Mental health cuts cost the NHS millions, charity says

Rethink said cognitive behavioural therapy could help cut long-term costs of care
Cuts to mental health care are costing the NHS millions of pounds long-term, a report has said.

More cases of psychosis and schizophrenia now end up in hospital rather than being treated in the community, it said.

Rethink Mental Illness published the report with the London School of Economics.

Cuts mean fewer people have access to early intervention treatment, such as talking therapy, Rethink said.

It said the NHS could save more than £50m a year by shifting its focus.

Britain’s recession in 2008 led to cuts across the NHS, as the government struggled to deal with ballooning deficits.

The report said it costs on average £13 a day to support someone with psychosis or schizophrenia in the community.

It said this compared with the £350 average daily cost of keeping a mental health patient in hospital.

‘Shift of resources’

Meanwhile, 54% of the psychosis budget was being spent on inpatient care rather than on preventive community services, the report found.

Family therapy, where families of people with psychosis and schizophrenia are supported, cognitive behavioural therapy, and peer support could help cut long-term costs of care, it said.

Health Minister Norman Lamb said early access to treatment in the community was “often the best option” for people with psychosis and schizophrenia.

He said: “Not only do they benefit from being in familiar surroundings among loved ones but they are less likely to need costly hospital stays.”

Mr Lamb called for a “shift of resources” to preventive care and said that the government had given NHS England a “clear objective” to put mental and physical health on a par.

Mental health trust budgets for 2013-14 have fallen by 2.3% from 2011-12.

The cuts have meant mental health trusts have been asked to save almost 20% more from next year’s budgets than hospitals.

Budgets for community mental health teams, which give continuing support to patients to prevent their health deteriorating to crisis point,reached a plateau for 2011-12 but referrals rose by 13%.

‘Parity of esteem’

The report also predicted more than £50m a year could be saved if early detection services could be strengthened.

It said the NHS saved £989 every time people were treated with cognitive behavioural therapy instead of going to hospital.

Rethink said mental health accounted for 23% of the disease burden in England but received only 13% of the health budget.

Dr Martin McShane, national director for long-term conditions at NHS England, said the report was “very helpful” and was supportive of what the organisation wanted to achieve.

He said: “We recognise we must work to ensure that in everything we do mental health has parity of esteem with physical health.

“We have significantly invested in improving access to psychological therapies and dementia care.”

Via Bridget via http://www.bbc.co.uk/news/health-26957435

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Mike has been found!

Mike has been found


Silent Cinema launches at the ORTUS

Come and join us at the ORTUS for our inaugural Silent Cinema event on Tuesday 28th January 2014 at 6pm. This will be the first in a series which will run on the last Tuesday of every month, when we will show a variety of films, all with underlying mental health themes.

The first film in the series will be “The Soloist”; a 2009 American drama film directed by Joe Wright, and starring Jamie Foxx and Robert Downey, Jr. The screenplay by Susannah Grant is based on the book, The Soloist by Steve Lopez. The film is based on the true story of Nathaniel Ayers, a musician who developed schizophrenia and became homeless.

Tickets:

Tickets are £5 and cover the cost of a hot drink and a cake from the cafe at the ORTUS. Just don’t forget your headphones!

If you don’t have your own headphones, no problem! We’re selling tickets with headphones for £9.

Spaces are limited and available on a first come first served basis, so you must pre-book. Book herehttp://www.maudsleylearning.com/events/events/silent-cinema-the-ortus-the-soloist/

Please make sure you arrive with enough time to grab your drink and cake from the cafe! The film begins at 6pm and the cafe will close at this time. 


“People still think that it’s shameful if they have a mental illness. They think it shows personal weakness. They think it shows a failing.”

How to end the stigma and talk about mental health: http://on.ted.com/bwg5


Schizophrenia Awareness Week 2013

Schizophrenia Awareness Week is 11th – 17 November 2013.

Matthew has done video and audio blogs  about Schizophrenia; its symptoms, what you can do to raise awareness of it this week and what Rethink and other organisations are doing to help with this illness.

The video is at:

The audio at:

The transcript of these blogs can be downloaded from:


HIP HOP PSYCH Event 21st November

HIP HOP PSYCH

21st November 2013, 7pm – 9pm. ORTUS learning & events centre, 82-96 Grove Lane, Denmark Hill, London, SE5 8SN

Co-Founded by Dr Akeem Sule & Dr Becky Inkster

“Demystifying mental illness through authentic beats and lyrics”

HHP Screens

Hip-hop culture is a powerful vehicle for raising awareness about mental health. It is rich with references to psychiatric illnesses that have not been explored, dissected and documented until now. HIP HOP PSYCH, co-founded by Dr Akeem Sule & Dr Becky Inkster, is the interface that links hip-hop with mental health.  Their medical credibility and authentic passion for hip-hop enables them to bridge this gap. They understand the culture, speak the language and want to share their knowledge in order to cultivate awareness and remove stigma surrounding mental health and hip-hop.

Although the lyrics of hip hop music are often associated with swearing, rapping about money and the exploitation of women, there are also rappers whose unfiltered narration goes beyond this by describing the harsh realities of their world and the coping mechanisms employed by some young people.  The music can be rich with references, for example, to addiction, psychosis, bipolar disorder and the effects of urbanicity, poor nutrition and destructive parental influences relating to childhood maltreatment in the absence of positive role models.  

For this event, HIP HOP PSYCH Co-Founders Dr Akeem Sule & Dr Becky Inkster will be focusing on dissecting and analysing a range of hip hop lyrics from different artists – such as Eminem, Tupac, Kendrick Lamar and J Cole – in order to demystify mental health.  In doing this they seek to disarm the boundaries between psychiatry, the humanities and hip-hop culture.  Their approach enables them to gain a deeper awareness into gang culture and allows them to get closer to the reality of the daily struggles and risk factors which people with mental health problems face.

The event will also feature a special performance by Key Changes. Key Changes provides music engagement and recovery services for young people and adults experiencing severe mental illnesses including psychosis, schizophrenia, bi polar and personality disorders. Their innovative approach draws on clinical therapeutic techniques and uses culturally relevant music activities and genres.

Twitter: @hiphopsych / Email: hiphopsych@gmail.com

Price: £15 per person. Booking is essential as spaces are limited. CLICK HERE to buy your tickets.

IMPORTANT INFORMATION: You must be at least 16 to attend this event.


South London and Maudsley on film: humanity and humour

Looking at a newspaper story about the murder of drummer Lee Rigby earlier in the year, Lloyd, who has a diagnosis of paranoid schizophrenia, said that hearing about schizophrenics in the news made him feel worse. He worried that he didn’t know his own mind and wondered if he himself could turn into a murderer too, since that’s what he read in the papers. Dealing with the symptoms of psychosis can be difficult enough in itself. Having to deal with society’s perceptions that people with your diagnosis are violent and unpredictable adds another level of difficulty.

Earlier today, I attended an advance screening of Channel 4′s new series on the realities of modern mental health care at the South London and Maudsley (SLaM) mental health trust.  In the screening room in the basement of Channel 4′s headquarters in Horseferry Road, a select audience sat in red plush seats watching one of four programmes in the series on modern mental health care. The series is entitled Bedlam and the name choice has caused controversy. To an extent it can be argued that, when a respected NHS trust calls a television series after a medieval asylum, it dilutes the strength of the case against Thorpe Park’s “mental patient scary fun” horror maze Asylum. But what of the series itself?

The episode previewed profiled the work of Speedwell community mental health team (CMHT) in Deptford, south London, over the course of a year. The four-part series, which starts at 9pm this Thursday, also covers the Anxiety Disorders Residential Unit, Lambeth Triage (the front line for emergency cases) and the older adults unit (over 65s).

Without giving too much away, we followed patients Tamara, Lloyd and Rosemary, all of whom experience psychosis. We saw them trying to cope with periods of illness, voices, delusional beliefs about bed bugs and with children being taken into foster care.  We saw them using prescription drugs as well as speed and alcohol to help manage their troubling symptoms. We saw them at times chaotic and disturbed, and at other times funny and happy.

We saw social worker Jim Thurkle doing his best to hunt down and help patients, a third of whom refuse to engage with him. We saw Dr Tom Werner doing his best to confirm the stereotype of the psychiatrist in the bow tie. We saw the fine line between enabling someone to live the life they choose and intervening in the interests of their own health and safety.

Not once did we see someone who could be considered a danger to anyone else. Not once did any of the patients present as anywhere remotely near the stereotype of the paranoid schizophrenic mad axe murderer. What we saw was patients struggling to manage their lives in difficult circumstances, and the professionals who tried to help them.

It was particularly interesting to see the work of a CMHT  which, along with GPs, carry out the bulk of psychiatric care in this country. As the booklet handed out at the advance screening says:

“The lion’s share of SLaM’s work takes place in a community setting, looking after more than 35,000 people with mental health issues. SLaM treats 8,000 psychosis patients a year; 6,000 of whom are based and treated in the community. We touch on different treatments available and see intense and moving interaction with social workers and mental health teams.”

As Pete Beard, the producer of the episode, who answered questions after the screening, said:

“We wanted to reflect the realities of this challenging work, following the actual narratives of people walking a tightrope with their mental health as it happened and the teams who act as a safety net. I feel that these realities are rarely reflected accurately in the media and as a result it is important to demystify the work performed as community teams, especially taboo subjects such as being sectioned”.

It was profoundly moving to see someone taken away from their own home, against their will, and detained with no legal authority other than the personal opinions of a social worker and doctors. No police arrest, no court process, no judge, no jury. Just a simple form signed, and you have no choice about even the simplest things like what you eat, where you sleep or what shampoo you use to wash your hair. And, on a more intrusive level, you have no right to refuse medication.

This extended scene cannot help but make you reflect on the balance of power between the state and the individual, and on what society deems to be acceptable norms of behaviour. This is especially so when you’re dealing with someone you don’t really know, as can be the case when a mental health team is called out to consider sectioning someone. Britain has a proud tradition of eccentricity, but that is not tolerated if you are deemed to be mentally ill. Simply being a nuisance to others but in no way dangerous to yourself or others can, ultimately, mean three people decide on your behalf that your quality of life will be improved by a compulsory stay in a locked psychiatric ward.

The sectioning sequence made me think about the boundaries or free will and autonomy and to what extent people’s peculiarities are tolerated. I have been on the receiving end of such a process, and it changed my life irrevocably. As Dr Baggaley said, when he’s taken part in sectionings he does wonder whether this was what he trained for. Although he sees it as difficult, he does see it as necessary.

Dr Baggaley described the person in question as a “revolving door patient” who would face repeated hospitalisations, some under section (compulsion), for the rest of their life. And yet this is someone who will – under the current welfare benefits system – also face repeated Work Capability Assessments. It is hard to see the point of such assessments in this case particularly since, as Dr Sarah Wollaston MP wrote today, WCA’s are not geared towards helping people with mental health problems find and retain employment.

One of the things which struck me in this episode was the amount of humour. Despite their difficult circumstances and troubling symptoms, the patients followed could come across as affable, amenable and warm-hearted. Ripples of laughter would regularly rumble across the audience, and not just because viewers were looking for a little light relief in what was, after all, a serious topic. As with any other fly-on-the-wall documentary, the colourful charaters in this episode were full of humour. The seriousness of the subject matter made the flashes of levity even more welcome.

Overall, this preview episode was intimate, insightful and profound. It showed human beings in all our difficulties, complexities and ambiguities. It showed the realities of trying to combat the stigma around mental illness with humanity and humour. It showed that danger and fear are the least of the concerns of the CMHT.

On a final note, I will end with a criticism that was raised by audience members with personal experience of mental health services: namely that the episode was somewhat naive and unrealistic. Audience members had received far worse experiences of mental health care, or had been able to deliver a far worse service due to cutbacks. It was acknowledged by the film makers that Speedwell CMHT had a ring-fenced budget, so had not been under the same constraints and workload other CMHT’s they’d liaised with had.

It was also highlighted that a lot of the difficulties patients needed help with were practical, and that these needs were not being met. The patients were unable to deal with these matters themselves and therefore they were stuck in difficult circumstances. Examples were the bedbugs which did actually exist in Tamara’s flat. It was not a delusional belief (though its extent may have been) and dealing with that practical problem may have lessened her delusional symptoms. This and her use of amphetamines may also have been the way she managed the immense sorrow of losing her children. Lloyd appeared to be using alcohol to numb his pain.

With a series planned over two years and filmed over twelve months, much footage will have ended up on the cutting room floor. It’s a shame, however, that the close relationship between medical help and social support, and the parts played by talking therapies and thereapeutic activities, were overlooked completely in this preview episode.

Nor was the 9% reduction in inpatient beds in the past 2 years mentioned.  Nor were the terrible cuts to community mental health services mentioned.

On the other hand, as Madeliene Long, SLaM chair said:

“Despite it affecting so many people, mental illness is still poorly understood. The stigma and discrimination that people face can make their mental health even worse and can prevent them from seeking help. So it’s really important that we do everything we can to raise awareness, challenge stereotypes and promote the facts about mental health. I’m really pleased that we have been able to work with Channel 4 and The Garden Productions on such an ambitious project which sets out to do exactly that.”

As executive producer Amy Flanagan said,

“Many of these patients had lived long lives with no history of mental illness. It could happen to our parents, to us.”

And, if it does happen to us or someone we know, programmes such as these will mean it feels a little less alien and a little more a part of everyday life.

Via http://sectioneduk.wordpress.com via Bridget