Tuesday, 4 November 2014

Busses, parking and the problems of a stressed out society

How do you stun a public meeting into awkward silence? It takes a conjuring trick no more complicated than mentioning the topic of mental health and the way society deals with the people it drives to distress.

The other evening I saw this happen for myself at a PACT meeting held at the Medical Institute in Hartshill, the speaker on the night was Julie Elden a nurse manager with the North Staffordshire Combined Healthcare NHS Trust. She had come to speak about the community triage system operated by NHS mental health services and the police.

It is part of a national agenda aimed at reducing the amount of time the police spend dealing with people with mental health problems who are not suspected of committing an offence and was initially funded by police and crime commissioner Matthew Ellis.

The team consists of three community psychiatric nurses and a support worker and take referrals from the police to deal with people in mental distress across North Staffordshire, the service operates between three pm and three am, the hours during which most call-outs are received and members are accompanied by a police officer.

Where the triage system differs from what was in place previously is in its focus on signposting people in distress to relevant support services and the willingness of members to attend service users in their own homes as well as in public places. They also assist the police with their responsibilities under section 136 of the Mental Health Act to take a person in distress to a place of safety, using an approach focussed on the needs of the distressed person as well as public safety to defuse potentially difficult situations.

Since being set up in November of last year the triage system has dealt with eight hundred incidents in locations ranging from private homes to a bridge over the M6 and offered one hundred and twelve people support over the phone, members have also helped the police hit their target regarding section 136 incidents.

Local officer PC Terry Dunn said he ‘enjoyed’ working with the triage team because it gave him and his fellow officers a wider range of options for dealing with people in mental distress and that he relished the opportunity to learn from members of the team.

Normally PACT meetings are marked by the lively questioning to which members subject sometimes unsuspecting speakers, when the floor was opened this time there was a deathly hush. This is not unusual, media misreporting and an enduring stigma makes mental illness one of the few subjects that still has the power to kill a conversation stone dead with embarrassment; even though one in four people will experience it in some form during their lifetime.

That is what makes initiatives like the triage system so valuable, a different approach from the police means fewer people in mental distress being arrested because there is no other way of getting them to a place of safety and so fewer scare stories for the tabloid press to misreport.

Ambitious plans are in place to expand the team to include paramedics; however this is dependent of the award of funding which must be bid for again with no guarantee as public purse strings are pulled ever tighter.

The next speaker, Nigel Eggleton, Managing Director of First Midlands Bus Company, got a far more typical, meaning robust, reception. He had some to receive feedback on the new and controversial bus timetable implemented in the summer. He made a few bland remarks about how well, from a business point of view the new timetable was working then opened the floor to questions.

Cue a barrage of angry questions and comments from the floor, many focussing on the flagship 3 service which runs through the hospital, much to the displeasure of local residents for whom it has caused traffic problems. He was also questioned about the age of the vehicles in the First fleet and the difficulty finding a service that connects with trains coming in to Stoke station.

Written down this sounds like tepid stuff, but the antagonism in the air was palpable, few things stir up passions like a change to the local bus service. Not without good reason too, having an old and rattling bus pass their house dozens of times every day can have a negative impact on an individual’s quality of life and being stuck in traffic hardly improves the already dull routine of the school run.

Mr Eggleton, who I’d guess has had media training of some sort, handled some tough questioning with an affably avuncular charm that is learnt rather than natural. Playing a straight bat Boycott style to drive off criticism whilst giving away as little as possible, the whole thing was rather like watching a junior minister handling the press, giving out the bare minimum of information without offending anyone; effective no doubt from a corporate point of view but frustrating to watch.

Local residents dealing with Mr Eggleton over their not unreasonable concerns may have to be prepared for a war of attrition rather than a single battle.

Last to speak was Mike Brown, Facilities Manager at the newly renamed Royal University Hospital of North Staffordshire. The name may be new but the problem here is singular and as old as the hills; parking.

By Mr Brown’s admission parking in and around the hospital is a ‘nightmare’ and unlikely to improve any time soon due to the on-going construction work. To his credit he didn’t try to slither past tough questions and the frustration of his audience.

The biggest problem seems to be the attitude of hospital staff to parking with many preferring to park in the surrounding streets rather than use the spaces provided by their employer even though the cost is minimal in comparison to other sites. They seem to see doing so as an inalienable right leading to inevitable and entirely understandable confrontations with local residents who hold the opposing view.

In the short term the only solution seems to be the sort of glum putting up with an awkward situation at which we Brits are so practiced, in the longer term. The longer term solution is the construction or multi-storey parking on the hospital site, the problem then of course is where to build it; that may be the opening shot in a whole new battle.

What draws these two seemingly more minor problems together with the work of the triage team? Both seem to by symptomatic to some extent of the stresses inherent to living on a crowded island where society seems to get more selfish, more determined about protecting individual rights at all costs with each passing year. It is impossible to say when and for whom those will boil over into distress; you just have to hope for good fortune and failing that for someone to be there to pick up the pieces.

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