Right here, right now: Mental health crisis care review

Discussion in 'Politics & The Economy' started by tapzilla2k, Jun 12, 2015.

  1. tapzilla2k

    tapzilla2k
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    The CQC has just released it's report into care given when somebody suffers a mental health crisis -
    Right here, right now: Mental health crisis care review | Care Quality Commission

    This is the next big scandal in the NHS, if something isn't done quickly to address the myriad of issues and lack of funding to provide safe and appropriate care we could see a Mid Staffs situation arise (if it hasn't already). It's high time we all took Mental Health just as seriously as physical health. You never know when you might suffer a mental health crisis or somebody you care about does.
     
  2. domtheone

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    Another looming crisis that will just get worse and worse with rampant population growth through peeps living longer and our open door border policy.
     
  3. EarthRod

    EarthRod
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    Care has to be taken with this (no pun intended).

    Professional NHS staff, especially those in the front line A&E, put up with a lot of abuse from patients and really do not have the time or the resource to deal 'sensitively' with mental health issues.

    The NHS is always on the borderline of breaking down due to too many cutbacks on front line staff - nurses and doctors.

    Also, it is not beyond belief that a patient with mental health issues will complain of mistreatment even though the NHS staff have dealt with the patient correctly.

    As we all know, physical health is down to finding the problem and repairing it, or at least trying to repair it. Mental health is a much more difficult thing to deal with and requires much more effort, time and resource.
     
  4. Toko Black

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    Primarily from drunks and scumbags rather than people with mental health issues.

    It's not just front line staff that are missing from mental health - it's through out the system.
    As I have stated before, the NHS doesn't even offer support to people like me who have to find alternatives in the charity and private fields to get the clinically diagnosed therapies which we have to contribute to or even fully fund.

    I do not think the statement of mental health patients complaining of mistreatment to be particularly fair.
    Yes someone with delusions and out of touch with reality may believe all sorts of things happened that didn't, but that doesn't represent the broad spectrum of mental illnesses, many of which don't feature such detachment from reality as to be claiming mistreatment that doesn't exist.
     
  5. tapzilla2k

    tapzilla2k
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    Those patients tend to be those who rock upto A&E on an regular basis and kick off. It may misinform some A&E staff about the nature of Mental Health for those who are in a crisis and have probably never been in A&E before for Mental Health problems. You do realise that over the last couple of years the NHS has been passing the buck to the Police to deal with Mental Health patients a lot of the time and with the lack of beds it's meant those in need of urgent care have ended up in police cells (it's changing now thankfully).

    The NHS Mental Health budget has had a real terms cut in funding of around 8% over the last 5 years vs rising demand for therapy and other treatments. Which has had a direct impact on CMHT and other crisis services. Put simply too many cutbacks and reorganisations mean there are not adequate staffing levels to deal with the demand for crisis care. It's not safe for the staff, the patients or the general public for that to be allowed to continued for very long. The way Mental Health services are provisioned needs to be looked at in depth.

    It's not but if you take the time to look at the stories of Mental Health patients who have recovered, you'll see a picture of a service near breaking point. It's not conducive to somebody's recovery if they are stuck in a hospital out of reach of Family and friends. I believe the bill for using private hospitals was around £25 million the last time I looked.

    If you are sectioned, it's subject to review. Checks and balances etc.

    The expertise is there to deal with Mental Health, it lacks the resources to make use of that expertise effectively. I'm lucky in that I live in Oxford as Oxford University is involved in all areas of health care including mental health. Which means I got to see an expert in mood disorders. Otherwise ? Access to Talking Therapies is limited and does not really work for my complex mental health condition. Or I've yet to be matched with a Therapist who can help me properly.
     
  6. EarthRod

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    OK, Basically I think we are in agreement that the problem lies in lack of resource and the NHS always seems to be on the brink of collapse - but that could be government politics and the media over-egging the cake.

    Also, the future might look pretty bleak as the lack of resource could lead to less spent on training young staff.
     
  7. tapzilla2k

    tapzilla2k
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    I wish that were the case -
    Norfolk & Suffolk Mental Health Crisis | Campaign to Save NHS Mental Health Services in Norfolk and Suffolk
    Glan Clwyd Hospital: NHS inquiry call after care failings - BBC News

    And a specific example where somebody has been failed when they most needed proper medical care - Parliamentary and Health Service Ombudsman | Man with mental health issues dies after failings by two NHS trusts
    A&E is under pressure as well - 'System failure' of NHS mental health services puts pressure on A&E wards | Society | The Guardian

    Plus if you read the various blogs and twitter accounts of various Police officers, the picture looks even worse. Police Inspector Gadget has given a fairly good account of what's going on and I think 999 What's your emergency on channel 4 has shown what goes on as well in terms of what the Police have to deal with. Police Officers are not social workers or trained mental health professionals but they've taken the brunt of the problems over the last decade at least due to the NHS and others increasingly relying on the Police to manage difficult patients. It's a waste of police resources (unless it's a situation that involves life and death decisions) and not good for people with mental health problems.

    The future is bleak tbh. Waiting lists for talking therapies can be anything from 6 months to 12 months or more if you are lucky, otherwise some people have to pay for it out of their own pockets. IDS has a barmy idea to link receipt of benefits with talking therapies. Given the size of waiting lists, I can see him attempting to deny benefits until therapy starts. And it has to be said, that Talking Therapies don't work for everyone and there is a risk it's seen as a one size fits all treatment.

    I was deemed to be a risk to myself (I have constant suicidal thoughts, not something I'm embarrassed to admit don't want any sympathy), so they rushed me through to CBT. Which helped identify a few extra problems (mania episodes mostly). I'm better than I was but I can feel myself slipping backwards. I have insight into my condition apparently, which probably makes it appear that I sound better than I actually am unless an expert is assessing me (and not an A&E Nurse working for ATOS thinking being mentally ill means you are close to violence and wanting to maim everyone in sight at the slightest provocation).

    Resources are stretched thin, training is still going on. But from what I've heard from a friend whose currently training to be a Mental Health Nurse, students are used to fill gaps when they are on placements. Sometimes in wards with patients who are not safe to be around i.e. usually requires a team to deal with them safely for all involved.

    Funding wise ? The cuts of the last 5 years have to be reversed along with increases where it's needed (Crisis care being one of those areas), a lot of NHS Mental Health trusts need to be overhauled and of course we need to continue to break down the stigma attached to Mental Health. IDS has done those of us with mental health problems no favours at all with his scrounger narrative, he's made it that much harder to recover from a mental health crisis (benefits are a vital lifeline) and eventually return to work. He's still refusing to release the DWP's internal figures on death rates that you can link to ATOS decisions even though he's been ordered to by a watchdog (I'm guessing it will take a court ruling to force him into it). That's a scandal waiting to blow up in his face. As the old saying goes if you've got nothing to hide....

    There are lot of interlinked issues here that the Tories will not address unless a scandal forces them into it.
     
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  8. EarthRod

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    Well, it is unlikely any resource will be released by the Tory government in the near future to help towards the NHS shortfall.

    Maybe there will be a reaction among the Tory backbench MPs plus support from Labour and the SNP MPs forcing a change of government policy on cutbacks and some serious funding to be injected into the NHS.

    Unlikely though - times are hard and the government has nothing in the coffers.
     
  9. Squiffy

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    The tories have a manifesto commitment to make up the shortfall of £8bn by the end of the Parliament. And they have not been making cuts to the NHS in any case.
     
  10. Enki

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    Life would be so much easier, if the NHS was the ony entity that cared for the most vulnerable, Community Mental Health Teams appear to be NHS only, they will typically be made up with Local Authority workers as well, cut to councils budgets and their community care support has had huge impact in what Community Mental Health Teams can offer. The inevitable decline in service, as jobs are lost, people are at greater risk of crisis and therefore possible stint in hospital.
     
  11. tapzilla2k

    tapzilla2k
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    They will if it starts costing them votes.

    There could be a reaction if we see a mid staffs like crisis in various NHS Mental Health Trusts.

    Actually they are reluctant to do the one thing that would generate money for the NHS - increasing NI by a certain amount and setting that increase aside (protected by law so Politicians can't raid it to pay for other things) for the NHS and Social Care budgets. It's a Labour idea, but it's worth looking into. Especially given those two services will come under ever increasing demands and pressure.

    That's an unfunded pledge, that will likely be found from the cuts Osborne is about to make or it will be borrowed off the bond markets. From what I've read NHS Mental Health budget needs at least £1 billion to reverse the damage already done and a whole lot more to get services to where they need to be. I doubt the Tories will do anything with NHS Mental Health budgets other than headline grabbing injections of cash into limited areas of the service (talking therapies seems to be the political flavour of the month). They'll want to use that £8 billion on the physical health side of things for political gain i.e. reduce waiting times for treatments people haven't been able to recieve in a timely manner over the last 5 years. There is a far bigger shortfall in the NHS Budget. £8 billion is a number plucked out of thin air, and is more akin to a sticky plaster. I expect services to deteriorate in the short term.

    Read the report, it covers this in a lot of detail. The main problem with NHS Mental Health Services over the last 5 years is the 8% reduction in funding (around £600 million). Services keep getting redesigned i.e. wards closed to save money in the name of efficiency and better care provision, staff cuts and so on. It's one of those NHS scandals that's going on in the background and then it will appear to explode into life out of nowhere. Basically NHS Managers are making decisions without looking at the clinical outcomes of those decisions.

    Jeremy Hunt's views on Mental Health leave something to be desired. So I'm not holding my breathe over NHS Mental Health services getting the kind of money it needs, it will limp on until it collapses due to the demands on the service. Ironic really given how much Mental Health conditions effect the wider economy in terms of lost productivity and so on.
     
  12. Enki

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    Many of its highlights are problems that people within services have been pointing out for 15 to 20 years, if not longer. Cuts to other services are having impacts.

    Step forward Big Society "integrating the free market with a theory of social solidarity based on hierarchy and voluntarism", or maybe not voluntarism, as appears to be the case.:)
     
  13. tapzilla2k

    tapzilla2k
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  14. Member 55145

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    I tipped up in A&E as a last resort earlier this year after mental health issues and lack of help from local MH. The nurse in A&E didn't give a sh*t, and this was an out of county one I attended due to failings in my local county.

    The staff don't have the experience or the time to deal with it and it is a burden put on them due to the lack of staff in the actual MH centres.

    TBH unless you have self harmed or been in a situation where you came close to death they won't deal with you. This is a real failing as a lot of people wouldn't get to these states if someone would just listen to them
     
  15. mij

    mij
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    It is a joke trying to get help with mental health problems and has been for decades, I had to go private to get my Bi-Polar diagnosis and treatment after more than ten years of getting no where with the NHS.
     
  16. Member 55145

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    Good to know its not me cracking up and others do recognise the failings of public services around us!
     
  17. McCol

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    I work on an acute admissions mental health ward and it saddens me to see some of the press coverage and comments on forums in regard to mental health care.

    The vast majority of the team I work with have deep rooted compassion and commitment to the job we do, often in difficult circumstances. However over the last 15 years there has been a constant stream of acute and rehab bed closures with nothing put in place to offset this.
    Despite claims from first Labour then the Tories, paperwork has not decreased, ok it has but only to be replaced by increased inputting of data into computers. Sometimes the same thing being recorded into a paper system and 2 different software programs. All this leads to less time spent with patients on the ward.

    The whole issue with the police and mental health is more complex than the media would have you believe. My own trust has now set up dedicated POS(place of safety) suites to assess and find suitable options for people in need, there is also now a street triage team that can offer on the spot help and suitable help.
    The main problem occurs when someone needs more help, quite often the POS is already being used or the client is too violent and aggressive(sometimes drug or alcohol fuelled) for NHS to deal with. In these situations a bed might be sought after on my ward, however we are always full due to losing so many beds over the last 15 years! Twice this month there has been no available bed nationwide during the night either NHS or Private for admissions.

    Not sure what the answers are to all this, as staff we know resources are limited and it is frustrating for us to see what is happening, I'm not convinced that tendering our services to the private sector is the solution, it might be for some community services but not imo front line more urgent need led services.
     
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  18. Member 55145

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    And your work is very much appreciated @McCol
     
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  19. mij

    mij
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    I have never had an issue with any NHS staff, it is the underfunding & cuts that has in my experience made it almost impossible to get the right treatment when needed.

    I was always dealt with in under an hour and sent on my way with an incorrect diagnosis with very powerful drugs. Going private goes against all of my beliefs and annoyed the hell out of me as I had paid into the system for a long time, so effectively I paid twice for a diagnosis.

    The really stupid part of this policy is that it probably costs more in the long term and causes a lot of unnecessary suffering.
     

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