that I can stop being a writer, activist and campaigner in mental health matters.  It does not mean that I can stop speaking out about psychiatric abuse.  It does not mean that I believe there has been justice done in respect of what happened to my son in Stratheden Hospital, February and March, 2012.

What it does mean is that I am prepared to work collaboratively with NHS Fife and Fife Council staff so as to make it safer for people engaging with psychiatric services, as a patient or carer, to raise complaints and to speak out with a critical voice about poor or bad practice.  The challenge will be as to whether NHS Fife and Fife Council Social Work Managers are willing to work with me, on a level playing field, as equals, listening to my voice without being patronising or straitjackets appearing.  

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cartoon is directed towards management in Fife mental health services, generally

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