Letters published in the 19 June edition of Community Care magazine
Letter of the week: The closure of the Henderson Hospital for people with complex diagnoses
My 12 months at the Henderson Hospital 10 years ago saved my life (http://www.communitycare.co.uk/108304). I am struggling to comprehend that this facility will no longer be available to others like me, who at the time of admittance, do not understand our distress and the impact our behaviour has on others.
The shift away from 24/7 therapeutic care and treatment for complex diagnoses such as personality disorder towards local, 9-5 services is not going to be cost effective. What makes a therapeutic community so powerful is the holding environment created largely by other psychiatric patients/residents and a minority group of highly trained therapeutic staff. It is truly empowering and very challenging to be cornered by others who have behaved in similarly manipulative and destructive ways.
Henderson Hospital created and promoted user empowerment long before anybody else. The fact that it failed to stop calling itself a hospital when that term became unfashionable within mental health, is unfortunate. But then Henderson Hospital never had to think of marketing itself. Its results were always persuasive and the model upon which it operated ingenious in its simplicity. So far ahead of any other user-led treatments is Henderson that those of us ex-residents now connected with other mental health organisations use our experiences at Henderson Hospital as a guiding principle. What Henderson Hospital didn’t and couldn’t predict was the removal of its ring-fenced funding to treat adults with complex personality disorders. So despite its unquestionable success in helping people, people like me, that counts for nothing.
Many of my friends and acquaintances who are still having to use their local CMHTs or languish in traditional psychiatric wards will probably be successful in taking their lives sooner or later. If lucky they may end up “managed” and “managing”. As for prospering and gaining independence and self-respect? What do you think?
Right now Parliament is deciding the numbers of people who like me need 24/7 residential care. The political wind blows in the direction of mixing day and full time residents/patients. To have two client groups completely undermines the power of the community. But then we can always top up afterwards with an annual dose of CBT and a change of antidepressants. Henderson Hospital is the real thing. Most people don’t need antidepressants afterwards, or for very long.
Henderson Hospital must not just fade away and be replaced by therapy-lite versions. Complex behaviours need this kind of (expensive, admittedly) treatment in order to change.
Hanne Olsen, Kingston Upon Thames
Beware of early specialisation
The social work degree was developed as a generic qualification (“Children’s social workers give degree poor marks”, http://www.communitycare.co.uk/108349). If social workers specialise too early in their career, the profession will fragment, more so if pre-qualifying education takes on a specialist format. It is important that all social workers have knowledge of other settings. The General Social Care Council post-qualifying social work structure allows students to move from a generic social work degree into specialist practice areas.
In our own study, the learning needs of newly qualified social workers were tracked through their first year of employment in adult and child care services. Findings indicated that most of the workers and their line managers were satisfied with the degree’s content. Nonetheless, there was anxiety relating to skills-based working, in particular, court skills, which parallel the Children’s Workforce Development Council concerns over child protection knowledge.
Unfortunately, placements which can offer students experience in these specialist areas are under pressure, in part due to the removal of the performance indicator for practice learning.
Keith Brown, Tikki Immins, Prof Jonathan Parker, Centre for Social Work and Social Policy, Bournemouth University
Benefit confusion reflects complexity
In your article on navigating the benefits system, (“A carer tries to tackle benefits system”, http://www.communitycare.co.uk/108414) I am concerned to see that the writer notes that “Eric (Tina’s husband and carer) thought his wife was getting disability living allowance. If that was the case she would continue to receive money now that she has turned 60.
“Instead, he now suspects that she was on incapacity benefit, which if true, will have ended on her birthday in April. That should have been replaced by attendance allowance.”
Incapacity benefit is usually paid to a person who qualifies for it, until they are able to either return to paid work, or retire. When Tina’s incapacity benefit stopped when she was 60 in April she should have qualified to receive her state retirement pension.
Attendance allowance is a non-means tested benefit payable to people over the age of 65 who have care needs. It is certainly not there to replace incapacity benefit, and is meant to provide extra financial help to those who need care support. In the case of Tina, even though she is 60 she should still apply for disability living allowance.
The article seems to be confusing incapacity benefit and attendance allowance. The benefits system is complex enough without adding to the confusion.
Allan Orrick, Welfare rights officer, Newcastle Adult Services Directorate
‘Volunteer social workers’ don’t exist
I would support the basic idea that there is a valuable role for volunteers working with families and children who are on the at-risk register (“Walking the Social Work Beat”, http://www.communitycare.co.uk/108199). I note that the article likened such a role to that of police community support officer, who work alongside the regular police service – although are clearly not police officers themselves. The proposal was for the development of the equivalent support officer who works as a volunteer alongside child protection social workers.
While the article itself was careful to specify that the volunteers were not qualified social workers, I was dismayed to see that Community Care’s cover declared “the rewards of being a volunteer social worker”. Surely one of the main purposes of registration with the GSCC was to clarify who is a social worker and who is not.
Jinny Gray, Mapperley, Nottingham