CHRONIC under-funding for mental-health services has led to hundreds of thousands of lives “put on hold or ruined”, and thousands of unnecessary deaths, warns a new report, published this week.
The Five Year Forward View for Mental Health, published on Monday, was commissioned by the chief executive of the NHS, Simon Stevens, and chaired by the Chief Executive of Mind, Paul Farmer. More than 20,000 people responded to a consultation.
The report shows that three-quarters of those with mental-health problems receive no support at all. In a postcode lottery of investment in services, waiting times for talking therapies ranged from six to 124 days, and only about half of community teams were able to offer an adequate 24/7 crisis service. There has been a ten-per-cent increase in the number of people sectioned under the Mental Health Act over the past year, and suicides have risen, after many years of decline, most markedly among middle-aged men.
Katharine Welby-Roberts, a mental-health associate at Livability, a disability charity, said on Tuesday that in 2012 she had waited two years for access to a psychiatrist.
There was much talk about mental health at present, she said, but that did not seem to lead to noticeable action and change. “Early intervention is key. If you can help people early on, when things begin to develop, then in many cases you could probably prevent a more serious later illness.”
The report’s foreword claims that people with mental-health problems have been “stigmatised and marginalised”, and that services to treat them have been “under-funded for decades”. It repeats calls for parity between mental- and physical-health needs within the NHS. Specific goals include helping a million more people with mental-health problems to access high-quality care within the next five years, at a cost of £1 billion; and reducing suicides by ten per cent.
Mrs Welby-Roberts believes that there has been an improvement in attitudes to mental ill-health “in certain quarters”, aided by social media, but says that there is a “huge amount” of stigma to overcome. “People are still holding those older attitudes which make it impossible to have parity of care. . . It is almost as if we need to untrain ourselves; to unthink what we have grown up thinking.”
Sam Royston, policy director at The Children’s Society, warned that “traumatised young people are being let down by a system which is unable to intervene early to prevent the development of more serious conditions.” The report notes that most children with a diagnosable mental-health problem receive no support; and that the average wait for routine appointments for therapy last year was 32 weeks.
Mr Farmer described the report as a “feasible and affordable blueprint” that offered a “once-in-a-generation opportunity to transform services and support for people with mental-health problems”.
The Bishop of Carlisle, the Church of England’s lead bishop on health care, the Rt Revd James Newcome, welcomed the report, and the Government’s support for it. “For a long time in this country mental health has been rather neglected when it comes to investment,” he said. “Many of us who have been campaigning for this over several years will be very heartened by the news.”
The “extra” £1 billion pledged by the Government to support the implementation of the report’s recommendations was immediately queried. Community Care argued that it contained many previously announced mental-health funding pledges. The Prime Minister, David Cameron, has emphasised that the funding will enable more people to return to, or remain, in work. Mrs Welby-Roberts warned that this could “make guilt greater, and increase anxiety”.
While there was great variation in churches’ responses to mental health, and a need for “self-education”, churches could play an important part, she said. “For a huge number of people with mental-health problems, religion is the first thing that will come to mind; so the Church could be a huge force for change, just by being an open door that welcomes people, and understands. It might get bit messy, but that is okay.”
Free therapy 'cuts to chase' in Toxeth
WHEN Suzi Curtis and and Steve Flatt were looking for somewhere to offer free therapy, St Bride’s, Toxteth, in Liverpool, offered some obvious benefits.
“I think the church, quite aside from the faith aspect, [is] a hub of the community and a place where people come together and good things happen between people,” Ms Curtis said last week. “We want to see more good things happening between people, through conversation.”
Ms Curtis, a clinical psychologist who works both in the NHS and privately, is working alongside Mr Flatt to offer free 30-minute one-to-one therapy sessions at St Bride’s, “to anyone who would like to give it a try”.
St Bride’s was already known to her as a “very progressive and vibrant centre of the community”, which attracted people who “might not find it very easy to access mental-health services”.
As a specialist in “solution-focused therapy”, Ms Curtis is keen to make it more accessible by taking it “where people were already congregating and felt comfortable, rather than having to go through the tortuous and time-consuming, and sometimes quite off-putting, process of getting referred to mental-health services through the NHS.”
She describes the therapy as “low-tech”. It does not require “taking lots of history, or giving people diagnoses, or really understanding where their problems might have come from in any kind of complex way. It’s more a cut to the chase, looking forward to getting where people want to get to.”
The focus, she says, is on “identifying people’s own strengths and coping with things. It honours people’s own views on what a good life looks like. We are not trying to squeeze people into a box or say ‘You have got to cure these particular problems.’ . . . Identifying steps and strengths is often a lot more productive, or productive in a shorter timescale, than going back and listening to details of problems and trying to fix problems.”
Although it “does not work for everybody”, she believes that it is a form of therapy that does no harm, and says that it has been shown to be effective across the board, from treating psychosis and schizophrenia to anxiety, depression, and chronic pain. She hopes that they will be able to demonstrate the therapy’s effectiveness, with a view to attracting NHS funding.
While she does not have a faith, she meets many clients who have, for whom she has “great respect. . . This approach allows people to bring their own values and their own belief systems along into the room, and they are not going to be challenged. The focus is very much on what works for this person.”
The sessions, which began on 27 January, will be available between 10.30 a.m. and 1 p.m. every Wednesday until 2 March.