Memorandum from Brian Paul Tovey
The concerns I wish to put forward regarding
the Third Sector and its probable increasing role in systems delivery
of Mental Health services orientate around underlying issues of:
1. Effectiveness of service.
2. Transparency and Freedom of Information
and the right of public challenge and account.
3. The diversion of money away from locally
developed systems of real patient choice, delivery and representations,
towards an increasingly large almost corporate-like sector with
an undeniable self interest in its own corporate growth.
4. Cross Organisational self interest, and
Charity representation on Advisory Boards or Panels at Government
level.
INTRODUCTION
Because I have monitored mental health on and
off for some years now I would like to confine all of my submission
to the mental health MH sector. This is where I have observed
mental health (MH) Charities and others in the Third Sector that
have partly been delivering services and indeed influencing government
in both advisory and also quasi civil service types of way without
enough scrutiny. The Government-third sector boundaries are not
altogether clear to an interested member of the public.
The danger is, some MH Charities might be driving
their own agendas for credibilised survival and funding rounds,
whilst having questionable effectiveness on certain publically
funded issues.
THE "ANTI
STIGMA" EXAMPLE
AND POOR
TRANSPARENCY
I followed the course of one MH Charity named
Mental Health Media linked to others. MHM created a mental health
anti-stigma "Open Up toolkit" in 2003-04 on the back
of a tripartite grant. The Esme Fairburn Foundation and the Gatsby
Foundation plus the Big Lottery Fund gave it money for that purpose
amounting to 573k ... The object of the anti Stigma "Open
Up toolkit" was to challenge mental health discrimination
and employer stances that are claimed by some in the MH community
to create difficulties for MH Service Users ...
My interest and the theme of my concerns was
sharpened in Mental Health Media and its links to others which
partnered it like Rethink in 2004 and 2005.
In a complex third sector weave, the Media Trust,
itself another charity, ran a project which was funded by Culture
Online (part of DCMS) combining all these charities. The Media
Trust was funded by the Home Office Volunteering and Charitable
giving unit. The project it started off was delivered through
the Community Channel and it was called "Mad For Arts".
Mental Health Media and Rethink sub contracted work from the Community
Channel. Mad For Arts as a project centred on a website creating
a rolling message board of exchanges between posters, "studio's"
for mental health user-artists, some short films attempting to
de-stigmatise mental health, and the awarding of prizes to MH
users for choosing public arts—like museum exhibits and
paintings.
After a short while of observing this Mad For
Arts project it became evident that all was not what it seemed.
Two of its advertised "advisory panel of Users" expressed
by email that they had no interest in it. One of them protested
his name was being used on MFA without his permission ! ... I
have retained information about this.
I wondered in 2005 who had set this "advisory
panel" up and discovered it was the responsibility of Mental
Health Media. I took an interest in their work from that period.
In parts of 2005 I asked the CEO of MHM to give me further information
about the work they had done in creating the tri-partitely funded
"Open Up anti Stigma" toolkit. She volunteered a one
page letter and told me in it there were some final "reports
to funders". I wrote to one of MHM's Trustee's who happened
to be the CEO of Sainsbury's Centre For Mental Health (SCMH) asking
her for more information and those "reports to funders".
She made a promise to get back to me in December 2005, but never
did.
I contacted the Esme Fairburn Foundation one
of MHM's anti-stigma "Open Up toolkit" funders for access
to the "reports to funders"—they answered in the
negative too.
I contacted the Gatsby Foundation another such
funder for access to the "reports to funders"—they
answered in the negative too.
I reasoned there might be several such "reports
to funders" so it was worth going to them.
I tried the Charity Commission (CC) by way of
complaint I claimed that it was not reasonable to have no access
to the "reports to funders" from MHM. They explained
the MHM Trustee the CEO of SCMH concerned had exercised their
discretion and the CC had nothing further to add. They closed
the issue down in mid 2006 and used the term "final"
to do so.
Later in 2006-07, I discovered the CC had not
signposted further tiers of adjudication on these matters. I am
still in the process in 2007 with the CC now of trying to access
to "reports to funders" from the original MHM charity
and the Trustee involved, and have had to use the CC's complaint
process over their own CC case handling.
I have argued for Freedom of Information Act
equivalence. Why? Because in principle there should be access
to the "reports to funders" on the basis that Mental
Health Media did in fact feed some of its work on the anti-stigma
"Open Up toolkit" directly into the Dept of Health on
a commissioned basis. MHM fed it into NIMHE (National Institute
for Mental Health In England).
The evidence was given to me (but not by any
of the MH Charities) and this is from a page of part of a report
generated originally by Mental Health Media itself —I quote:
"Open Up [The anti-stigma `toolkit'] was
commissioned by the National Institute For Mental health in England
(NIMHE) to co-produce a scoping review of effectivess in anti
discrimination and anti-stigma programmes".
That is the Government's linkage to the Mental
Health Media charity's work . Where is the proof or work that
demonstrates any effectiveness of the "Anti stigma toolkit"
or its thinking? I have never seen it.
What I have tried to demonstrate here is a confusion
of boundaries and a lack of will even by the Charity Commission
to create simple transparencies so that work can be viewed, accounted
for, validity of the exercises examined from the outside and value
for money ascertained, after all the Big Lottery was involved
in part funding the MHM anti-stigma "Open Up toolkit"
and that is more directly public money.
What I further discovered about Mental Health
Media's work was it was evaluated by staff from Sainsburys Centre
For Mental Health (SCMH)—who themselves are funded by the
Gatsby Foundation. A colleague discovered that SCMH had in fact
purchased the registered website domain of NIMHE too in 2001!
... The boundaries here are alarmingly overlapping and the question
is are some charities pushing ideologies that may appeal to politicians
but actually have questionable effectiveness and few current methods
of independent transparency that can challenge them?
I will place that information about SCMH registering
NIMHE inside this pdf file at the end of this submission.[101]
EFFECTIVENESS OF
SERVICE (MAD
FOR ARTS—WEBSITE)
THE STATE
AND THIRD
SECTOR VERSUS
PRIVATE ENTERPRISE
The effectiveness of Mad For Arts as a kind
of service was also doubtful and it illustrated state and partly
charity , third sector, ineptitude. The Minister of DCMS David
Lammy submitted that it had 25000 "unique views" per
month. Whilst the Media Trust reported in its own 2005 Report
that MFA had 80,000 "unique views" overall.
DCMS claimed 5,000 active participants. This
was simply not true the front end website—its main area
of activity on average only had a community of at the most 20
active posters since I followed it throughout 2004 and 2005 up
till its end.
The cost of MFA was initially publically announced
in 2005 as 316k plus VAT (372k).
I pursued a Freedom of Information Act question
through DCMS about this matter and the costs have now gone up
to 424k and I am still pursuing further information as to the
VAT.[102]
I have asked about the costs of the prizes MFA
was supposed to have awarded to users of the website. DCMS cannot
find any such information.
MFA's website closed down officially in March
2005 but ran courtesy of Culture Online past its own contract
date of closure up until Jan 2006. Most of the active posters
from the MFA website went over to a USA arts/photo website named
Flickr.com where I also form part of their community and where
the cost for uploading pictures of arts and being a poster is
free for the first 200 pics and £24 2gb upload per months
for a "pro account".
MFA a state and Third Sector run venture by
contrast, could not get any extra longevity because it was not
viable. Viability came with the private sector—the State
and its Third sector partners failed and the cost to the taxpayer
may well have been close to 500k in reality. One of the points
raised by some users was that money could have been used for many
local websites more effectively rather than a national top-down
corral . MFA also had no educational web usage policy for MH users
rather it captured and monopolised them right to the end. Some
of us in the MH Online community administered MFA users over to
other web resources for free.
Transparency into the costs of MFA has been
like looking through treacle and wading through FoIA tar over
a very very long time.
Mental Health users complained at MFA that it
treated them like second class citizens by not awarding any prizes
for their arts but instead awarded prizes for museum pieces and
"public arts". That was not good anti-stigma logic by
the state or the charities involved—yet it suited them as
a Top Down project for a while.
Rethink itself an MFA partner, hot on the trail
of the "anti-stigma" social engineering tendency wasted
money with the Churchill statue fiasco which caused major protests
when a statue of Winston Churchill was shown in a straitjacket.
The BBC on March 13th 2006 announced on its news website:
"Charity removes Churchill statue—Statue
of Sir Winston Churchill in a straightjacket—The statue
has been condemned as `an ignorant gimmick'". A charity's
controversial statue of Sir Winston Churchill in a straitjacket
has been removed after it caused outcry. Rethink commissioned
the sculpture, unveiled in The Forum building in Norwich at the
weekend, to highlight the stigma of mental health problem.
In 2005 and 2006 both Rethink and SHIFT an arm
of NIMHE were duplicating "anti-stigma" work. The driver
of which has been MH theorists like Rethink and MHM that the mentally
ill are the victims of mass discrimination that if combated will
get them back into work. Yet who is forming the basis of this
view? Mental Health media with its publically unavailable "reports
to funders?" NIMHE/SHIFT who have originated out of matrix
of Government and Charity?
Certainly Rethink are partly forming these views
and I question their validity because funding is ultimately being
diverted away from the patient consumer back into campaigns and
costly top down theoretically credibilised attempts to socially
engineer.
I question the validity of all of this MH third
sector intrusion into the domain of the patient in mental health
(the real consumer) because in an underlying and paradoxical stigmatic
way it distracts from the patient being the actual consumer and
democratic driver: the truer shaper of treatments that fit by
Patient Choices.
The Third Sector have been backing Cognitive
Behaviour Therapy CBT as a one size fits many answer to mild to
moderate depressions and some cases of psychoses.
According to Lord Layard with his clarion call
for 10,000 CBT therapists a maximum of 10 sessions should be able
to fit people back to work. The distractive anti employer stance
countenanced by the charities like Rethink has also given someone
to neatly blame for further failures of assimilation back into
the work economy.
Yet reality-creep is happening while the MH
Third Sector blow the rather biased cheap trumpet of CBT and anti-stigma,
because the Prime Ministers own e-petition website is as of tonight
nearing 10000 signatures asking for more therapy choices other
than CBT. At the last look at the time of writing this text, the
petition was 9,720.
Quote:
"We the undersigned petition the Prime
Minister to consider other psychotherapy approaches, not only
CBT, in the proposed expansion of psychotherapeutic services within
the NHS, instead of restricting choice for members of the public
to one only model of therapy."
The MH third sector I believe have helped the
Government skew the vision away from the patient driving treatment
choices and their own autonomous attempts to integrate into work.
It's a top down approach informed by an anti-stigma anti-employer
ideology. It appears it may have been what the Government appears
to have wanted. It is likely to fail and cost more in doing so
because MH patients need recovery Choices that they own, and they
need to become the drivers of their own recoveries with real options.
The third sector have been only ritualistically verbal about this—meaning,
not too loudly.
Importantly I believe the MH Charities were
involved in setting up the cross organisational NIMHE which by
2006 had cost £65 million (DoH FoIA Answer).
That was £65 million deducted from patient
chances of choices of recovery treatments other than the third
sector pushed CBT coupled with a top down anti-stigma set of drives
which has been percolating ineffectively through various third
sector costly projects which have been partly used to re-inform
Government, badly in my opinion.
CONCLUSIONS
There needs to be an enhanced Freedom of Information
Act equivalence on the third sector so access into its functions
and networking can be viewed properly.
There needs to be very independent publically
open evaluations of Charity work when the third sector is being
used to influence Govenment MH strategy and not a situation where
a charity like Mental Health Media can be funded by the Gatsby
Foundation and evaluated by a team at Sainsburys Centre For Mental
Health which itself is funded by the Gatsby Foundation and whose
CEO is also a Trustee of Mental Health Media and the "inheritor"
of a registered website domain purchased for the Dept of Health's
National Institute For Mental Health In England who itself "commissioned"
work from Mental Health Media.
Finally, the Government should learn to trust
MH patients as drivers of their choices of recovery orientated
treatments of which there might have been more if the third sector
had not partly played out its own questionable distractive agendas.
101 Not Printed. Back
102
See Annexe 1 Mad for Art Costs. Back
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