I fear for the future…

training_primary_care_NHS_mental_health

Last year, the publishers, Barnes and Noble, reported the sale of books about anxiety surged by 25%.

Globally, more than 700 million people suffer from mental health problems and the world is ill-equipped to deal with them.

According to an exclusive in the HSJ, when people with MH problems arrive in some A&E’s, we’ve got nowhere to put them. Apparently some could wait days.

I would have thought a couple of rooms in a local hotel, and a CPN, or two, might get over the immediate hiatus but what do I know…

The 2017 Gallup, Negative-Experience Index, a snapshot of the world’s emotional state, drawn from 154,000 people in 145 countries, recorded its highest-ever levels of stress, sadness, anger, worry and physical pain.

According to the World Economic Forum’s Global Risks Report 2019;

‘For many people, this is an increasingly anxious, unhappy and lonely world. Complex transformations, societal, technological and work-related, are having a profound impact on people’s lived experiences. A common theme is psychological stress, related to a feeling of lack of control in the face of uncertainty.’

There is no such thing as ‘society’ there is just ‘us’. At least, not until we come together in relationships, families, work, communities and countries, at each stage with the purpose of togetherness.

When that fails, we are left to face loneliness, poverty, disputes and uncertainty.

In part it explains, as we are living through a time of disruptive politics, some cling-on to a familiar past and others see no risk in the future. We are divided.

The causes may be macro but the effects are micro.

As a ‘society’ we cannot look after our old people. We haven’t a clue how we are to fund their needs. We kick-the-can down the road.

No green paper on funding adult social care, in sight. And, is dementia a mental health issue? Where does it really sit in the scheme of things.

Should we define a new and better place?

Do you think the elderly are oblivious to that neglect. Do you think that dissolves their depression and fears for the future?

Mental health and wellbeing is a global risk. Where do we sit in the global league tables?

It is very difficult to find reliable data and comparisons are complicated. Our length-of-stay may be seen as high but might be linked to interoperability between health and social care.

Even comparisons on suicide come with a caution.

Where else can we look? The first two places I always look; patient’s complaints and staffing.

Complaints.

According to last year’s Parliamentary and Health Service Ombudsman Report;

‘Vulnerable patients with mental health conditions are being badly let down by the NHS…’

It’s a pretty horrible list; failure to diagnose, inappropriate discharge, poor risk assessment, human rights and dignity issues and poor communication with families.

The CQC, 2017, tell us just under 40% of MH Trusts require improvement and some were inadequate. Tales of poor crisis-care, staff shortages, locked rehab wards. 2019, children and young persons services came in for particular criticism.

Staffing.

It looks like an exodus. According to the DH+’ own figures, two thousand mental health staff, a month, are leaving the English NHS.

A total of 23,686 mental health staff left the NHS between June 2017 and the end of May 2018.

Despite minister’s promises to increase MH staffing by 19,000, in 2018 the MH workforce grew by 0.5%.

Psychiatrists?

2017, the vacancy rate grew to 9% (latest numbers), rise in the use of Locums (not good) and recruitment problems. Familiar story.

All these problems despite record levels of investment. Something can’t be right?

As a kid I remember my Dad suffering bouts of mental health problems. Like a lot of men, he’d had a ‘difficult’ war.

He was hospitalised, Mum and I moved in with her sister. We had no money. My Uncle did overtime to keep us all together.

Drugs, ECT, inpatient care… none of it worked. My Mum insisted, Dad agreed and he came home.

In time my Dad made a full recovery. It was love, patience and family that put him back together, something that millions, world wide and on our doorsteps, don’t have.

I fear for the future.

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Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.