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Health chiefs apologise after “unacceptable” impact of day centre cuts is revealed

Three people tried to kill themselves following closure of Highgate Day Centre, report says

03 August, 2017 — By Tom Foot

Campaigners against day centre closures outside Town Hall 

NHS and council chiefs have issued a joint apology to some of Camden’s most vulnerable residents after dictaphone diaries revealed the “unacceptable” impact of day centre cuts.

Camden and Islington NHS Foundation Trust and Camden Council were responding to a damning 40-page report from a patient-led watchdog into a decision to shut lifeline services at Highgate Day Centre in autumn 2015.

The Camden Healthwatch report said that dozens of “service-users” – mental health patients who used the centre in Highgate Road – had been “failed” by the cost- cutting move and that many reported suicidal thoughts that “were not only perceived but real”. Three residents tried to kill themselves after the decision was taken, the report says.

“Anxiety, uncertainty, depression, isolation and sense of loss were caused by the changes,” the report said. “The very high number of reports of negative mental health, including suicidal thoughts, give cause for serious concern.”

Over seven months, Healthwatch obtained “evidence of increased use of emergency services, hospital and crisis house admissions that appear to be a direct consequence of changes”.

In autumn 2015, the foundation trust and the council – which respectively funded and ran Highgate Day Centre – agreed to stop a group of about 80 “associate members” using the service.

The associate members were people who did not use the day centre all the time but could go there if they had a relapse.

The council at the time claimed the changes were clinically-led – part of a push towards a “recovery model”, where service users are encouraged to no longer “depend” on some services, including day centres.

“The changes were also intended to save costs at a time of signifi- cant budget constraints,” the Healthwatch report added.

To track the impact, “service users” were giv- en dictaphones and asked to record weekly diary updates over seven months after the day cen- tre cutbacks. They also met Healthwatch during the process.

Some of the diary entries show:
– “I took an overdose on Thursday. I hadn’t self-harmed since [before the changes at the centre].”

– “I’m actually in the crisis house.”

–  “I have urges to hurt myself and I just feel really unsafe.”

– “I was looking at get- ting a job. I was doing well. I feel like a lot of that is being undone.”

– “I’ve been drinking more… really missing friends at the centre as it would have been great to have somewhere to go and talk about things.”

Healthwatch, having assessed the diaries, said its evidence showed that the NHS’s and the council’s “belief that service users at the Highgate Centre would be able to reduce their dependency on the service” was only justified in a “very small number of cases”.

The report added: “We know from the diary entries that these risks were not only perceived but real.”

Over the 30-week period of reporting, the diaries indicate that there were suicide attempts by at least three of the nine audio diary project participants.

“We also know from the diaries that three participants were admitted to a crisis centre and one participant was admitted to a mental health hospital ward.”

Healthwatch recommended that in future “the concerns of existing service users must be respected”.

In a joint statement, the foundation trust and the council said: “Although we believe that the combination of financial challenge and focus on mov- ing towards a recovery model remains valid, we apologise for and recognise that service users felt that they were not listened to as part of the process, that their views weren’t taken into account and that they weren’t adequately supported through the transition process.

“[We] will learn from this report and accept the need to be proactive and positive in response, using the report to improve practice and future service user experience.”

Healthwatch Camden is an independent organisation with a remit, under the Health and Social Care Act 2012, to make sure patient voices are listened to and responded to properly.

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