CASS Steering Group Minutes

12 April 2016: Knowle West Health Park

Present:

DeepaBakrania – SARI (Senior Project Officer) Chair in the absence of Alex Raikes

Helen Gunson – Positive Minds

Monira Chowdhury – CASS (Manager)

Narinder Chana – Rethink (Community Development Worker)

Jason Edwards – Single Parents Action Network (SPAN – Father’s Worker

Roger Griffiths – Ujima Radio (Director)

Lilly Khandker – Bristol Multi Faith Forum (BMFFDevelopment Worker)

Agata Palmer – CASS Networker, Minutes Taker

Apologies:

Alex Raikes – Stand Against Racism & Inequality (SARI Strategic Director)

Sally Gapper – North Bristol Advice Centre (NBAC Chief Executive Officer)

Sue Brazendale - Voscur (Health and Social Care Network Co-ordinator)

Laura Welti – Bristol Disability Equality Forum (BDEF Manager)

  1. Introduction

The minutes of the previous meeting were re-visited and Terms of Reference. Monira introduced CASS structure, team and role to new group members. It was also explained that each meeting of the Steering Group would take place at one of the 3different localities for service, possibly the locality Hub for CASS if appropriate; meeting will be attended by the local CASS Networker, who will also take the minutes.

  1. Selection of The Chair and Vice-Chair

Alex Raikes was willing to be the Chair but also happy for others to volunteer. She was voted in as the Chair of CASS Steering Group unanimously.

Vice Chair still to be decided on, selection deferred to next meeting in July.

Action: All members to consider if willing to become Vice-Chair and confirm at 21 July meeting

  1. Terms of Reference

Previously there was a discussion of objectives;gaps were identified as well as barriers and need to bring things to the attention of the commissioners.

It was agreed that there would be up to 12 members of the Steering Group, so far 10 members have been confirmed. It is important that the people on the Steering Group all bring different perspectives to the table and notjust expertise on one are. For locality leads, that is not only a good knowledge of their specific organisation, but also some expertise of the particular area of the city and its community.

The plan is to have themed meetings, where relevant key stakeholders are invited to join that meeting, in addition to the regular steering group members. The best days to meetwere agreed as Tuesday and Thursday,best times in terms of accessibility to transport for Laura,was between 1-3 pm; meeting s would alternate so everyone on group could attend at least every alternate meeting.

All Terms of Reference as agreedwould be reviewedannually.Bristol Refugee Rights has confirmed their acceptance of invite to join and their named representative was Andrew McCarthy. Missing perspectives identified at last meeting were: male, African-Caribbean and LGBTQ perspectives, but with current members all these perspectives are now represented on the Steering Group.

Further suggestion is to liaise with Rachel from 2Way Street, a Black led service user and carer group; Roger mentioned that he has been in touch with them. Narinder raised the issue of capacity for small organisation, which includes 2Way Street. She suggested that some volunteer expenses should be paid, Monira said that this would be possible. The group’s attention was bought to the fact that certain groups/projects who were part of voluntary groups who were partners Bristol mental health couldn’t be invited to join the steering group due to potential conflict of interest, this applied to Freedom Youth and Project Zazi who were actually managed by Off The Record.

Action: Roger to find out if Rachel or another member of 2Way Street would be interested in joining steering group

  1. Planning of CASS Network (Reference Group)

The Network to be held twice per year,is aimed at a wide range of stakeholders, both current user groups of CASS and those who haven’t accessed service yet. The aim of event is to provide opportunity for a wider context for CASS accountability and help set priorities for future work.SARI would act as an independent facilitator; CASS Networkers would assist with organising and delivery. Discussions and planning are in progress with SARI. The initial plan was to hold it on 14th June, bus as Alex is not available on that day, 28th June is the new date. The venue is The Park, Daventry Road, Bristol BS41DQ.The next planning meeting is due on 22 April 2016.

Invitations will be sent out with the help of Networkers – to get wide range of participation from groups, like faith, mother & toddler, voluntary community sector and other groups. SARI would supplement that with invites to their contacts. Longer-term views on particular issues, like communication,will also be collected via surveys in addition to the two events. Inevitably attendees are expected to raise issues relating to BMH not just CASS.

In discussing the potential agenda, the following points arose:

  • Communications from Bristol Mental Health – poor quality of resources and website, lack of printed leaflets and materials
  • Helen raisedissues with GPs referring patients for secondary care for assessments. Whilst these patients may be too complex/severe for Bristol Wellbeing Therapies, they often do not fit secondary care services so this leads to referrals often being signposted elsewhere and a client being bounced between services. This is not so much a problem of lack of training for GPs in mental health, but more a lack of clarity from secondary care about what clients they will work with. This will only increase with the ‘access through any door’ idea. It also highlights the gap between primary and secondary services.
  • Additionally, IAPT is to be re-commissioned. There are real issues arising with what GPs say to patients, for instance, when peopleare told to self-refer. After self-referral followed by formal assessment they often bounce back or end up with no support and then possibly with only support from non-specialist voluntary sector.
  • Suggested – a Flowchart designed especially for GPs to improve pathways for referral and outcomes. GPs not understanding services are a critical barrier in the service provision.
  • Getting to Step 3 services without having to go through the Stress Management Groups is also an important issue, as pressure to attend groups is big barrier for many.
  • BCCG has regular contact with GPsand BMH is trying to develop links, so that a uniform way of referring patients could be agreed upon for all GPs. Furthermore, CASS Baseline Questionnaire findings so far show that sometimes GPs are the barrier due to not knowing the service and sometimes they add to the stigma by the way they act.
  • Monira added that each GP Practice is supposed to have a Mental Health Lead. Suggested the important thing is to find out who the Mental Health Leads are per surgery and then to pass this information on to VCS groups supporting individuals.
  • There are some GPs on the Clinical Commissioning Group, who are passionate about this and are engaged with the system. The concern for GPs is that they are so time-constrained that they often don’t even have time to fill in the referral forms. Hence self-referral can go so wrong with people who are not confident at it.
  • Narinder suggested using Facebook community to promote ‘No Wrong Door’. However, oftenpeople don’t meet the threshold for further referrals and are not able to access the right source of help for themselves.
  • Helen emphasized that when people are signposted back and forth, they become very frustrated; and with community based services that clients can easily contact and have a quick catch up with, their mental health can quite often be supported via a one off intervention to prevent crisis.
  • Monira brought up the example of ACE with the triage system with the referring agency; though ACE havereached capacity very quickly.
  • Peer-led, unfunded organisations depend on volunteers. CASS commissioned to build capacity but how they can support thesetypes of groups is limited, important for BMH not to ‘wash their hands off them’
  • Post-Traumatic Stress Disorder – a lot of people are dealt with at all levels of BMH, but not enough ongoing help; complex support is not easily accessed for clients unless they have sexual abuse related issues and can access sexual abuse services.
  • Improvement of Communication and Services – How do we get the communication and information to groups and community?
  • Helen summed up that things in the South Bristol are hard, e.g. Focus on Family lost funding, and also WISH Domestic Abuse Support service is closing. Changes in local authority funding put many services at risk of not surviving, depending on what the new re-commissioning priorities are. We need to see how we manage expectations and create realistic situation, how to do it creatively so communities have realistic expectations of their needs being met.
  • Discussion about re-commissioning for IAPT, which will not happen by June this year, postponed for new services to start autumn 2017.

Narinder raised that it would be really important to have the views of the Service Users and Carer who are in interested in raising issues, particularly those who don’t engage with the formal system and services.

  1. Summary of CASS recent work with VCS and equality groups, including gathering information on access issues and barriers
  • Time to Change - Time to Change chose Bristol as a Hub as part of two national pilots, CASs managed champions fund and CASS identified a project of working on stigma in geographical area of North Bristol (Southmead and Lockleaze), by running targeted events.
  • BAME equality event at Rose Green with focus on men, faith, older people and caring
  • LGBTQ Manifesto event, with focus on access issues, barriers to services and service improvements
  • International Women’s Day event with about 50 workshop participants, again looking at access issues, barriers to services and service improvements
  • Bristol Older People Forum (BOPF)

Continuing actions for CASS Steering Group:

  • Tracking the changes, existing and emerging gaps in provision, whilst CCG is re-commissioningIAPT (Improving Access to Psychological Therapies).
  • Mapping service which will be missed in localities or for equalities communities
  • Noticing when services drop off – even if impacts do not show immediately (for instance Recovery Navigators can end up referring people to VCS that no longer exist)
  • Identify key communities/equalities that present the gap – locality based, but also generic for specific equalities and groups in community

Further Discussion:

  • Capacity – time and resources available to groups/communities to support around mental health.
  • Ongoing issue of engaging Gypsy and Traveller communities.
  • Lily gave examples of places of religious worship and Pakistani and Bangladeshi communities who decline any help – in denial
  • Helen added that she spends quite a lot of time with clients doing pre-counselling workto help them feel confident and ready to access counselling, especially with the standard limits of 6 CBT sessions from Wellbeing Therapies.
  • Transport being problematic.
  • Primary Care not being the only answer in the equation.
  • Roger points out that plugging organisations like SPAN or 2WayStreet into existing networks is vital.
  1. Minutes of Last meeting and Matters Arising

Minutes agreed as accurate

  1. Any Other Business

-Mental Health Awareness Week 16-22 May – CASS will not be running any activities, but linking to the local campaign of raising awareness. (Public Health are waiting till after elections to get involved, but will do something for MH week)

-Linking with Campaign Against Living Miserably (CALM)

-Depression Awareness Week 18-25 April

-World Mental Health Day - October

-Youth Matters Sept/Oct – whole month of activities around young people

  1. Future Meetings:

21 July (Thursday)–1.00 – 3.00 pm Central and East Bristol,

St Pauls Learning Centre

11 Oct (Tuesday)- 1.00 – 3.00 pm North Bristol, Southmead Development Trust (Greenway Centre)

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