A PhD candidate’s account of her time at The Centre
Early in 2019 Ligia Bugelli Hermano Santos, a PhD candidate at the University of Coimbra in Portugal spent a short internship with the CfMH&S. This is a brief account of her learning experience at the Centre.
“I spent a substantial part of the time looking at the work of Caniad and also the NPS project in Wrexham. Caniad is a joint Hafal’s and Cais’ project, commissioned by Betsi Cadwaladr University Health Board and North Wales Area Planning Board. Its mission is to involve people who use mental health and substance misuse services, in the planning, design, delivery and evaluation of services.
Hafal is the principal third sector organisation in Wales working with individuals recovering from serious mental disorders and their families. Cais has been a leading provider of substance misuse services in Wales and operates a medically managed detox service in Wrexham. These two organisations are dedicated to empowering people to fight discrimination, achieve recovery and help them to enjoy equal access to health and social care, housing, income, education, and employment. They are therefore of considerable interest from a human rights perspective.
The NSP (New Psychoactive Substances) Project arose out of the need to respond to a public concern about the numbers of drug users congregating in the town of Wrexham. Complaints from members of the public meant that at any time officers were deployed to this issue and away from other duties. The increasing levels of Synthetic Cannabinoid use across Wrexham and the Town Centre led the police to understand that this is not only public order problem but also a health and social care issue. In response to this realisation, a crises management strategic level ‘Gold’ group was assembled by North Wales Police, consisting of the Assembly members (members of the Welsh parliament), HM Government Member of Parliament for Wrexham, Wrexham local authority, the health board, and local charities for NPS (such as Caniad). The NPS taskforce aims to integrate all the relevant social services in town, together with health services access to housing providers and social workers’ support; the meeting that I attended was to discuss the continuation of this initiative.
By providing a joined up response with a single point of contact but multi-agency provision, the NPS taskforce has been successful in meeting the local needs and has already achieved national recognition. Other regions and cities in Wales and wider across the UK have identified similar problems and as a result are looking to the service model set up in North Wales as an exemplar for moving forward in meeting the challenging experienced in different areas. The NPS Gold project of Wrexham is being treated as a Good Practice that can be replicated elsewhere and has a great potential of becoming a national and global public policy and I would like to be part of it! Since undertaking this internship my supervisor at the University of Coimbra has agreed that I can study this project further as part of my PhD so I am getting my wish!
I observed several other interesting meetings and there are too many to report on all of them so I will just briefly mention two. The Forum meeting aims to identify and maintain pro-active procedures about the criminal justice, substance misuse and mental health gateways, in order to support delivery of best practice in service user’s engagement, empowerment and civil rights. The members have the chance to better understand how the mental health services are being delivered in daily life and some gaps that may need to be addressed. This initiative is a great example of co-production and how the service users can become directly involved in the decision-making processes that affect them, from the beginning.
I also observed the Community Care Hub, which is the place that the homeless people with substance misuse problems, including those from NPS project, have access to a different kind of health service. It is a space provided by The Salvation Army in which they can gain instant access to a GP appointment, nurses, Mental Health attention, Probation, Department of Work and Pensions support, Housing Providers and Substance Recovery Workers, all in one place, as well as a cup of tea and some toast.
To sum up, my brief experience in North Wales’s mental health devices, better exploring the research projects in this field and observing the NSP and other Caniad projects, allowed me to broaden my perspective about the international human rights treaties in the sense that they can actually be put into practice. The UK government (in contrast to some others around the world) realized that it is more advantageous to provide genuinely integrated community health and social care to the population, to tackle unemployment, homeless, drug abuse and so on rather than wait until the problem has become so bad that institutional solutions are all that is left.
Finally, again in contrast to some other countries, I observed that all of the professionals involved has a shared mindset. Regardless if it is a GP, nurse, psychologist, occupational therapist, police person, psychologist, dentist, social worker, carer, whoever health professional is, their mind is set on the following principles: non-stigmatization, treat with dignity and respect, users empowerment, safe environment, involvement and engagement and, most of all full recovery of the human being. All the services, meetings and conversations that I had the opportunity to be part of, were almost very much compliance with the Human Rights legislation and I realized that a major concern was how to put into practice all the values, lessons learned and human rights’ guidelines to improve policies and services. This means that with a will and with support these values can be operationalized, an important lesson for countries struggling with the nurture of these values and putting them into practice.”
We are grateful to the agencies mentioned for facilitating this internship, and look forward to seeing Ligia back in Wrexham to continue her studies.