Sunday, 29 June 2008
MENTAL HEALTH 4 ALL: SHAME
Today I use the banner not only for Mrs Carr but for all those who suffer now and those who will suffer.
The Observer has two articles on mental health:
The Mental Health Units That Shame The NHS" which describes the terrible state of in-patient mental health care. "The incoming president of the Royal College of Psychiatrists has admitted .... that he would not use them himself - nor allow a member of his family to do so."
In a second article - an interview with the incoming president " - he ... launched a powerful attack on the state of Britain's acute psychiatric care system, saying many inpatient units are unsafe, overcrowded and uninhabitable, adding: 'I would not use them, and neither would I let any of my relatives do so."
The Observer also carries a very powerful editorial about mental health - Mental Health Must Be Taken From The Shadows". Although I do not agree with all the points raised I make no apology for including the entire editorial.
"In the 19th century England, mental health issues were governed by what was known as 'lunacy law'. Although Victorian parliamentary acts changed the status of those suffering from mental illness from prisoners to patients, they were still kept in brutal asylums.
Today, modern medicine has a sophisticated understanding of the broad spectrum of disorders that constitute mental illness, but politics seem scarcely to have moved on. Mental health treatment is in crisis. Acute psychiatric wards are 'not safe' and are 'uninhabitable', according to Dinesh Bhugra, the new president of the Royal College of Psychiatrists, whose damning verdict is reported in today's Observer. Patients are neglected and often put at risk of violence and sexual assault. The problem, as it has been for decades, is a woeful lack of funding compounded by ministerial failure to address the needs of mental health patients.
Nine years ago, the government cited transforming treatment of mental illness along with heart disease and cancer as one of its top three priorities for the NHS. Since then, the only substantial change has been the Mental Health Act 2007, which strengthened the regime under which people can be forced to accept medication and be 'sectioned' - detained on wards against their will. Those wards were described earlier this year by the Mental Health Commission as having become 'tougher and scarier' places in the last decade. In other words, the most vulnerable and disorientated people are sent to a place likely to exacerbate depression and psychosis.
The 2007 act was motivated as much by the desire to assuage popular fear of the mythological marauding 'violent schizophrenic' as by the hope of getting better clinical outcomes. Without sufficient resources, what we have is a return to punitive confinement.
But only a relatively small proportion of those suffering from mental illness require in-patient treatment. One often-cited estimate says that one in four people will be affected at some point in their lives, a figure that is often met with scepticism because of the culture of shame around mental illness. The number sounds less inflated when the full range of conditions is taken into account: teenagers who starve themselves in pursuit of an unattainable body image; people out of work who self-medicate for chronic low self-esteem with drink and drugs; teenage mothers who run a higher than average risk of postnatal depression; work-related stress that leads to crippling panic attacks; young children self-harming. Problems on such a scale in any other area of healthcare would propel it to the forefront of political debate, as has happened, for example, with obesity.
The government would be pilloried if it simply gave up on improving cancer survival rates, but it has managed discreetly to drop its fervour for revolutionising mental health treatment. Mental illness does not attract the same lobbying zeal, the celebrity-led charity appeals and hospital picketing that force politicians to act on other NHS issues. It is a lonely epidemic.
There are, of course, health trusts that provide excellent out-patient care, therapy and community support. But people are often unaware that they are entitled to such things and GPs are reluctant to offer them because they know how scarce resources are.
This week, Health Minister Lord Darzi will publish his review into the future of the NHS. It will focus on giving patients more choice over where and how they are treated. If carried through, that, in theory at least, could force health trusts to start meeting the complex needs of people suffering from mental illness. But psychotherapy, community psychiatric nursing teams and acute wards will still have to compete for funding with expensive drugs for other illnesses. They will lose out as long as taboo, denial and ignorance define the way mental illness is discussed.
Nothing Labour has done in government suggests that will change. That is a betrayal of millions of lonely, vulnerable people. It is also a challenge to other parties to develop policies that will finally move us beyond the age of 'lunacy law'."
I disagree with the statement "Today, modern medicine has a sophisticated understanding of the broad spectrum of disorders that constitute mental illness, but politics seem scarcely to have moved on.".
I believe medicine is a million miles away from this position.
The comments left at the Observer website I found to be incredibly moving and enlightening. You can read them here.
Posted by CalumCarr at 14:29