Often dubbed the Cinderella service, mental healthcare often languishes in the shadows of its more public facing cousin, overlooked and struggling to attract staffing. But, as Gazette reporter JANE HARRISON discovers, volunteering to become a much-needed Mental Health Act manager can be a surprisingly interesting and satisfying experience.
CHAMPIONS of the mentally ill may not seem the most obvious and easiest of roles to take on, but they are desperately needed to avoid the dark ages when people were incarcerated their entire lives.
While we have come a long way since institutionalising social outcasts, improved and enlightened treatments and therapies mean that some people in mental units can and should be released into the community.
To review detention and decisions to keep patients in hospital against the wishes of their relatives are only two of the issues now considered by the little-known Mental Health Act manager (MHA), lay members of the community.
A safety net between the patient and tribunals, they provide independent scrutiny to ensure patients get a fair crack of the whip. While the stigma of mental health is reflected in alarming tabloid headlines suggesting machete-wielding maniacs are growing in number, the reality is one in four people will have some sort of mental problem, ranging from slight depression to a mental breakdown.
Anne Martin, 67, from Ealing was a lay visitor to police cells, involved in local issues and politics and has been a MHA manager for 18 years. She said: "Mental illness can happen to anyone, ordinary people. It is important that we present the situation like it is. It (hospital) is not a place full of axe murderers who are going to kill you.
"Unfortunately the stigma is still there and it's an important part of our work to change that."
Having a grown-up daughter herself she is painfully aware of how schizophrenia can wreck young lives.
She said: "You look at young people who get it and think, 'that could be my daughter'."
While she admitted the role could be emotionally draining, she says it can also be incredibly uplifting. She said: "Some people are in pretty hair-raising situations. If I was in that situation I would like someone from out-side who was not a professionalss to listen to me.
"It can be depressing and sad. We go in threes and sometimes we come out and don't say a word to each other. You are walking out and these people aren't. You are very conscious you are dealing with their liberty, but it's so satisfying when you come across people who are making tremendous progress and can really move on. Occasionally, over the years you let people go."
MHA managers are formally appointed by the trust board under the Mental Health Act 1983, usually sit as a panel of three or more and attend hearing appeals by patients who want to be discharged from detention.
While they do not need to be professionally qualified, they do need a reasonable knowledge of the Mental Health Act as they have to read reports and in-house training and support is given. Hearings are currently held at Ealing, Charing Cross, West Middlesex and St Bernards hospitals.
Nuala O'Brien, communications director of the West London Mental Health NHS Trust, said they wanted people from all walks of life, but certain skills were essential. She said: "They certainly require personal qualities like common sense; decisions made by panels must be reasonable, sometimes weighing issues of personal liberty versus public safety, approachability; sometimes hearings can be very stressful for patients and staff, patience, empathy and discretion.
"While we are not looking for people who simply enjoy overriding the decisions of experienced psychiatrists and other health professionals, we are interested in those who feel capable of bringing an informed lay view to the review process."
Glen Barnham, 63, a former Ealing councillor for 20 years, including chairman of social services, who lives in South Ealing, has been a MHA manager for 15 years and said it was very rewarding.
He said: "Having gained the experience I have, I thought it would be nice to be able to put some of that experience to use, as well as knock down some of the myths and taboos. Many people in their lives have break-downs, yet there is till the tabloid headline about murderers which is an extreme case. One in four of us will know someone with mental health problems."
He believes the MHA manager has a vital role to play in a situation that could happen to anyone. He said: "We are part of a system to safeguard to protect people who could be put into a secure unit against their will. There have been cases which have been borderline; I didn't think they should be there so we review it and decide whether they should go somewhere else.
"You are a safety net to ensure the right systems are in place. You need to have common sense; have your feet on the ground."
Kevin Towers, head of patient services at the West London Mental Health NHS Trust, said: "This provides a vital link between the local community and those who are unable to leave hospital by ensuring that decisions taken by health and social care professionals are subject to scrutiny by ordinary members of the public." [25a0] If anyone is interested in becoming a MHA manager they should contact firstname.lastname@example.org.
About Mental Health Act managers
The trust has 20 MHA managers at the moment and wants to recruit another 15-20.
They will need to attend for a day or half a day at least once every other month, an evening meeting every three months and training twice yearly.
Emotional, administrative and legal support is given. Managers are vetted and have to give details of criminal convictions and may need an enhanced CRB disclosure.
An attendance allowance and travel expenses are paid.
One in four British adults experience at least one diagnosable mental health problems in any one year and one in six experience this at any given time.
One in 10 young people suffer from behavioural, mental or emotional disorders that need some form of professional intervention.
West London Mental Health NHS Trust has almost 1,000 inpatient beds, at: Ealing - 475 beds Hounslow - 93 Hammersmith and Fulham - 84 Broadmore - 300 other beds - 50 (hospitals/nursing homes further afield)