Mental Health

All in A Day’s Work: Mental Health Provision, Wellbeing and Scrutiny in Brent Council

/ inlogov / 1 Comment

Cllr. Ketan Sheth

As Chair of the Community and Wellbeing Scrutiny Committee at Brent Council, Cllr. Sheth has a behind the scenes look at the workings of local government. Here he shares his experience in trying to improve Brent’s mental health provision and his views on what good local authority overview and scrutiny looks like. 

One in four people will experience mental ill health at some point in their lives – so it is likely all of us will directly or indirectly need support from the valuable services that support people to recover and to remain resilient.

Mental health – a once under-reported and some would say under-valued aspect of our health and wellbeing – has been making headlines recently and is a stated national priority. Earlier this year the Prime Minister announced plans to transform mental health services with a particular focus on children and young people. This was subsequently followed by an announcement last month by the Health Secretary of a plan to create 21,000 new posts, investing £1.3bn by 2020. Again, the commitment to mental health services for children and young people was affirmed.

This brings a welcome focus given children and young people’s mental health and wellbeing can ultimately shape their life chances and outcomes. So now we must think about how we – as a local authority overview and scrutiny committee – understand what is going on behind the headlines and – as elected councillors – continue to shine the spotlight locally.

Scrutiny work that adds a real value and makes a positive difference to local residents’ lives must remember a number of important factors: are elected councillors supported to carry out a meaningful review? Do they understand how to capture the service model? Do they understand how to draw out the challenges to effective delivery of that model? Do they have the tools and information they need to be responsive local decision makers?

In Brent, my Community and Wellbeing Scrutiny Committee recently went behind those headlines to better understand mental health provision for children and young people across Brent and to see how we might add value to the current service model. A Task and Finish Group on Child and Adolescent Mental Health Services (CAMHS) was set up to review this complex area, and their report makes for very interesting read.

The task group was put in place to gather evidence – qualitative evidence from face-to-face interviews and research, and quantitative data and this was done alongside NHS Brent CCG, local health providers, schools and further education representatives and community representatives. I want to highlight two things my committee learnt in undertaking this work.

Firstly, the involvement of young people in this research was vital. Let’s face it, elected councillors in a local authority tend to be far older than the demographic we were seeking to reach, so it was incredibly helpful to have the input and perspectives of young people. We appointed a former member of Brent Youth Parliament (now a student at King’s College London) and they brought an excellent viewpoint to the task group’s work and deliberations.

Secondly, it was essential we recognised and embraced the complexity of this area. CAMHS is a complex and challenging subject for overview and scrutiny members because it cuts across local government and health responsibilities. Whilst this is excellent news for integrated care, it means you must be able to grasp and work across a range of people and organisations. You must also recognise the child or young person and their family and carers are a vital part of this system and network of care, and understand their perspective as well.

Effective scrutiny can be a powerful vehicle for change if committee members can stand back and really understand what is happening across local government and health services. If we are honest, overview and scrutiny committees nationally have varying relationships with public sector colleagues; however, in Brent, my committee’s relationship with NHS Brent CCG and wider health services is a good one. We try to be constructive and fair in forming our recommendations, especially in areas where we think things could be done differently and outcomes could be improved.

We have now made our recommendations to the Brent Council Cabinet and NHS colleagues and will monitor progress as a result. In Brent we will ensure mental health for adults and children and young people remains on the agenda, irrespective of the headlines.

To read the CAMHS task group report, visit http://www.brent.gov.uk/scrutiny.

 

 

Picture1.png

Cllr. Ketan Sheth is a Councillor for Tokyngton, Wembley in the London Borough of Brent. Ketan has been a councillor since 2010 and was appointed as Brent Council’s Chair of the Community and Wellbeing Scrutiny Committee in May 2016. Before his current appointment in 2016, he was the Chair of Planning, of Standards, and of the Licensing Committees. Ketan is a lawyer by profession and sits on a number of public bodies, including as the Lead Governor of Central and North West London NHS Foundation Trust.

When will they ever learn?

/ inlogov / Leave a comment

Catherine Staite

The news of the death of Pete Seeger has reminded me again of his old song ‘Where have all the flowers gone?’ The line ‘oh when will they ever learn?’ has been running through my head since I saw an item on the local news about police officers and mental health professionals working together to prevent people with mental health problems ending up in police cells for want of the right support. ‘Good stuff!’ you might think.  Indeed it is  – but it is also profoundly depressing to hear such a venture being reported as ‘new’.

In 1993 I led a multi-agency, multi-disciplinary team, which diverted people with mental health problems and learning disabilities from custody.  The team included all the right skills and necessary statutory powers – a specialist social worker, two community psychiatric nurses, a senior probation officer and a police inspector.  We had the backing of all the chief officers and the team went wherever they were needed, the police station, the bridewell below the magistrates court and the remand and hospital wings of the local prison.

The approach was simple but effective. By bringing the right skills into the system at the right time, we were often able to help get the right decisions and find the right services. Within a year, the prison hospital wing was no longer full of prisoners with mental illness and learning disabilities. This was a time when the local mental hospital was being run down for closure, so it was no small feat. Of course, some of our clients were very disturbed and a small number were dangerous, or had committed very serious offences so they had to stay in prison or be moved to a secure hospital but at least we knew who they were and where they were.  We advocated for them. They were not dumped and forgotten.

We shared our learning and even wrote a book about our approach which was replicated and adapted all over the country. It was cheap and effective because it made better collective use of existing individual professional skills, capacity and powers and partner agencies’ budgets.  It was about reducing demand, reducing costs and reducing re-offending – but most of all it was about reducing risk and suffering.

‘What’s not to like?’ you might ask and you’d be right but, somehow or other, twenty years later, police officers and mental health nurses are re-embarking on the same journey. Is it because mental health services are still the “Cinderella’ – and their budgets have been cut even when the rest of the NHS has had increases in funding? Is it because we are still so ignorant and fearful about mental illness? Or is it because innovation is generated by enthusiasts on short-term funding so it doesn’t get mainstreamed or embedded? Perhaps it is all of the above.

Whatever the reason, our collective inability to use the available evidence to guide our thinking and to take shared professional and organizational responsibility for public policy challenges means we are doomed to keep making the same mistakes.

When will we ever learn?

Catherine Staite

Catherine Staite is the Director of INLOGOV. She provides consultancy and facilitation to local authorities and their partners, on a wide range of issues including on improving outcomes, efficiency, partnership working, strategic planning and organisational development, including integration of services and functions.