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Mental health: system in crisis
Photo JC Count (Creative Common) (Click to enlarge)
Mental health worker, South London
Mental health services are being cut to the bone and patients are dying as a result. There has been a 20% spike in deaths in mental health care in the last year.
Incidents where people with mental illness or those close to them suffer significant harm have risen by 34% in a year according to the Guardian.
Home treatment teams increasingly have to cope with patients who should be in hospital but aren't due to the closure of hospital beds. As a result suicide rates among those receiving home treatment have risen sharply.
Southwark News says a freedom of information request revealed that a quarter of nursing posts in South London and Maudsley NHS trust were vacant in July 2015.
The workload of all frontline staff is increasing and the pressures on us are mounting. There is an unacknowledged staffing crisis in most mental health community teams and management are not addressing this.
Results
Payment by results means that there are demands on staff to spend significant amounts of time completing admin which impacts on the amount of time available to offer patients and carers a service.
Individual staff who can't keep up with the crushing workload are placed on 'performance management.'
Rather than supporting and assisting patients we are instructed to use coaching methods to encourage patients to 'do things themselves'.
This advice is appropriate when a patient is in the final stages of recovery but is wholly inappropriate for the majority of patients we see who are in the acute phase of illness.
Services that help mental health patients recover like psychology, hearing voices groups, benefits advice and support and vocational help are being cut.
Medication and sections of the Mental Health Act including community treatment orders are increasingly the only options left to staff who are struggling to help patients recover from relapse.
Addiction services have been privatised throughout south London resulting in many not getting the assistance they need to support them to cut down on their substance misuse.
Increasingly, community mental health teams are struggling to cope with supporting those with addictions when many don't have the specialist training, knowledge and skills to offer this support.
Struggling
It is difficult for frontline NHS staff to understand the decisions made by senior hospital managers. The pay freeze and training cuts mean that hospital trusts are struggling to recruit permanent staff.
Trusts are either unable or unwilling to come up with incentives to attract permanent staff but paradoxically they end up spending far more money on temporary staff over the long run.
Agency staff don't have the same job security as permanent staff and if any agency nurse dares to speak out about problems or issues, they find themselves out of a job within a week.
Hospital beds are shut down while patients are increasingly being shipped out to private beds across the UK at treble the cost. These private admissions cause added stress to the patient and to families forced to travel to support them.
Pressing need
There is a pressing need for NHS staff to unite in solidarity and to become activists in the trade union movement. The trade unions should be the bodies organising to force NHS trusts and councils to make patient-centred choices about where public money is spent.
We must make concrete demands on health managers via our unions and stop accepting the lie that there is nothing that can be done locally and that there is no money for health or social care.
The facts
- Mental Health Network NHS confederation factsheet published in January 2014 titled "Key facts and trends in mental health":
- Men in the lowest income group were three times more likely to have a common disorder than those in the highest income households (23.5% and 8.8% respectively)
- Young Minds' most recent survey found 67% of councils have reduced child and adolescent mental health services funding between 2010 and 2013
- In 2004, the Office for National Statistics estimated that one in ten children and young people between the ages of 5 and 16 had a clinically diagnosed mental health disorder. Children and adolescents with poor mental health have relatively worse prospects throughout their adult life
- People with mental health illness are almost twice as likely to die from coronary heart disease as the general population, four times more likely to die from respiratory disease, and are at a higher risk of being overweight or obese
- Around 30% of those suffering from a long-term physical health condition also have a mental health problem. The King's Fund estimates that between 12% and 18% of NHS expenditure and management of long-term conditions is linked to poor mental health and wellbeing
- Compared with the general population, people with mental health conditions are one and a half times more likely to live in rented housing, with greater uncertainty about how long they can remain in their current home
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