24 October 2001

Present: Mark Bertram; Jay Watts; Tracy Millar; Sid Goldstein; Jean Cozens; Ange Drinnan; Emma Jacobs; Carla Willig; Linda Fernando; Taiwo Afuape; Sara Stanton; Nina Stevens; Sian Kinrade; Kerry Scutts; Paul Ellis; Dave Harper; Steve Halperin; Josie Bloom; Martin Bloom; Mike Slade; Louisa Mackrell; Janet; Sybil Ah-Mane; Karin Sjostrom; Pete Shaughnessy; Paul Wren; Jeremy Laurance.

Apologies: John Blackett; Anne Cooke; Mike Crawford; Chris Freudenberg; Peter Linnett; Diana Rose; Hermione Thornhill; Toby Williamson.

Rufus announced there was a meeting that evening on early intervention in psychosis sponsored by a drug company. He and 1 other member left early to attend.

Flyers for ‘Adverse Reactions to Psychiatric Medication’ conference on 8 November and an Amnesty petition re: US action in Afghanistan were distributed.

Mention was made of a march in Central London on 27 October for those who had died in police custody/ prison/ psychiatric hospitals.

This was on the theme of ‘Creative Practical Alternatives’; which arose from the discussions of the previous 2 meetings- Recovery (Aug) and Creativity and Mental Health (Sep). There was brief feedback from these 2 meetings for the benefit of those who had not been present.

Individuals then gave examples of which they were aware of in relation to alternatives to conventional treatment settings. Mention was made of a user-led centre in Birmingham which had been featured in that day’s ‘Guardian’, the Bradford Home Treatment Service which incorporates a user as a team member, A user-led drop-in centre in Tower Hamlets, Springboard in Exeter who held a conference at Exeter University last year, and Croydon Mind who offer a range of services designed to meet the practical needs of users.

It was felt that it would be a good idea for the forum to have a database of such alternatives (possibly paper-based in the initial instance). One member kindly offered to collate this for the group- bring info. along to future meetings.

We then split into smaller groups for further discussion around the same theme.

1. This group had discussed the care programme approach (CPA) and how it did not involve users in a meaningful way. There seemed to be a need for a focus on workers protecting themselves by emphasizing risk management. It was thought that workers could do more to prepare users for the CPA meeting in advance-ensuring the individual was aware of what positive outcomes such a meeting could have for them.

Mention was made of the ‘Direct Power’ pack for use in CPA available from Pavilion Publishing.

2. This group had focused discussion around what individuals did not want, the most important being compulsion. One member of the group had a positive experience of an ‘Advance Agreement’ with her psychiatrist and this led to wider discussion among the larger group about how enforceable such agreements were in reality.

3. This group had talked about ‘safe houses’, and how it was necessary for such services to be totally separate from mainstream mental health provision. Such places needed to be a refuge where an individual could be during crisis in the presence of non-judgmental others.

The other main issue discussed was that it was important that training for mental health workers generally was more holistic, rather than concentrating on a medical approach.

4. This group had discussed a mental health service in Sweden, where provision of holidays for users was offered. This was felt to be important, as many users are no longer in a financial position to be able to afford holidays without help.

This group had also discussed how direct contact with patients was seen as being of low value in the mental health system as generally the further up the hierarchy a worker progressed, the more removed they were from close contact with patients. Possibly some abuse of users was due to junior workers feeling unsupported.