October 10th is national mental health day and with a reported one in four experiencing mental health problems within their lifetime, and that net casting even further to encompass their friends family work and social life, it is an area of the NHS that is buckling under the persistent tide of over prescription and under funding.
Mental health problems go largely unnoticed with the suffer, often painting a mask on their face to hide what is really going on, out of shame and a fear of not being understood. Any form of mental health diagnoses is a lonely diagnoses; that offers no immediate resolution. Even when treatment is offered the road to recovery cannot be explained in the same way as a hip replacement and the success rate of the treatment doesn't have the same certainty. The chances of relapse are high and the overall journey of the patient is dependent on their input effort willpower and determination rather than the skills of a surgeon. Put simply lives are being wasted because they are not getting the treatment needed to be able to fulfil their full potential. Some lives are being taken while on waiting lists or having been turned away. The stigma of mental illness still exists and these barriers further the crippling need for help.
On a basic level mental health patients complain of battling for diagnoses suffering lengthy waits for treatment, are dealt an over prescribed reliance on drugs and receive a lack of compassion. Two thirds of people with depression in the UK receive no NHS treatment. This is in stark comparison between the most serious of physical conditions (cancer) and mental health treatment. Those working on the frontline describe a system that is underfunded, strained and not fit for purpose. If patients don't fit neatly in to boxes they fall through the cracks and get lost in the system. Dr Annie Hickox specialist in neuropsychology and mental health believes "more psychological awareness (amongst GP's) would not only save money but would meet the needs of the patients more quickly and more comprehensively than the fragmented services we have at present."
By nature of the illness those most in need often cannot face getting help, it's just too over whelming. This in turn can lead to non attendance of sessions and rather than working with that patient the therapy is offered to someone else, leaving the original patient stranded. There is an over whelming sense that GP's readily prescribe antidepressants as a one dimensional approach. More often than not therapy is requested by the patient rather than GP led. Talking therapies such as CBT are limited to a set amount of sessions regardless of the reason for referral. Patients feel like they have only gone part way through the process and come out the other side back at square one as a result of the premature ending of therapy. This vulnerable group of patients are left feeling as though there is no hope and like they have exhausted all options.
Deputy Prime Minister Nick Glegg put forward the coalition's plans to improve mental health services in Glasgow on the 8th of October. He announced that from April 2015 those needing counselling will get it within 18 weeks, the same as for a surgical procedure. Those experiencing psychosis for the first time (Schizophrenia, Bi Polar or severe Depression) will be referred for treatment within 2 weeks, the same as for cancer treatments. There is also £120 million being put towards NHS improvements. In theory this should mean that a mental health patient would have the same clear time frame as a routine operation patient.
If these reforms do happen it will go some way to closing the gaps in the health service provided to those with mental health problems. The real difference needs to come from attitudes and understanding. When you have a mental health problem there is a feeling of despair that shrouds you because no one really understands what is going on. It's an invisible illness, but it's as corrosive as a terminal disease or one that attacks the skeleton. Some would argue that mental health problems have terminal potential if not treated and more importantly treated correctly.
With an area of health care as complex as the mental health sector there are no quick fixes or definitive answers; because of this there needs to be flexibility for the health care professionals rather than strict parameters that have to be adhered to because someone detached from the process decided that was the rule. There needs to be a two way trust between the health care professionals and the patients and this is only going to happen if the frontline staff has access to and autonomy over the patients treatment. There needs to be an education piece for GPs who not exclusively struggle to manage the early stages of the patients' journey and this is a crucial time when dropout rates could cost lives.