Thursday, 26 December 2013

unfit for purpose

The Mental Welfare Commission for Scotland had declared the IPCU/Ward 4 at Stratheden Hospital, Fife, "unfit for purpose" way before my son was forcibly detained there in February 2012.  An old building with different levels, dormitories, a locked seclusion room with a light switch on the outside used as a "naughty step", a front door and a back door (which I was sent to) and staff who were in the habit of rolling their own cigarettes when on duty, in front of the patients.

If the building was unfit for purpose does this mean to say that the staff were unfit to practise?  Was it and is it possible for psychiatric staff working in a building that is unfit for purpose to, nevertheless, behave in a fitting way and with humanity?  Can the limitations of the building be blamed or responsible for dehumanising treatment?

I say no. 

There is no excuse for denying the basic human rights of locked-in psychiatric patients.  We live in a democratic and developed country where even prisoners have their rights protected.  The Mental Health Act for Scotland has a number of safeguards in place that are meant to protect the rights of people with a mental disorder under the Act.  The Mental Welfare Commission is a safeguard.

And yet, despite knowing what our rights were, my son and I fought to be heard and to be treated with respect, by the psychiatric nurses in the Stratheden IPCU.  I had to advocate for my son at meetings and was told by the RMO (registered medical officer, a consultant forensic psychiatrist) that people without capacity don't require advocacy.  This RMO kept trying to speak with my son without an advocate being present. 

My son was locked in the seclusion room, overnight for hours at a time, with no toilet or water to drink, the light switch flicked on and off at random.  He was forcibly injected in this same room with haloperidol which caused him to lose balance whereupon he was castigated.  I had to remind staff of procyclidine for side effects.  I was both his carer and named person, and for neither was I given the due respect of the roles.

The Mental Health Officer aligned herself with the psychiatric professionals and even offloaded her own personal story of a family member in a psychiatric locked ward for over a year, to my son and I at a meeting in the community after he was discharged.  Which caused a lot of upset for my son.  A complaint I made to Fife Council Social Work got the response that it was a "learning point" for the MHO. 

Fife Council Adult Protection team investigated my complaint about my son's treatment in Stratheden and tried to blame me for causing "psychological harm" when my son was having his basic human rights denied in the IPCU.  No toilet, no water to drink and no pen to write with.  My character was investigated and the lead investigator, a Fife Council social worker and MHO, along with my son's MHO, questioned a psychiatrist and CPN about me.

Trying to blame a mother for system failure, a building unfit for purpose and staff unfit to practise.  

Then last week at a mental health focus group meeting I had to sit there while a Fife Council Adult Protection worker handed round various promotional materials - fridge magnet, spectacle cloth, notepads, pens, mirror, keyring - which had the adult protection logo on it.  Many of the service users at this group will have been subject to forced treatment in psychiatric settings where adult protection investigations are on the side of the oppressors.

Rubbing our noses in it. 

Such is the state of affairs in Fife where "meaningful involvement" in mental health matters is nothing of the kind.  It continues to be a tick-box, tokenistic and tedious undertaking.  The powers that be have no intention of letting go the reigns or of letting folk with lived experience in to the decision-making agendas.  It's still a cosmetic exercise and we still have no independent advocacy in Fife.  In my opinion.

It will require a paradigm shift, an about turn.

Sunday, 24 November 2013

Lomond Ward internal redesign, my plan sent 17 October 2012 - no response

Here is the plan I devised for redesigning the inside of Lomond Ward, Stratheden, so that female patients could be separate from male patients in their sleeping areas, and keep some degree of privacy.

I also proposed more activity rooms for patients and areas for psychological therapies, WRAP, Peer Support and groupwork.

I sent the plan off to senior NHS Fife managers on 17 October 2012, here is the Email:

"I have attached a rough plan of proposed changes to Lomond Ward that will improve the female patient experience and make the ward safer for them.  And thereby have a positive impact on all patients.  I believe that if the female patients are looked after well then everyone will be better off.  I say this as a former Lomond patient, feeling very unsafe in the end dormitory overlooked by males in single rooms.  I also speak from the experience of a carer who has visited the ward on many occasions over a 17yr period, since 1995, when my oldest son was an inpatient.

I have also proposed changing other rooms, to make more space for patients and staff to interact with each other, building relationships and promoting recovery.  As a member of the new Fife patient safety group I wanted to make a positive, initial contribution.

Here are the main points:

  • that the female sleeping area be completely separate from the male bay - one of the single rooms here could be used for 'observation' of females
  • that the observation rooms could be male single rooms, the sitting room into another 2 male single rooms
  • that the staff room, used to be quiet room, should go back to being a patient area, quiet room, with books, magazines, crafts, computer, OT activities
  • that staff use the original rooms across from what were the observation rooms, these could be made into one room, where staff could ensure the privacy of female patients
  • the ECT rooms be made into one large sitting room/TV/music room
  • the group therapy room/meeting room for patient use rather than clinical meetings - for group work - WRAP, peer support, strengths/confidence building, psychological therapies
  • a meeting room could be in the OT kitchen which looks a similar size
The aim would be to make Lomond a more patient-centred ward and this could be done with the minimum of upheaval or cost.  Rather than the focus being on clinical meetings.  Making more space for patient interaction and group work.  A more safe sleeping environment for female patients.  All of this will encourage recovery and a return to wellbeing and to the community.  It's what I would have preferred when an inpatient in Lomond."  

I got no response.

Tuesday, 19 November 2013

FOI request response received today - Stratheden Hospital redesign programme

I received a letter today, from Roseanne Fearon, Head of Adults and Older People's Services, Social Work, Fife Council, in response to my FOI (freedom of information) request for information about the moving out of medium and long stay psychiatric patients from Stratheden Hospital, Fife.

A Fife Health and Social Care Partnership agenda, on 19 November 2010, entitled "Discharge Programme at Stratheden Hospital (Mental Health Service)" mentions a sum of £1,403,929 to be transferred to Fife Council to "successfully progress discharge from hospital to community based services based on person centred planning and community centred planning".

Here is another agenda from the Partnership meeting on 24 November 2011 entitled "Stratheden Hospital: Rehabilitation Service Redesign", where it says "If individuals are not discharged there is a risk that Fife Council Social Work Service and NHS Fife will not meet statutory duties in relation to NHS and Community Care Act 1990 and Mental Health (Care and Treatment) (Scotland) Act 2003, and individuals ready for discharge will remain delayed in hospital." and that "To date, two people have been discharged as part of this service redesign programme.".

It's now 2 years later and I continue to hear from long-stay patients at Stratheden that their needs are not being met in terms of their discharge preferences, in addition to the ongoing issues at the Circles Network managed Fife advocacy project.  Here is a copy of my questions and the council's response:

Sunday, 27 October 2013

don't put your wives and daughters in the psychiatric hospital near me (Stratheden)

When my son got out of the Stratheden Hospital locked ward 4/IPCU with the locked seclusion room at the end of February 2012 he was put back in the Lomond Ward where he'd been cornered in a room by 3 male nurses and had to break his own hand to escape.  I kept a close eye on him, visiting the ward every day, taking him out on passes.

They put him in one of the two male dorms, not the quieter one.  I got him moved after the guy waiting to go to court on an assault charge was put in the bed opposite my son.  This guy seemed to have the run of the ward.  He was often in the staff room using their phone.  He seemed to be a favourite of the staff.  I suppose like attracts itself to like.  Bullies to bullies.

After I got my son moved from the noisy bay and from the team led by the staff nurse who assaulted my son on 1 February, it was easier for my son in the ward although he wanted home as soon as possible.  The treatment in the IPCU had traumatised him.  He had stood up to bullying and human rights abuse.  It had taken its toll.

Other male patients weren't so fortunate.  After they stopped locking my son in the room and were forcibly drugging him, they locked another patient in.  This man, same age as my son, had been in and out of Stratheden for years so was used to the "cooler" which had a light switch on the outside, patient inside left in the dark.  

This guy had been in the State Hospital.  He, along with many other Fife IPCU revolving door patients, were used to the dehumanising treatment there.  They expected nothing different.  In February 2012 he eventually was sent to a more secure ward in Ayr and spent over a year there.  

I saw him recently at Stratheden, he's now in the new low secure unit.  He was asking after my son and we reminisced about my son being locked in the seclusion room and what happened.  He was proud of what my son did, standing up to the treatment by the nurses.  He talked about his mother who is the same age as me.  I've know this guy for a few years now and it's not been easy for him.

Back to Lomond Ward March 2012.  In the quieter dorm one night my son was sleeping when suddenly he was woken up by a female patient coming out from under his bed.  He asked her if she was OK.  She said nothing and went out again.  I spoke about this to a staff nurse the next day.  They checked the notes and confirmed matter-of-factly that this had happened

This female patient was in the observation room, a very unwell woman, who used the toilets in the corridors without closing the door.  My son alerted me to this, I reported it.  But I wasn't hopeful of her being looked after properly.  Soon after this the woman disappeared or absconded or probably just wandered out of the ward unobserved.  Very easy to do this in Lomond Ward.  It seemed that the nurses really couldn't care less.

In 2010 when my son was a Lomond inpatient there had been a young female Russian/Armenian student from St Andrews who had been brought into the ward by the police.  She was in the observation room, on 24/7 obs for a time.  She wasn't keeping her clothes on.  I knew this because the nurse watching her kept telling her to put her clothes on.  

The male patients walking back and forward could hear this also.  I could see through a gap in the curtain that she was in her underwear.  No doubt other folks passing could see the same.  There was little dignity in this ward.  I raised a number of concerns in 2010, didn't take them to a complaint.  I was particularly concerned about the safety and dignity of women in this ward.  

No doubt this is why my son and I were targeted by staff in 2012.  Badmouthed, bullied and subject to human rights abuse.  Thankfully I don't have daughters.  But I have two younger sisters and a mother who experienced psychiatric treatment, fortunately not in Fife.  

I have links with a number of universities in my role as a survivor activist and carer.  A senior nursing lecturer spoke to me in late 2012 about his experiences working as a nurse in Stratheden about 30 years ago.  When women were forcibly given ECT with no respect for their dignity, their private parts uncovered.  This guy has been in education for a long number of years but the memory of this still stays with him.  

At the time I asked him not to tell me any more.  My mother had many courses of ECT against her will in Murray Royal Hospital, Perth, in the 50's and 60's.  I couldn't bear the thought that she might have been subjected to this type of abuse.  Or that my sisters might have experienced similar.  My mother never went into detail about it but voluntarily took the depixol depot until the day she died. 

My advice, don't put your wives and daughters into Lomond Ward, Stratheden, it's a very risky business.  Bad history.  Bad medicine.  They might not come out of there alive and kicking.  It takes a strong person to withstand abusive treatment, disrespect and neglectful care.  

And if you raise any complaints be very careful how you do so.  In my experience they don't countenance complaints at Stratheden.  They are not accountable and haven't been for many a year.  It's an oppressive system that has been allowed to get away with it.  But their days are numbered.

Friday, 25 October 2013

here's what I saw and heard the other day in Stratheden

[update 8 December 2013, I've been told they are going to deal with the urine smell.  Finally]

I dropped by the Ceres Centre in Stratheden Hospital the other day, to say hello to an OT who had contacted me by Email.  I went first into the shop area which has tables, chairs and sofas where patients sit and pass the time of day.  Especially the long-stay or "left behind" patients.

And right enough there were a few of them sitting or snoozing.  I noticed that nothing had been done about the toilet doors that open out on to the lounge area.  No spring to automatically close them, still cardboard labels saying Mens and Ladies.  But if one is occupied then the other will be used, regardless of gender.

They've put down a new carpet in the lounge area but the smell of urine still persists.  I think it must be in the floorboards or coming from the toilets.  The patients will have got used to it over the years.  That doesn't make it OK.

The patients were telling me that they were getting moved out "into the community".  Glenrothes and Newburgh, it seems.  No choice, or at least only a choice between the two.  The woman who I've spoken to a lot and who wants Burntisland, where she was born and brought up, where family members live, isn't getting what she wants.  

With £1.5 million for the 'Stratheden Rehabilitation Redesign Programme' you'd think that at last the patients would get person-centred care or choice.  But no, it looks like they will all be herded into units where they can be kept an eye on "in the community".  After years of chemical lobotomisation the forced treatment continues.  Locked doors of one sort or another. 

No surprise there then.

However I spoke to one male patient who said he isn't for moving.  Stratheden's been his home for many a year.  He knows everybody and knows what's going on, and is a campaigner for justice in the confines of his environment.  He told me that there is money sitting in a fund that should be for patients, from when there was a user-led collective advocacy group in the hospital.  I'll need to check this out.

Now we don't have independent advocacy in Fife.  The statutory agencies did away with the user voice.  Much easier just to get us to rubber stamp their decisions, after the fact.  They don't have a clue about what involvement really means.  Because then they would have to change the way they work and they don't want to do this.  They've got away with it for too long.

As I was waiting in the queue for the shop I noticed one of the long-stay female patients go into the Mens toilet after a long-stay male patient and flush the pan, closing the door afterwards.  I suppose it's something she is in the habit of doing.  Looking out for her fellow patients.  

Someone has to.

Tuesday, 20 August 2013

therapies and Stratheden - an oxymoron?

Oxymoron: a rhetorical device or figure of speech in which contradictory or opposite words or concepts are combined for effect eg “cruel kindness” or “to make haste slowly” 

I remember back in 2010 meeting with heads of psychological and occupational therapies at NHS Fife, to discuss the lack of such therapies when my son was a patient in the Lomond acute ward that summer.  In fact patients were prone to walking up and down the wards, or even round in circles, for therapeutic exercise.  Patio activity could be picking up the cigarette butts.

These meetings seemed to be a waste of time, looking back, as they didn't bring about any changes in the wards.  This was obvious in Feb/Mar 2012 when my son again found himself an inpatient of Lomond then the IPCU.  Read more of this in my blogs written at the time on Mad in America January to September 2012 and later that year in Chrys Muirhead Associates.

The voices of patients, service users and carers in Fife are not as important as the opinions of staff working in Stratheden and NHS Fife mental health services.  I call it staff-centred rather than person-centred treatment.  Keeping people in jobs and doing what they like with public monies.  I think they get away with it because the customers are deemed to be mentally illWithout capacity

I'm not sure what it will take for managers at Stratheden to make real changes in psychiatric services so that patients and their carers receive the benefits.  I want to see a choice of therapies on offer in the wards at Stratheden.  Not just drug therapy.  For some of us drugs are not therapeutic, in fact they make us depressed, anxious, lack confidence and have far less quality of life.

I say to the clinical managers and their allied health professionals that they should listen to their customers, the patients, service users and carers.  We are the ones with lived experience, who have survived, come through it, out the other end.  Without us you wouldn't have a job.  So give us the respect that's due.

Monday, 17 June 2013

one-way system, refurbished benches and garden views

I drove back home tonight through the Stratheden Hospital grounds and stopped to take photos of the refurbished benches, new one-way system and the horticultural therapy gardens.  

The sun was shining, blue sky bonnie views, patients sitting on the benches in the alcoves of the speed calming measures.  They waved as I drove by.  

Across from Lomond Ward the fields stretched down into Cupar Muir and the college farm.  
While down the road a bit the old tennis courts fences have been removed, next to the old piggery which I've been told has plans being made for a new purpose.  Beyond this the playing field and Elmwood golf course.

I took a walk into the gardens on the west end of the estate, passing a patient and visitor on the way.  Rabbits grazed on faraway patches of grass while the sun sparkled through the trees and flowering bushes.

There's no doubt the country views and garden paths are pleasing to the eye and the improvements to the roads and one-way system make walking more pleasant, less risky.

Being an optimistic person I'm hoping for similar efforts inside the buildings:
  • Patient centred nursing practice and recovery focused care
  • Respect for carers and families
  • Regular ward community meetings
  • Therapeutic activities in the wards by Occupational and Physio staff
  • Group work and collective advocacy
  • Information available for patients and visitors
  • Patio areas with a variety of plants, kept tidy
  • Plans for volunteer involvement in wards
IPCU building in background
outside Lomond looking up towards main gate
back door of IPCU

Thursday, 13 June 2013

and yet again still no answer about Recovering Eden

As before, no answer as yet to my Email on 23 February asking about the Recovering Eden developments.

I'm assuming there is still nothing to report ...
Update 13 June 2013

Never did get a response ...

Wednesday, 20 March 2013

still no information re Recovering Eden

No answer as yet to my Email on 23 February asking about the Recovering Eden developments.

I'm assuming there is nothing to report ...

Saturday, 23 February 2013

recovering eden?

I've sent off an Email asking for information about the proposed Recovering Eden project planned for the hospital grounds.  It's been about six months since I heard about the many ideas to bring community groups into the Stratheden site.  However I'm not noticing any changes when driving through but it may all be going on behind the scenes.

More information to follow when I hear word ...

Sunday, 13 January 2013

new build IPCU? yes or no

I've just been visiting Stratheden, going here and there, and heard that there isn't going to be a new build IPCU. Contrary to what I was told back in October.

Have sent off an Email to NHS Fife management, asking for confirmation. I'm thinking I may have been misled.

Update 18 January:

I'm informed that the application for funding to Scottish Government is still ongoing, taking time to complete.

Meanwhile there is to be a refurbished ward at Stratheden for low secure patients.