Race equality groups seek big changes to the mental health act to end stereotyping and over-medication

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Sir Simon Wesseley, planning to report on reviewing the mental health act later this year

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While Theresa May is battling to hold her line on Brexit her almost unreported initiative to reform the mental health act is leading to demands for the government to introduce radical reforms for treatment and new rights for patients.

A submission from Race on the  Agenda and the Race Equality Foundation to the review  by Sir Simon Wesseley, set up by Theresa May to look into why so many black Afro Caribbean people were being detained in mental hospitals and the need for changes to the Act. It also comes against a disturbing background of deaths in police custody.

The submission has been backed by the Runnymede Trust;Patrick Vernon OBE, Chair of the Labour Party’s Race Equality Advisory Group, writer Amy Kenyon and Professor Rachel Tribe, of the School of Psychology at the University of East London among others.

NEED FOR BIG CHANGES

The Downing Street interim report  contained many warm words but not a lot of action. It stated: “Experience of people from black African and Caribbean heritage are particularly poor and they are detained more than any other group. Too often this can result in police becoming involved at time of crisis. The causes of this disparity are complex.” The  full report  and details of its members  and terms of reference is available here.

Now the submission to the inquiry proposes major changes to tackle the problem. The link to it is here. The main proposals are:

1. The Mental Health Act (the Act) should set out principles that define human rights, anti-discriminatory practice and a commitment to combat institutional racism.
2. The Act should be amended to include a clause that states explicitly that a diagnosis for a ‘mental disorder’ must take account of the patient’s social and cultural background. And the Act should allow for appeals against diagnoses via a Tribunal, with a panel that includes experts from BAME backgrounds.
3. Patients detained under the Act should be empowered to choose which carers or family members have a say in their care and can support them during an appeals process.
4. A new system of appeal whenever a new diagnosis is applied and/or continued, to a tribunal-like body, with the right of the patient concerned to have legal representation at the hearing.
5. All mental health service providers should be set targets to reduce the use of Community Treatment Orders and minimize racial inequalities in their use. This should be monitored by the Care Quality Commission  during inspections. Specific amendments in relation to supervised treatment in the community should be made to ensure this is statutory.
6. Statutory bodies should be regularly inspected by the CQC or other appropriate body to ensure that training of professionals working in mental health services addresses issues of racial bias and cultural competence.

The  submission  says: “:We were glad to see an emphasis on the urgent need to address the disproportionate number of people from black African and Caribbean backgrounds being detained under the Mental Health Act (MHA).

Equally, we were unsurprised that Black, Asian and Minority Ethnic (BAME) focus group participants highlighted a lack of cultural awareness in staff and a need for culturally appropriate care as paramount. We would express concerns about racism, stigma, stereotyping and overmedication. We hope that these findings will guide and underpin the recommendations made in the final report ”

It is to be hoped that Sir Simon and Theresa May do take action to remedy these many faults in the system. Otherwise it will be another case of political posturing  like help for the ” just about managing” which has so far amounted to warm words and little else.

There were concerns expressed at the recent conference organised by Rota at the University of East London that little would really be done to tackle this. If little happens it will only make matters worse and there is a need for strong campaign to make sure Downing Street does really listen.

Theresa May’s risky gamble with reforming an ” institutionally racist” mental health act

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Sir Simon Wessely, chair of the mental health review

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With very little publicity and dwarfed by Brexit  Theresa May has committed herself to a major reform of the Mental Health Act. Last year she convened a meeting at Downing Street and appointed a former president of the Royal College of Psychiatrists, Sir Simon Wessely. to conduct a review.

This month it published an interim report with a lot of warm words, some constructive proposals and a public admission that far too many people were locked up and a disproportionate number were from  the black and ethnic minority communities. A report in the Guardian on  May 1 highlighted some of the issues.

This Friday the charity Race on the Agenda  will host a conference at the University of East London on the  Stratford campus tackling the issues head on by addressing the issue of institutional racism in the mental health service.

They will have a lot to go from the interim review report which firmly  puts the case for change by highlighting the poor  and  often inhumane treatment of people of black African and Caribbean heritage in the worse case scenarios results in deaths in police custody.

It also appears to want to redress the balance between the role of the police and the NHS.

The interim report states: “Experience of people from black African and Caribbean heritage are particularly poor and they are detained more than any other group. Too often this can result in police becoming involved at time of crisis. The causes of this disparity are complex.” The  full report  and details of its members  and terms of reference is available here.

Among some of the salient points raised include phasing out the use of police cells to detain mentally ill people and using ambulances rather than police cars to transport mentally ill  people and increasing NHS involvement by looking at NHS England taking responsibility for  commissioning of health services in police custody.

This week’s conference will  go further than the report by looking at the culture and attitudes towards black people – the stereotyping, unconscious bias  and sometimes politically incorrect racism – as well as the role psychiatry has in defining who is mentally ill.

So why should this be a risky gamble for Theresa May ? The answer is the countervailing trends in society which could mitigate against reform.

First there is austerity. The state of some mental health hospitals , including one not far from the conference in Tottenham, have to be seen to be believed because there isn’t the money to provide adequate services. Thus all the reforms in the world could fall down because there are not the staff nor proper facilities to help people.

Then there is current hostile environment which led to the Windrush scandal , the rise of Islamaphobia and the Prevent strategy  which creates a climate of fear and fuels latent racism and fear among the white community of “the other”. The fight against terrorism can morph into discrimination against  particular ethnic groups in society.

So in the worst case scenario all Theresa May will be left with is warm words and no action – which, given the hope rising from the mental health act review, could make matters worse than they are now.

That is why it is important that conferences looking at issues the report may find difficult to confront – such as institutional racism – are being held and issues thoroughly aired.

 

 

Esther Baker case: How the child sex abuse inquiry itself abused survivors’ trust and privacy

Alexis Jay at the Rotherham inquiry Pic credit BBC

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UPDATE: Since the publication of this blog the Crown Prosecution Service have responded to my questions. A spokesman said the CPS does not investigate allegations of a crime, including perverting the course of justice. Any allegations coming to them would be referred back to the relevant police force. In this case this would appear  to be Staffordshire police.

 Esther Baker is one of the few child sex abuse survivors who went public  about her allegations that she was abused by her father and other people.

The only other case I can think of recently is  46 year  old Andi Lavery who went public to the Scottish Sun but that followed a trial in Glasgow which led to the conviction of  paedophile Father Francis Moore after Lavery gave evidence anonymously.

Therefore it is rather surprising that independent child sex abuse inquiry should publish  considerable detail naming Esther Baker  in an adjudication in a case they themselves decided was ” highly contentious”. Even more given she had not asked them to re-investigate the case which has already been investigated by Staffordshire Police and could lead to separate civil proceedings. And then they published a false statement against her that they had to retract.

The ruling by Alexis Jay is worth quoting in some detail: This is what she said :”On behalf of Esther Baker, it was submitted that the allegations which she has made
should form part of the Westminster investigation.

Ms Baker alleges that she was sexually assaulted by her father and by persons of public prominence associated with Westminster and that there were institutional failings in connection with that alleged abuse by police and law enforcement services.

She says that her father introduced her to a paedophile ring which included persons of public prominence associated with Westminster. She also says that she was abused from the age of 8 to around age 12 and that the abuse was organised and sometimes ritualistic, that it was filmed, and that the police acted in a security role.

She says that at various times she tried to report the authorities, and as such there were institutional failings.”  I have decided that the Inquiry will not investigate the issues that Ms Baker has raised that relate to her own alleged experiences of child sexual abuse…

“Ms Baker’s allegations are highly contentious.They are the subject of both contested civil proceedings and an ongoing police investigation. I am also aware that Mr Hemming ( former Liberal Democrat MP for Birmingham, Yardley) is reported to have made a complaint to the CPS that the allegations that MsBaker has made about him amount to perverting the course of justice.

“The fact that both the police investigation and the civil proceedings are ongoing is a factor that weighs strongly against the Inquiry attempting to investigate these matters. Even if it were appropriate for the Inquiry to investigate these matters before the conclusion of the other proceedings, such an investigation would be extremely resource intensive and would be likely to distract the Inquiry’s attention from the six core issues set out above.”

Now this statement has led Graham Wilmer, himself a former member of the first child sex abuse inquiry, to lodge a complaint which is now being investigated.

He wrote to them”Your decision to publish incorrect information about Esther Baker requires a robust independent investigation. The very idea that the IICSA would publish such incorrect information about a vulnerable victim of child sexual abuse is incomprehensible, and I am now asking you to investigate how this can about under your policies to protect vulnerable witnesses who come forward to the IICSA, regardless of the route.

“The below article in the Daily Mail is yet another example of why vulnerable victims of CSA/CSE should NOT come forward to the IICSA, without absolute assurance that they will be protected at all costs, which in the case of Esther Baker, you have failed completely so to do. As you are well aware, there are ongoing proceedings involving Esther, myself and others, and we will endeavour to expose the truth behind the lies, smears and malicious campaigns that have been waged against us, simply because we spoke out and disclosed what we had suffered. ”

An inquiry spokesperson did not want to comment.””The Inquiry does not comment on private correspondence it receives, nor on ongoing investigations.”

Now apart from releasing this information involving a named person – in other cases the person would have been anonymous -there is a serious flaw in the information that has been released. It implies that she could be investigated for perverting the course of justice for being as the Daily Mail put it ” a fantasist”. Worse their original public statement which was put up without Esther Baker’s knowledge  stated ” I understand that the police inquiries are now focused on whether Ms Baker should be charged with  perverting the course of justice.” 

I am told this was withdrawn after Staffordshire Police contacted them to tell them it was untrue and defamatory and it is now deleted from the website. The inquiry confirmed they had deleted it. Instead there is a reference to a complaint by Mr Hemming to the CPS.

There is NO investigation into Esther Baker about her perverting the course of justice. It is itself a fantasy. Staffordshire Police in a carefully crafted statement said she was a ” victim of crime ” and they are still supporting her. When I asked the police force whether there were further investigations into Esther Baker – after Mr Hemming is said to have complained  about the ” false accusations” against him – they made it clear there are none.

The reason why this is important is that the inquiry is already not trusted by a number of survivors who don’t believe they will get justice. Part of the reason is that survivors think the inquiry will  provide definite proof of sexual abuse against them. But that  is not the purpose of the inquiry – which is instead concentrating on the institutional failures of people not acting when they were told about sexual abuse. The inquiry in the Rochdale case was not afraid to pin people down for not doing their duty but they did not list or name fresh perpetrators.

In these circumstances you would expect the inquiry to be very sensitive about handling vulnerable survivors. Alexis Jay has already – rightly in my view – asked both survivors and those  representing people   who have been accused – to tone down their language.

Her previous ruling ends: ” I would …make a final plea that all those who report on the issues with which this Inquiry is concerned, and all those who comment on those issues using social media, should do so exercising a level of restraint and respect that is commensurate with the sensitivity of those issues, and the vulnerability of many of the individuals involved.”

Sound advice. She needs to take it herself.

: ”

 

 

Revealed:The over budget safeguarding system that doesn’t know if your kids are safe from sexual predators

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Disclosure and Barring Service Pic Credit: gov.uk

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Another day, another waste of taxpayer’s money on a scheme run by private contractors that was meant to cut costs for employers but has ended up with a huge unforeseen bill for the taxpayer.

While the privatised part of the probation service has had to be bailed out by the Justice ministry, at the same time the Home Office is having to pay out hundreds of millions of pounds to keep on track the digitalisation of the Disclosure and Barring Service.

This is the service that provides proof that people working with children do not have criminal records, and aren’t paedophiles so children and vulnerable adults can be safe. The service -like many others- had been run by Capita.

The government in 2012 decided to digitalise the service – promising big savings for employers, and a new updating service transferring the cost to the person seeking the job.

By this year the Home Office thought the number of disclosure certificates needed by employers would drop by a massive 67 per cent as 2.8 million people  seeking work with children would pay out £13 a year for an update of their certificate negating the need for new certificates. The cost of certificates to employers was expected to be cut.

As a National Audit Office report  released recently shows nothing of the sort happened.

Instead only 900,000 people decided to do this. Why? Because normally the employer pays for the certificate so it costs the applicant nothing.

As a result the NAO says: “The update service is losing DBS £9 for every sale. DBS’s 2016-17 Annual Report and Accounts report that the update service costs DBS £22 but is priced at £13 per paying applicant per year. ”

Then the 2,250 profit making firms who check the identities – from GB Group plc and  Atlantic Data Ltd to Capita Resourcing Ltd. make much more money from processing full certificates than checking updates. So they never promoted the service on their websites.

But there was far worse to come. The government appointed Tata to modernise the service and  build a new IT system  and then promptly changed the specification of what was needed. This resulted in delays and led to a one year extension for Capita which was running the service. Payouts totalling £26m had to be made to Tata for the delays and changes.

And then costs rocketed by £229 million and it is now three and half years late. Bizarrely because people have not switched  to the update service the DBS has got extra income worth £304m. Tata and Capita are still making profits. Rewards for failure at a cost to employers.

So who lost out? First employers who were promised cheaper bills – each certificate costs them £56.

But also us. There is one thing the DBS don’t do. After supplying the information about a potential employee, they never check whether the employer does disbar him or her. Since the whole point of this huge process is to protect children and vulnerable adults from predators and violent abusers you might have thought they would check up.

And given the current fashion where people who claim to be sexually abused might not be believed or labelled fantasists – I don’t think we should wait for a horrible incident to find out.

 

 

 

Designer label Dudes: Beware of a new police ” street strip and search ” plan for Rotterdam

A Rotterdam police arrest pic credit Lou Robens

A Rotterdam police arrest – not yet to do with designer dudes Pic credit: Leo Roubos Flickr

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If there is going to be a return to  the Met Police  expanding controversial ” stop and search ” of mainly black youths in London to combat rising knife crime – this is nothing compared to an initiative planned by police chiefs in Rotterdam to tackle suspected drug dealers.

The Dutch police are planning to stop  and search young people wearing designer gear in the city if they will decide they are too poor to be kitted out in Gucci jackets. If they don’t believe they should  be wearing them, they are going to confiscate them on the spot.

Frank Paauw, chief of Rotterdam police, is reported to have told De Telegraaf ( in Dutch). ” We are going to undress them in the street”.

“These young people have no income, sometimes even debts from a previous conviction, but also wear an outfit that exceeds 1500 euros. That is undermining the rule of law if you make it very big, but also a completely false signal to local residents. Taking away is therefore important, “says Paauw.

Police will be on the lookout for include “big Rolex[es], Gucci jackets, all those kinds of clothes,” the department spokesperson said.  One wonders what would happen if they are wearing Calvin Klein boxer shorts.

Not surprisingly people have slammed the idea  because it could lead to racial profiling. The  Netherlands version of the website  Vice contains some particularly strong criticism  after Vice spoke with  young people in Rotterdam.

“Police won’t consider a white guy walking around in an expensive jacket to be a potential drug dealer,” said Quincy, a 20-year-old man. “But it’ll be a different story with minorities.”

 

The Great £300m Probation Bail Out: You Pay, They Prey

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Richard Heaton, permanent secretary Ministry of Justice. Pic Credit: wikipedia

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On Wednesday two very highly paid civil servants £185,000 a year Richard Heaton, Permanent Secretary, Ministry of Justice and £190,000 a year Michael Spurr, Chief Executive, HM Prison and Probation Service will appear before MPs to explain their latest botch  up  – the privatisation failure of parts of the probation service.

I hope MPs on the Commons Public Accounts Committee will not only be briefed by the excellent National Audit Office report  and investigation into the failure of Community Rehabilitation Companies – the fancy name for profit making companies like Sodexo and Seetec.

They should also read the coruscating report by Dame Glenys Stacey HM Chief Inspector of Probation and Peter Clarke  HM Chief Inspector of Prisons last June on the performance of these companies and their failure to either help ex offenders go straight or protect the public from child abusers and  perpetrators of domestic violence.

This sorry tale goes back to 2015 when Chris Grayling ( he of the  current Virgin rail privatisation botch ups)  was Justice Secretary and thought it a brilliant idea to privatise swathes of the probation service for prisoners serving 12 months or more who were at low risk of self harm.

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Michael Spurr, Chief Executive of the Prisons and Probation Service. Image credit: Channel4

From the very beginning they bungled it. They planned to give the 21 companies £3.7 billion until 2022 to handle and help large numbers of prisoners. The companies planned for this but Whitehall  had overestimated the number of low risk ex offenders leaving prison and underestimated the number of high risk ex offenders who are still being helped by the publicly run probation service. As a result the companies would only get £2.1 billion.

So of course now the companies are in deep trouble facing losses of  £443m by 2022. So what do these top civil servants do. They give them more  of your cash to help them with their profit margins.

They have had a £42m bail out for dealing with fewer offenders in 2016 and another £22m to keep the companies going while the ministry kindly re-negotiates their contracts  to deal with fewer ex prisoners.

It has now agreed to pay another £278m up to 2022 but has changed the terms of contract so the private firms will get even less money if any of the released prisoners re-offend.

Now if you read the inspectors’ report on the performance of these companies, this is a sick joke. The inspectors think their provision is so bad and useless that they might as well not exist.

They said: “Clearly there is more time for resettlement work with these prisoners, but CRCs are making little difference to their prospects on release. We found them no better served than their more transient fellow prisoners were some eight months ago. The overall picture was bleak. If Through the Gate services were removed tomorrow, in our view the impact on the resettlement of prisoners would be negligible. ”

But not only are they useless but they could be a menace to society. They were so bad at rehabilitating prisoners – they spent their time sitting at desks  writing up reports on the computers – rather than helping them face to face. Some prisoners left to become homeless with little chance of getting a job.

But more seriously they let out child abusers, violent individuals who had beaten up their partners and drug addicts putting their victims at risk by having no proper supervision or rehabilitation plans.

In my view this £300m would be better spent funding refuges for victims of domestic  violence ( in desperate short supply) or linking it back to the publicly run service.

You are paying for these companies to prey  on the taxpayer without  delivering any decent result and also allow  released criminals to prey on  their victims by their failure to rehabilitate them. No doubt the two highly paid civil servants will distance themselves from their failed policy  when they appear before MPs on Wednesday

 

 

 

 

 

 

Exclusive: Are whistleblowers now too frit to reveal when NHS patients and care home residents are in danger?

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Dr Henrietta Hughes, 4 day a week National Guardian Pic Credit: CQC

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Tucked away in a recent National Audit Office report on the NHS and social care regulator, the Care Quality Commission, is the extraordinary statistic that the number of whistleblowers who tipped off the regulator fell by a staggering 16 per cent to 7452 in 2016-17. That is one in six fewer whistleblowers than the previous year. See paragraph 2.19 of the report.

The figure compares with 153,000 members of the public – an increase of one per cent – expressing concerns about services during the same period.

I have written about this in Tribune this week.

And the latest figures come after  a report by Robert Francis QC to Jeremy Hunt, the health secretary,which was highly critical of the way some had been treated after they made a complaint.

In 2015, Francis reported widespread severe victimisation of staff by senior management when they spoke up for patients. Francis recognised that sacked whistleblowers are blacklisted and recommended a re-employment scheme but nothing seems to have come of it.

His most substantial recommendation was for a National Guardian to protect staff. This led the CQC to create a part time post with no powers. The first appointee, Dame Eileen Sills, quit before starting.

Since then Dr Henrietta Hughes . a GP has been appointed  as National Guardian, on a four day week. And according  to the CQC  yesterday marked her first year as the National Guardian for the NHS with the publication of her first case review report and her annual report highlighting the work of Freedom to Speak Up Guardians.

The one case review she published covered Southport and Ormskirk Health Trust which  has the unenviable reputation for bullying and discriminating against black and ethnic minority staff , a dodgy appointments system favouring some people against others and an attitude of not bothering when staff raise concerns about patients. This might sound familiar incidently for those who have followed my articles on staff practices at the Equality and Human Rights Commission but we should wait for the employment tribunals to see what happened there.

Dr Hughes has recommended a series of recommendations to put matters right – 22 in all – and there is promise from the interim chief executive of the trust, Karen Jackson, to act  with a new senior management team. We shall see. Also this was a trial – how many reports are we going to get from her in future?

The National Guardian has also produced a series of high flown documents which sound terribly good in theory – but again I think we should wait to see what happens.

What has happened so far is that the appointment of a national guardian has coincided with a drop in whistleblowers telling the CQC when things are going wrong.

What we do know is that staff do lose jobs are blacklisted and get the reputation of being troublemakers. There is a  website which covers 11 such cases here. All designed I suspect to cover up an NHS and care system creaking at the seams and not being adequately financed. I hope Dr Hughes does not turn out to be a convenient fig leaf for a service in trouble.