Agenda item

David Smith, gave a talk upon the history and work of The Retreat.  The following points were noted:

5.1  The Retreat occupies a central place in the history of psychiatry. Every textbook on the subject mentions the unique part played by the organisation in the reshaping of attitudes towards people who are mentally ill.

5.2  Opened in 1796 by William Tuke, a retired tea merchant, the original Retreat was intended to be a place where members of The Society of Friends (Quakers) who were experiencing mental distress could come and recover in an environment that would be both familiar and sympathetic to their needs. Some years earlier, a Leeds Quaker, Hannah Mills, had died in the squalid and inhumane conditions that then prevailed in the York Asylum, and appalled at this Tuke and his family vowed that never again should any Quaker be forced to endure such treatment.

5.3  Nowadays The Retreat is a registered charity delivering a number of specialist services, primarily funded by the NHS. These include specialist Eating Disorders and Personality Disorders Units along with Complex Mental Health Care and Specialist Care for Older Adults. Aside from the main hospital, The Retreat also delivers community services from its psychological therapies centre (The Tuke Centre) and a range of educational activities though The Recovery College.

The following questions and comments were noted:

a)   What is the cost of the Retreat’s detox programme? 

David responded that he could not remember off the top of his head, but estimated that it would be £4000 for ten days.  He added that this included funding for a full multi-disciplinary team upon every unit, and that, as the Retreat was a charity, money would go directly into patient care.

b)   How much does the Retreat rely on bequests?

Response was given that the Retreat did not rely upon these, as 98% of patients are funded by the NHS.

c)   How easy is it for an NHS patient to be admitted to the Retreat? 

David said that this was normally quite straightforward.  A GP or primary or secondary mental health worker could make a referral for funding if there was a need for the type of care provided at the Retreat.  The patient would be talked through the process.

d)   Can patients from outside of York be transferred to the Retreat? 

Response was given that theoretically, patients should be able to choose where they went.  If they had a desire to be transferred to a specific venue, then they should talk to their care co-ordinator.  Patients are entitled to free advocacy, in order to ensure that they have a voice.

e)   What percentage of patients admitted to the Retreat are female?

David responded that females made up roughly 60%, which was due to the Retreat’s specialist female units for eating disorders and personality disorder.  He added that there was a huge inequality here, as there is a general need for more male eating disorder care.

f)    At what age is a patient considered to be an adult. 

David said that an adult was generally considered to be 18 and over, but there was some ambiguity with regard to 16 to 17 year olds, with whom the Retreat occasionally worked.

g)   In respect of the Retreat’s work with offenders, why does this work not take place in prison? 

David responded that the Retreat worked with serious offenders leaving prison, and that this took place within the community.  The intention was to work with adults in order to demonstrate the effectiveness of the talking therapies in preventing relapse.

h)   Does the Retreat view the possible closure of Bootham Hospital as an opportunity to expand its services? 

David explained that Bootham was unsuitable for acute intensive care, however due to it being a listed building, it was difficult to make modifications.  The Clinical Commission Group was currently looking at three different options – whether it would be possible to do something different at the Bootham site, at Clifford or at the Retreat.  Something that is currently missing at the Retreat is crisis care, so this would be an enhancement.   However, David added that there is nothing to bid for right now.