Thursday, July 17, 2008

Out Of Sight, Out Of Mind

Author's Note: The author of this post is not "The Devil's Kitchen"

Via Letters From A Tory, MPs are complaining, through a cross-party committee, that they face discrimination and stigma if they make mental health problems known.

At least they will be able to get help. Meanwhile, those who aren't paid over sixty grand a year are stuck with the NHS. And thanks to chronic waste, mismanagement and general neglect, NHS mental health services are nothing short of a disgrace.

On reading the blog of Calum Carr*, one would hope that his experience in trying to obtain help for his mentally ill wife, only to meet with abuse, evasiveness from medics and politicians, and Byzantine bureaucracy, is unique. However, I seriously doubt that it is.

Dr Crippen described provision for the mentally ill in this country as "appalling" and psychiatric services in his area as "dreadful", with "unqualified amateurs who think psychiatry is a game". For their part, psychiatrists, as reported by the Times, report that:
The doctors say that patients with serious problems are often referred to psychologists and social workers rather than clinicians and do not receive the medical therapies they need.

So, no, Mr & Mrs Carr's predicament is far from unusual.

In hospital, the situation for the mentally ill isn't much better. A report by Dinesh Bhugra, the incoming president of the Royal College of Psychiatrists, paints a damning picture of mental health-care in the NHS in 2008. In-patient acute psychiatric care is described by Bhugra as:
So poor...that he would not use them himself - nor allow a member of his family to do so.

Some wards are "frightening and dangerous places", perhaps not surprisingly when it is "standard practice for many wards to be run at up to 120% occupancy".

Mental health is chronically under-resourced and mismanaged. Why? Because mental health is a low priority. It isn't 'sexy' - It doesn't make for great press-releases or grab headlines; and it is difficult. Treatment of a patient with a complex mental disorder requires more than giving them the right drug so they'll get better. When a so-called health service is run for the benefit of politicians and managerialists rather than patients, it is inevitable that unglamorous areas such as this will become neglected. It's no surprise that, after 60 years, mental health in the NHS so often lives down to its oft-repeated description as a 'Cinderella service'.

MPs: If you really give a shit about people suffering from mental illness - and I don't mean 'stress' as a result of somebody finding out about your latest expenses scam or affair with your secretary - how about actually doing something to sort out the absolute fucking national disgrace that is NHS mental health care neglect.
You may suffer embarrassment as a result of mental health problems being highlighted by the media or otherwise becoming public knowledge...but it'll be cold day in hell before any MP ends up on the mental health scrapheap that people like Mrs Carr are consigned to by the fucked up system that you have left to rot.


* The bloggers' campaign is at Mental Health 4 All.

5 comments:

Patrick said...

Ian,

Apologies for my oversight regarding your blogs in the past...

However, you are dead right about mental health... Until one of these theiving fuckers gets one (a mental illness).. They are unlikely to give a shit...

However.. One may imagine that the very diffinition of a politician would indeed be mental illness.. However they are oblivious to this of course... To busy in Lala land scooping up all that free cash...

Calum said...

Ian

Thanks for highlighting Mrs Carr's problems and the much larger problems with mental health care in general.

An excellent post.

Henry North London said...

Having just walked out of a locum in a sink (rehab) ward of the NHS ( locked with untreatable and unwanted patients) on the first day of getting there because it was so direly disorganised and made me feel like death I wholeheartedly agree.

After all it was only when an ex MP couldnt get treatment for wet AMD that the NHS got lambasted for being such a penny pinching organisation

the a&e charge nurse said...

As far as I know the NHS has never been accused of leaving a 49 year old woman to die in a psychiatric emergency room while staff ignored her [even though she was face down on the floor, and had been waiting for 24 hours] - guess which country did ?
http://www.youtube.com/watch?v=ybOJUujKxPg

The care of the mentally ill suffers from exactly the same bind as the wider NHS: too much is promised, to too many.

The tendency to medicalise or pathologise 'problems in living' has placed intolerable pressures on health services in general....... but psychiatric services in particular.

Such services are now routinely used as a bin for:
Drug addiction [which in my view is not a medical problem].
Alcoholism [ditto].
Homelessness.
Unemployment.
Dysfunctional families, unable to cope with the vagaries of everyday life.
Children, frustrated by the lack of access to open space and robust physical activities.
Economically oppressed single parents, etc, etc.

In short many psychiatric services are in danger of becoming little more than the medicalised arm of the welfare state.

Some even argue that there is no such thing as mental illness [as an organic disease] and that the interventions of professionals only makes things worse.

Certainly we have seen a huge rise in the number of heroin addicts since the 70's and commentators such as Dalrymple [Junk Medicine] claim that the treatment apparatus merely perpetuates this burgeoning problem.

The number of children with a psychiatric label is also on the increase [especially in the USA] - I think we are right to feel deeply suspicious about such developments.

Now, I suspect the Darwinian instincts of the libertarians will begin to twitch if certain sectors of our society are entitled to a free lunch at their expense - anyway, will putting more money into a discipline with such an equivocal knowledge base actually guarantee any measurable improvements if so many customers are clammoring for attention ?

Rob said...

"The doctors say that patients with serious problems are often referred to psychologists and social workers rather than clinicians"

Great. You won't get treated and additionally you'll lose your kids. That'll help the depression.