It’s Time to Talk About the NHS’ Mental Health Crisis

Mental Health Awareness Week poster reading 'No Health Without Mental Health'

Trigger warning: terrorism, suicide, mental health issues and treatment.

A little under a year ago, Manchester Arena was attacked by a suicide bomber, and 22 people died, and many more were injured. Money was donated to the survivors, and local and national government made all sorts of promises. But, for the children who survived the attack, they were looking at median waiting times of 8 weeks for Child and Adolescent Mental Health Services (CAMHS) in the North of England.

If you suffer a mental health crisis, all of the advice tells you to immediately seek medical attention — an emergency appointment with a GP if possible, or A&E if necessary. But, in 2016/17, it was found that only 7% of acute hospitals (i.e. ones with an accident and emergency department) had mental health crisis teams that achieved the service standard – known as Core 24. The hope, in the five year plan where the statistic appeared, is that this would raise to 50% by 2020/21. A crisis team will try to treat you in your own home or within the community, in situations that generally could require hospitalisation. Hospitalisation for mental health issues have dropped, but this may have more to do with a lack of beds than anything else.

Note: If you are having serious thoughts of harming or killing yourself, please still do seek immediate medical attention. Things cannot get better if you are not here, and these places can help keep you safe.

The government targets show a similarly bleak picture – the standard is that you have a right to treatment within 18 weeks, and from April 2015, trusts were trying to achieve 75% of referrals being seen for talking therapies within six weeks. They are mostly hitting these targets, but the picture still doesn’t look good from the perspective of someone looking to seek help for mental illness. The average is still just over three weeks, and there’s a postcode lottery element that comes into it as well. One area boasts an average of less than a week, but a busy city trust had an average exceeding the 18 week target.

Campaigns like Time to Talk and Be In Your Mate’s Corner do a good and important job. I love to see tweets from people saying “You can talk to me if you ever need to/if you’re feeling suicidal etc.”. Stigma is still a massive issue – stigma is the reason Bekki Fletcher feels she can’t tell people at work, the reason Sharon McDonagh-Delves apologises for showing symptoms in public places, the reason Prince Harry and the Daily Mail need to shut up about our pills. We need to keep talking about mental illness — but it’s not the only thing that we need to do.

At my local GP, I have received advice to self refer myself to the counselling service — even if I don’t feel I need it at that time. Chances are, my doctor says, by the time the appointment comes through, I’ll have either improved so much I’ll cancel it in plenty of time, or I’ll have deteriorated to the point where I need it. The state of waiting times in our area means that you have to guess how you will feel a month or two from now in order to ensure you’re getting the appropriate care.

Choice is also another huge factor. A report from Mind showed that 58% of people didn’t have any choice in what kind of therapy they received, and 75% had no choice of location. Getting to the point where you can talk to your doctor and say you need help is excellent, but it is essentially futile if you’re shoehorned into a therapy that doesn’t work for you, or that is in a location that you are unable to get to. Half said that there weren’t enough sessions, something echoed by many people in university. 

If we’re raising awareness, we should be raising awareness of the different kinds of therapy available. CBT is the one everyone seems to know, but group therapy, art therapy, less intense one-on-one talking therapies exist, to name but a few. Or, like Becki Crossley, you might find your first lot of therapy doesn’t work at all and not know there are other options and even just other therapists that you can try.

“We need to talk, but we also need there to be someone to talk to; and we’re not getting that at the moment from our Tory-run NHS.”

As we break down more internal barriers to accessing mental health services, more people are more likely to come up against these external barriers — you’ve spoken to someone, but what now? And our government seem to be ignoring the problem. In 2016, the Prime Minister told us that there was to be record spending on mental health services, when in fact a freedom of information (FOI) request to Clinical Commissioning Groups (CCGs – these spend the most of the NHS budget on services) showed 57% were planning to reduce spending. It might still be possible that spending is going up in other CCGs, but the government no longer publishes the report that would inform us of this.

Health Secretary Jeremy Hunt boasted in November last year about the 3.7% increase in funding to CCGs, but this figure didn’t account for inflation. The actual increase was a much more modest 1.5%. He also spoke of the 4,300 more staff that were employed in mental health units — but failed to take into account that not everyone who works in a mental health unit actually delivers the kinds of therapies that are desperately needed. That figure hides the fact that there are 5,000 fewer mental health nurses, and over 100 fewer fully trained doctors, although there are more junior doctors.

For this Mental Health Awareness Week, 10 Downing Street also put out a video on Twitter of the Prime Minister showing her support for Mental Health Awareness; a video which has received a lot of responses pointing out May’s hypocrisy in being a part of the party that is causing undue stress on our NHS mental health services. From not funding it as much as it needs to be, to the stripping of disability benefits from people with mental health issues, to the general unrest and increase in various conditions as a response to austerity measures.

Theresa May also mentions that more people than ever before are receiving treatment for their mental health, a statistic which is true — there has been an increase on a few years ago of numbers of referrals received. However, of referrals received, only 42% of people go on to “finish a course of treatment”. Of course, some of the patients who never attend an appointment, or who attend but are not treated will have had this outcome because of the stigma associated with seeking mental health treatment — the report doesn’t state reasons for patient dropout — but at least some of these are going to be due to lack of options and lack of choice.

As we work on getting people to talk, work on the ever so important job of breaking down stigma, the record levels of people seeking treatment are going to continue to go up — and I hope they go up to the point where everyone who needs treatment gets it. But the fact is that the services the NHS is providing are just not going to cut it as society gets better at opening up.

We need to talk, but we also need there to be someone to talk to; and we’re not getting that at the moment from our Tory-run NHS.

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