Monday 8 February 2016

Ymddygiad gwrth-gymdeithasol a iechyd meddwl – beth mae gwasanaethau angen ei ystyried? Anti-social behaviour and mental health – what do services need to consider?

Meddyliau o brosiect ymchwil gan Philip Moisson
Thoughts from a research project by Philip Moisson

Gall ymddygiad a dargedir gan y ddeddfwriaeth ar ymddygiad gwrthgymdeithasol fod yn arwydd o broblemau iechyd meddwl (fel yr ysgrifennwyd amdano yma - efallai y bydd y cynnwys yn peri gofid i rai darllenwyr). Mae'r blog hwn yn ymwneud â phroject ymchwil yr ydym newydd ei gwblhau a oedd yn canolbwyntio ar 'bobl fregus ac ymddygiad gwrthgymdeithasol'. Bu i ni edrych sut yr oedd ymarfer cyfredol yn edrych i bobl â phroblemau iechyd meddwl y mae ymddygiad gwrthgymdeithasol yn effeithio arnynt, naill ai fel dioddefwyr, tramgwyddwyr neu dystion.

Behaviours targeted by the anti-social behaviour legislation can be a sign of mental health problems (as written about here - some readers may find the content upsetting). This blog is about a research project we have just completed that focused on ‘vulnerable people and anti-social behaviour’. We explored what current practice looked like for people with mental health issues who are affected by anti-social behaviour, either as victims, perpetrators or witnesses.

Roedd fy rhan fy hun yn y project hwn fel hwylusydd grŵp ffocws, ac roeddwn i'n un o'r bobl a hyfforddwyd gan academyddion o Brifysgol Bangor i wneud hyn ochr yn ochr â phobl eraill mewn cysylltiad â PAVO ac Unllais yng ngogledd Cymru. Mae'n hynod o bwysig i bobl â phrofiad o hyn fod yn rhan o'r broses o gasglu a mireinio gwybodaeth am y materion hyn, a chwarae rhan wrth ffurfio argymhellion ar gyfer arfer da.


My own involvement in this project was as a focus group facilitator, and I was one of the people trained by academics from Bangor University to do this alongside other people in contact with PAVO and Unllais in North Wales. It is incredibly important for people with lived experience to form part of the process of gathering and refining knowledge on these issues, and in playing a part in forming recommendations for good practice.

Yn ein cyfarfod cyntaf cawsom roi cynnig ar gymryd rhan mewn grŵp ffocws, lle bu i ni drafod un o'r senarios a baratowyd yn ofalus, a oedd yn troi adroddiadau heddlu go iawn ar ffurf hanes ffuglennol bywyd cymeriad. Ar ôl hyn, fe wnaeth ein hyfforddiant ein harwain at gyflwyno'r grwpiau ffocws a chawsom ein gwahodd yn ôl hefyd i drafod y canfyddiadau o'r ymchwil cyn cadarnhau a chyhoeddi pethau. I rywun fel fi sydd ag amser sbâr, mae bod yn rhan o broject fel hwn yn arbennig o ysgogol.


At our first meeting we had a go at taking part in a focus group, where we discussed one of the carefully prepared scenarios which turned real life police reports into the form of a fictional account of a character’s life. After this our training led us onto delivering the focus groups and we were also invited back to discuss the findings from the research before things were finalised and published. For a person like me who has spare time, being involved in a project like this is incredibly stimulating.


Yr hyn yr oeddem ni'n ei wybod o'r cychwyn yw bod yr heddlu'n aml yn cael eu rhoi mewn sefyllfaoedd amhosib wrth ddelio ag ymddygiad gwrthgymdeithasol yn y ffordd fwyaf effeithiol. Er enghraifft, efallai nad ydi'n briodol bob amser gorfodi sancsiynau sifil neu droseddol, a bydd llawer o sefyllfaoedd lle mae dyletswydd gofal yn bodoli yng nghyswllt unigolyn bregus. Hefyd, mae trefnu cydweithio rhwng amrywiaeth o wasanaethau yn aml yn anodd yn yr amgylchiadau hyn.

What we knew from the outset is that the police are often put in impossible situations in dealing with anti-social behaviour in the most effective way – for example it may not always be appropriate to enforce criminal or civil sanctions and there will be many situations in which a duty of care exists to a vulnerable person. Also, organising collaboration between a range of services is often difficult in these circumstances.

Prif amcanion y project yn gyffredinol yw deall y set o broblemau uchod o safbwynt gwasanaethau, ac o safbwyntiau defnyddwyr gwasanaeth a gofalwyr. Roedd y project hefyd yn ceisio tynnu sylw at ffyrdd y gall gwasanaethau gydweithio, a chydnabod yr hyn a allai fod yn rhwystro hyn ar hyn o bryd.


The main aims of the overall project were to understand the above set of problems from the perspectives of services, and from the perspectives of service users and carers. The project also sought to highlight the ways in which services can work together and to acknowledge what might be preventing this at present.

Drwy gyfweld ag amrywiaeth o weithwyr proffesiynol a sgwrsio efo defnyddwyr gwasanaethau a chynrychiolwyr gofalwyr yn ein grwpiau ffocws, mi gasglwyd llawer iawn o ddata i'w dadansoddi. Mae ymddygiad gwrthgymdeithasol ei hun wedi cael ei ddiffinio gan ddeddf seneddol 2014 fel “Ymddygiad sydd wedi achosi, neu sy'n debygol o achosi, aflonyddwch, braw neu ofid i unrhyw un.” 

By interviewing a range of professionals and talking to service user and carer representatives in our focus groups, a large amount of data was gathered for analysis. Anti-social behaviour itself has been defined by a 2014 act of parliament as “Conduct that has caused, or is likely to cause, harassment, alarm or distress to any person.”

Roedd gan lawer o'r rhai a gymerodd ran yn y project wahanol safbwyntiau ar hyn, ac roeddent yn pwysleisio nad oedd pethau bob amser mor glir wrth siarad am bobl fregus. Mae'r heddlu felly'n aml mewn sefyllfa annifyr wrth benderfynu sut i ymdrin efo pobl sy'n achosi problemau heb fod o'u gwirfodd.


Many participants in the project had different views to this, and emphasised that things were not always so clear cut when talking about vulnerable people. The police are therefore often in an awkward position in deciding how to deal with people who are not wilfully causing problems.


Daeth llawer o argymhellion gan ddefnyddwyr gwasanaeth a gofalwyr allan o'r project, a dyma rai ohonynt:
  • Mae ar sefydliadau statudol angen gwybod mwy am waith da'r sector gwirfoddol.
  • Mae ar asiantau angen cydweithio i helpu'r unigolyn mewn angen, yn hytrach na chael ateb wedi'i ddiffinio ymlaen llaw wedi'i seilio ar label, h.y. ‘sgitsoffrenig- angen meddyginiaeth.’
  • Dylai'r heddlu a thimau iechyd meddwl gydweithio mewn timau blaenoriaethu (neu triage) a dysgu swyddogaethau'r naill a'r llall.
  • Mae Eiriolaeth Iechyd Meddwl yn hanfodol.
  • Mae angen cryfhau hyfforddiant i heddlu yng nghyswllt gofid a gwrando.
  • Dylid defnyddio gofalwyr ac aelodau'r teulu bob amser gan fod ganddynt lawer o wybodaeth. Dylai defnyddwyr gwasanaeth a gofalwyr bob amser fod yn rhan o'r cynllunio a gwneud penderfyniadau.
  • Mae cydymdeimlad, parch ac urddas wrth ddelio â phobl i gyd yn hollbwysig
  • Mae tai a ffactorau cymdeithasol eraill yn bwysig iawn.
  • Mae'r system cyfiawnder troseddol yn amhriodol i bobl mewn gofid difrifol
  • Dylid ceisio cael atebion tymor hir yn hytrach na mesurau sy'n datrys pethau'n gyflym ond dros dro.
There were many recommendations from service users and carers that came out of the project, and here are some of them:
  • Statutory organisations need to know more about the good work of the voluntary sector.
  • Agencies need to work together to help the individual in need, rather than have a pre-defined solution based on a label, ie ‘schizophrenic- needs medication.’
  • Police and mental health teams should work together in triage teams and learn one another’s roles.
  • Mental Health Advocacy is crucial.
  • General training for police around distress and listening needs to be bolstered.
  • Carers and family members should always be utilised as they have a lot of knowledge. Service users and carers should always be involved in planning and decision making.
  • Sympathy, respect and dignity in dealing with people are all paramount.
  • Housing and other social factors are very important.
  • The criminal justice system is inappropriate for people in severe distress.
  • Long term solutions should be aimed at rather than quick-fix measures.
Mi wnes i helpu Anne Krayer wrth gyflwyno'r canfyddiadau hyn a chanfyddiadau eraill i grŵp yn cynnwys gweithwyr proffesiynol iechyd meddwl ac uwch swyddog yr heddlu'r wythnos ddiwethaf. I mi'n bersonol, os ewch chi â dim ond un peth o'r ymchwil hon, hynny fyddai ei bod yn hanfodol i'r holl bobl ac asiantau, yn cynnwys yr heddlu, grwpiau yn y sector iechyd, gofal cymdeithasol, tai a gwirfoddol, ddeall ei gilydd, a chyfathrebu'n gyson â'r naill a'r llall i ddatrys materion cymhleth iawn.

I assisted Anne Krayer in presenting these and other findings to a group consisting of mental health professionals and a senior police officer last week. For me personally, if you only take one thing from this research, it would be that it is vital for all of the people and agencies, including the police, health, social care, housing and voluntary sector groups to understand each other and to constantly communicate with one another to solve very complex issues.

Am fwy o wybodaeth, cysylltwch ag Anne Krayer ym Mhrifysgol Bangor: a.krayer@bangor.ac.uk

For further information please get in touch with Anne Krayer at Bangor University: a.krayer@bangor.ac.uk


Cyllidwyd yr ymchwil gan Lywodraeth Cymru trwy Ymchwil Iechyd a Gofal Cymru


The research was funded by the Welsh Government through Health and Care Research Wales


2 comments:

  1. I would like to comment on my observations concerning mental health and policing 1. patients or cared for sometimes have Co Morbidities as well as mental health problems and need regular Physical health reviews which mental health nurses and social workers and the police never consider as important when planning care . who takes responsibility when things go wrong ? IT IS ALWAYS THE CARERS FAULT . I always find this very sinister. It is no wonder that hospitals are in Special Measures ! Carers are best placed to know when cared for need specialist care, We need to be listened to, Not punished or criticised. I would also like to point out that social workers like to use words like DANGEROUS BEHAVIOUR as a means to keep patients incarcerated in unsuitable placements( usually mental health hospital ) this practice has to stop. Dangerousness should only be used when it has been proven to be so by a court of law not the whim of a Social Worker or a collection of authorities that DO NOT HAVE THE BEST INTEREST OF THE PATIENTS IN MIND or their relatives.

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    Replies
    1. Thank you so much for your comment and for sharing your thoughts with us. We found from conducting this research that this is a highly emotive topic for many people. One of the recommendations is very close to what you are saying here- that carers need to be listened to as they are the people with the specialist knowledge in many circumstances. Your comments about 'dangerousness' are passionate ones too. One thing we can say is that we fed back from this research to a wide range of organisations, (including the police) and we sincerely hope that good, co-operative, multi-agency practice can be furthered.

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