NSF(S): National Schizophrenia Fellowship (Scotland)

Non Gamstop Casinos Fast Withdrawal Casinos Uk Betting Sites Not On Gamstop Non Gamstop Casinos Casinos Not On Gamstop

Report of Members Event and AGM
Saturday 28 October 2000 at the Royal Overseas League, 100 Princes Street, Edinburgh.
For the agenda of the day, please click here.

Chairman Susan Kirkwood addressing the Members Event

The Members Event consisted of two talks, one by Andrew Gumley on The early detection and prevention of relapse, the second by Dr Fiona Lang, a consultant psychiatrist from Edinburgh who spoke on her work as Medical Health Adviser to the Clinical Standards Board for Scotland on Schizophrenia standards.
This was followed by the Annual General Meeting which, like the rest of the day, was chaired by NSF(S) Chairman Susan Kirkwood.

Chief Executive Mary Weir with Chairman Susan Kirkwood

An informal discussion among Board members

The early detection and prevention of relapse - service users, families and professionals working together

Andrew Gumley, Clinical Psychologist, University of Stirling

Andrew Gumley

In a thought-provoking talk, Andrew Gumley described a nearly-completed research study aimed at preventing relapse in schizophrenia. The subjective experience of psychosis can be a time of intense distress, preoccupation and heightened awareness.
The issues around the experience of relapse into psychosis are:

lack of control
entrapment in symptoms
stigma
The commonest symptoms of a pending relapse are:

sleep problems
irritability
anxiety and tension
withdrawal and depression
A number of important psychological changes before relapse have been detected:

worrying about one's own thoughts
negative thoughts about oneself
negative beliefs about others
positive beliefs about oneself
Early signs monitoring is used to detect and identify these changes in order to prevent relapse. Depending on the method used, there are varying degrees of success in this effort. However, research confirms that when early signs monitoring is in collaboration with individuals, detection is improved.
The purpose of early signs monitoring is to permit early intervention to prevent relapse by using:

increased medication
cognitive therapy (a relatively new idea, which is now becoming accepted)
collaborative early intervention.
This latter approach is very important, as it involves the individual, the professionals, and families in these ways:

education about relapse
finding the 'relapse signature' (what are the unique signs and symptoms experienced by an individual during early relapse)
developing a prevention plan
rehearsal and monitoring
learning through relapse (which, if it happens, should not be regarded as a failure but a further opportunity to learn)
The early warning signs of relapse are very individual. Working in partnership and monitoring are both very important at this stage.
A relapse prevention plan should be put in place, containing the following:

who to contact
what the individual can do
what the family can do
what the key worker can do
contact phone numbers
This has been implemented by North Cunninghame Community Mental Health Team (Ayrshire).
Relapse is an opportunity for learning more. It is not a failure, but a chance to learn about:

early signs
what helps and why
how the individual can increase understanding/control of what is happening
The value of cognitive therapy is that

relapse gives a chance to learn
it focuses on individual thinking, feeling and behaviour
beliefs can accelerate relapse
fear of failure
increased anxiety
You can work with these beliefs to:

increase control
reduce the impact of psychosis
work towards prevention
In conclusion, monitoring the individual's beliefs can detect subtle changes in early relapse in 78% of cases. Full results are due shortly on a comparative study of 144 individuals. The best results can be achieved:

in partnership between families, individuals and professionals
recognising that actual relapse is an opportunity to learn
a relapse plan can be of positive help
cognitive therapy can offer a way forward.
The talk was followed by a discussion.

Clinical Standards for Schizophrenia
Dr Fiona Lang, Mental Health Adviser to the Clinical Standards Board for Scotland

Dr Fiona Lang

The Board was established at the beginning of March 1999 under the chairmanship of Lord Patel to develop and run national standards in the five key priority areas, which include mental health (concentrating in the first instance on schizophrenia).
The task has been particularly difficult because of a lack of hard quantifiable evidence and benchmarking standards. In addition, schizophrenia is very a very different experience for different people and involves lots of services and lots of different people.
In addition, there is a wide range of views as to what standards should be put in place. This is the first time that standards are being set in mental health.
There is unfortunately no robust clinical evidence base in the mental health sphere. We need to set standards that are:

achievable but stretching
designed to improve current care
agents of change.
Standards should be concern themselves with:

needs assessment
carers and their needs
treatments and interventions
all 'stages in the journey' through mental illness
The quality of evidence is generally poor. Existing studies are selective and there is no long- term follow-up. The Standards Board initiated the gathering of such research evidence as exists in the literature.
The framework for standards in mental health was based on this process:

consultation with professionals, carers and users
focus group meetings
drawing up April/June draft standards
Piloting the draft standards
The standards now adopted concentrate on the following:

needs assessment
initial diagnosis
initial assessment and assement a year after diagnosis
ongoing care
admission and discharge
carers
drugs
psychological and social interventions
drugs and alcohol misuse.
The Standards are to be launched in the last week of November in the form of a number of documents. A key element of the standards will be the audit tool.
The process will be that Trusts send in assessments and the Standards Board will use a combination of self-assessment and peer review visits, involving carers and users, who will be offered training for this role. The first Trust review will take place in February 2000.
There was a discussion after the talk.

Annual General Meeting
The Annual General Meeting approved last year's minutes with one minor correction, accepted the accounts and reappointed the Auditors. For further details, see the Annual Report.
Two retirals from the Management Committee � Bill Easton and Gordon Bryce � were recorded, with thanks to both for their work. Two members were re-elected to serve for a second term: Marie McKeown and Jacqueline Atkinson.
Two new members were elected.
Mary Weir reported on the last year's work of the Fellowship. For further details see the Annual Report.

Lord Campbell of Croy was retiring as Patron and the meeting expressed its gratitude for his work on behalf of the Fellowship. One new Patron is currently being appointed.
Ian Gilmour described the current financial difficulties of the Fellowship and the need to adopt strict financial disciplines in the coming months. The problems have been largely caused by MISG (Mental Illness Specific Grant) funding being frozen for the last six years, and level funding from other providers.
The Annual membership fee was increased by £5 to £15 by a unanimous vote.
It was also agreed to explore the possibility of increasing user involvement in the Fellowship.
The meeting closed with a vote of thanks to the Chair.

Top of this page | Home page

Report of Members Event and AGM

The early detection and prevention of relapse - service users, families and professionals working together

Clinical Standards for Schizophrenia

Annual General Meeting

Cool websites