Excerpts from My letter to coroner Alan Blunsdon 13/12/18 which elicited the Reg. 28 report.
Given the information I’ve discovered and detailed below, MIMHS/CAMHS services hasn’t been sufficiently improved to prevent serious risks of fatalities. It has just made referrals simpler but not safer, by removing the necessity for the CRHHT involvement. The devil is in the detail.
A shortfall in assessment and implementation of appropriate services, to prevent escalation of mild to moderate and to severe symptoms/cases is another cause for concern here. It is essential that early informal opportunites are taken to gain trust with mothers and take them seriously.
Firstly the information for patients and families and self referrals, for access to MIMHS is not sufficient and readliy available. A leaflet and box ticking exercises are not enough especially in circumstances of difficult birth or complex history. ( See Perinatal Accounts)
MIMHS telephone assessments (which can take days into weeks to arrange and execute), according to the perinatal accounts I have, miss and don’t ellicit sufficient and vital information. For cases presenting as non urgent at that time, (how can MIMHS reliably know whether or not it is urgent by phone) a 28 day wait for further MIMHS input is an unrealistic estimate (as anecdotal accounts say it takes considerably longer) , for assessment considering the information below, and may fail to take into account a previous care plan or important treatment, and/or facts, that may have included medication/s with immediate and life threatening risks to both mother and/or baby.
Barriers are created by the impersonality and complexity of referral services and insufficient practical measures/ implementations in place to prevent deterioration,
for example, vital mentoring before hospital release, and as a first line of assistance, invaluable ‘home helps’, who in the 1990’s, gave domestic relief, evaluation, and personal interaction. Health visitors whose services have been drastically withdrawn, also provided a professional and domestic based informal service.
From the information I have gathered, mothers, babies and their families remain at the mercy of an undersubscribed service.
My personal experience of mental health referrals and treatment since the shock of losing Rebecca, (in the last 3 1/2 years )to this day is abysmal and has driven me to utter despair, and yet to receive effective help, and reflected below. It is those with the greatest and complex needs who the system can’t accommodate. Just to arrange a workable appointment has proved impossible because of poor interdepartmental communication and reliance on: the patient for self administration and management and : mental health care plans IE., a leaflet which is regarded as an insult by in this case, perinatal mothers who’s Personal Perinatal Accounts have been documented by our Campaign.
It seems underfunding and a deficit of ‘hands on’ basic support is lacking.
The inefficacy of the hierarchical system frustrates discourages, and exacerbates mental health conditions, driving a wedge between vulnerable women, babies and effective help.