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.

Change, hardship, sorrow and a first for me

The last few weeks have been filled with a great deal of change and they have had a seriously corrosive effect on me.  The only thing that is currently getting me through it all is the fact that, despite my earnest intention to never take on another cat, I adopted my parent’s cat following her visit to stay with me while my parents were away on holiday.  Blossom is both a comfort and a constant reminder that my beloved son and companion Merlin is gone as she is very similar in appearance to Merlin given that they are from the same breed.

My latest round of life-altering changes came about three or four weeks ago when, finally, the local council offered my ex-wife a flat of her own so the enforced living together that we have endured since our divorce came through has finally come to an end.  Not that the days between Diana getting the flat and her actually moving in weren’t stressful as there were moments when we thought the whole deal would fall through due to financial worries on Diana’s part and the amount of time it took for most of the furniture to be delivered to make the flat habitable.

Of course, when Diana signed the tenancy agreement, the enormity of the hardship I would be subjected to finally hit me as I became solely responsible for the rent, Council Tax and all the bills for the flat that was our marital home.  It has been a long time since I have been responsible for the financial affairs for the household being out of work for so long with my mental health issues so I was unprepared for the huge cost of living nowadays.  I thought that I was struggling before now but I realise that I was extremely lucky to have shared expenses with Diana for so long during this extended period of enforced joblessness.  I will certainly look back on the days of being able to order dinner from a takeaway every so often with a certain nostalgic melancholy.  My £100 a week Employment and Support Allowance is eaten up within hours and I’m not entirely sure that I’ll be able to cope.

It seems ironic that the things I have tried to inform people about – how benefits are too petty an income to live on and be expected to pay towards rent and Council Tax and the injustice of the Bedroom Tax – have now become a reality for me.  Where once I could only imagine the financial strain on someone on benefits, I am now facing a future of personal experience of those issues.

Diana finally moved out on Friday 27^th May and I was left alone with my new cat in a flat that now feels so empty.  Don’t get me wrong, it is certainly better for my relationship with Diana but the situation I’m now in should have been with my beloved son Merlin and not with a latecomer adopted daughter like Blossom.  I do love Blossom but this future was one I always envisaged to be mine and Merlin’s.

I’ve kept myself busy with housework, watching the DVDs I bought to cope with Merlin’s loss (something I can no longer afford to do so thank God for Blossom) and doing stuff on the computer.  It’s still a state of affairs that, although something I’ve been wanting for ages, is hard to cope with especially as it came just a matter of days before my birthday last Monday which is always a time of great depression for me.

My birthday depression is heightened now by the fact that the anniversary of Merlin’s death comes less than a week later on 5^th June and this year, being the first anniversary, has been particularly hard and I found myself bursting into tears from time to time and trying to get comforting hugs from Blossom who is much more active and agile than you would expect from a cat coming up to her 10^th birthday in a few months.

However, despite all the sadness and stress of my new living situation, it has opened up opportunities for new experiences such as my first attempt at cooking scrambled eggs for breakfast.  I know, it’s shocking that a 45-year-old man hasn’t done scrambled eggs before but I only had them when on holiday or Diana cooked them for me on special occasions so I’ve never had the need to cook them for myself.  However, as I am trying to live within very restricted financial means now, I have decided that scrambled eggs will be an integral part of my shoestring catering repertoire.  My first attempt was not entirely successful as, despite seasoning the eggs with pepper, they tasted of nothing and I probably over-cooked them as they were extremely dry and not at all like the scrambled eggs I have had in the past but I will persevere.

With all the doom and gloom that surrounds me at the moment, there is a slight chink of light which may offer some hope.  A couple of weeks ago I met a man who was interested in my ideas for running mental health awareness training from a sufferer’s perspective (much like the stuff I did for Anglia Ruskin University and Thurrock Council) and he seems to think that I would be accepted for a grant of £500 towards starting up a social enterprise delivering such training.  Certainly something to cheer me up if I was that easy to cheer up, knowing as I do how fleeting such chinks of light can be.

I was also introduced to a lady from Thurrock Council who helps social enterprises get started who also seems to think that my ideas for mental health awareness training could work and is currently looking into how she can help me break into such a niche vocation.

If either or both of these links pan out, I might one day be self-employed and on my way to having a fulfilling life but there’s a part of me that can’t get over the fact that I’ve been in a similar position before, where life looked as if it was finally going to be a little brighter before the roof caved in on me and left me so near to suicide it took the act of a stranger to save me from taking my own life.  While I will try to look at the future in a positive light, I think I’ll wait until the other shoe drops before I start to celebrate a positive change in fortunes.

A message for my regular readers

I’d like to thank the small but ferociously loyal band of regular readers for your continued support.  Your loyalty shows you to be extremely hardy and/or masochistic in character to be able to cope with what is a blog filled with pessimism and personal darkness and I find such an act of loyalty to be the only thing that gives any indication that the human race is redeemable.

Some blog writers seem to forget that the only thing that makes their efforts worthwhile are the readers who look up their inane drivel on a regular basis.  I would never make the mistake of thinking I’m better than my readers and, although I get a lot of passing trade, I’m happy enough with those who show character enough to forgive me the dark, pessimistic nature of my output and come back time and time again.

There are long gaps between entries sometimes and that stops me from being the wild and viral success I could be; however, my regulars keep me coming back because I know that there are some people out there who are willing to look at the world through my eyes for the experience and for the different viewpoint on life.

I’m really honoured that my small band of loyal readers is there and continue to be there no matter how dark I get.  I really do appreciate you all.