Mental Health – “Right Steps” or Wrong

Mrs Carr is improving and receiving the treatment (outside the NHS) which she needs but I remain committed to better Mental Health Services.  This is my first post on these issues since my recent return but this won’t be my last.  I am not going away.

A friend (F) has been on the receiving end of appalling (mal)-treatment at the hands of his local NHS and other supposedly caring and supportive agencies.  Because of ongoing issues I will not identify his geographical location but his story is a warning to us all.  I relate not the complete tale but only one aspect of the most recent happenings with the minimum background.

For years, F had been denied treatment for Post-Traumatic Stress Syndrome (PTSD), was left alone and unsupported until late 2008 when, apparently magically, a highly qualified psychotherapist was assigned to him.

Was this the start of progress?  No!

The issues with the psych (P) need to remain unheard other than to say P is being investigated for malpractice by the NHS and the professional psychotherapists’ body.  This left my friend (F) worse off in early 2009 than he’d been in late 2008: he thought he was going to get psychotherapy but he didn’t and instead he found himself caught up in P’s problems. 

Eventually through his GP the local NHS acted ….. except they didn’t in the way we would expect.

Did they apologise and immediately offer another psychotherapist?  This would seem sensible and considerate given that F has been assessed as being in need of psychotherapy.

No! Of course they didn’t.  That would be too simple.  For months nothing happened other than the NHS were carefully collecting information for their investigations of P.

F was left still in need of the original help but now with extra needs as the result of P’s involvement.

Then just when F thought that help would come he was told that his NHS had changed its system of providing mental health services: it had outsourced services and he would need to enter this new system at the very start although it was clear that this outsourced service could not provide the help required.

Now we must enter a new world of acronyms and jargon.  The NHS has a programme called IAPT: Improving Access to Psychological Therapies.  Mind you, calling it Improving Access to Piss-Taking might be more appropriate. Their website stated:

“The Improving Access to Psychological Therapies programme aims to improve access to evidence based talking therapies [CC says: evidence based talking therapies normally means cognitive behavioural therapy] in the NHS  through an expansion of the psychological therapy workforce and services”

and again

“National Institute for Health and Clinical Excellence (NICE) recommends a range of psychological therapies to treat people with depression and anxiety disorders and bring them to recovery. It also recommends these therapies are used to provide a system of stepped care, shown in the diagram below. Stepped care has two principles:

1. Treatment should always have the best chance of delivering positive outcomes while burdening the patient as little as possible.
2. A system of scheduled review to detect and act on non-improvement must be in place to enable stepping up to more intensive treatments, stepping down where a less intensive treatment becomes appropriate and      stepping out when an alternative treatment or no treatment become appropriate.”

          [Emphasis added by CC]

On paper the programme looks reasonable but people aren’t treated on paper.  The stepped process - one organisation calls its process “Right Steps”  -  must still function properly within the overall NHS framework and it is here that my friend’s treatment has fallen flat. 

TREATMENT!  Did I say, “treatment”?

There has still been no treatment.

Within the Right Steps programme, F has been assessed by a psychologist not face-to-face but over the telephone, a very detailed questioning. 

The outcome?

As we knew from the beginning of the Right Steps saga, F was too ill to take advantage of the therapies available through this outsourced process.  Of course, this would mean that he would step out and receive alternative treatment as the NHS website states.

NO!!  That would be too simple, wouldn’t it.

Rather than stepping out into an alternative treatment, F has been made to step back to the beginning.  He is now back with his GP who has to find an alternative.

Christ!!  More than 15 months ago the NHS eventually made the correct decision and offered psychotherapy.  Why on earth is it so difficult to do so again?  It’s a no-fucking- brainer!

Failure of systems?  Forget the systems for a few minutes and look at the needs of an individual.  F is not alone.  What is happening to F will be happening to many many more: let down by the system but systems should only support those who work in the NHS and not become the tool which they implement blindly and coldly

Those with mental ill-health need much more than systems.  They need:

Common sense!

Caring!

Compassion!

Three words which don’t fit into tick-box systems but words which should be written large throughout the NHS as though it were a huge stick of seaside rock.  With these qualities so much pain would be avoided.  Without them … pain and death.

This shouldn’t be hard to do even with cuts in funding.  All it requires is that patients, sufferers are treated as people and not as lumps of shit to be discarded and washed off as quickly as possible.  Sometimes, often it seems, simplicity is beyond most within Mental Health services. 

Disgracefully, many, like my friend F, are left to suffer behind closed doors, an unseen and unreported statistic.

 

2010 must be the year that we stand up and demand that the NHS gives us:

Common sense!

Caring!

Compassion!