Carers UK Forum

Yep ... today's Guardian :

https://www.theguardian.com/politics/20 ... prevention

Mental health services under-resourced, says Matt Hancock.

Health secretary says services are ‘way off ’ what is needed, as suicide prevention minister appointed.

The health secretary, Matt Hancock, has conceded that mental health services have been under-resourced and undervalued as he announced the appointment of a minister for suicide prevention.

Jackie Doyle-Price, a health minister, will be given the new brief and tasked with ensuring that every local area has effective plans in place to stop unnecessary deaths, and investigating how technology can help identify those most at risk.

A report by Whitehall’s spending watchdog, released on Wednesday, found that even if current plans to spend an extra £1.4bn on the sector were delivered, there would be “significant unmet need” because of staff shortages, poor data and a lack of spending controls on NHS clinical commissioning groups.

Hancock said the National Audit Office report showed service provision was “still way off where we need to be” but improvements had been made.

“The truth is that, for an awfully long time, mental health has simply not had the same level of support – both in terms of resources, but also in terms of how we as a society talk about it – compared to physical health, and we want to change that,” he told BBC Radio 4’s Today programme.

As well as having a minister for suicide prevention, the government wanted to ensure that “as we write the long-term plan for the future of the NHS, which we are writing at the moment, we make sure that mental health is a crucial component of that”.

Doyle-Price, whose new title will be minister for mental health, inequalities and suicide prevention, said she would put bereaved families at the heart of her strategy. She is believed to be the world’s first minister for suicide prevention.

She said in a statement: “I understand how tragic, devastating and long-lasting the effect of suicide can be on families and communities. In my time as health minister I have met many people who have been bereaved by suicide and their stories of pain and loss will stay with me for a long time.

“It’s these people who need to be at the heart of what we do and I welcome this opportunity to work closely with them, as well as experts, to oversee a cross-government suicide prevention plan, making their sure their views are always heard.”

At a reception on Wednesday to mark World Mental Health Day, Theresa May will say mental health provision is one of the “burning injustices” she pledged to tackle when she became prime minister.

“Together we can change that,” she will say. “We can end the stigma that has forced too many to suffer in silence. We can prevent the tragedy of suicide taking too many lives. And we can give the mental wellbeing of our children the priority it so profoundly deserves.”

The prime minister has also pledged up to £1.8m to ensure the Samaritans’ helpline remains free for the next four years, as well as new mental health support teams for schools, who will be given help to measure their students’ health, including their mental wellbeing.

However, the children’s commissioner for England, Anne Longfield, thought the proposed five-year plan was too long to wait for some children, and said five years “feels like a lifetime to a young child”.

“I want to see a counsellor in every secondary school, every primary school having access to counselling services, a closing of the huge gap in what is spent on adult and children’s mental health and a system in place that provides support and treatment for every child who needs it, when they need it,” she said. “Today’s announcement is a step forward that must now be matched by proper funding and more ambitious delivery.”

A good start ?

New suicide prevention minister previously made jokes about suicide.

Good luck !

Suicidal tendencies ... a combination of factors.

Different factors for every person.

A textbook approach ?

Or , more shrinks to be available ... at an affordable cost ?

Children in poor families seven times more likely to harm themselves, study finds

" Though to some extent, we all make choices, what children go through does have a powerful effect on these harmful behaviours. "

Growing up in poverty can have an “adverse impact” on child development, which can in turn lead to higher risk of self-harm and violence, researchers at the University of Manchester found.

Suicide rates twice as high in deprived areas.

Monday 6th March 2017

As Samaritans releases a report linking inequality with a higher risk of suicide, the charity is calling on the government, businesses, industry and sector leaders to be aware of the risks of suicide and to direct supportive resources to those with unstable employment, insecure housing, low income or in areas of socioeconomic deprivation.

If Austerity is cited as a common factor , will " Our Boy " seek to change Government policy ?

Or ... keep quiet ... for the sake of the Party ?

Still get 1 to 10 ON ... if you're quick !

#########################################################################

I thought the name ... Jackie Doyle-Price ... rang bells :

https://www.carersuk.org/forum/news-and ... le%20Price

She of a " Responsibility to care " , and a staunch supporter of the bedroom tax , fame.

Make it three luv ?

A West Sham United fan ... that will make my day !

A vixen in charge of the hen house ?

I have a looooong memory !

May slaps down minister in dementia tax row by saying the elderly CAN pass their homes on to their children

Health Minister Jackie Doyle-Price was filmed making the claim to Tory activists.

She said the elderly were not 'custodians of an asset to give their offspring.'

PM said it's fair and right that Brits are able to pass on homes to their children.

Tory plan to fund social care was branded the 'dementia tax' in June's election.

The policy was dumped after the backlash helped destroy May's majorit

I couldn't do a better job in making this up if I tried ???

I wonder why ?

At a slight angle but can be thrown in under this thread :

https://www.theguardian.com/society/201 ... s-mps-warn

People in mental health crisis neglected by NHS, MPs warn.

All-party report says patients forced to visit A&E as core services in England deteriorate.

Growing numbers of people who experience a mental health crisis are having to visit A&E or are detained for their own safety because NHS services to help them are deteriorating, MPs and peers have warned.

The 700,000 people in England with severe mental health problems such as schizophrenia and bipolar disorder also face increased delays to get treatment, they said.

“Those who are the sickest often wait the longest to get help,” said a report published on Tuesday by the all-party parliamentary group (APPG) on mental health. Delays make people feel they are “hopeless, and like nothing can help”, it said.

One patient who was unable to access help for their psychosis only received assistance, in the form of “talking therapies”, after their GP told them to lie and downplay the seriousness of their condition, the report said. NHS talking therapy services usually treat only those with anxiety and depression, and not people who have more complex forms of mental illness.

In recent years, core mental health services – particularly community mental health teams and crisis teams – have been overlooked by NHS chiefs, who have prioritised spending on improving treatment in other areas of mental health need, such as support for new mothers and those suffering a first episode of psychosis.

“Faced with rising demand, both of these core services are struggling on their current resource allocation, leading to more people reaching crisis point, attending A&E or being detained under the Mental Health Act,” the report said.

Dr Andrew Moore, a spokesman for the Royal College of Psychiatrists, said: “The neglect of core mental health services, which form the backbone of secondary mental health services, is distressing to see.”

Brian Dow, the deputy chief executive of the charity Rethink Mental Illness, said: “People are being tipped into crisis waiting for treatment. That means more lives are at risk and more strain on the system.”

Core services need to be a key focus of the plans to improve mental healthcare that will feature prominently in the NHS’s forthcoming long-term plan, the APPG believes.

Pressure on NHS services from the growing tide of mental illness means some care is in effect rationed, the APPG inquiry found. “People are being turned away from services or put down to the bottom of waiting lists because they are ‘not sick enough’ for secondary mental health services,” the report said.

For example, some eating disorder services only treat people below a certain body mass index, even if they are already worryingly thin, because specialist nurses and doctors are so overwhelmed.

Care for people in a crisis, perhaps involving suicidal thoughts, self-harm or an attempt to end their life, remain inadequate, despite NHS England’s plans to make them available everywhere by 2021. Every area should operate a 24/7 helpline service for those in acute mental health need to get rapid assistance, the report added. It said the number of people with a psychiatric condition attending A&E had almost doubled since 2009-10.

More positively, the APPG praised the “transformational” impact seen in the four key areas NHS England has made a priority: maternal mental health, early intervention in psychosis, psychiatric liaison services in A&E, and improving access to psychological therapies (talking therapies).

For example, thousands more mothers than originally anticipated are getting specialist help with mental illness related to giving birth.

A cabinet committee should be set up to monitor progress on improving mental health, overseen by the Cabinet Office, the APPG added.

Boy ... has Our Boy got some work to do ???

More from a slightly different angle ... akin to the delay in the Green Paper on Social Care :

https://www.theguardian.com/commentisfr ... lth-review

Mental health patients have been thrown down the Brexit rabbit-hole.

Normal government has effectively ceased, leaving a crucial health review on hold.

The whole thing reads like a misprint: if you present at your GP’s with mild to moderate depression or anxiety, you will wait, on average, six weeks for treatment, which itself sounds like a significant amount of time. But if you arrive with a very severe mental illness – schizophrenia or bipolar disorder – you will wait much longer, 14 weeks, just for an assessment. The average wait for treatment to begin is 19 weeks.

One in six people wait longer than six months. Parking the human beings for a second, it makes no sense as a system: physical and mental health are not equivalent, and having a psychotic episode is not the same as breaking your leg. But in the broadest possible terms, this is like fast-streaming people with arthritis while leaving cancer sufferers in a half-year limbo. It’s not a system anyone would design; it’s hard to fathom how it could simply evolve.

Reading the report from the charity Rethink Mental Illness, though, you cannot park the human beings for very long. Heartbreaking testimonies leap off the page: “These answers were on behalf of my husband, who sadly took his own life six weeks ago … I truly believe that, if he had received therapy sooner, he would still be here.” “I was left for months at a time with no contact from my community psychiatric nurse. Following a suicide attempt, I did not hear from them for a month.”

The perception of the health service from the outside is of a system left threadbare by nearly a decade of underspending and restructuring, held together by the determination of the people working in it. This is wishful thinking: all the determination in the world cannot make more hours in the day, magic more staff on to community psychiatric teams. What’s really going on is a huge amount of suffering, for want of a plan.

Mental health, bear in mind, has been at the centre of the government’s rhetoric since 2012, when the Health and Social Care Act specifically brought up “parity of esteem”. Its failure to enact or, for that matter, define it notwithstanding, there didn’t appear to be any shortage of intention. There are civic catastrophes going on that seem to be part of a deliberate approach: universal credit is the striking example. It is a failure as a social safety net, but if your plan is to destroy security as a duty of the state then it’s working quite well. Mental illness is not such a case: David Cameron made a specific pledge to bridge not just the esteem gap but also that of funding.

Theresa May made what was, in retrospect, an astonishing speech nearly two years ago, in which she undertook to “employ the power of government as a force for good to transform the way we deal with mental health problems”; it was a “historic opportunity”, she said; it would sweep away the years of injustice, the “completely unacceptable stigma”. Sure, she says a lot of things that don’t transpire. Yet the failures in this area speak of something more significant than insincerity. May has been unable to employ that “power of government” because government has, effectively, ceased. It’s disappeared down a rabbit hole in which it has somehow managed to trap us all: when Brexit is all it can talk about, that is all any of us talk about.

Meanwhile, in the spheres where life is lived, where crises occur and professionals wrestle with them, everyone is forced to proceed as though normal service will resume shortly. The long-term plan for the NHS – slated to consider, among many other things, how to spend the extra £2bn on mental health that the chancellor, Philip Hammond, promised in last month’s budget – was due on 10 December. Two days later, the independent review of the Mental Health Act 1983 was set to deliver, and two days after that, the green paper on adult social care. Taken together, these would be profoundly consequential, not just for spending, waiting lists, targets, the treatment of severe mental illness, and the transition for young adults out of child and adolescent services, but also for the deprivation of liberty safeguards – which themselves, handled badly, represent a serious threat to civil rights. Yet the chances of this work going ahead look ever more remote.

Matt Hancock, the secretary of state for health and social care, is another Conservative who has spoken trenchantly of his commitment to mental health – but how does he carve out the time, and command the attention of his party and of parliament, in the wake of the vote on the final deal? Who could concentrate on abstract concepts such as parity, or esteem, while simultaneously strong-arming pharmacists into stockpiling insulin? How do you change the weather from within the eye of this enraging, needless tornado?

One of the tenacious myths of our current politics is that every time the prime minister survives another crisis, the clock is reset, her authority is restored, and she soldiers on. What actually happens is that each crisis draws us further into entropy; processes break down, knowledge is lost, and the cracks in the system have become the system.

Mental health strategy ... like our carers' strategy ... into the long grass whilst all attention is focused on Brexit.

Come whatever Brexit , what will be the state of play as a direct result of postponing the reviews ?

Continuation of the meltdown making all work done to date redundant ???

Forget ambulances , say hello to " Blues and Twos " ?

https://www.theguardian.com/society/201 ... m-patients

Police " Picking up pieces of mental health system " , says watchdog.

More than half of patients who need to be taken to hospital are picked up by a police car.

Overstretched police forces are having to “pick up the pieces of a broken mental health system” on top of tackling crime, the emergency services watchdog has found.

More than half of all mental health patients who need help in a place of safety are taken there in a police car rather than an ambulance, according to Her Majesty’s Inspectorate of Constabulary, Fire and Rescue Services.

The Metropolitan police (MPS), the UK’s largest force, deals with a mental health call once every four minutes, and sends an officer just to deal with mental health issues once every 12 minutes.

Some health professionals are telling patients in need to call the police in order to beat long NHS waiting lists, the report said.

The watchdog said police were being dragged away from their actual job because officers were making up for gaps left by medical experts as a “national crisis” blights mental health services.

It is the latest report from an official watchdog to criticise the government in robust terms over the effects of austerity on policing, following on from a report from the National Audit Office in September.

Zoë Billingham, its author, said mental health services were failing to cope with the demands on them. “There has been a significant reduction in the availability of specialist mental health nurses over the last four years,” she said.

“So clearly there is an issue relating to increases in demands and the availability of specialist services, and you will know that has been recognised and there is further investment happening across the NHS in mental health.”

Billingham added: “We cannot expect the police to pick up the pieces of a broken mental health system. Overstretched and all too often overwhelmed police officers can’t always respond appropriately, and people in mental health crisis don’t always get the help they need.

“People in crisis with mental health problems need expert support – support that can’t be carried out in the back of a police car or by locking them into a police cell. All too often, the system is failing people when they most need help.”

Officers are covering for the NHS by taking patients to hospital, waiting with them while the right type of bed is found, and checking on or finding vulnerable people.

Police – instead of NHS staff – take ill patients to hospital about 12,000 times a year, or in 52% of cases, according to the research.

Peak times come when NHS services clock off at around 5pm, the report found, with repeat callers taking a disproportionate amount of police time.

“The top five individual repeat callers to the MPS (all of whom have mental health problems) called a combined total of 8,655 times in 2017. It cost the service £70,000 just to answer the calls.”

Mental health incidents require more time than other types of calls to police, but there is no national estimate for how long.

Merseyside police estimates that 25% of its officers’ time is spent on mental health issues, while Lancashire police calculates that 20,000 hours of response officers’ time, out of 70,000 hours every year, is spent dealing with mental health issues.

Billingham said that, while working on the report, she witnessed one incident last week in Leicestershire in which a man was threatening to jump from the seventh storey of a car park. The man lived, but it took 20 officers and police staff to deal with the incident.

The report sets out what officers have been alleging for a long time, that a collapse in mental health services was dragging them away from fighting crime.

Police Federation chair John Apter said: “The government’s austerity policies have led us to this dire state.

“I hope the prime minister and the home secretary read this report and hang their heads in shame at the situation they have not only created, but were warned about on numerous occasions.”

A spokesperson for the government said: “The government is clear that the best place for people suffering a mental health crisis is a healthcare setting which is why we are investing £2bn in mental health services, including £249m in rolling out liaison mental health teams in every general hospital by 2020-21, and are investing £400m to improve mental health crisis resolution services in the community.”

NHS to look into deaths of 100,000 mental health patients a year.

All fatalities in England to be investigated after Connor Sparrowhawk case highlights poor care.

The NHS is to start investigating the deaths of more than 100,0000 mental health patients a year in a drive to cut the number of fatalities linked to poor care.

England’s 54 specialist mental health trusts have been told to start looking into every death in an effort to learn from mistakes.

In future they should more fully investigate cases in which the patient may have received poor or unsafe care, especially if they had bipolar disorder or an eating disorder.

The first guidance to trusts on the subject has been drawn up by the Royal College of Psychiatrists and is being backed by NHS England. It is meant to end the existing ad hoc system whereby different trusts examine smaller or larger numbers of deaths.

“We hope that this will improve care, save lives and reassure friends and family who have lost a loved one that if they have concerns, they will be acted on [by the trust which was providing care],” said Dr Adrian James, the college’s registrar.

Mental health trusts’ failure to look into patients’ deaths became an issue in 2015 when it emerged that Southern health trust had not examined the death of about 1,000 patients with autism or learning disabilities.

Its failures were highlighted by the poor care it gave to Connor Sparrowhawk, an 18-year-old with epilepsy and autism, who drowned in a bath in the trust’s Slade House facility in Oxford in 2013 after his doctor made 39 different errors.

Under the guidance, any one of four “red flags” will automatically trigger an in-depth inquiry by a senior trust doctor who was not involved in caring for the patient who died.

They include relatives or staff having voiced unease about the deceased’s care and any patient having recently had psychosis or an eating disorder.

An investigation will also be mandatory when a patient had recently been treated in a psychiatric ward or been under the care of a crisis team or home treatment team when they died.

Louis Appleby, a professor of mental health at Manchester University and the director of the university’s National Confidential Inquiry into Suicide and Safety in Mental Health, welcomed the move.

“This is about two things: learning from what goes wrong and the public accountability of public services,” he said.

“Families can be hugely frustrated by the repetition of ‘lessons will be learned’ after a tragedy. Here is an attempt, a practical process, to make sure that happens.

“Large studies are one way but examining individual cases can turn up crucial details – gaps in care that can be put right for the safety of others.”

The Guardian disclosed in March that at least 271 mental health patients in England and Wales had died since 2012 after errors by NHS trusts.

Dr Panchu Xavier, the associate medical director of learning reviews at Mersey Care NHS trust, said that his trust – one of the 11 involved in piloting the guidance – uses it to look at 350-400 deaths a month.

As a result it has recently increased the number it then subjects to review from three or four to eight or 10 a month.

“The college’s guidance has been extremely effective. We found that the red flag system highlighted all the most pressing cases and is saving us hundreds of hours of staff time.”

Barbara Keeley, the shadow cabinet minister for mental health, said: “For families of people with mental ill-health, this guidance will provide vital reassurance that the deaths of some of the country’s most vulnerable patients will be investigated and that these heartbreaking cases can be stopped from happening in the future.”

Caroline Dinenage, the care minister, said: “Each preventable death is a tragedy and we must learn from each one.

“This new guidance will equip trusts with the tools to more quickly identify areas of improvement, provide more support for families and implement changes to better care for people with severe mental health conditions.”

Mental health : target to boost staff numbers by 21,000 set to be missed.

NHS mental health trusts in England employed just 1,524 extra personnel in past year.

Ministers are on course to miss their target of increasing the number of mental health staff by 21,000 by 2020, according to NHS workforce figures obtained by Labour.

A year after the government made the pledge, NHS mental health trusts in England had employed just 1,524 extra personnel, according to statistics collected by NHS Digital.

The very small rise is a setback for Theresa May’s plans to dramatically improve mental health care in order to reduce treatment delays, introduce new waiting times and reduce unmet need. Mental health chiefs and staff groups are worried that staffing problems will undermine those ambitions.

In July 2017 the then health secretary, Jeremy Hunt, said the recruitment of 21,000 extra personnel including psychiatrists, mental health nurses and therapists would help the NHS treat 1 million more people with mental health problems by 2020-21 and provide 24/7 care.

NHS Digital figures show that in August 2017 mental health trusts employed 179,333 staff. That had risen to 180,858 by August last year.

Barbara Keeley, the shadow mental health minister, who highlighted the statistics, said: “This government’s failure to act on the mental health workforce crisis could threaten to turn the burning injustice of mental ill-health that the prime minister pledged to tackle into a raging inferno.”

The disclosure of the modest increase comes days before the publication of the NHS long-term plan. In it NHS England will set out how it will use the extra money the prime minister has pledged to give it over the next five years, rising to £20.5bn more by 2023-24.

Improvements to mental health care over the next five to 10 years are expected to form a key part of the document. May has made mental health a priority in her two and a half years as prime minister, and promised that the long-term plan will increase mental health’s share of the NHS budget by at least £2bn by 2020-21.

The NHS Digital data also shows that if staff employed by two community services trusts in Liverpool and Staffordshire taken over by mental health trusts are included, the overall number of those working for the latter rose by 6,748 between August 2017 and August 2018.

However, that higher total includes about 5,000 staff that previously worked for the community trusts being reclassified as mental health staff as a result of the mergers.

A spokesperson for the Department of Health and Social Care said: “Mental health is a key priority for the government. We are transforming services with record amounts of funding, with the NHS spending almost £12bn on mental health in 2017-18.

“But we want to go further, which is why the prime minister has made parity between physical and mental health a priority for our long-term plan for the NHS supported by at least an additional £2bn a year.”

Still no help for people

No help because it's so exorbitantly expensive. And possibly isn't even effective.

I wonder what the 'cure rate' for all mental health ailments is (ie, in the case of 'best care that medical science/psychiatry can provide irrespective of cost').

I suspect that for a sizeable (majority?) of mental illnesses 'lifelong' care is required by the very nature of the illness. ie, the patient can never be 'discharged needing no more treatment'.

It really isn't surprising I guess, sigh, why the cheapest treatment option, ie pills, is so resorted to. In comparison with paying the hourly rate of highly expensive psychiatrists, pills are cheap as chips.....

As a society, the bottom line is: does it cost more to TREAT mental illness than to endure the existence of a percentage of the population who have mental illness.

It could simply be loads cheaper to let loads of mentally ill people lurch unhappily around the country than providing the psychiatric care they need.

It's pretty well accepted, in Cancerworld, that the cheapest option is to let people develop cancer to the point where it is terminal, and then let them die ASAP. Much cheaper than treating them! And since very few people of working age get cancer, there is no real loss to the economy. Most people who die of cancer are retired. Saves on their state pensions for a start....

I think illegal drug and alcohol abuse is so widespread, its a few decades of that catching up with the population.

The bean counters are in total control.
We are living a balance sheet life?