The UK’s mental health care is in crisis – the next government must act urgently

Posted: August 10, 2014 | Author: | Filed under: News | Tags: , , , , , , , , , , , , , , , , | Leave a comment

Mentally ill patients forced to travel hundreds of miles for treatment, forcible sectioning in order to get beds and medical students begging for greater teaching on psychiatry: we’re not getting it right

A report this week was grim reading for those involved in mental health care. The survey of GPs revealed that one in five had seen patients harmed as a result of “delays or a lack of support” from mental health services, while shortfalls had forced 82 per cent of doctors to act “outside of their competence”. While this news is shocking, it is just another example of the UK’s mental health care crisis.

Just last week, data obtained from freedom of information requests led to claims that the NHS treated mental health care as a “second-class service”. Indeed, thousands of mentally ill patients have been forced to travel “hundreds of miles” for treatment in recent years. Extreme cases have seen patients being forcibly sectioned so that they can receive care in overcrowded wards. Even medical students have resorted to asking for greater teaching on psychiatry, highlighting the derisory attention that mental health issues receive. Yet the state of mental health services is unsurprising considering that they receive only 13 per cent of the NHS budget, despite mental illness affecting around a quarter of the UK population.

Worse still, national spending on mental health has consistently decreased over the past three years. And the trend isn’t limited to adult care; mental health services for children and adolescents have also seen a fall in funding. This decline seems even more irrational considering adolescence is the period when many mental illnesses first manifest, and that hospitals are recording a rise in hospital admissions for conditions such as eating disorders.

The budget cuts have had a noticeable impact, with doctors citing the changes as a cause of “avoidable deaths and suicides,” while mental health organisations claimed that the cuts “put lives at risk”. Mental illness also has a significant impact on a patient’s quality of life, and is thought to contribute to poor physical health, having been associated with diabetes, cancer and cardiovascular disease. As well as the ethical concerns of these cases, such neglect of the mentally ill also has practical implications; a report by the London School of Economics found that the NHS could save over £50m a year by reversing budget cuts to preventative and early intervention therapies.

Yet perhaps the most striking aspect of the decrease in funding comes from the comparison with other areas of health care. The government, for instance, took great pride in announcing that the Cancer Drugs Fund would be ring-fenced until 2016. While it would be wrong to question the severity of diseases such as cancer, it is worth considering that this budget is reserved for treatments that aren’t ordinarily commissioned because they are not cost-effective. Given the nature of the NHS’s funding crisis, it seems unfair to fund relatively inefficient treatments, while the NHS’s most vulnerable patients are left without basic care.

This is the problem. Eager to brand their “reform” of the NHS as good for patients, the coalition has protected the emotive areas of health care that already benefit from public awareness. Aware that severely cutting the budget for paediatrics or cancer care would result in public outrage, the government are cynically withdrawing care from those most lacking a voice in society: the mentally ill.

Although this current crisis is alarming, such disregard of mental health isn’t a recent phenomenon. Plagued by a history of taboo and prejudice, mental health care has historically been chronically underfunded. With a media happy to brand mentally ill people as “psychos” and a threat to society, it has been relatively easy for politicians to excuse this injustice. But public perceptions are changing; a report by the charity Rethink Mental Illness found that public understanding and tolerance of mentally ill people is improving, while 63 per cent were aware of a close friend having a mental health problem.

This is important; for a politician to stand up for mental health care now wouldn’t just be a principled action, it’d be a popular one. With time, and the excellent work of campaign groups, this positive trend in public attitudes will only continue, allowing society to grow in confidence to discuss one of our greatest health challenges. The mental health charity Mind suggests that the next government commits to a 10 per cent rise in the NHS’s mental health budget over the next five years. Considering the state of mental health care and the current funding disparity between health services, this is not an unreasonable request.

Past governments have chosen an area of health care to focus on, in order to target voter demographics. In 1999, Blair announced his “crusade against cancer”. Seeking the “grey vote”, David Cameron called for a “national challenge” to beat neurological diseases such as dementia. But the disgrace of the NHS’s mental health provision goes beyond party politics. Regardless of who wins the general election, the next government must embrace bold reform to end our longstanding neglect of the mentally ill.

Via http://www.newstatesman.com

Don’t tell me the mental health system isn’t in crisis – I’ve been in it

Posted: June 30, 2014 | Author: | Filed under: News | Tags: , , , , , , , , , , , , , , , , | Leave a comment

Vulnerable people like me are being put at risk by cuts to essential services, and I’ve already given up trying to get support

The mental health system is in crisis. It’s a car crash waiting to happen.

That’s according to Prof Sue Bailey, the outgoing president of the Royal College of Psychiatrists, in an interview earlier this week. Her comments came a day before the British Medical Association’s annual meeting, where delegates were told that cuts to mental health services are resulting in avoidable deaths and suicides. Sadly, neither of these stories told me anything I didn’t already know. I’ve seen at first-hand how the mental health system is failing vulnerable people. For many of us dealing with mental illness, the car crash has already happened.

In fact, my experiences of mental health care were so bad that a few years ago I completely gave up on trying to get support. I’d been going through a period of severe anxiety and had waited for months to see a therapist. But after a few sessions, she told me she was being transferred. I’d have to go back on the waiting list and start all over again.

The whole experience made my anxiety worse, so I decided I’d be better off looking after myself. That can be a real challenge because I have a long-term and serious mental illness, schizoaffective disorder. Sometimes I struggle and need support, but like many people with mental health issues, I find it difficult to ask for help. That’s partly because of the stigma around mental illness, but it’s also because I’m afraid of going back into the mental health system.

It’s been the same story since I first tried to get help when I was 17. I was feeling suicidal, but the waiting lists were so long that I didn’t get the therapy I needed. If I’d had a serious physical illness, I’d have been treated within 18 weeks, but there are no maximum waiting times for mental illness, so people can wait for years to get support. Many people miss out altogether.

My mental health gradually got worse, until eventually I reached crisis point and had a breakdown. I was taken to A&E after being found walking down the middle of a busy dual carriageway. There were no beds available, so they just sent me away with a handful of Valium.

After that I gave up hope, and decided to end my own life. Luckily for me, a stranger stopped me and talked me out of it. He gave me a simple message of hope – that I could get better. I’d never been told that before, and it changed everything for me.

From that day, things started to improve, and earlier this year I launched a campaign to find the good Samaritan who’d helped me. My search was made into a documentary, Finding Mike. Since then I’ve been inundated with messages from people who’ve been through the same kind of thing. It really brought home to me how much we’re all affected by mental health issues. All of us know someone who’s faced mental illness. But too often people tell me they’ve been let down by the system.

The fact is that not enough money is spent on care. Mental health accounts for around 23% of the disease burden in the UK, but gets just 13% of the NHS budget. Worse still, spending on mental health has been slashed even further over the past few years.

It is not just people with mental illness that have been let down. I know many doctors and nurses who feel incredibly frustrated that they can’t provide the care they want to because of the cuts.

We can improve the system, but the government needs to listen to the patients, carers and organisations who know the system best.

Research by the charity Rethink Mental Illness shows that early intervention services – which help people from the moment they become ill – make a huge difference in helping patients recover, and also save the NHS money. With the right treatment, people can get better. But instead of getting much-needed investment, these services are facing major cuts. It means that millions of people are suffering because they can’t get support, and each day 16 people in the UK take their own lives.

That’s why we must keep putting pressure on the government until it takes real action to give people with mental illness the care that we deserve. At the moment I’m going through another period of anxiety, and I should feel that I can get the support I need. It’s not right that people like me so often go through this alone.

Via Bridget via http://www.theguardian.com/commentisfree/2014/jun/27/mental-health-system-crisis-vulnerable-people

Funds cut for mental health trusts in England

Posted: December 16, 2013 | Author: | Filed under: News | Tags: , , , , , , , , , , , , , , , | Leave a comment

By Michael Buchanan BBC News

Paramedic Emma Bardney from Nottinghamshire was diagnosed with complex Post-Traumatic Stress Disorder after a childhood trauma
Mental health trusts In England have had their funding cut by more than 2% in real terms over the past two years, figures show.

The BBC received data from 43 out of 51 mental health trusts following a Freedom of Information request.

The coalition has guaranteed the NHS budget will rise by 0.1% in real terms over the course of this parliament.

The Royal College of Psychiatrists is warning that mental health services are near breaking point.

Separate data for the same period shows referrals to crisis and community mental health teams have risen by 16%.

Care & Support Minister, Norman Lamb said: “It is completely unacceptable for local commissioners to disadvantage mental health in the allocation of funds to local health services.

“This completely conflicts with the government’s clear position that there must be parity of esteem – equality – between mental and physical health. This must be a priority for NHS England to address.”

The revelations come just weeks after one of the country’s leading psychiatrists told BBC News that mental health services are unsafe and in crisis.

Comparing the total 2011/12 budgets with that for this year, 2013/14, there was a reduction of 2.36% in real terms. Of the 13 trusts that were able to provide indicative budgets for next year, 2014/15, 10 are expecting more cuts.

Prof Sue Bailey, President of the Royal College of Psychiatrists, said: “Even small cuts at this time can have a disproportionately large effect on the welfare of our patients.

“The services are stretched to their limit and if they stretch any further, the elastic band is going to snap.”

Dr Martin McShane, from NHS England, said: “If you look at the figures, mental health trusts have taken more work on, they’re more productive, they’re delivering better value for the NHS.

“There are other parts of the system that are delivering services that might have been delivered by mental health trusts, such as psychological therapies.”

Paul Farmer, chief executive of the mental health charity Mind said the ultimate consequence of the cuts would be that people do not get the help they need in crisis.

That is certainly the experience of Emma Bardney, who has a complex post traumatic stress disorder, but says she’s been failed by her mental health trust.

“Its been really tough… fighting for the right to get better,” said the 42 year old paramedic.

“There’s been no community mental health support available to me. So my care plan has been sporadic out-patients with a consultant or crisis support and nothing in-between and the only way you can access support is when you are in crisis.

“So you have to get to a very low point before you get any type of support or help.”

The pressure on crisis and community health services is highlighted by information provided to the online journal Community Care.

Using data provided under a separate Freedom of Information request, they found that:

  • Budgets for ‘crisis resolution teams’ fell by 1.7% in real terms compared to 2011/12. Referrals rose 16%. These are the staff who provide intensive home treatment in an effort to prevent acutely unwell people being admitted to hospital.
  • Budgets for community mental health teams shrunk by 0.03% in real terms since 2011/12 but referrals have risen 13%. These teams give ongoing support to patients to prevent their health deteriorating to crisis point.

“Mind hears all the time from people who have lost the community health care that was helping them to cope and who now find themselves unable to get through to their local crisis team,” said Paul Farmer.

“They feel ‘fobbed off’ when they do, because there simply aren’t enough staff to cope with the numbers of people in desperate need of help.”

An analysis of the board papers of mental health trusts and reports from the Care Quality Commission shows the problems in the system:

  • Patients in Cornwall receiving dismissive advice, with one being told “I am the only one working, don’t kill yourself on my shift”.
  • Community health teams in Bradford complaining of “unmanageably high caseloads”.
  • Patients in need of an urgent assessment in Barnet, north London, not being seen for five weeks.
  • Crisis teams in Kent spending as little as 10 minutes with patients. Mental health services in England are facing budget cuts despite the government’s promise to protect health spending.

Via http://www.bbc.co.uk via Andrea