All Party Parliamentary Group for Mental Health

Notes of meeting: June 2004

Joint Meeting of the Drugs Misuse and Mental Health All Party Parliamentary Groups

Mental Health and Drugs Misuse:

Are we going enough for people with complex needs?

8^th June 2004

The panel consisted of:

Brian Iddon MP – Chair, Drugs Misuse All Party Group

Lynne Jones MP – Co-Chair, Mental Health All Party Group

Lord Victor Adebowale – Chief Executive, Turning Point

Eloise Cooper - Complex Needs Service Co-ordinator and Cognitive Behavioural Therapist, at Turning Point’s Drug link Hammersmith and Fulham

Liz Garrod – Director, London and East of England Regional Office, Maca

Lord Victor Adebowale

Turning Point is the largest provider of substance misuse services in the country and also provides services for people with mental health problems and learning disability. Many of their clients have complex needs. He noted that it was a timely meeting considering the findings of the recent Social Exclusion Report on Mental Health and Social Exclusion which showed how poverty and isolation can be big factors in the lives of people with complex needs. Many of the people who Turning Point see are homeless and many are from BME backgrounds. Using the term ‘dual-diagnosis’ can be helpful as a medical diagnosis of concurrent problems but it may also cause people to be excluded from services which fail to provide joined-up care. Turning Point are currently working on a dual diagnosis toolkit in conjunction with Rethink (due out in August). Commissioning bodies must take into account the needs of people who have dual diagnosis so that they do not fall between the remit of traditional services, there also needs to be better communication with accident and emergency departments and the criminal justice system.

Eloise Cooper

The Complex Needs Service in Hammersmith and Fulham was developed in 2002, to meet the demands of a growing number of clients with severe and enduring mental health problems, complicated by substance misuse, physical and/or learning disabilities. These people were very affected by stigma and exclusion and many faced exploitation by drug dealers. The area is the 33^rd most deprived in the country and has many social problems. Clients are referred to the Complex Needs Service by CMHTs, inpatient wards and social services. The service is able to offer flexibility, visiting people in their homes, in hospital or in a neutral venue and they also provide long-term support. Complex needs are low on the political agenda and low in the National Service Framework.

Liz Garrod

Maca is a leading national mental health charity offering a range of services incorporating people with dial diagnosis and complex needs. Maca celebrates its 125th anniversary this month (see EDM 1305). They have encountered a problem of boundaries between different funding streams, targets and programmes aimed at specific health or social problems which means that it can be difficult to secure funding for complex needs services. However, substance misuse is now a well recognised area within mental health care. Maca provides residential services, personal development and forensic workers in probation services. The residential services tend to be houses with a few clients living together and supported by staff. Neighbours can be unsupportive but the police are usually helpful. Their drug and alcohol services provide pro-active care and promote the building of social networks. Maca’s probation work includes working with people with complex needs to provide long-term support.

Q&A

After the presentations Brian Iddon thanked the speakers and noted how difficult it must be to work in this area, he highlighted DrugScope’s report on dual diagnosis which is available from the organisation. Lynne Jones noted that alcohol abuse needed to be mentioned as well as drugs and asked where the funding for services came from.

Eloise Cooper said that residential services tend to get funding from drug action teams but none from mental health services. Liz Garrod noted that though Maca owns its properties the organisation is under constant pressure to keep the beds full. PCTs and social services also commission services.

Lord Adebowale noted that there is a postcode lottery for alcohol treatment and the Government’s Alcohol Strategy made a serious omission by failing to address dual diagnosis, many of the people affected are revolving door clients.

Earl Listowel asked whether staff in these services have access to counselling and support themselves so that they are encouraged to stay in the services and whether services can find funding for this. Lord Adebowale replied that commissioning bodies tend to believe that staff in voluntary bodies do not need human resources support.

The meeting discussed the need for differently structured services to be provided for different groups such as for children and that there should be more support given to transition periods.

David Chaisty from COCA said that services needed to look beyond harm reduction and recognise the many different problems that clients may have. The panel noted that services need to communicate with each other more and provide a multi-disciplinary approach.

Lynne Jones pointed out that it can help to have some trigger to get groups working together, such as the reform of the Mental Health Act has done in the mental health world.

The two Chairs thanked the speakers again.

Present	Apologies
Brian Iddon MP	David Chidgey MP
Lynne Jones MP	Tom McNulty MP
David Drew MP	Mohammad Sawar MP
Lord Adebowale	Baroness Finlay
Rudi Vis MP	Nigel Beard MP
Bill Tynan MP	Sue Doughty MP
Earl Listowel	David McLean MP
Baroness Masham	Mike Hancock MP
Doug Naysmith MP	Terry Davis MP
Baroness Wilkins	Nigel Evans MP
Agnes Wheatcroft - RCPsych	Rosie Winterton MP
Natasha Vromen - DrugScope	Rt Hon Michael Ancram QC MP
Mathew Young - LGA	Alan Campbell MP
Catherine Mangan - LGA	Cheryl Gillan MP
Jane Harris - Rethink	Baroness Massey
Jan Annan - ICDP, St Georges	Sydney Chapman MP
Martin Ball - Maca	Melanie Johnson MP
Catherine Mangan - LGA	Alistair Brook MP
Bill Puddicombe – Phoenix House	Win Griffiths MP
Cathy Howlett – Norfolk DAT	Ken Puchase MP
Matthew Young - LGA	Richard Burden MP
Caroline Hawkings –Turning Point
Eloise Cooper – Turning Point
Liz Garrad - MACA
Deidre Boyd – Addiction Today
David Chaisty – COCA
Martin Barnes – DrugScope
Richard Mullins – HO
Philip Dixon-Phillips – Hearing Voices Movement/UKFSMHA
Keith Coni – COI
Tom Hamilton - Maca