by Terry Skyrme, social worker and Approved Mental Health Professional
I have been a qualified social worker since 1972, right at the birth of the generic social services department. In a few weeks time I will complete my last shift. I’ve felt driven to retirement. This post aims to explain why.
For the last five years I’ve worked as a social worker for a mental health crisis team and as an Approved Mental Health Professional (AMHP) in Norfolk.
When I joined, the team had five social workers. We managed to carve out the space to do proper social work. We worked at times of crisis with patients and their families to help resolve social and family problems. We carried out our duties as AMHPs and had a degree of pride in our work. We truly felt we were making a difference, protecting patients’ rights, advocating for their entitlement to services and using our knowledge of local resources.
I realise now we were lucky. When our mental health trust became a foundation trust in 2009 things changed. The trust claimed this as a great achievement. In retrospect, it heralded the beginning of serious cutbacks.
It brought in a culture where the thing that mattered most was balancing the books or else Monitor would takeover. Then came the so-called Nicholson challenge – the quest to find £20bn of ‘efficiency savings’ across the NHS. In our trust, that led to a £40m cost-saving programme, the ‘radical redesign of services’.
Suddenly our community services were cut back and there were not enough beds to meet the demand for inpatient admissions. By 2012 we were finding it difficult to admit patients to our local psychiatric hospital due to no beds being available. Gradually the crisis has worsened and it can now be a weekly event that no psychiatric beds will be available in Norfolk and Suffolk.
We reached a peak this year where 40 patients from our area ended up placed in private hospitals all across the country. What this meant for us as AMHPs is that we could no longer practise safely, professionally, ethically, and sometimes, it felt, not lawfully. Informal admissions (as opposed to compulsory admissions under the Mental Health Act) became more difficult to arrange; the safe, human conveyance (transport) of patients became more difficult to ensure, and alternatives to hospital admission ceased to exist.
Locally we saw a rise in unexpected deaths of patients under our so-called care. As AMHPs we called for meetings with the chief executive, we wrote to the CQC, to Norman Lamb, our local NHS commissioners and others but to little substantial effect. Our own trust continued to deny a crisis and even claimed they were enhancing community services.
Since November last year, I have been part of a group that launched a Campaign to Save Mental Health Services in Norfolk and Suffolk. We have been successful in uniting staff, patients, relatives, trade unions and community groups under our banner.
Personally I’m exhausted. Days on AMHP duty are becoming a nightmare. The delay in finding beds and arranging conveyance means that AMHPs are working incredibly long hours when on duty. The other week I started at 8am and finished at 1am the next day. We are losing AMHPs rapidly, some to sickness and some are giving up altogether. We calculate that we have lost 14 AMHPs this year.
Things have reached the point where the police are so concerned about the infringements of people’s rights that they are now issuing letters to AMHPs when we are unable to detain someone who is in police custody because there is no bed.
I’ve chosen October 1 as my day to retire. The same day our AMHPs and mental health social workers are being transferred back to Norfolk council as the section 75 agreement the council had with the trust broke down earlier this year.
I’m not in the scope for the TUPE transfer and the trust has not indicated to me that they want me to stay on. In any case, I fear that the opportunity for real social work will no longer exist. Best of luck to my colleagues who remain; I will be devoting more energy to the campaign to save mental health services.
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I can only second these comments-I started in social care in 1979 and have recently been cajoled into early retirement by my employer. My life has been devoted to Learning Disability and real Social Work which no longer exists. I pity those younger dedicated people who follow me whose opportunities to make a difference to people’s lives is now severely limited.
well said Terry.
I intend to volunteer from now on!!!!
Terry we think you are a hero!! Please keep up the good work , but remember to look after yourself.
We have only known you for a short time due to our own personal tragedy, but in that time we have seen how tirelessly you have worked for the Campain to help other families like us not to
have to go through what we have had to endure.
The world needs more People like you and we admire all you have done ,kind regards ,
From Alan & Jan Coolinson.
I retired in July after two successive NHS employers got rid of me because of the way I was doing CAMHS work. After the second time I finally got the message that “old school” social work (trying to follow in the footsteps of David Brandon and Bob Holman in doing ‘the right thing’ rather than ‘doing things right’) was no longer acceptable. Who would have thought that a social worker could be sanctioned for ‘providing care to a parent’ and ‘signposting parents to internet resources’.
I wish I could say I miss being at work, but having claimed my pensions I am enjoying the freedom of not being employed by dysfunctional and disrespectful state organisations led by managers seemingly more concerned for their careers than for the people they are meant to serve. I am in the process of letting go of my status as a social worker so I can do more of what I want to do in my local community and beyond without feeling the need to protect my back (which I was never good at doing anyway!)
Good wishes for your retirement and campaigning.
David
Sadly your story is replicated in other parts of the country. As a social worker and AMHP I have seen mental health services deteriorate exponentially. No longer can social workers or CPN’s for that matter, give the time that patients deserve. Like your area, informal admission is a rarity, and compulsory admission to out of county hospitals is becoming the norm. Patients are left until their illness is so severe before intervention, that other forms of community intervention are all but impossible. And along with that the crisis teams have been ‘reorganised ‘ so often they hardly exist.
Like your area, AMHP’s are leaving and not being replaced. We have about 5 agency AMHP’s in our area costing the county thousands of £’s. No longer are social workers and AMHP’s considered valuable assets to the organisation. We are considered a necessary evil.
Good luck with your new chapter in life and wish you all the success it deserves.
Bob
Good health in your retirement Terry, I always enjoyed working with you and despite all the changes and challenges we did have a few laughs. Your work ethic and dedication has always been respected by me and it will be hard to replace I’m sure.
All the very best x
I am with you Terry stand up for the people without voice and be sure that head of this organisation not victimise you in the process. I have done same as you but my stand off was for children and young people that is at risk of sexual exploitation. I have over rule orders and involving the police but I was then blacklisted as trouble makers. Please be careful and stand up for the rights and equality of those who can’t speak for themselves because they haven’t the mental capacity. Good luck in your retirement and should you need any help please don’t hesitate to me.