It troubles me to read positive comments about things that the current UK government say about mental health. Last week, the Prime Minister made a speech about mental health and a lot of things I read were about how great it was that she was talking about it and wanting to make changes. Have people already forgotten that these changes are long overdue and the government keeps failing to deliver any real support for mental health?
This is the same party whose decisions on benefits cuts and changes to applications have literally resulted in people dying. I’d ask that people do not take anything at face value. As both a service user and someone working in the field, I’ve only seen things get worse. So what is different now? Perhaps I’m being pessimistic but it seems unlikely that mental health services are going to improve. Even if all of these plans go ahead, are they really the right ones to make a real difference?
It would be great if I was proven wrong but here’s some of the stated plans for improving mental health and my thoughts on them. Please don’t read this if you’re already feeling down, it won’t help!
Trials on strengthening links between schools and NHS specialist staff, including a review of children and adolescent services across the country
A review of child and adolescent services is long overdue and from experience and stories from others, I can guess that it’s going to conclude that major changes need to be made. Children’s concerns around mental health are still often put down to ‘attention seeking’ and not taken seriously. It’s not enough to strengthen links between schools and the NHS. Children’s mental health needs to be a priority. We should be working on preventative measures, looking at how to prevent potential future mental health issues. Childhood trauma is a very common experience amongst adults with mental illness. It might be a difficult issue to tackle but surely we should have a focus on supporting children after trauma rather than waiting to see if it has an impact on them later on in life. By that point, it could be too late.
Carrying out a review on improving support in the workplace & employers and organisations will be given additional training in supporting staff who need to take time off
If this happens then it would be great. However, I’m sceptical because ultimately if someone is working for a business and them taking time off is going to make a dent in the profits then an employer probably will not care too much about supporting them. More importantly, what about people with mental health conditions who are unable to work at all? Will they continue to be called in for benefits assessments which cause a huge deal of anxiety? Is it less important to give them support because they may not have the potential to contribute more to society in a purely financial way?
More focus on community care such as crisis cafes and local clinics, with an extra £15m towards this, and less emphasis on patients visiting GPs and A&E
The level of crisis that mental health services are at means that an extra £15m is barely going to make a dent in things. The problem here is that GPs are not trained enough in mental health yet are often the first point of contact when someone experiences distressing symptoms. It is much easier to access a GP appointment than it is to find other local support services. Plus, those other services are already under strain trying to deliver services on less and less money, staffing and time.
As it stands, A&E is the place recommended to go if you are experiencing suicidal thoughts and this gives A&E departments more pressure because they often have nowhere better or more suitable to send people. The 3 times that I have been on my way to being sectioned, I’ve been sent home due to lack of beds. The follow up from crisis services is almost non existent. Whilst the NHS continues to fall apart, mental health services cannot get better. Why? Because even if community projects separate from the NHS get better, there are still medical professionals who are necessary to management of mental health. For example, someone may have a few local social groups they attend which help them stay well but they could still need medication assessments and therapy referrals and everything else that goes with it.
Community care can work really well but it has to be well funded with trained staff and accessible to people with a variety of mental health conditions. Currently, this is not the case and this extra money is very unlikely to change that. A lot of the community care is provided by not for profit organisations and many of these are failing service users by focusing more on the amount of services they can afford rather than the quality of service they provide. Essentially, money is all well and good but more low standard support is not what is needed, we need the current support to be useful and high quality.
In short, community care has to work as a partnership with the NHS. They are not separate entities and therefore rely on each other to keep people well. While the NHS seems to be in crisis in various areas, this will impact on mental health services outside of that as well.
The reallocation of £67.7m, mostly from the existing NHS digitisation fund, for online services, such as allowing symptom checks before getting a face-to-face appointment
Online services can be beneficial if they are provided to people appropriately. My concern would be that it would be an easy thing for professionals to refer patients to online CBT courses and such because it works out cheaper for the NHS. However, for a lot of people, online support simply is not enough. With diagnoses such as BPD the relationship built with a therapist is a really important part of treatment and this cannot be overlooked. Also most people check symptoms through Google before going to any appointment anyway, don’t they?
There you have it – some thoughts on the government’s response to mental health. It kind of seems to me like they haven’t really thought about what is needed and quite how things are going to work in reality. How are you feeling about these proposals, more optimistic than me?