Plans to slash NHS mental health services in Cambridge to meet government-imposed budget cuts have been met with defiant resistance.
An occupation of part of the Tenison Road building which hosts the Lifeworks service is approaching its sixth week.
Service users won an important victory this week in their battle to stop the closure as Cambridgeshire county council's scrutiny committee asked the mental health trust to reopen Lifeworks while it conducts a consultation exercise, something which it had failed to do prior to announcing the plans.
The service, which offers support for those with personality disorder and borderline personality disorder, had been scheduled to close as part of a wider service redesign by the Cambridgeshire and Peterborough Foundation Trust (CPFT).
The trust, which faces a £6.5 million budget cut next year and is one of the most poorly funded in the country, embarked on a reorganisation exercise in 2011.
As a result of this financially driven restructure, the decision was taken earlier this year to close Lifeworks, part of the Cambridge complex cases service which has been operating for the past 12 years.
Mental health services across Cambridgeshire have been decimated over the years. Budget cuts in 2004/5 saw the closures of the S4 adult acute inpatient service, elderly mental health wards and the long-term rehabilitation unit along with community services and day centres.
The children and young people's service saw the closure of a unique therapeutic community for those aged between 17 and 25.
Warnings at the time, including a letter from 27 consultant psychiatrists condemning the cuts, were ignored as health bosses claimed that financial constraints meant they had to close services in order to balance the books.
Widespread opposition from trade unions, pensioners groups and mental health charities culminated in a demonstration and rally in central Cambridge.
There was a hostile response from the trust, which took a heavy-handed approach to those trying to speak out against the cuts by imposing a gagging order with the threat of disciplinary action against staff if they spoke to the media.
Despite the mass opposition and a delegation to the then Labour health secretary Andy Burnham calling for a halt to the cuts, the closures went ahead.
This has left Cambridgeshire with a severe shortage of services, and those services that should be in place to support people following the closure of Lifeworks either no longer exist or are already overstretched.
Concerns have been raised by local organisations which say they do not have the capacity to support any more people than they already do.
The trust claims that service users will be offered a new GP-led pathway that will last for 18-24 months.
But around 90 per cent of those who currently use Lifeworks say that their condition is lifelong, not time limited, and that they are not being referred to the GP service.
Furthermore, they say the majority of their GPs were not even aware of the closure of Lifeworks, making a mockery of claims that clinicians would be at the centre of decision-making following the latest NHS reforms.
Further cuts loom in the background with plans to close art and music therapy and other services in Cambridgeshire. There is very little evidence to suggest that the closures, including that of Lifeworks, are clinically led.
Mental health trusts across the country face a crisis as they are being forced to make around 20 per cent more savings in next year's budget than hospitals and other areas.
In Cambridgeshire, disastrous PFI builds in Peterborough and Huntingdon have meant that more financial resources are being diverted away from mental health and community services into acute services, leading to an ever more precarious situation for the local health economy.
Service users began their occupation in early March and the fight has been largely led by women, who make up around 95 per cent of those who use Lifeworks.
Initially planned as a two-hour sit-in, the occupation has been going strong for the past five weeks with no sign of ending.
The decision to occupy was taken after service users were sent a generic letter advising of the closure. Those that I spoke to insist that they have never been consulted as part of the plans.
Ann Robinson said: "We were told that Lifeworks was for life, hence the name.
"We are really angry that nobody bothered to speak to us about the cuts and that they have not consulted with service users, carers or even GPs.
"Mine did not even know about the closure until I told them and it is them that we are supposed to be referred back to.
"We will not be ending the occupation until we have assurances about the long-term future of Lifeworks."
Another service user said that Lifeworks had saved her life. She explained how she had been "in a mess," with no contact or support from mental health services and fears that the closure of Lifeworks would leave her vulnerable and isolated. With cuts to her benefits and other services, including falling victim to the bedroom tax, she described Lifeworks as being all she has
As many other service users have said, Lifeworks is seen as a lifeline, offering interventions such as crisis management clinics and other sources of vital support.
The failure to consult has been acknowledged by the trust after pressure from service users, supporters and the intervention of Cambridgeshire council's scrutiny committee. In a strongly worded statement on March 21, scrutiny chair Cllr Killian Bourke said: "Last week I was approached by several members of the public and Cambridge's MP about the sit-in at Lifeworks and this week I met with the service users and the mental health trust to better understand the situation.
"Having done so it is clear to me that the proper consultation with service users has simply not taken place. The consultation that did take place was extremely high level and made no specific mention of closing Lifeworks. Service users only learned about the closure of the service four weeks ago - that is why they have staged a sit-in.
"This clearly isn't good enough. The Health Act requires commissioners and providers to ensure that service users are properly involved in decisions about the planning and provision of services.
"Therefore I am urging the trust to stop the closure of Lifeworks while we get to the bottom of this and service users are consulted."
The occupation has received wide-ranging support from the community, including trade unions, health workers, charities and community groups.
The service users turned occupiers have held two well-attended demonstrations in the city centre, gathering around 1,000 names to their petition and highlighting their cause.
They have learned how to negotiate the bureaucratic processes of scrutiny committees, clinical commissioning groups and other bodies in an attempt to stop the closure and hold those responsible to account.
They have bravely stated their case in meetings of these organisations and are refusing to be intimidated despite threatening behaviour from the trust, which seems to be more concerned with the building they are occupying than the service users' health and well-being.
Occupiers have accused the trust of continuing to mislead the public, the scrutiny committee, the community care group and GPs over the closure of Lifeworks.
Health bosses are clearly rattled. Medical director of the trust Chess Denman accused the council of a "hostile and personal attack" on her following questions asked by the scrutiny committee about the decision to close Lifeworks.
Scrutiny chair Bourke says that there was "a very robust scrutiny session where we asked the mental health trust some frank questions and got some answers."
While Denman is playing the victim, occupiers say it is mental health service users that suffer as a result of the cuts. Those who are making key decisions must be accountable for their actions, they insist.
In a victory for other services as well as Lifeworks, the scrutiny committee has demanded that the trust make it aware of any future planned service changes and has established a working group to scrutinise the process further.
The trust has been ordered to carry out a full and proper consultation and the scrutiny committee has asked that they reopen Lifeworks while this process is carried out.
At a recent rally, one speaker said that those who are occupying Lifeworks have achieved more for mental health services in Cambridgeshire than anybody else has done for decades.
The occupation continues and messages of support can be sent to email@example.com. The petition can be signed online at epetitions.direct.gov.uk/petitions/61183
Steve Sweeney is regional organiser for the GMB and a health activist
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