1)The Vision for Change refresh "Sharing the Vision" was supposed to be released tomorrow but has been pushed back (again) to the 17th of June. I'll have moved on from this account by then so there are a few key things to evaluate it under: Warning - long thread ahead
2)Is it launched with specific costings, timescales & deadlines for implementation and budgetary commitments? Currently #mentalhealth is only 6% of the health budget. If this isn't increased to 10-12% of the budget this will be a tick box exercise only.
3)The original AVFC detailed how many of each discipline should be on each #mentalhealth team per 50K of population. We need this bench marking to hold government to account about proper resourcing of teams. Without these targets how do we hold them to account?
4) Outcomes for those who use #mentalhealth services have to be more than wait for 1st appt. That is still important, but so is the experience you get when you get access. The basics of did you get the help you needed / hoped for & if not why not
5) Service user participation has to be genuinely collaborative, with co-creation of narratives and embed services users at every level of the service from governance, consultation, education, recruitment
6) Lived experience of mental health difficulties enhances your ability to input into the service you are part of. Service user involvement has to be externally evaluated by an independent advocacy service that governance wise is on a par with service management
7) Community mental health teams should be truly multi-disciplinary and not dominated in number or governance by any one discipline. All disciplines in mental health have a valuable contribution to a recovery focused service
8) Leadership & Governance in mental health should be based on a competency framework and not specific to any one discipline. The UK moved to this model in CAMHS in 2011. It's about time we caught up.
9) Mandate not recommend inter agency working. Those who need multiple services need to stop being bounced between the services they need. "No wrong door" policy is a political figment of imagination and bears no reality to a service users experience on the ground
10) What will the policy say about children and adults with ASD? Not all mental health difficulties can or should be attributed to "that's part of their ASD" so someone else has to meet that need first. Working collaboratively shouldn't be such an alien or frightening idea
11) We have move from an individual therapy model to once that recognises the need to support parents / carers / families. Mental health doesn't exist in a bubble, we have to have a more systemic focus of support and include families
12) "It's the economy, stupid", the equivalent of this in mental health is primary care. We all know if you want to reduce pressure on specialist services you properly resource primary care, this is where the greatest amount of funding should be directed to
13) It makes sense (maybe too much), have enough clinicians in primary care to be available to listen & support when difficulties emerge then people are less likely to need CAMHS or Adult services.
14) Telephone / Online options are a useful adjunct to face to face, in times of global pandemic or when there are geographical / travel issues. They're not a replacement for face to face genuine human therapeutic connection and are not the panacea for our mental health services
15) Oversight of implementation has to be independent of services, self-evaluation is not good enough anymore, oversight has to involve service users, it's their service, they are best placed to know if it is working for them or not.
16) There HAS to be Youth Advisory Panels embedded from the outset in CAMHS. @JigsawYMH & @StPatricks have been doing this for years with success, the wheel doesn't need to be reinvented, get young people involved in their service, it is theirs after all.
17) Dual diagnosis: this archaic interpretation of mental health & addiction difficulties being distinct & you have to address addiction before you can support a persons mental health needs to be confined to history.
18) The much referenced biopsychosocial model of mental health support is great, but only when the bio psycho and social perspectives are treated with equivalence. This equivalence needs to be clearly spelled out in the new policy
19) Long after the #COVID19 curve has been flattened we'll be the mental health impact. It more important than ever that the AVFC supports vs hinders the efforts to address this need. Accountability is more important than ever, use your voice to make sure questions are asked.
