1. Update from
the President.
2. Mental
Health Act 2007: Key Documents
3. Commentary
on the Health Select Committee Report on MMC by Dr Ollie White,
Chair, Psychiatric Trainees' Committee
4. National
twin study of schizophrenia and bipolar illness: Professor Robin
Murray, Professor of Psychiatry, Institute of Psychiatry
5. Mixed Results from 2008 DoH
Survey on Attitudes towards mental illness
6. Healthcare Commission: Call
for a continued drive to improve drug addiction treatment
7. Preston's Barbershop scoops
top award
8. ‘Making a reality of
recovery’:A note on the Sainsbury
Centre for Mental Health policy document by Dr Glenn
Roberts
9. Psych Vision: Charity
Cricket Match: 20th July 2008
10. A new national campaign to raise
awareness of alcohol units
11. What’s new
1. Update from the President, Professor Sheila Hollins:
the Annual Meeting, the 60th Anniversary of the NHS new and
Collge government policy and the APA Conference
2008
The Westminster Government is preparing to
celebrate the 60th Anniversary of the NHS during the same week that
our Annual Meeting will be taking place at Imperial College
London.
My valedictory lecture to mark the end of my
three years in office as President clashes with one such
celebratory event at Westminster Abbey on 2nd July. The College
will recognise the 60th anniversary by launching FAIR DEAL - our
own statement of aspirations for our patients with the help
of Ivan Lewis, Minister of Health, on the same
day.
During the weeks leading up to the
anniversary, several important government policy announcements are
expected - so do look out for them.
Firstly, the Darzi Next Stage Review will have
been completed in England and a national report presented. Then we
are expecting the launch of an NHS Constitution.
The Secretary of State will be announcing a
new Health Inequalities Strategy. I have had a place on the expert
panel advising him and am hopeful that my advice to include some
action to eradicate the inequalities experienced by our patients
will have been heard. A new Strategy for Carers is being launched
during the first week of June and this is another initiative I have
been able to contribute to as a member of the Prime Minister's
Standing Commission on Carers. An Independent Inquiry into Access
to Health Care for People with Learning Disabilities will also be
launching its report and recommendations in June - another
initiative I have contributed to as a panel member. So it’s going
to be a busy few weeks.
If you have not yet committed yourself to come
to Imperial College during the first week of July then do think
carefully to see if you can fit even a day into your schedule. I
think we have a lot to celebrate. Also the cost is down this year
even though there will be no Pharmaceutical Company sponsorship at
the meeting. If you are one of those who have been requesting that
we manage our meetings without sponsorship, then do support this
initiative. If you are sceptical about the need for such measures,
then also come and experience the difference. Then give us your
feedback.
Last week I attended the APA annual conference in Washington
with the President-elect and College Officers. As well as our joint
Presidential symposium with the APA President and presenting on
other sessions, we visited Capitol Hill for meetings with
Democratic Congressmen and Senator Obama's mental health advisor to
discuss their plans for developing mental health services.
College Officers with Congresswoman
Schakowsky from Illinois
We also had a College stand in the exhibition and many visitors
expressed interest in becoming an International
Associate - a new category of membership similar to UK
Associate which has also just been approved by the Privy
Council.
I am pleased to announce that three of our
short-term Scoping Groups are ready to report on their findings. We
will be launching each of these Scoping Group reports with an
evening seminar in Belgrave Square.
5.30pm on Wednesday 28 May
2008 – “Managing Urgent Mental health needs in
the Acute Trust” This report has been endorsed by the
Academy of Medical Royal Colleges.
5.30pm on Monday 2 June 2008
– “Assessment of Risk to
Others” This report is relevant to all specialties in
psychiatry.
5.30pm on Friday 13 June 2008
– “Psychological Therapies in Psychiatry and Primary
Care” This report a joint report with the Royal
College of General Practitioners.
If you would like to attend any of these
events, please contact Elen Cook (ecook@rcpsych.ac.uk). There are
only a limited number of tickets available and these will be
allocated on a first come, first served basis.
2. Mental
Health Act 2007: Key Documents
The final versions of the revised Code of
Practice to the Mental Health Act 1983 as amended by the Mental
Health Act 2007 and the associated secondary
legislation have been published. To access
these documents please go to:
http://www.dh.gov.uk/en/Healthcare/NationalServiceFrameworks/Mentalhealth/DH_4001813%20
Please note that it may take a little time for
the secondary legislation to appear on the OPSI website. Also on
the website are: guidance on the transitional arrangements for ACUS
patients; a summary of the changes to the Hospital Guardianship and
Treatment regulations; a summary of changes in the revised Code;
and the report of the consultation exercises.
The Code and secondary legislation will come
into force on Monday 3 November this year, which is when the
majority of the main changes made by the Mental Health Act
2007 to the Mental Health Act 1983 will also come into effect.
The revised Code is only available
electronically at present. Parliament now has 40 days during which
it can vote against the Code. Unless that happens. The
Stationery Office will publish a hard copy of the Code for purchase
once that period has passed.
3. Commentary
on the Health Select Committee Report on MMC by Dr Ollie White,
Chair, Psychiatric Trainees' Committee
On 8th May 2008, the House of Commons Health Select Committee
published their report on MMC (Modernising Medical Careers). This
is the latest review of the substantial difficulties trainees and
trainers experience last year and includes evidence from many
organisations, including the College.
It is helpful that the report charts the development of MMC and
MTAS (Medical Training Application Service) that originates from
'Unfinished Business', the CMO's 2002 consultation document
outlining the problem of a 'lost tribe' of SHOs. The specific
problems with the policy development of MMC are highlighted,
including the lack of flexibility in training that has resulted
from a system designed to address this very deficiency.
The lack of leadership of the overall implementation of MMC and
MTAS is rightly criticised but the report also blames the medical
professional as a whole for its lack of unity.
MTAS receives heavy criticism with its emphasis placed on the
flawed short-listing methodology via a defective application form
and an unsafe computer system. This vindicates the feelings of the
large numbers of trainees who went through this process, resulting
in enormous stress. However, many psychiatric trainees will
be concerned about the criticism of the failure to limit
applications from overseas doctors.
Our speciality has a large contingency from outside the EEA
(European Economic Area), many of whom have built their lives in
the UK over several years and the Psychiatric Trainees’ Committee
(PTC) supports the view that trainees who are already resident in
the UK should be considered on an equal status with EEA
applicants.
The report endorses the existence of a 'mixed economy' of
training whereby individual specialities can decide on the length
and type of training best suited to their discipline. Colleges have
a key role in this and we need an open debate within our own
College to determine the best way to train psychiatrists of the
future.
The report recommends that responsibility for recruitment and
selection should be at a deanery level, but there would be
advantages for Colleges to give a clear national steer about future
processes. The need for improved workforce planning is crucial and
the report calls for the DH to confirm whether healthcare should be
a consultant-delivered or a consultant-led service. This has
implications for the size and future of the consultant workforce,
particularly in psychiatry when considered alongside New Ways of
Working. We need transparency with regards to post-CCT career
progression and the PTC, in line with all trainee groups, is
against the establishment of a sub-consultant grade.
4. National
twin study of schizophrenia and bipolar illness:
Professor Robin Murray, Professor of Psychiatry, Institute
of Psychiatry
We are looking for same-sexed TWINS who have a
diagnosis of schizophrenia, schizoaffective disorder or bipolar
affective disorder in one or both of the twins. This is for a
national twin study at the Institute of Psychiatry, King’s College
London. We have ethical approval for national
recruitment.
Please could you consider your clinical
caseload to identify possible twins.
The study involves a clinical assessment, some
psychological tests, an EEG and an MRI brain scan. The aims
of the project are to more accurately establish the aetiological
influences on these illnesses, and to increase our understanding of
these complex psychiatric disorders. The study does not
involve any change in your clinical management. However, we
can provide a full review of cases or offer hospital admission if
you feel this would be helpful.
We will reimburse travel expenses and
accommodation costs and will make a small payment to participants
for their time.
If you have any queries or possible subjects
for the study please contact Anna Georgiades on 0207 848 0023 or
email Anna.Georgiades@iop.kcl.ac.uk.
5. Mixed
Results from 2008 DoH Survey on Attitudes towards mental
illness
The latest national statistics on Attitudes to
Mental Illness produced by the Department of Health were released
on 8th May 2008 and reported mixed results.
On the one hand, several attitudes that had
got worse over the period up till 1997 have since improved. The
number of people who feel frightened about people with mental
health problems living in residential neighbourhoods has dropped to
the same level as in 1994, having peaked in 1997. Only two
attitudes have changed significantly since last year, both an
improvement; more people think those with mental illness have been
subject to ridicule for too long, and fewer think it is easy to
tell them from 'normal people'.
On the other hand, fewer respondents to the
survey favoured a more tolerant attitude in society towards people
with mental illness, and fewer agreed that those with mental health
problems are 'far less of a danger than most people supposed'.
1703 adults aged over 16 were interviewed in
England in January 2008 for this survey. Questions on attitudes
towards mental illness have been asked as part of a face-to-face
Omnibus survey since 1994. The most recent surveys in the series
were carried out in 2003 and 2007.
The 2008 survey asked questions about fear and
exclusion, and understanding and tolerance, of people with mental
illness; integration into the community; causes of mental illness
and the need for special services; ways of describing someone who
is mentally ill; experience of mental illness; and publicity about
mental illness issues.
On the positive side, the survey found
that:
- More than 7 out of 10 still agree that no-one
has the right to exclude people with mental illness from their
neighbourhood, and that mental health services should be
community-based (attitudes that have not changed since 1994)
- Only one-fifth of people think that those
with mental health problems should be excluded from public office,
compared with a third in 1997
- 7% agreed that people with mental
illness are a burden on society, a decrease from 10% in 1994.
A number of attitudes that got worse during
the 1990s have since started to improve:
- 10% fewer agreed that it is frightening to think of people with
mental health problems living in residential neighbourhoods,
compared with in 1999.
- The percentage agreeing that locating mental health facilities
in a residential area downgrades the area has fallen from 29% in
1997 to 20%.
- 5% fewer agreed that a person should be hospitalised as soon as
they show signs of mental disturbance, compared with in
1997.
On the negative side:
- 9% fewer respondents favoured a more tolerant
attitude in society towards people with mental illness.
- 57% agreed those with mental health problems
are 'far less of a danger than most people supposed', a drop of 5%
since 1994.
- Agreement that 'I would not want to live next
door to someone who has been mentally ill' increased from 8% in
1994 to 12% in 2008.
- The oldest group of respondents (aged 55+)
had the most negative attitudes towards people with mental illness;
and respondents in the DE social grades were generally more
negative towards people with mental illness than those in the AB
groups.
Health Minister Ivan Lewis said, “Most people
hold reasonable views about mental illness. But the attitudes of a
stubborn minority reflect enduring prejudices that should not be
acceptable in today's society. The reality is that many of us - or
someone we care for - are bound to be affected by mental health
problems at some point. But there remains a climate of fear and
rejection that can prevent people from seeking the help they
need.”
The report Attitudes to Mental Illness
2008 was prepared for Shift, Care Services Improvement
Partnership (CSIP) by TNS UK. For more information email: shift@csip.org.uk
6. Healthcare
Commission: Call for a continued drive to improve drug addiction
treatment
Following the publication of a joint report
between the Healthcare Commission and the National Treatment
Agency for Substance Misuse, the Healthcare Commission
is calling for a continued drive to improve drug addiction
treatment, to ensure services are delivered consistently across the
country.
The report, which covered 149 'local drug
partnerships' in England, focuses specifically on how services are
commissioned and harm reduction service provision. The findings
reveal the majority of services are performing well within
acceptable levels across these categories.
The review also showed that there had been
considerable improvement in the commissioning and performance
management of drug treatment services, resulting in more service
users receiving better treatment.
However, there were also significant deficits,
particularly in the provision of vaccination for hepatitis B and
testing and treatment for hepatitis C.
More on the review of substance misuse services
7. Preston's
Barbershop scoops top award
Barbershop, an innovative magazine created by
Preston community arts charity, Alison, in partnership with Central
Lancashire PCT has scooped a North West Health and Social Care
Award at the largest ceremony of its kind, held at Bolton's Reebok
Stadium.
A community magazine that markets positive
mental health, Barbershop targets young men living in areas of
deprivation, including gang members, drug users and those not in
employment or education. The focus of the magazine is a comic strip
that tackles mental health issues and a typical issue will include
real life accounts, poetry and artwork. Now others are hoping to
replicate Barbershop's success across the country.
Local barber, Ishtiaq Hussain has been right
behind the magazine from the start. He said, "People just don't
realise the seriousness of mental illness, they fear being
stigmatised. The Barbershop campaign is all about raising awareness
of mental health in the community. My customers are always talking
about it. It has made them realised that there is depression."
Mark Anderson, a local artist who developed an
innovative real-life comic-strip for the magazine, was delighted to
join the team at the awards ceremony. He said: "This award is
great. I'm really proud to have been involved in the magazine. It's
made me more aware of the mental health problems that people face
on a daily basis. Everyone is really pleased."
Tyrone King, mental health race equality
officer has been the driving force behind the magazine. He
congratulated everyone who has been involved. "We couldn't have
done this without the support of all the barbers, the artists and
community groups who have supported the magazine. This award
is for them, they are the heart of the community and it is a
delight to work with them."
Tony Roberts, Programme Support Manager for
Central Lancashire PCT said, "Winning the NHS award for Mental
Health and Wellbeing is great news for the community of Preston.
Barbershop magazine has been inspired and driven by the
community and we're delighted that the NHS has recognised the value
of working together with local people, who are the most talented
and committed people I've ever worked with."
The Health and Social Care Awards are the
flagship awards of the Department of Health and coincide with the
60th anniversary of the NHS. The awards highlight and celebrate
innovation and excellence and recognise and encourage working
together across organisations and professions, with patients,
service users and local people.
8. ‘Making a reality of recovery’:
A note on the Sainsbury Centre for Mental Health policy
document by Dr Glenn Roberts
The College Annual Meeting in Edinburgh last
year opened with the launch of the Joint Position Statement on
Recovery (CSIP, RCPsych, SCIE, 2007). This is an
authoritative overview of the international movement towards
developing recovery oriented practice and services. However
the document fell short of offering practical guidance on how to
implement such changes as these had yet to be worked out beyond a
handful of pioneering agencies and services. It concluded by
hoping that those interested would take up the challenge of working
out how to turn these principles into practice.
The Sainsbury Centre for Mental Health has
begun to do just that. Their recent policy document,
Making recovery a reality is a succinct restatement of the
recovery approach intended to be useful in itself but also to prime
a year long programme of work towards the production of guidance
for NHS trusts on how to implement recovery oriented
practice. This policy guide includes a clear statement of the
guiding principles of recovery, a list of 10 top tips for recovery
oriented practitioners, a review of some of the key problems people
have with the recovery concept and an analysis of what may be some
of the implications for service design in developing in a recovery
direction. These include restructuring the workforce to
include more people with personal experience as providers.
The SCMH workstream will develop through
a series of workshops based in five NHS trusts over the coming
year. The workshops will explore aspects of practice and
service development, drawing on the experience of local service
users, carers, managers and practitioners. The aim is to
produce guidance on implementation, what to do and how to do
it. The present policy statement and keeping in touch with
the associated workstream will be helpful for all interested in the
progressive development of recovery oriented practice and
services.
References:
Care Services Improvement Partnership, Royal
College of Psychiatrists, Social Care Institute for Excellence
(2007) A common purpose: recovery in future mental health services.
London: SCIE.
Shepherd, G., Boardman, J., Slade, M. (2008)
Making recovery a reality. London: Sainsbury Centre for Mental
Health.
9. Psych Vision:
Charity Cricket Match: 20th July 2008
PsychVision is an independent body founded by
enthusiastic psychiatric trainees in the United Kingdom who want to
make a positive difference in the field of mental health. The aim
is to “connect minds” by working with a philosophy to enhance
mental health awareness, promote 
research and fight
stigma.
We strive towards sensitising not only medical
professionals but the greater public by organising mental health
conferences, educational sessions and charity events, with
effective media involvement. Though there are a number of
organisations working independently for mental health, we would
provide a common platform to engage and support these organisations
to work jointly.
Our members are from various professions and
we invite medical students, foundation trainees, junior doctors and
all individuals from any background or walk of life to join us.
Charity Cricket Match: 20th
July 2008, 10.00 am to 7.00 pm, Dulwich Cricket Ground, London
SE21
PsychVision proudly presents, in association
with The Psychiatry Research Trust and The Royal College of
Psychiatrists, a Charity Cricket Tournament with Lashings World XI
on 20th July 2008 at Dulwich cricket ground. The theme
of the event is mental health awareness and fighting stigma. Funds
raised will be donated to The Psychiatry Research Trust for
research in mental health.
We value your support and contribution to this
cause. Active participation in the event, donations, and
sponsorship are all welcome. Tickets cost: Premier £50 (including
lunch) and Standard: £15.
For more information on the above event
contact Dr Samir Shah or Dr Omer Malik on psychvision@googlemail.com
or log on to: http://www.psychvision.co.uk/
10. A new national campaign to
raise awareness of alcohol units
On 19th May 2008, the Government
launched a campaign to raise awareness of alcohol units and the
health risks of regularly exceeding Government low-risk levels.
A national advertising campaign explains how
many units there are in typical alcoholic drinks, and what the
low-risk levels are. The second phase of advertising will draw
attention to the health risks of regularly exceeding these low-risk
levels. A new NHS website supports the advertising. For people
who identify that their drinking is putting them at risk and are
interested in cutting down, support is available through a
self-help booklet and a telephone helpline.
As part of the campaign, the Department of
Health has worked with clinical experts to develop and test
materials that will support healthcare professionals to identify
patients whose drinking is putting them at risk and to provide
brief interventions and advice for them.
This campaign is a piece of work at the heart
of public health. It will help to tackle the general well-being and
health of patients. It has the backing of the CMO and a range of
the medical colleges, including the Royal College of
Psychiatrists.
Materials for healthcare professionals are at
www.nhs.uk/alcoholstakeholders
- Factsheets, with general alcohol information
including units and levels of risk
- A quick-reference wall-chart
- An alcohol advice leaflet for patients
- A fold-out card for patients explaining
recommended low risk limits, and some tools and support to cut down
if they want to
11. What’s new