Funding priorities for MH care

[CanelliniBeans]

Just reading the latest on the failures in MH care in the sad case of Valdosta Calocane.
AIBU to think we should prioritise funding for serious mental health issues over the funding of treatment for lesser MH conditions like anxiety? There's not enough money to go round and we need to ensure people who are a risk get treatment.

But you’re saying don’t treat anxiety. Treating and investigating anxiety can uncover underlying issues which is supported in time can cut costs to the NHS further down the line.

The balance is that providing support before crisis can keep people being productive members of society and crucially can be cheaper too as a short course of therapy could be all they need at that point, letting people deteriorate so they are unable to work, potentially homeless and spiralling down to the point of serious interventions helps nobody

What do you think inpatient treatment involves? Hospitals aren't therapeutic places - they are simply there to provide containment and stabilisation via MEDICATION. That's what all the psychotic and manic people are getting. The evidence for suicidialty isn't great especially when the patient experiences it chronically.

You need to prioritise the person who is a risk to self and others, and has grossly impaired functioning. Teams should also be offering the least restrictive option - home treatment avoids the problems of an inpatient setting, although I agree that it has become a glorified medication delivery service.

Really obtuse comment. Yes funding should be increased across the board. But it shouldn't be controversial to prioritise the more severe, debilitating and higher risk condition.

Well it should be controversial if struggling people are left to become more severe, debilitated and higher risk as is happening.

Your job must be so very hard at times for the reason you state - public safety vs a persons right to accept and take treatment for their mental health illness. What trumps the other? If people are going to be told that they are going to be forced to take medication for a mental health illness how the hell is that going to be monitored/managed unless they are kept under hospital/prison style arrangements?!

Whilst these kinds of cases appear to be rare, they still happen and people die and families have to battle to be heard. It's unbelievably tragic. I feel so so sad for these families and their struggles; they'll no doubt be needing mental health services as a result of the tragedy...I wonder how well that's gone for them!

I don't know what the answer is and finding the answer to please everyone probably doesn't even exist no matter how much money is ploughed into the system.

what should actually be happening is treatment should be available a long time before reaching the point of being severe and debilitating.

Many people are crying out for support but there is nothing there, you shouldn’t have to reach crisis point where you are a risk to yourself or others before you can be helped. If it gets to that point something has gone wrong.

prevention is better than cure!

Home treatment team is beyond shite. A person who has several diagnosis, who self harms and has tried to kill them several times should be getting treatment. They aren’t. They’re shoved on medication and left. Such people are not getting treatment in the community before they’re left to spiral and ping pong in and out of hospital. They then become the higher need cases.

What help do you think people with anxiety get (apart from Sertraline). And do you understand how severe and lif limiting anxiety can be? What an awfully nasty and ill informed post.

Once upon a time people without a diagnosis weee struggling people trying to get help. They’re now ignored and left so they spiral and so it goes on.

The system is broken but reducing what little there is at the beginning isn’t the answer.

When there is limited funding in public services in any sector an immediate risk to life will always be prioritised.

Many people do not tell the complete truth when it comes to their MH issues, I was one of these. I hid stuff and was diagnosed with anxiety. Due to an acute episode witnessed by MH services and then me admitting to stuff in my past I was diagnosed with bi polar.

I have met many people with all kinds of conditions having been under MH services for years. I found many people lied about taking their meds and I mean loads of them. I also remember some manipulating staff.

Then there is always the is it their personality or their MH issues?

I was an in patient and was also in a category 4 programme for 2 years as an outpatient. MH professionals will understand just how unwell I was. Some enduring MH issues even with the best treatment, those people can never reach a level where they are safe.

And many many people can be if they get the right treatment when they need it.

The alternative is a society where people are made to undertake treatment because they might be dangerous-an idea which has much wider ramifications.

I think that's fine, presumably if rhe extent of their MH condition is that they might murder strangers in cold blood, then it's surely not unreasonable to presume they can't make informed decisions about their health and whether to take medication or not therefore why not have it legally enforced?

And those that might just kill themselves get shoved on medication because they don’t get access to treatment.

What treatment would help? 'There shoved on medication and left'. That is pretty much what happens in hospital whilst exposing the person to the iatrogenic harm of the inpatient environment. 'Revolving door' is as much of an issue with SMI patients. I agree we need more community provision and psychiatric care generally seems to lack compassion. But there are no magic bullets - access to therapy is always going to be limited because it is so expensive vs medication.

What a load of ignorant bollocks! NHS mental health care needs a complete overhaul, anxiety can be debilitating but it can also be a symptom of something far more serious.

There are lots of treatments those out of inpatient could access except very few can.

If we ignore ‘lesser’ illnesses like anxiety the already substantial shortage of workers will increase dramatically.

1 in 3 have a mental health issue. The workforce could shrink by a third if it’s ignored.

@Trail374 the main point is many people are not honest about their thoughts and feelings. I was dishonest because I had children and was worried they would be removed.

I have met people who have been under MH services almost all their adult lives. The worst was a man who had tortured someone and had spent quite a bit of time in a high security mental hospital as a young adult, he positively enjoyed terrorising the other patients. He absolutely hated women, I mean hated, if you showed any weakness at all he would try and get in your head. We did report him to staff and he was spoken to multiple times, he seemed to enjoy the drama and said just enough to upset but was clever.

More ignorant bollocks.

We are down on (in my service - which isn't mental health but is within a largely MH trust):
Psychology - wait list of 2 years+
Psychiatry - this one is generally us having the staff but horrendous levels of sick leave
Occupational Therapy - waiting list of 18 months at the moment but they seem to have found some of them
Nursing - in some areas we have ONE for the entire patch
SALT - waiting lists controllable but that's at staff burning themselves out to fill the holes where we've had posts out to recruitment for over a year
Physio - they seem to be running relatively OK
Admin - hah hah - they're all retiring and not being replaced!

It is a fucking mess - and the shortages are so bad that any good staff get poached across teams and services like buggery!

There's a whole political and sociological history underpinning this - going back to the 1980s/90s when the old asylums closed and community care was the new way to treat people with mental health problems. Initially it was going OK as there were more services available from day hospitals and centres to longer term therapy. Slowly over the 2000-2010 period those services too were cut and now there's very little available for those who need long term support. Everything is now about outcome measures and time limits. It's a financial issue but also the result of a long process of change in MH services.

I should add hospital treatment probably made me worse. People can pick up others habits, a bit like a contagion. I think day centre treatment was what helped me the most a category 4 treatment programme three days a week for 2 years, many dropped out though. I think one of the markers in genuinely being a lot better is admitting your own part and always being aware that you can relapse and never ever taking your period of wellness as well I’m done now. You have bipolar or schizophrenia you are never actually better.

You’re not listening, anxiety can be a symptom of something far more serious, add to that a negligent NHS & you’ve got a perfect storm. I suggest you have a good think about who you’re talking to here, mental health sufferers & their family, as always on mumsnet there are just a load of ignorant idiots being controversial for fun.

Early intervention for mild/moderate mental health difficulty is important to prevent escalation to “worse” disorders. The thing is the care current care provided for difficulties like schizophrenia is really poor. I worked on wards- they typically follow the medical model and release individuals into the community really early. It’s also a lottery on whether you are going to have a kind and compassionate staff. I have sat in reviews where I have witnessed doctors actively worsening a patients mood by the way they talk to them- degrading, no empathy etc.