Thursday, 7 February 2013

Care: Mental, Social and others - CHAMPIONS

I would just like to set the record straight regarding what I feel about those who provide care for those who suffer from various needs of the mental, social, housing, medical and benefits kind. For those who devote their lives to addressing the needs of those with problems I have nothing but respect and admiration. I chance across many who are committed to their role and see them struggle against decreasing budgets, diminishing staff numbers, increased workloads and restrictions that would make a saint swear like an East End docker and they deserve, no demand, applause and respect by the bucket load.

BUT (has to be a but) to reflect on 2013's experience to date:

I have seen first hand those people who make decisions long before they've engaged with their client and the reason for this has nothing to do with proper or effective care. The reason is merely a desire to make the problem go away. The reason for this is the fact that they are no longer doing what they joined up to do (and most of the social workers did join to make a difference) but are merely pumping out the clients in an effort to keep their own heads above water. The need to rationalise their own jobs means that many who are client-facing are no longer proving care but merely attempting to contain things.

I happened across a case where someone was presenting serious mental health issues but when one of the family called their local unit for help they were told that they'd been 're-diagnosed' and so they were no longer on the unit's list. 'But they are a danger to others and themselves,' pleaded the family member. 'In that case here's the other team's duty crisis number,' said the voice on the other end. The number duly given, they hung up. Worse than useless as the number they were given turned out to have been changed last year! By the time they found someone from the 'right' team the person with problems had been picked up by the police (who could do nothing but bring them home to be a problem to the family and not the community - not a knock at the police, they had no power to do anything else as the local team wouldn't come out!).

I found a child who had been removed and placed for adoption before conditions such as getting support and undertaking training had even been started. 'Best for the child'? I hope so because it looked like it was simpler for the caseworker and the team involved from where I stood. Another example of what might well be poor outcomes coming about because it required less effort and energy from those who are supposed to be supportive and caring.

Another case meant I found myself coming into contact with involved someone about to be made homeless with their partner and children. There were health issues and yet when they went to their local housing people they were told that they were at the very bottom of the pile because one of the couple had some income from a part-time job. The answer? They were made 'redundant' by the person they did five hours for and now at least they are moving up the list. Not so the person who left the army and was told that they 'were someone else's problem as they'd lived in married quarters in the SW and so were that council's problem!' Of course the rules regarding priority (mental and other health issues, released from prison, left the armed forces) are rarely considered because of the 'yes/no' game that many play to mitigate their workload and protect a non-existent social housing stock (yes - it's great selling houses to people but the money should have built new social housing stock!!!).

A plea to my clergy colleagues regarding the creation of 'Champions' in their congregations:

Build up a group of local 'champions'. People who can become experts (or at least be informed) regarding the various areas of need, which I suggest are, as a minimum:

  1. Mental Health - one of the greatest and least addressed needs that face us.
  2. Housing - Not just homelessness, because many who are housed will soon be homeless unless they find champions.
  3. Debt - Debt coaching courses and support are essential parts of the pastoral care role of Church and yet, amazingly, few are equipped to come alongside and engage with it!
  4. Family Issues - Yes, I know we do this as pastoral care but we need to know the law and the ways of protecting people at risk and we need to do it intelligently.
  5. Old Age - one of the areas where provision is being withdrawn and where, even though people think the 'old' are always complaining, little is said as services disappear.
  6. Addiction - and not just drugs and alcohol. It's amazing how sex and gambling often fall below the radar and how compulsive spending and other issues just don't feature at all.
  7. Relationship and Reconciliation - can cover so many areas from providing a neutral place for engagement through to training and counselling
  8. Health Issues - and this can include preparation for death, palliative and bereavement issues (including how to fund a funeral when the bereaved have no money!).
Eight areas which I reckon takes at least ten to twelve people to engage with if a church is going to offer support to the community outside (and within) its walls. It needs coordinators and someone who will keep the minister in the loop without making them the sole point  of contact.

When I have broached this with some clergy the response has been, 'Well that's what CAb and others are there for!" And indeed they are but I have to ask whether or not we have given up our pastoral birthright for a mess of 'other agencies' potage and I fear that the answer is 'Yes!'.

So feel feel to disagree (or add areas that you feel I've missed) but if you've read this then take it back to the church or team and see who and what you have to meet the needs for as money becomes even more tight the services will feel even more of the squeeze and clients less of the care and support.



DrJ said...

Oh dear, I did not mean any criticism in our exchange after your other post - I agree with you, I was meaning to express sadness that things are that way.
In the same way, the fact that I can understand exactly the likely reasoning in the case you describe of the family trying to get help for their relative does not make me any less sad or angry about the iniquitous systems that are developing. But if there are two units with adjoining responsibilities, and one applies the rules strictly, and the second dares to apply some compassion or common sense, then that second unit will rapidly find itself with an even heavier workload and be even less able to help the people who are clearly its responsibility.
In the NHS, I can confidently predict a large increase in the number of people who, because their problems do not fit nice neat bureaucratic divisions will find that they do not appear on anybodies list of "we have to take responsibility for this person", and GPs like me will spend even more of our time phoning and writing to try and crack some heads together.

But from your Champions list, can I plug the work of Christians Against Poverty:

who work mainly from local churches and who, as I understand it, have declined Big Society money in part because of all the strings attached. Oh, and they have upset the National Secular Society too, for good measure!

Vic Van Den Bergh said...

Didn't think you did - was just clarifying in case I had :-)
Use CAP (and others) and had three debt coaches trained by another group at one stage.

It is a sad state of affairs we find ourselves with indeed.