*** !!! NEW Help me here, please - unsettling news

Latest July 2009 National Confidential Enquiry into Suicide and Homicide [ on their front page - go to 'latest news' top right ]
... unexpected increase in homicides committed by people who were mentally ill
.. but not currently 'patients in NHS care'
.... pages 32,33. between 1997 and 2005:

Homicide annual rate by schizophrenia sufferers is up. - from 25 in 1997 to 46 in 2004 and an estimated 40 in 2005.
A pointer to a poor service ? The increase is from people not in contact with local services.

The source material for the recorded increase comes from the psychiatric reports to the Courts.
There will have to be a review of these, now, specific to schizophrenia, looking to how local NHS care could have been involved.
The National Director has been rightly sceptical of the usefulness coming from individual Inquiries, sympathetic to the view in the Royal College establishment.

That body that did not greatly demur when a member wrote in that schizophrenia was no longer the 'heartland of Psychiatry. Funding has gone off to the Gp practices. to be delegated for counselling, often not monitored, for the numbers of ' Layard conditions' now the first concern of the Primary Care Trusts .

Plenty of research into genes and brains; little into practice in getting a lead, and a hold on provision, and 'sticky' management, keeping an eye on those with vulnerability in residual illness.
The old activities available on the mental hospital campus grounds for the long-term ill are lost to them [ Pentreath Industries ]

There should be a Rehabilitation service in every Trust area
National Institute for Clinical Excellence [NICE } points the way

Inquiriesinto Care and Treatment after Homicide
at last North West legacy Review

CTO 2000 Community Treatment Orders in the first year.
see relevant Mental Health Act for chapter 4scroll down ;
No category diagnosis figures as yet ... the Maudsley [ as usual ] leads the way - 126 - Manchester - 6 ?! - Liverpool - 58
Do they get a proper after-care service in exchange for their loss of liberty.

A professional comment at the introduction of the new MH Act about the effect on family carers

If there is no resource, available, to take them into an acceptable active routine, for self care and occupational engagement what does the supervision and authority bring to bear on their situation.

Why a specialist service is a necessity to improve the connections of the enduring but unvocal troubled and inactive.

... it is who gets their way to the water hole first - the Layard Cognitive Behaviour Treatment, conditions, vocal, well connected, and numerous, with problems that are passing, with the help of friends and relatives till they pass; or the worst off, with permanent hardships who, if not protected, find the water gone, or what is left muddied by the careless splashing of the active !!

? Rehabilitation ?

National Institute of Clinical Excellence
on schizophrenia it is buried in the
three hundred pages. Here it is NICE

New Horizons ...link to consultation form
put in for 'breaks in the week' !! ... my proposal answer here next month
:- To replace the National Standard Framework for mentally ill - lapses September
- ?? .. priority to serious and enduring,
to give way to the worried well ? It looks that way.
Well, vide supra

Carers Week survey
the website is well worth a visit.
carer week survey people
[ thank you, Sushila ] pulled out
mental health for me ...
11.5% = around 270 were adult mental illness carers
76% said they had been near breakdown.
... Carers Strategy

aCarers Strategy One Year On
- More Help For Carers
A one-stop information and advice
service for carers
launched by the Care Services
Minister Phil Hope.

*** !!!NEW !!! ...
Rethink have a carer diary

A carer's blog

There is a new NHS Inspectorate,
part of the Care Quality Commission [ CQC ]
replacing the old Mental Health Commission.

go to the CQC tell them
in the next 'inspection' in your area
, you want your carer
after-care experience to be sampled

This is what the MHC used
to ask providers to reply to ...
MHC

Note the absence of any indication
that provider Trusts should tell
what they were delivering
as service to aftercare - rehablitation,
supported housing ,sheltered lodging etc
.

tell the new body that you carers are not
to be left out in any review
of local mental health service;

*** !!!NEW !!! ... Comparitive mental spend per person:
English Primary Care Trusts
can we find 'the best buy area'
to live in for after-care?

*** !!! e.g.

Comparitive mental spend per person: English Primary Care Trusts
can we find 'the best buy area' to live in for after-care?

*** !!!

If you are internet and
literate with linking
try this service mapping website
to find for your geographical area ...
compare them to other areas
[ e.g. supported housing has wide variation:
Dorset lots, Cornwall eight ].
Or for your local Mental Health Trust
{ go to LIT - provider Trust area ,
under service group,
tick 'allservices' then,
at bottom, click RUN REPORT
and ; or in particular service type
... try continuing care ...
type ... Rehabilitation and Recovery services
- the after-care service ]

the quandaries facing the professional services.

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Judicial Review Forms

about Schizophrenia

*** !!! NEW

Is memory difficulty the disability ? Three studies

An experimental study agrees

a man twenty years on with long-term schizophrenia, now well settled to a routine, describes a difficulty that continues.

a long discussion with X. re: reading which he has just started, having always read quite a lot before the onset of illness. he was finding difficulty with the reading. He has to return to a page or a chapter and re-read it to retain its content. It was a simple book from childhood (Robinson Crusoe) .
Another point about memory is that he likes long words, and he does remember the Latin names of plants etc. though he never learned Latin.

He got a copy of "The Woodlanders" which he had read as a school project.
He told me that he had great difficulty in connecting the characters with the descriptions intervening.
He had found the same with other books he had tried to read.
He also finds that any disturbance affects his ability to retain anything he has read.
e.g. someone talking to him.Someone putting the T.V. or radio on. Someone calling him away to undertake another task.
He then finds it difficult to "pick up the string" and has to return to a previous area of the reading.
He is able to write and uses the computer for this, but again does not like disturbance.
A short ability to continue a project, though he does usually return to complete it. The discs also showed how he made a record of what he had done, in order that he could return and pick up the "train" at a later date.
He sometimes goes to the garage to get something he wants, and forgets, so goes back, and then rmembers again. Perhaps the name of dementia praecox was pretty accurate after all!. His long term memory is good and he often talks about thngs that have happened in the past

This is an experimental study with the same conclusion

More confusion to the disadvantage of those affected by schizophrenia - the new Capacity tests [ Mental Capacity Act MCA] , and the new Deprivation of Liberty route [ summary DOLS Guidance ] , leads many with schizophrenia to be left in the lurch with their illness .... ' it's their choice ... they were not ill enough as I saw them ..'
Decisions allowing sufferers to go on with with fluctuating capacity, are being taken by people from inadequate qualification and experience, delaying patients getting to the people with authoritative clinical lead. Insist on their being seen by doctors.

The NHS complaints system ... ... your right in a serious and untoward incident. [ SUI ]
Try your local PALS first " to give advice and support to clients [ patients - PALS are not health staff, even though paid and employed in NHS; 'clients' gives a different relationship for Pals ] , families and carers " ... - in my experience they are the most sympathetic, practical, functional and responsive of the helpers - your mental Health Trust will have a contact number

Mental Capacity: advice for Carers
Red Information for carers - allowances, benefits, direct payments etc :- click for the government website

Not so new ..... into the NHS mental health services ... click on ....The patient [ and carer ] journey through illness

"We all like to have anchor points of certainty in our lives, and even in psychiatry, with its whirlpools and eddies of doubt, we are searching for reminders that some fundamentals remain unchanged. The trouble is that relatively few are left [.,,,, a lead word for the editor of the British Journal of Psychiatry ,,, ' shame that he does not connect this thought to helping the sufferers from schizophrenia, who flounder without any such future anchor points in the the chaotic lives in their days, and weeks, ahead.

Establish the lack of 'activity breaks' in the week, and you have a measure of missing aftercare needs for carers and sufferers.
A good service would give family carers three session, in the ten session week [ monday - friday: morning ; afternoon = sessions ] when family sufferer is out doing something that occupies them - education, training, interest activity, sheltered work: and being out on a regular basis, family carers can then do something in their own time in those three sessions
These breaks relieve emotional tension in the care situation, and that reduces both relapse and violence.
Get that registered as a care situation need - documented with the your local NHS mental Health Provider Trust, and the local NHS commissioner Primary Care Trust as UNMET NEEDS at the first Needs Assessment stage [ the first step they have to do, when the specialist service meets your family sufferer ] of the Care Programme Approach