EXPERIENCES IN MENTAL HEALTH CARING

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                                          BARRY TEBB

                         CAMDEN           SIXTIES PRESS 2005

The Camden New Journal has reputation for exposing council scandals and fighting for the underdog but in my view the CNJ is careful always to avoid doing serious damage to anyone on the council, however appalling their policies and conduct. When I paid the CNJ £80 to advertise ‘Life and Death in Camden’ I was phoned at 5.15 pm the night before publication and told by the editor that unless I withdraw the names of Councillor John Rolfe and Brenda Williams the advert would not appear – in spite of the prepayment and the contractual obligations. Under duress I agreed but without the names the book, I knew wouldn’t sell and in the end only two copies went.

The first of my letter was printed in the Ham & High but my second letter (to the CNJ) was omitted. As a precaution I had circulated the full council with copies before the following Monday’s stormy meeting.

Councillor Penny Abraham said those who had concerns about the proposed day centre closures were ‘scaremongers.’ Once Brenda Williams and I had faith in her. For two years she sat beside us at Camden and Islington Mental Health & Social Care Trust Board (CIMHSCT) meetings and encouraged us ask leading questions about policies we believed (as we do in the present matter) were dangerous, short-sighted and opportunistic. I now believe her role was as an agent provacteur, loyal to Erville Millar in every way and leaking to him our every stratagem.

Abraham is a back-stabber par excellence. She walked out as Executive Cabinet Member for Social Services in December 2004, accusing fellow councillors of acting without consulting her, re-instated herself a few days later and finally stepped down in May 2004. Millar subsequently put her on the CIMHSCT Board as Deputy Chair to replace Councillor John Rolfe, who suddenly stepped down, perhaps to make room for her, perhaps not.

In the fight to restore Brenda Williams’ care (a fight that is not yet won even after two years of unceasing struggle, she has an RMO but no care in the community, no CPA plan and no care co-ordinator) Councillor Abraham had seemed so supportive but when Clair Buck, Brenda’s MP, suggested a meeting between herself, myself, The Strategic Health Authority, Camden Council and CIMHSCT Abraham emailed all parties and said that Brenda should back down and accept care in Westminster, the very thing we had fought against for so long. We eventually won this battle because the DOH directed PCT’s to accept ‘cross border patients’ in the November 2003 directive, Establishing the Responsible Commissioner. Details of this in the form of an exchange of letters can be found in my Life and Death in Camden (Sixties Press 2005.)

I wondered whose back Councillor Abraham would stab next and now I know: those poor wretched souls of the Day Centres. Shame on Councillor Abraham and shame on all those who support her.

If you’re depressed in Camden

The only bed you’ll get

Is when you’re dead and on a slab

In the cold morgue of regret

Barry Tebb

I forwarded this letter as a question to be circulated at the meeting on the 21^st of July of the Camden Mental Health Liaison Group. Councillor John Rolfe refused the question, stating that my criticisms of Tulloch Kemp and other unnamed people constituted possible libel. This is outrageous and untrue – it is no more than fair comment and I have had assurances to this effect from a reputable journalist. The bulk of the letter had already appeared in the Ham & High.

Sir

I was aghast to hear that the vital Jamestown, Crossfields and Camden Mind’s day centres, which care for around 500 of the borough’s most severely mentally ill, are to close if plans revealed by the Social Services’ Press Office go ahead.

The rationale used as an excuse is a report of the Social Exclusion Unit but this simply says that the mentally ill should not be excluded from the mainstream of society, e.g. they should not suffer stigma. The Council carelessly conflates this with the DWP’s intention to move 1 million of the less ill on incapacity benefit into work over the next decade.

The 500 users of the centres are almost entirely on disability living allowance, i.e. the much more serious end of the spectrum.

Tulloch Kemp, Chief Executive of New Directions Camden, which runs all but the Mind Centre, defends the policy and says these patients are becoming ‘institutionalised’ when in fact the centres support them to live in their own homes and the network of friends established over years helps them to live and to stay alive.

The suicide level in Camden (already the highest in the UK – 1 suicide every ten days) is shameful and reflects badly but accurately on the Camden and Islington Mental Health and Social Care Trust – a ‘fused’ board made up of Camden Social Services and the Mental Health Trust.

The proposed closures are barbaric and stem from a clinical ineptitude that leaves me breathless. A GP friend of mine in Camden asked pointedly: ‘And just what work are these patients supposed to do and who will look after them if the centres close?’

Who indeed?

Tulloch Kemp is content to co-operate with this policy rather than fight it. In other words he will stand by as patients die by their own hand. He should resign, as should all those in power who support this truly off-the-wall onslaught on the most vulnerable.

The ‘four working groups’ set up ‘to look at how to change services to encourage recovery and social inclusion’ do not include a GP or a psychiatrist.

What about risk assessment?

Recovery cannot be ‘encouraged’ – its not a football team to be cheered to victory. The whole ‘best value for money review of day services’ is GARBAGE. I have been a carer at the ‘hard end’ of mental health since the eighties. The level of illness among patients at the day centres is only slightly above that of those on acute wards. The so called ‘STAR WORKERS’ have been described to me by one patient as ‘ Like the Gestapo.’

My message to Camden Council is STOP IT AND STOP IT NOW.

Barry Tebb

Trustee – Survivors’ Poetry, London

Losing Erville was the title of an article in The Camden Bugle which immediately reminded me of an obituary. The slush of sentiment came as no surprise to me or to any Camdenite. I shall not name the so-called user representative who authored this sickening piece of sychophancy. Suffice to say he represents only himself and always has. It appeared in The Camden Bugle, the newsletter of Camden Council Mental Health Consortium funded by the council. The director/editor operates from a swish set of offices in Hampstead Old Town Hall while Brenda Williams continues her lonely protest vigil in St. Pancras Churchyard.

The sick, slick piece about Mr Millar is in contrast to an extract from the fascinating website run by the PPIF (Patient and Public Involvement Forum).

I have been deeply concerned that there are some misconceptions regarding some of the changes proposed by the Mental Health Best Value Review.

Despite the fact that many of us will suffer from mental ill health over the course of our lives, users of mental health services often still find themselves excluded from community life.

The review aims to find ways for us to make sure this doesn’t happen in Camden. There appear to be concerns that en masse closures are being proposed and I want to reassure readers, service users and carers that day centres will of course continue to play a part in our provision. But they cannot be the only way. From the findings of the review we know that day centers alone are not meeting the needs of the vast majority of our mental health service users and in particular those who are young or from minority communities and for these reasons we are proposing some changes to our services

We need to develop ways to make sure that those who use our mental health services can access all the leisure, education and training facilities which Camden provides rather only those designated as mental health services.

In order to do this, we know that some people will need extra support and the Jamestown Centre will pilot this one to one approach. Finally, there are a lot of concerns raised about the budget for these sorts of services. In a recent survey carried out by Islington comparing their 10 closest London borough’s, Camden had the largest local authority commissioned expenditure on mental health services both in real terms and in spend per head.

Furthermore, this year Camden has invested an extra £800,000 in the mental health budget.

However this does not take away the need to make sure that the money we do spend provides a range of services which meet the needs of majority of service users in the borough.

I hope this letter has reassured readers about the future of Camden’s mental health services.

(Camden New Journal 8th September 2005)

Mental health patients marched through Camden on Tuesday in protest at the threatened closure of a day centre they call their lifeblood. About 20 furious objectors who use the Jamestown Day Centre in Adelaide Road, Swiss Cottage, marched from the centre to the town hall.

The march also highlighted threats to the Crossfields Day Centre in Fairhazel Gardens, West Hampstead the Highgate Day Centre in Highgate Road and the Barnes House Day Centre in Camden Road.

Council officers met the marchers at the town hall in Judd Street, King’s Cross, and ushered them into a side room for a heated meeting.

Jamestown Centre user Anthony Kessler, who lives in King Henry’s Road, Primrose Hill, told officials: "Every time the council says they are thinking about things, they have already made a decision. I don’t believe a word they say."

Paul Lansbury, who has used the same centre for eight years, added: "It is the only place I feel secure. There is nowhere I feel safer. People aren’t rude or nasty to me. I am able to feel like a human being. The centre is our lifeblood.

"Camden has the highest suicide rate in the country and if we end up in hospital it costs £300 a night." Another user asked: "What can we do to keep the day centre open?"

Camden Council wants to send outreach workers to patients’ homes rather than provide buildings for their care. The council carried out a consultation of 400 day centre users in June, to which l06 people replied.

Vijay Patel, 47, another day centre user said "All users said they didn’t want it to close.

"The consultation was politically engineered to avoid asking us the straight question of whether we wanted the centres."

Haverstock ward Lib Dem councillor Jill Fraser joined protesters on their march. She said: "It looks like a foregone conclusion. This centre is what makes them feel good about themselves and give them the confidence to do what they did today.

"Caring in the community is not about doing this to people."

A final decision on the future of the Jamestown Centre will be made on October 11.

Councillor Fraser will demand an explanation for the proposal from Geethika Jayatilaka, Camden’s executive member for health and social services, at Monday’s full council meeting.

Councillor Jayatilaka said: "Through this review we aim to ensure we provide the right support to everyone with mental health problems in the borough. We have already talked to the residents that need and use mental health services across Camden and it was clear that the majority wanted help to get out of their homes and on with their lives."

But Councillor Fraser added: "The fear is that closure of the centre could result in a very real tragedy."

(Ham & High 9th September 2005)

Dear Letters Editor,

Cllr. Jayatilaka’s letter is a prime example of council blather, a cleverly concocted conflation of buzz-words e.g. "social exclusion", "reassurance" (e.g. ‘we’ll do it but pretend we may not’) and factual misrepresentation.

Paragraph 3 of Cllr. Jayatilaka’s letter is intensely irritating to anyone like myself at the ‘hard end’ of mental health caring. I have a close relative on a psychiatric intensive care unit in another part of the country. The unit has beds for only ten patients to cover a large northern city, but for those who, sadly, are sufficiently ill to need its specialised services, it provides a haven of security.

Diversity in care provision has to be planned according to local need and statutory requirements, and because day centres aren’t hospitals, they can be abolished at the council’s whim without the statutory pre-closure public enquiry, thus providing easy targets for cost-cutting and eventually the selling-off of valuable freehold properties (cf. the CNJ’s in-depth coverage of the sale of just such a property ‘£1M home option is selling family silver’ p.10.)

The assertion that Camden spends more than the ten neighbouring boroughs on mental health should be qualified in that this reflects Camden’s having the highest number of the mentally ill in the U.K. and the highest suicide rate in the U.K. (one suicide every ten days) and that funding by no means solely comes from the council’s coffers. The Camden and Islington Mental Health and Social Care Trust, a "fused" body of both boroughs’ mental health and social service provisioning comes from a variety of sources, two primary care trusts (one for each borough) plus huge direct funding from the Department of Health titrated to meet the area’s special needs.

Paragraph 5 of Cllr. Jayatilaka’s letter suggests that young non-white patients don’t use the centres. If this is the case, then I am most surprised because I spend a lot of time visiting a variety of mental health facilities, and the number of patients in this ethnic category appears concomitant with current ethnicity levels and, were it not so, NHS diversity monitoring groups would long ago have drawn attention to the fact. These day centres - if the councillor’s assertions are true - need to attract these very "excluded young people" and if they don’t, the councillor should be asking her employees why they have failed to pick up on this and actually do something about it. Patients don’t just "drop in" to day centres; they have to be referred by psychiatrists, and Cllr. Jayatilaka is not to my knowledge a clinician. In my recent book "Life and Death in Camden" (Sixties Press) I pointed out that the groups set up to review day services did not include a single GP or psychiatrist, and that, from my equally non-clinical stance I believe that the proposed closures are barbaric and stem from a clinical ineptitude that leaves me breathless.

The councillor’s penultimate paragraph beggars belief and befogs the issue: it is not about or shouldn’t be about councillors deciding what’s good for patients, basing their decision on a "Day Services Review" carried out by an ill-assorted and unqualified set of housing managers and employment advisors, e.g. the usual set of carefully chosen Camden Council aparachiks. There should be a competition for the "Aparachik of the Year" and Tulloch Kemp, Chair of New Directions Camden, who runs the centres and has chosen to cooperate with the closures rather than oppose them, would be my nomination. Who pays Mr. Kemp’s wages? Surely, however indirectly, it is the Council.

I quite agree that a "Mental Health Plan" is certainly needed, but as Cllr. Jayatilaka’s letter is noteworthy only for unproven allegations of social exclusion, factual distortion and the worst kind of political gerrymandering, she is the last person I would want to be in charge of any such plan. Camden Primary Care Trust employs highly qualified, experienced and specialised Care Commissioners like Caroline Blair and, had she been drafted in, I am sure, that she could have inexpensively, expeditiously and compassionately made suggestions which wouldn’t have begun by depriving the most vulnerable of their only lifeline.

Yours sincerely,

Barry Tebb

Dear Lord Falconer,

I was angry and distressed to see the way in which the St Pancras Camden Coroner conducted the inquest into the death of Margaret Walsh yesterday.

Dr. Reid’s predecessor, Dr. Chan, was dismissed and fled the country and I had hoped that his successor would have been an improvement, but this does not seem to be the case. I was present when Dr. Chan carried out the inquest into the death of Christine Blake and he was perfectly professional. Dr. Reid’s ‘performance’ yesterday was outrageous: the half dozen of her friends, including myself, were angry beyond words and one felt her only appropriate response would have been to walk out.

I am a campaigner for better mental health standards in Camden, which has the highest suicide rate in the country - 1 every 10 days. I have been a mental health carer on and off since the 80’s and I think it would be fair to say I have considerable knowledge and experience.

I wrote to Dr. Reid many weeks ago and enclosed the two books I enclose herewith. There can be no question of his not having received the packet because I saw one of his officers carrying the two books yesterday.

I raised a number of points which (as a newcomer to the area) he might have been unaware of and some details regarding the case that had come to me through various reliable sources, e.g. fellow patients of Margaret’s.

Dr. Reid did not have the common courtesy to acknowledge my letter. Are coroners above such things?

When I phoned to request that I be given the date of the inquest, I was told that I must ‘sit at the back and keep quiet’. Does Dr. Reid suppose I am in the habit of interrupting court proceedings?

But these are inconsequential compared with the actual inquest. The circumstances leading to Margaret’s death were complex, and the leading witness, the gum-chewing crisis team worker, gave the impression that she’d been told she’d be given ‘an easy ride’ as indeed she was. Very briefly, Margaret had been deteriorating for a number of weeks and had taken an overdose only a fortnight before her death. Hospital admission would most certainly have been indicated, and had this been done I’ve no doubt Margaret would be alive today.

Dr. Reid elicited few facts which I didn’t already know, but some were of great significance, but in no way did Dr. Reid draw attention to them, nor indeed to any issue did surrounding the way the crisis team handle her case.

I will be frank and state I have no faith in crisis teams in general as they tend to aim at keeping patients out of hospital, and risk assessment in this area is highly subjective.

Various events occurred up to the period prior to Margaret’s death which showed she was worsening, but still no action was taken to hospitalise her. Indeed the crisis team worker admitted she had spoken to Margaret the day before the fatal overdose and saw ‘No cause for concern’. The question of hospital admission was mentioned (very briefly) and the onus of responsibility was shifted to Margaret and it was stated that she felt this option was ‘not for her’. Yet I know (by hearsay, I agree) yet I still do know that she had told another patient on the previous Friday, three days before her death, that she would ‘do anything’ to get a ward admission but was ‘afraid to ask’.

I reported this to Dr. Reid, but he failed to follow up on it - as he did on all matters I put to him.

The Crisis Team manager has a very bad reputation. A patient who is ‘under’ her described her as ‘a right cow’ when I spoke to her on the phone after the inquest, and her power clearly vastly exceeds her knowledge capabilities.

Margaret’s CPA status had been downgraded from enhanced to standard, a few weeks previously, yet she was clearly worsening as the two overdoses, one fatal, demonstrate.

My distress is not just about the facts of the case, but about the ‘rubber stamp’ atmosphere of the Court. Dr. Reid could and should have asked some hard questions. As he is, I gather, a doctor and a barrister, he should have been well trained in this area, yet he allowed the crisis team worker to mumble her evidence so not everyone could hear her, failed to challenge her on a single point, and failed to ask her to explain to those present what terms like ‘CPA’ (Care Programme Approach) actually meant.

In the month preceding the inquest, I suspect Dr. Reid was ‘warned off’ me because of my vigorous campaigning. Clearly, if this was the case, he should not have listened. The quality of mental health care in the area is appalling. At present, the Medical Ombudsman is formally investigating a case I have brought against the Primary Care Trust and a case I have brought against the Camden & Islington Mental Health & Social Care Trust. Formal investigations are not begun until an in-depth screening over many months has taken place - there have to be grounds far more significant than a normal ‘prima facie’ possibility.

Brenda Williams and I are very unfortunate in having a son who, although hugely gifted (a King’s Scholar at Eton and the holder of two degrees in Classical from Balliol) suffers from the most untreatable kind of schizophrenia. He and we are very fortunate in that he is in the care of the Leeds Mental Health NHS Trust, whose excellence is demonstrated to us month after month, year after year, in their care of him.

The very last thing any judicial authority in Camden should do is listen to any smear campaign against me, put out by the very people responsible for the appalling state of affairs that exists in the area and which I outline in my books.

I believe Dr. Reid needs reminding of where and to whom he is responsible, and that the death of any subject is a tragedy, not only for the family but for the community, and this particular death was, in my opinion, totally unnecessary.

Yours sincerely,

Barry Tebb

Congratulations to the Ham & High for its splendid coverage of Brenda Williams’ protest against the failure of crisis teams. In the NHS there’s a saying ‘Crisis teams can deal with anything except a crisis!’ In Leeds there are crisis resolution teams, whose job it is to find a bed urgently when home-care has failed. I know of no such facility in Camden.

Congratulations also to the Archant Group (the Ham & High’s owners) for launching ‘The Camden Gazette,’ a free paper aimed at breaking the stranglehold of ‘The Camden New Journal’. Readers may wonder why it is the Ham & High that has twice given coverage to Brenda Williams’ protest while the CNJ has avoided them like the plague. Could it perhaps be that John Carrier (Chair of Camden Primary Care Trust, which received only one star in the recent ratings) has two sons on the editorial staff of the CNJ and ‘not rocking the boat’ is more important than telling the public about local NHS failures.

Brenda Williams and I are not protesting only about the proposed closures of the day centres for the most chronically mentally ill (detailed accounts of these and other local matters of concern are to be found in my Life and Death in Camden (Sixties Press.) All matters are serious but none more so than the Ripper case and the subsequent much delayed non-inquiry whose report runs to more than 240 pages. Knowing from the very beginning that a whitewash on the grand scale had been ordered I got in touch with Jackie Valad and with her intrepid solicitor, Victoria Johnson of Betesh Fox.

Victoria and another partner travelled from Manchester and spent an afternoon with Brenda and myself (for which they received not a penny) discussing the details of Brenda’s own case (now with the Ombudsman) and the ramifications of the Ripper case. Victoria is one of the country’s most brilliant lawyers in the small but vital group which deals with ‘public interest matters’ which usually end in the European Court of Human Rights.

So much is wrong with the Ripper report that it will take me a book to rebut its manifold inadequacies. The use of a forensic psychiatrist as an expert witness who happens to be from Brent, Camden’s neighbouring borough and one which is also under the suzerainty of the same strategic health authority does not bode well. (It was the SHA who, on the orders of the Dept. of Health, commissioned the report in the first place and arranged who was to be its members.)

The inquiry’s ‘No one to blame’ conclusions insults the living and the memory of the dead. ‘The worse the action the more mad the perpetrator’ is a useful summary of progress in psychiatry since Freud.

David (not his real name) a friend of mine who knew Hardy well, said "He was always raving mad and often high on drugs or drunk. I never once saw him when he could remotely be classed as sane." Wisely the legal definition of what constitutes insanity is ‘What the average person would believe.’ No one (professional or lay) could ever believe the curious conclusions of the inquiry that Hardy’s mental state was clinically normal at the time of the killings. The forensic psychiatrist who came to this astonishing and convenient conclusion could be referred to the GMC’s ‘Fitness to Practice’ Directorate and this could be done by Brent PCT but somehow I suspect that this august body will take its lead from the Strategic Health Authority and not tread on any toes.

"You need to tread on toes to keep people on their toes" a manager of Supporting People Camden said of my campaigning but as all NHS complaints systems except the Ombudsman are deeply flawed, so I write books instead with "Let Loose in Camden" as a working title . I’ve been asked by Kester Aspden, formerly a lecturer in history at Leeds University and currently finalizing his book on the notorious Oluwale case (to be published next year by Faber) to help fill in the background for a much more detailed study of Hardy.

A carer ‘at the hard end’ since the 80’s I’ve visited acute wards and psychiatric intensive care units and in my view (in most people’s I suspect) Hardy should have been sent to Broadmoor years ago. The reports by the forensic psychiatrist who sent six red-letter warnings about releasing Hardy and not shown to the panel which discharged him, together with his full ‘confidential’ medical report so carefully and determinedly guarded by Erville Millar (Chief Executive of Camden and Islington Mental Helth and Social Care Trust) would prove the case for his confinement. However dreadful his actions, Hardy is very mad and was so for many years. Millar’s defence of Hardy’s discharge is indefensible and I suspect it was Millar who ‘moved’ Hardy to a less hard-line psychiatrist, thus facilitating his release, as no one but a chief executive has such power.

Who was that psychiatrist? The 240 page report names no names. This psychiatrist’s name is key in untangling the puzzle – a view shared by Debbie Abrams OBE, Investigations Manager of the Healthcare Commission. My request that the Commission investigate the role of managers in Hardy’s release was at first accepted until John Hutton, then a junior minister but in reality deputy Secretary of State, overruled Sir Ian, saying such an investigation ‘would only duplicate the ongoing inquiry.’

Hardy’s trial was botched beyond belief. The prostitute who was to be the Crown’s main witness told me how she was suddenly ‘no longer required’ when defence and prosecution barristers went into a huddle when Hardy charged his plea. No evidence was presented so I have written to the Director of the CPS, asking for it to be released under the freedom of information act.

Neither Margery Wallace of ‘Sane’ (‘liberal’) nor Michael Hewitt of the Zito Trust (‘lock ‘em all up’) come out of this well. Wallace especially seems to think Millar a good man and a great loss when he leaves Camden in December. The present mental health act does provide ways of detaining patients as ill as Hardy as being ‘a danger to others.’ His career as a serial rapist, periods of imprisonment and enforced detention in psychiatric units, if known to the panel would have prevented his discharge.

I lived in Leeds during the period of the Yorkshire Ripper’s reign of terror when the streets were deserted after dark and a policeman rode shotgun on every bus. At the trial the judge refused to accept an insanity plea and insisted that the public ‘had the right to a trial.’ How wise he was: justice needs to be seen to be done. (Sutcliffe was briefly imprisoned but after a violent incident sectioned under the act and transferred to Rampton, where he remains.)

In view of the Hardy inquiry’s failure to do anything but apply whitewash in large quantities it is clear that a public inquiry is the only way forward. Victoria Johnson is one of the Country’s leading public interest lawyers. She has a razor sharp mind and the passion that goes with it and it is these qualities she puts into her cause, the case for justice for Jackie Valad’s granddaughter, whose mother was murdered by Hardy. Leaving justice to a gang of aparachiks who came out of a 12 month inquiry waving a banner proclaiming ‘No one to Blame’ leaves the powerful and guilty to continue to enjoy their high salaries, prestige and perks while the victims’ families are abandoned to their grief and anger at such a conspicuous betrayal.

In order to gain justice (which they did) grieving parents recently brought an action for ‘Malfeasance in Public Office,’ a statute that has lain dusty in law books since the seventeenth century but might just meet a case such as this.

Barry Tebb

Camden and Islington Mental Health Trust has defended its treatment of Margaret Walsh, who took an overdose in May. Friends of Ms Walsh, who was artist Damien Hirst’s god mother, say she was denied a hospital bed and are staging a protest about her treatment outside St Pancras Coroner’s Court.

A spokeswoman for Camden and Islington Mental Health and Social Care Trust said: "The Care Trust understands that Margaret Walsh’s family and friends remain distressed about her death. However, their criticisms are at odds with the thorough and independent inquiry into this case carried out by Her Majesty’s Coroner. The care trust has more than 400 people in in-patient care and no mental health day hospitals have been closed in Camden. The recent Healthcare Commission survey found that 76 per cent of our service users rated their care as good, very good or excellent. The Care Trust would like to extend our condolences to the family and friends of Margaret Walsh, but we confident that the care she received was comprehensive and appropriate, and indeed the coroner’s summing up reflects this."

Ms Walsh died in her flat in Dennington Park Road in West Hampstead on May 9.

Note: The 76% who rated services as ‘good, very good or excellent’ is the average national figure released by CHAI and does not relate to Camden in particular.

BT

Camden’s social services boss has been warned that controversial proposals to close mental health day centres will lead to more suicides.

Pressure is mounting on Labour councilor Geethika Jayatilaka - the department’s elected chief for the past two years - to scrap plans to shut Jamestown Day Centre in Adelaide Road, Chalk Farm. She dodged questions on the proposals when angry service users marched on the Town Hall last week only to find her unavailable to meet them.

This week, she was put on the spot when opposition councillors turned the closure threat into the most hotly debated issue at Monday’s full council meeting. Liberal Democrat councillor Jill Fraser said: "This much-loved resource (Jamestown Centre) is a lifeline to many vulnerable people who are now afraid that, without its services, they will have nowhere to socialise and will be subjected to long hours of loneliness in their homes. "The fear is that closure of the centre could result in a very real tragedy."Her concerns were echoed by Lib Dem colleagues, including Councillor Heather Thompson, who added: "I have suffered from depression and anxiety and I know the need to communicate with people who empathise.

"I have no doubt that if the day centres close there will be an increase in suicides and hospital admissions."

The Jamestown centre, which opened in 1968, is the biggest of Camden’s six mental health day centres. It faces the axe as council chiefs review spending and the £1.5 million the Town Hall pumps into keeping day centres operating. With its large garden and pond, it has become a haven for sufferers of mental illness. It holds cooking courses to help build sufferers’ self esteem and runs schemes to encourage people back to work.

Lib Dem concern about the threat to the centre - seen by supporters as a vital contact point for mental health service users - was matched on the Conservative benches.

Councillor Jonny Bucknell said: "I popped in there today and I was quite impressed with what was going on. This is a precious service in an area where there are many people suffering from mental health problems."

Labour accused political opponents of causing panic among the borough’s most vulnerable residents. Former social services Chief Councillor Penny Abraham directly accused them of scare mongering. A final decision is due next month on the proposed cuts, which come after a 12 month "best value" review of Camden’s services.

But Cllr Jayatilaka gave no hint that the closure plan will be reversed. She told the meeting "It is a very emotive issue. Three out of four service users do not access day centres. We want to focus on coalescing services. We need to ask why we are spending 60 per cent of our daycare budget on people who make up a quarter of service users. We need a borough to listen to them and provide for them." Cllr Jayatilaka added in a written explanation to councillors: "Where the needs of service users are best served by building-based service then this type of service will be provided."

Friends of Damien Hirst’s godmother, who committed suicide in May, have begun a pavement protest against Camden and Islington Mental Health and Social Care Trust.

Margaret Walsh, a writer and poet, was found dead in her flat in Dennington Park Road in West Hampstead on May 9.

An inquest held last week at St Pancras Coroner’s Court revealed that her death was due to an overdose of alcohol and medication. But her friends are angry with the way she was treated by mental health services and have pledged to campaign outside the court every day for the next nine months.

Brenda Williams, a poet from St John’s Wood, said: "At the inquest I was hoping something about the way she was handled by the trust would emerge, that the coroner would investigate more.

"There was a delay in getting to her and getting help but it wasn’t investigated. Margaret told the crisis team she was desperate for a bed in the Royal Free Hospital, but they follow this rule of keeping everyone in their homes. "I suffer from depression and I know that is the worst place to be because you feel more and more depressed and alone there. I think she expected to be found but when the care workers did get the police to break in it was too late. She was full of life, she suffered with depression but she knew when she needed a bed. People are dying in Camden because of these crisis teams and no one is doing anything. Previously when she was ill she went to day hospital and it always brought her round. But Camden is closing these down too. All her friends feel the same both those with mental health problems and those without."

Ms Walsh, who openly criticised the work of her artist godson, had survived two previous suicide attempts. The most recent one led to care workers visiting her at her home daily.

Ms Williams’ ex-husband Barry Tebb, who is also protesting, said: "Camden has the highest suicide rate in the UK, if Margaret had been in a ward she wouldn’t have died. I think it is the worst mental health trust in the country. Being visited by a care worker doesn’t work. Margaret was a very talented woman. She had a play at the Tricycle Theatre and she could have gone to Oxford when she was younger. She was a great character and very energetic. They have this very silly idea that all these people should have jobs and be in the community but they are at the extreme end of psychotic illness and they should be taken care of."

They come to me like wraiths out of the mist,

Lost, insignificant, the dispossessed

Searching for their shadow mislaid or missed,

Effaced from the day. They linger oppressed

Without end with the knowledge of someone

Since forgotten that will not go away,

They pass with only their own reflection

For consolation outstaring the day,

The outlandish night left there, endlessly

Merging as an early oblivion

And into everything they cannot see.

And sometimes in dreams, in low light unshone,

From echoes remembered something is heard

Yet recurring mnemonic and conferred.

31st October-6th November 2003

They trace the heel of the day forever

In front, with something of a life straight from

The heart as they react between after

And before, held in its arc as they come

And go with a truth that has come apart

And a name’s echo they cannot go back

To, a future that refuses to start,

That stalling lies abandoned in its track.

The last light of a day is all there is

Left, the sudden footsteps falling away,

Throbbing endlessly through the arteries

Of a life on hold with nowhere to lay

Its head, hollowing out a centrifuge,

An open dark without any refuge.

7th-12th November 2003

Brenda Williams

Barry Tebb sees his own poems as ‘an urchin gang sobbing and snotty-nosed.’ Like children they are oddly alert. An ogress who chewed the dangling stumps of her teeth taught him religious instruction. He remembers the school-smells - chalk-dust and stale urine - and sniffs, like little Hanno Buddenbrook, a new coffin’s fragrant pine wondering why it is so obscene. He plays at patterning the frosty pavement with his footprints and watches the ‘mist-making strollers.’ The love poems are precocious and outspoken. Mr. Tebb mixes innocence and experience compellingly.

Heartfelt and always the real thing

Barry Tebb’s visionary poetry of Leeds.

I like that Perfect Rose

I found ‘The Lights of Leeds’ utterly absorbing and moving. 1 found myself compulsively reading the poems like ‘My Perfect Rose’ and ‘Uncle Bob’ which sputters into silence as he did.

I loved it.

Yet ‘Follain’s Leeds’ is also Paulin’s and the notable poetic rhubarbarians include Harrison, Silkin, Heath-Stubbs, Hill, the Apocalyptics, J.F. Hendry, Dorian Cooke and Keidrych Rhys, who passed himself off as Dylan Thomas to obtain drinks in local pubs and

Barry Tebb, whose wonderful day-glo Sixties Press productions keep the Apocalyptic flame alive.

He is plain spoken and lets us know his enemies. Trendy poets are among them. He has plenty to say and he says it with verve and wit and in as contemporary a diction as any…a fine user of words but a risk-taker... ‘The Road to Haworth Moor’ captures with aching tenderness the Wordsworthian dream that took the young lovers to the ‘crooked corner of an old house they made into a home with a few hundred books and leftover furniture bought at auction’... Here is a poet whose work operates on different levels and whose deeply felt, vividly written poems are beacons of light in a world where true poetry too often has to give way to the superficial prosiness of impostors.

Barry Tebb is a wild card, a delightfully awkward old cuss, as anyone who is lucky or unlucky enough to regularly receive his spirit duplicated, Sixties Press published ‘Poetry Now’ pamphlet, will already know. Barry Tebb is a stubborn survivor whose life is full of poetry in every sense. Treasure it!

In his ‘Plea for a History of Working-Class Leeds’ Barry Tebb wants a true history of his city. He has already dug the foundations and scrutinized the scars.

One Carer’s Story - Barry Tebb       Schizophrenia - A Carer’s Journal - Mike

     Schizophrenia – A Mother’s Story – Georgina Wakefield                         My Journey Of Sadness – Stan Hagon

                                       The Voice Of Carers – Amanda Cummin           Yemeni Carers’ Stories – Debjani Chaterjee

   Beyond Our Reach, But Not Our Love – Brian D’arcy                        Carry On Caring – Emily Machin & Lucy Machin

     Enigma And Other Poems - Georgina Wakefield                        Killingbeck Drive – Brenda Williams

      Searching The Beyond And Other Poems – Daisy Abey     Sharp Edge – Daisy Abey     The Long Good Bye – Barry Tebb

      Looking Back – Barry Tebb     Nameless In Camden – Brenda Williams      Autobiography – Simon Jenner      

The Sick Image Of My Father Fades – John Horder      Are You A Carer?      Caring About Carers