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Change is needed to help those affected by mental health issues

On World Mental Health Day, medical negligence solicitor Gemma Castrofilippo looks at the current state of NHS mental health care in England from a professional and personal perspective.

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Gemma is an experienced clinical negligence solicitor who has specialised in this area since qualifying in 2008.  Gemma handles a wide range of cases, with a particular interest in obstetric cases, brain injury cases, mental health issues and cytogenetic work. You can follow Gemma on Twitter on @LD_Gemma
To coincide with World Mental Health Day this year, I have been looking at the current position in relation to NHS mental health care in England.

I know, from a personal as well as a professional perspective, how the failures of mental health care in this country can affect many lives.

A close friend of mine suffered from mental health issues for many years. She had been sectioned a number of times under the Mental Health Act but each time, after a minimal period of review, she was discharged against her wishes.

My friend had pleaded to be kept in hospital longer, to be given more support before she returned back home but this fell on deaf ears.  She attended A&E a number of times to ask for help, as the mental health team were unwilling to provide the assistance she needed; she was desperate for help and had nowhere else to go to access medical input.

One of these A&E attendances resulted in her being voluntarily sectioned but, as had happened previously, as soon as her mental health issues were assessed as not severe enough to warrant further hospitalisation, she was discharged home without adequate ongoing psychological care and treatment in the community.

At a very low point in my friend’s life, when it was feared by those around her that she was in crisis, a relative telephoned her mental health worker to seek urgent intervention. The mental health worker was unable to take the call. No one else in the mental health team wanted to take ownership or was available to assist. My friend’s relative also tried to contact the local Crisis Mental Health telephone line, but received no answer. Tragically, when the mental health worker returned the urgent call a few days later to check how my friend was, they were told it was too late as my friend was already dead.

My friend’s family and I believe that with adequate mental health care she would still be alive. The failures by my friend’s mental health worker/team affected not only my friend, but her partner and young children – who will never get the chance to live out the plans they had made together - plus her family and friends.  The effects were and continue to this day to be far reaching. 

While this particular failure is very close to my heart, there are many more people who have suffered and are still suffering because of mental health matters and not receiving the care they desperately need. I have heard from a number of families that despite those affected by mental health failures being known to the relevant agencies, the support and treatment they received was (and is) ineffective and limited.

Why is this allowed to continue?

If someone attended hospital with a broken leg, they would not be turned away or sent home with simply a bandage. They would be assessed, undergo diagnostic X-rays, have the injured limb placed in a plaster cast and a follow-up appointment or two would be scheduled. They would not be discharged from medical care until the fracture had healed, and if there were subsequent issues with, for example, movement of the affected limb the patient would be referred to the necessary department to receive the needed continued care.

Why then are psychological concerns not treated as seriously as physical health conditions? Why are those affected by such issues sent back into the community without having had adequate assessments and without suitable treatment and support put in place?

Just because a person’s suffering may not be apparent from their exterior, this doesn’t mean it should be ignored or treated inadequately.

Simon Stevens, chief executive of NHS England, has admitted that mental health services have long been the NHS’s “poor relation” , but that changes would be implemented to ensure psychological health is put on an equal footing with physical health, by improving the care and treatment offered to those in need.

Demand exceeding supply

A report  published in July 2017 by NHS Providers shows that those seeking treatment for mental health matters are facing long delays to access care, with “not even a third of mental health providers confident that national workforce planning will deliver appropriate numbers of clinical staff to deliver services”.

While this is worrying enough, the report goes on to state that “over 70% of chairs and chief executives from mental health providers expect demand for services to increase in the next six months”.

Severe staff shortages are also flagged, caused by problems recruiting and retaining psychiatrists and mental health nurses.

The government has said the NHS will create 21,000 mental health posts by 2021 . The Royal College of Nursing’s Chief Executive, Janet Davies, does not appear to be convinced. She said: “It is clear the Government will need to work hard just to get back to the number of specialist staff working in mental health services in 2010.  Under this Government, there are 5,000 fewer mental health nurses and that goes some way to explaining why patients are being failed. The NHS needs to see hard cash to deliver any plans.”

Sadly, in relation to well needed funds to help the NHS with its mental health plans, it was revealed earlier this year by BBC’s Panorama programme that mental health trusts in England have had their funding cut by £150m over the last four years.  This is disputed by the chief executive of NHS England, who said: “Overall mental health funding is demonstrably and indisputably up by £1.4bn in real terms compared to three years ago.”

In response to the July 2017 report by NHS Providers, a spokesperson from the Department of Health said: “We are committed to seeing mental health services improve on the ground and we expect NHS England to ensure the record amount of funding we’re giving to mental health reaches the frontline, with an extra £1bn a year by 2021.”

What happens now?

Mental health issues do not discriminate. They do not care about social class, race, age, gender etc. They affect all of society, in some shape or form, and their effects are far-reaching.

Yet, instead of being addressed adequately, failures in mental health care continue to be highlighted.

It is unacceptable that some of the most vulnerable people in society are not receiving the care and support they so desperately need, due to inadequate funding for mental health facilities and staff. It is of paramount importance that those suffering from mental health problems are assessed and diagnosed as soon as possible, and that they have continued access to the support and help they need.

It is clear that improvement is needed. But, it is not just in the NHS and private hospitals where change is required. As a society we need to look at our own perception of mental health matters and begin tackling the stigma that remains in relation to psychological issues.

This is something you and I can do; we can be part of the change too.

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