Information and understanding of mental health has been transformed to an enormous extent in the last decade, especially for children and young people. Previously, those with mental health conditions were considered difficult, dangerous and unable to be treated, which resulted in many people feeling like they were no longer able to function in society, turning to addiction or other dysfunctional coping mechanisms to ease symptoms.
Much effort has been made to close the gap between treatment and understanding of mental health and physical health since 1948, but it is only in the last few years that the two have begun achieve a more evenly balanced platform in the health and social care landscape, especially following several high profile cases of celebrities and young people taking their own lives as a result of unidentified or untreated mental health conditions, such as the most recent case of Caroline Flack. These cases have called for a growing sense of importance for our nation taking care of its emotional and mental wellbeing the same as its physical health.
Currently mental health is a leading discourse amongst politicians, healthcare professionals, teachers and parents, and there is currently the highest number of people receiving treatment and support for mental ill health. The Care Quality Commission undertook a comprehensive assessment of the quality of mental health care in England and found that while a huge amount of progress has been made in terms of treatment availability, accessibility and attitudes surrounding stereotyped characteristics of certain mental health conditions such as Schizophrenia, there were still significant areas that needed urgent attention, such as funding and leadership which directly affects wait times, training for staff and quality of mental health facilities.
Furthermore, there is much more to be done to break down the stigma that surrounds those suffering from mental health. It is believed by some that people with certain mental health issues are dangerous and unpredictable, whereas in reality people with these conditions pose a far higher risk to themselves, with between 80 and 90% ending their own lives as a result of the distress they experience. In addition, those treating individuals suffering from personality disorders such as Borderline Personality Disorder (BPD) have found that a lack of training and knowledge by professionals of what typically leads a person to suffer from this disorder acts as a significant barrier in knowing how to treat the condition, or to inspire hope in the individual that symptoms can improve; rather than the individual wearing the diagnosis like a ball and chain.
Others may say that people just need to “pull themselves together”; it has been reported that employers have historically discriminated against those who disclose a mental health condition, as they may require more time off work sick. However, what has been found is that many people who suffer from mental health conditions are hiding it from employers and as a result taking more time off, due to the strain of hiding symptoms from employers rather than receiving the necessary support. Therefore, untreated mental health issues can impact on not only the individual but their family due to lost income, lower educational achievement and overall quality of life and life span.
Fortunately, the dated opinion of people needing to ‘get on with it’ is reducing rapidly; schools, universities and workplaces have been put under pressure and encouraged to establish support networks for those struggling. While it may have been a point of derision from tabloid newspapers that some universities were creating ‘safe spaces’ for those that need them, it is a positive indication of the direction opinions are going in terms of how mental health is viewed.
The Care Quality Commission has committed to work closely with national partners to inform the Five Year Forward View; a government backed plan on how to tackle the issues they identified in the CQC’s inspection. The issues they seek to address are widespread; such as a high number of people of all ages who have been left with no choice but to receive care in facilities many miles from their home, waiting times for up to 18 months, even for children and young people and the inconsistency of using physical restraints.
While it is deeply concerning that between 70 and 75% of people who diagnosable mental illness are not engaged with any service and receive no treatment, the fact that these statistics are now widely available, repeated often and discussed at the highest point of government is a positive. The beginning of every long, difficult journey begins at the first step.
The government has made separate pledges to improve mental health treatment for children and young people and to amend and improve the Mental Health Act to better support those most severely affected by mental health conditions. Additionally, ministers have considered introducing wait-time targets similar to those for physical health such as operations, A&E and other treatments like chemotherapy. Unfortunately the overarching challenge for plans to improve mental health treatment is a severe case of understaffing and lack of funding for meaningful projects to take off. The NHS has implemented a maximum wait time for those suffering from psychosis, however due to understaffing and underfunding, the government’s promise to ensure children are seen within four weeks of seeking help is only expected to be rolled out in a quarter of England in 2023, which does nothing to combat the consistent criticism that public services in the UK are a ‘postcode lottery’ in terms of what kind of quality you can expect to receive in treatment.
Speaking to the National Institute for Health and Care Excellent (NICE), Portia Dodds gave three recommendations for how mental health services could be improved:
'Train GPs and doctors in noticing early signs of mental health issues - depression, anxiety, OCD, bipolar and other common issues - in all people. Not just young people and teenagers, but everyone.
Create more localised CAMHS services to make them more accessible to people all over the country, and more support groups too.
Allow 18, 19 and 20 year olds to stay within CAMHS rather than moving them onto adult mental health services, and make them more accessible when they go off to university.'
It is extremely positive that institutions such as NICE and CQC are using empirical evidence and the experiences of those using the systems to improve them; while a great deal of work is required to improve the delivery of treatment for those with mental health conditions, it is undeniable that our understanding and commitment to improvements have made significant progress, which must be sustained and maintained with the support of the government.
- ↑ http://indepth.nice.org.uk/mental-health-and-the-nhs/index.html#group-a-patient-perspective-Zh1QFagikD (accessed 27/3/2020)
- ↑ https://www.cqc.org.uk/sites/default/files/20170720_stateofmh_report.pdf
- ↑ https://mhfaengland.org/mhfa-centre/research-and-evaluation/mental-health-statistics/ (accessed 27/3/2020)
- ↑ https://www.england.nhs.uk/five-year-forward-view/ (accessed 27/3/2020)
- ↑ https://www.theguardian.com/society/2018/oct/09/mental-health-patients-waiting-nhs-treatment-delays (accessed 27/3/2020)
- ↑ indepth.nice.org.uk/mental-health-and-the-nhs/index.html#group-a-patient-perspective-Zh1QFagikD (accessed 27/3/2020)