Service users opinions on how they have been affected by changes to services

1. Service users opinions on how they have been affected by changes to services Suzanne Nash Viewpoint

2. Have services changed?

3. In what ways have services changed for the worse? • CMHTs and CSTs have become more and more under-staffed: • e.g. The Bridge, Jubilee Rd, Handside Hall, Holly Lodge The Bridge, CMHT, Welwyn Garden City

4. How else have services changed for the worse? • Coffee mornings/meeting places cut • e.g. The Bridge, Jubilee Rd, Foresters Hall • Gaps in support or loss of it altogether • Changes in, or loss of, psychiatrists • Loss of staff, i.e. not being replaced • Loss of day hospitals • e.g. Fairfield, Oxford House

5. How else have services changed for the worse? • Relocation of services • e.g. Harlow and Chase Farm to QE2, St Michael’s House from Letchworth to Hitchin • Loss of drop-ins • e.g. Mind in South-West Herts St Michael’s House, Letchworth

6. How else have services changed for the worse? • Lower frequency of out-patient appointments • e.g. Welwyn Garden City & Borehamwood • Loss of professional reps. at groups • Loss of art therapy • Closure of Wilbury Ward, Lister • CPAs not being held properly

7. What do service users feel about these changes? • “Losing the relationships I had with them (support staff who were left and not replaced) has been very distressing” • “Had a gap without anything for a month or so, now only have short-term CBT. When that ends I’ll be on my own.” • “I had a period of psychosis triggered by the loss of art therapy and class friends” • “Lots of the groups have been stopping or reducing...makes me feel more isolated.” • “Fairfield day hospital closed. Now what am I going to do?”

8. Have there been positive changes? • Very good support from GPs • e.g. in North Herts and Tring • Good support from CMHTs • e.g. Edinburgh House and The Bridge

9. Have there been any other positive changes? • Support from local Mind groups • e.g. Mind in Dacorum • Very good support from CAT teams • Re-opening of early intervention in psychosis • Service user and carer involvement has increased

10. What have service users said about positive changes? • “Having CAT team in Watford is a definite improvement to the services” • “Support (of early intervention in psychosis) is excellent and frequent” • “Edinburgh House seems to run more efficiently these days” • “My previous experience of the system prior to the CAT team was it was less organised, still good but less responsive..”

11. What alternative sources of support have people sought? • 16% - Support groups e.g. Mind in Dacorum, Lighthouse Club Waltham Abbey, Guideposts Watford. • 4% - still looking/have not found • 4% - Yoga, meditation, Tai Chi • 4% - Physical exercise Henry Smith House, Watford

12. What other alternative sources of support have people found? • 3% - Samaritans • 3% - GP • 4% - Self help groups • 6% - Counselling • 3% - Viewpoint • 3% Complementary medicine

13. What additional alternative support would people like? • CBT • Counselling • Financial help and advice • Training facility to help people back into employment • More day centre services in Bishops Stortford

14. What have service users said about alternative support? • “Used Living Room, Stevenage…and that helped wonders. I’m now sober.” • “I really don’t know where to look” • “I feel I have no need to look elsewhere, as the services I receive couldn’t be better.” • “Mind in Hemel…very good, better than mental health services” • “I have tried (to look for alternative support) and no-one gives a damn” • “I am looking into going on a Learn Direct computer course. I don’t know what I will do really, when that finishes”

15. How easy is it to obtain help in a crisis?

16. What do people think of the crisis help received?

17. What types of help have people used when in crisis? • 21% - CAT teams • 12% - CPN • 9% - CMHT • 15% - GP • 9% - Psychiatrist • 6% - A&E • Other: Counsellor, NHS Direct, Samaritans, Emergency access centre, out-of-hours, CST, support worker, CAB, family & friends.

18. What have service users said about crisis help received? • “Not easy…when I do get help – which is like gold-dust – it is very good” • “You cannot get any help at all, whether you are a service user or a carer” • “…excellent…My consultant spent one hour seeing me…follow-up excellent as well” • “The CMHT and CAB were useless…CST at Silver Birch have been wonderful” • “…find it extremely difficult to cope, help received is only just adequate” • “Easy to get help, though kept waiting ages at A&E”

19. What are peoples’ recent experiences of in-patient care?

20. What were the reasons for the negative experiences? • 36% - dissatisfaction with staff (e.g. at St Julians and Albany Lodge) • 9% - too regimented (e.g. at Abbey PICU and Lister Mental Health Unit) • 9% - a need for more activities • Other comments: not enough prevention of absconding, lack of follow-up after discharge, difficulty in obtaining personal items on the ward, dirty environment, vegetarian food difficult to obtain.

21. What were the reasons for the positive experiences? • Approachable staff • Excellent support • Very good care at Shrodells • Food very good • Clean and modern environment

22. What have service users said about their in-patient care? • “St Julians was a terrible place with lazy, bored staff who just wanted to ignore patients and mostly did!” • “Very good…excellent support from nurses…no complaints at all” • “Awful – never want to be in that situation again!” • “…it was a place of rest and a much needed break” • “Look back fondly on hospital in places because of some of the people I met” • “Horrendous – I would never set foot in one again!” • “First class. The food was superb”

23. The End Suzanne Nash, Viewpoint www.hertsviewpoint.co.uk 01707 328014