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From The Socialist newspaper, 26 April 2017

Cuts, profit and bureaucracy lead to 50% rise in mental health deaths

Mental health trusts are paid by amount of 'activity', not by successful patient outcomes, photo Bhernandez (Creative Commons)

Mental health trusts are paid by amount of 'activity', not by successful patient outcomes, photo Bhernandez (Creative Commons)   (Click to enlarge)

'Harriet Ryman', NHS mental health nurse

Cuts are putting at least 11,000 mental health patients each year at greater risk of suicide because they are not promptly followed up after leaving in-patient care. Mental health charity Mind obtained these numbers in a Freedom of Information request.

At the same time, there has been a 50% rise in deaths of people using mental health services over the last three years, according to a BBC Freedom of Information request.

The Tories have tried to explain away this increase by claiming the NHS has improved the way it is recording deaths. But any employee in a mental health setting, and any service user, can see the truth about what is happening.

These tragedies have occurred in the face of mental health trusts losing £150 million from their budgets over the previous four years.

Liberal Democrat Norman Lamb is joining Mind in calling for discharged patients to be contacted within 48 hours as a solution to the escalating problem. This is a demand that socialists should support.

But it does not go far enough to address the dangerous crisis unfolding in mental health services - which has ramifications not only for patients themselves, but for the whole of society.

In order for NHS mental health trusts to implement 48-hour follow-ups, NHS England, clinical commissioning groups (CCGs) and the trusts themselves need massive investment in resources on the front line.

Alongside increased funding, NHS England and the CCGs should review all private contracts and so-called 'mixed models' of service provision. They must start a drive to bring all outsourced services back in-house.

The current expensive model of investing in 'leadership' is turning mental health trusts into upside-down Christmas trees. A multitude of managers harasses shrinking numbers of workers - in a system driven by meeting unrealistic financial targets instead of health outcomes.

Mental health trusts generate their income by increasing "NHS activity" - admitting, assessing, screening and then rapidly discharging patients over a brief timespan.

Worryingly, the management view is that even if the same patients get discharged and then quickly readmitted, it doesn't matter. It all shows up as 'activity' and so the trust gets paid more by the CCG.

This attitude goes against the principles of the "recovery model" - where patients are helped to manage their mental conditions, and return to fullest possible functioning in society.

NHS trusts argue that they are meeting "access targets." But the question about what the patient is receiving within the NHS needs to be raised by health unions.

Shut out

There is an increasing trend towards managing patients off waiting lists by rejecting them from mental health services, sending them "opt-in letters" and "signposting" them to services that charge. This means an increasing number of vulnerable people are shut out of mental health services altogether.

Tory and Blairite policies mean rising poverty and inequality, and the rates of mental illness will increase as a result. The correlation between inequality and mental illness has been researched by the epidemiologists Richard Wilkinson and Kate Pickett, who presented their findings in the book 'The Spirit Level'.

Any sincere effort to address mental illness in society must address the increasingly harsh material realities NHS patients - and workers - struggle under.

Fighting on policies like these could rally even greater numbers of NHS workers and service users to Jeremy Corbyn's campaign.

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