Friday, 9 September 2016
The Problem with Mental Health Services and Their Users
I submitted this article to Your Thurrock but they didn't post it so here it is for anyone who's interested.
There are a number of big problems with mental health services in the UK all of which paint a very bleak picture for the future and unless they are addressed in quick measure that future won’t get any rosier.
The first problem is the chronic lack of funding that is pumped into the mental health services by the Government which is a self-defeating proposition given this time of ideologically driven belt-tightening. It is self-defeating because, in the long run, properly funding mental health services will save money in the rest of the NHS which is also dangerously underfunded, understaffed and near breaking point.
People suffering with poor mental health get physically sick more often and for longer requiring more money to be spent on making their bodies better while not properly curing the underlying psychological cause of the illnesses. There is also the matter of those who physically self-harm or attempt suicide, causing untold damage to their bodies that has to be patched up, costing the wider NHS a considerable amount which could have been avoided if the mental health service was given the resources to catch such behaviour before a patient exhibits it.
The second problem is the ‘Payment By Results’ system that is in place which encourages the different mental health trusts to get someone stable enough to be discharged from services but not necessarily well enough not to fall back into crisis in a relatively short period. The mental health trust gets paid on the patient turnover so for every ‘new’ patient there is a reward. Why then would a trust want to do more than stabilise a patient and discharge them? Every ‘new’ referral comes with more funding for the trust in question.
This brings us to the third problem which is that of mental health services (and this includes voluntary sector providers) building dependence into their services for their service users. In the case of statutory services, the fact that people are being discharged from services before their underlying problems are fully addressed means that the patient keeps returning to the service provider, giving the trust a welcome injection of cash and a regular supply of patients. In the case of voluntary sector service providers, the focus is not so much on getting people to live independently but to be such a vital part of a service user’s life that they come to depend upon the service being provided. Voluntary organisations are viewed as successful, much like statutory services, by how big their budget is and how many people they ‘help’ so it is important that they don’t encourage too much independence amongst their service users otherwise their client pool will dry up and their reason for existence will likewise disappear.
The final problem is the users of the services themselves. The dependence bred into them by the various mental health service providers causes apathy amongst even the most able of individuals. They will complain about a lack of services or the poor quality of those that they do receive but they will do nothing about it. Give them a chance to voice their complaints and they will, in the main, not take it. Offer them a chance to contribute to a project that might provide the services they do want and cannot get elsewhere and they decline. Give them a chance to provide their own services, as some plucky service users have done in some parts of the UK, and they cower in fear rather than getting off their fat backsides to make a difference for themselves and others. So many people bemoan the fact that the mental health services, both statutory and voluntary, fail to meet their needs in terms of type or quality of provision but then allow themselves to be dependent on those inadequate services.
Unless mental health service users get a grip on themselves, start to look beyond the provision that is currently out there and try to set up their own peer support projects, they will have no one but themselves to blame when nothing seems to suit their needs.