Our mental health services are a mess; can Labour change it?


10:20 am - May 12th 2012

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contribution by Alan White

One day, when I was a teen, I started to cut myself, making thin little slits on my ankles and arms with a penknife. I stopped sleeping. I started to hear strange noises and voices in my head at night.

Then I started to fall out with everyone at school; I found myself dipping into a weird sense of ecstasy: watching myself saying and doing vicious, nasty things to my peers, incapable of stopping myself. I told my parents I wanted to kill myself.

There was no reason for this to happen: I had been happy enough at school.

The road to normality took a year of counselling and hospital appointments. During that time, I never thought I might be mentally ill. No one who treated me ever said that could be the case. My family and I never discussed my problems in terms of illness. I was just going through a difficult patch. The suspicion I might be a loony – that was just unpalatable, to me and everyone else.

Andy Burnham wants to tackle this culture. In an under-reported speech earlier this year he said: “A country which has so often led the world in challenging discrimination needs to recognise we’ve much to learn from other countries when it comes to the stigma.”

It’s a noble aim. One in four of us will suffer from a mental health problem at some point in our lives, yet still the shame persists.

Just as he wants to change public attitudes, so Burnham wants to reform services. He cites the fact that 70% of prisoners have two or more mental health conditions. I’m surprised the number’s that low.

When I was researching gangs I remember a psychiatrist telling me to look out for “frozen watchfulness” among the kids – their faces would be expressionless, their eyes constantly shifting around – a legacy of domestic abuse.

I remember meeting a former gang member who was undergoing counselling for what was essentially PTSD. If you live your life in constant fear of being shot, it’s what you’ll get – a lack of empathy, of bottled up emotions.

I spoke to Amanda and Steve (names changed), a pair of psychiatrists based in the Midlands, and asked them about Burnham’s claim that the NHS “treats, rather than prevents” because of these splits.

Amanda replied: “He’s absolutely right about the physical division of services. It makes relations strained. But my problem is that his take is idealistic. I’ve heard a lot of it before. People throw these buzzwords around – ‘collaborative’ is another one – but simply changing the language isn’t going to help.

“The real problem is that GPs have ten minutes with each patient. If someone comes to see them with a sore throat, of course that means they’ll dish a prescription out for a sore throat. There are some perceptive GPs who realise that mental and physical health problems can manifest as each other, but they’re constrained by time.”

What about Burnham’s claim that failure to centralise mental health costs money? Steve said: “He’s right. If you have a doctor who’s receptive to mental health needs, you could save millions. So many mentally ill people are heavy smokers, for a start, or can’t manage their diabetes. But the problem is this: if you refer them, you will save money in acute care but those savings won’t be passed on to us.”

Within this culture, it must be very difficult to see the wider picture. Amanda says: “I sometimes think politicians don’t realise people go into healthcare because they’re caring people. The police will hand people over to us as a way of filling the gaps. And I had an old lady in with dementia. We could have discharged her, but we didn’t – basically because her social worker was anxious she wouldn’t let her care workers in.”

But Nick Clegg pressed the opposite case for the Bill, using mental health as an example. He told ITV’s Daybreak: “GPs will tell you many of the people they see actually have mental health problems. If you give those people greater say maybe they’ll provide more support to mental health services.”

It’s a fairly big maybe, and it’s not one with reams of evidence to support it.

——-
Alan White’s work has appeared in the Observer, Times, Private Eye, The National & TLS. As John Heale, he is the author of One Blood: Inside Britain’s Gang Culture, republished this year. He tweets @aljwhite

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Reader comments


It’s a sad relfection that mental illness is still stigmatized and it’s the stigma which is the greatest disability.

Since the 1992 Community Care Act, there have been attempts to educate employers and local people about mental health, some services have nurtured good relationships with schools, the police and other agencies to bring about a change in attitudes. There is even a World Mental Health Day which is usually supported by most hospital trusts.

There have also been new services, such as accident and emergency liaison teams and community mental health teams practising in doctor’s surgeries. Sadly many of these services have had to be ‘reconfigured’ which is a metaphor for saying that large numbers of staff have been deployed elsewhere and another, understaffed service can take on the work.

As unemployment grows there is an increasing number of people suffering with depression just as services are being decreased. The best they will get is ten minutes with the G.P. and they will be given a prescription for anti-depressants, the worst scenario is they will treat themselves with alcohol and street drugs, another recipe for suicide, which is either successful or an admission to a psychiatric acute ward.

And, with regard to dementia care, relatives of sufferers are now having the small number of hours help per week withdrawn unless they can pay, their care, given with love, saves the taxpayer dearly.

It really does make depressing reading.

I’m not sure “mess” is a strong enough. I can only speak for my local Mental Health services but the whole thing is falling apart. Due to cuts, there’s clumsy ‘restructuring': basically dividing all service users in two groups: ‘crisis’ and ‘recovery’. The immediate concern, understandably, is crisis but the handling of recovering is ridiculous. It doesn’t matter how chronic or severe the condition is, it’s severely time-limited and the actual support on offer is saddening. Group work is the norm, even if it’s not really appropriate, as it’s cheaper and it gets more people back out the door quicker and more cheaply.

‘Mindfulness’ is now the only model of therapy than most people will now receive and I’m fairly certain the employment of this new mental health ‘cure all’ is partly due to it being able to be delivered through photocopies of material and the service users being told to work on it ‘at home’.

Everyone I know who uses the local Mental Health Services are seeing cancelled one-to-one appointments and ‘mysterious double bookings’ as the norm rather than the exception too.

@steveb

I think stigma has changed over the years. I think depression is ‘understood’ and tolerated better than it once was if only through exposure. I think most people, if they’ve not suffered themselves know of someone who has and it has less of the ‘other’ about it. Similarly, amongst a youth demographic, self-harming and food issues are more common.

However, I think anything more ‘exotic’ is still facing almost Victorian levels of suspicion and revulsion from the wider society as well as employees etc. Worryingly, this is at a time when Duncan Smith, ATOS etc are deciding that mentalists really should pull their socks up and ‘give back’ to a society that does its best to shun them in the first place.

I’ve often wondered whether this is actually mirrored in the media, as mental health gets a fraction of the coverage of any other health issue.

3. So Much For Subtlety

Andy Burnham wants to tackle this culture. In an under-reported speech earlier this year he said: “A country which has so often led the world in challenging discrimination needs to recognise we’ve much to learn from other countries when it comes to the stigma.”

No he doesn’t. He is simply mouthing sound bites written for him by his civil servants based on reports written by self-interested charities. Because there is no real stigma associated with mental illness and we have nothing to learn from anyone else. Well that is not true. We could learn from Nigeria. They do nothing whatsoever for people with schizophrenia and by a total coincidence have a much better success rate when it comes to treatment.

It’s a noble aim. One in four of us will suffer from a mental health problem at some point in our lives, yet still the shame persists.

The fact anyone can produce this nonsense statistic proves it. No, one in four of us will not. Not even close. This is the usual lying-by-statistic approach. God knows why people do it, as if lying about mental illness is going to help. We have about the same rate of serious mental illness as we have always had. No more.

Just as he wants to change public attitudes, so Burnham wants to reform services. He cites the fact that 70% of prisoners have two or more mental health conditions. I’m surprised the number’s that low.

Again lying-by-statistic. In this case they define drinking more than they think is good for you as a mental health issue. In reality the mentally ill are not that common in British prisons.

I remember meeting a former gang member who was undergoing counselling for what was essentially PTSD. If you live your life in constant fear of being shot, it’s what you’ll get – a lack of empathy, of bottled up emotions.

Well no. If you join a gang it is likely you have a lack of empathy to start with. There is more and more evidence PTSD, if it exists at all, is a product of what we expect people like that to have. Not something they develop on their own. The anti-War protesters assumed Vietnam was so evil that the soldiers would suffer. They did not. But the meme persists and has only expanded. The best thing you can do for someone with PTSD is ignore it.

The fact is we fail people with mental health problems because none of the real professionals has much of a clue what they are doing. Talking cures don’t work by and large. CBT may a little. The drugs only make people quiet, not better. Some of them may make people worse. We treated people more successfully in 1900 when we did virtually nothing for them than we do now. Nigeria and India still treat people more successfully than we do. A sensible mental health policy would be to simply shut everything down and fire everyone involved. Leave the ill to sort themselves out – cruel but more successful than what we are doing now.

Oliver. A relative of mine has schizophrenia.
His current medication does not prevent distressing and frightening voices breaking through. He tried, but couldn’t tolerate, a stronger drug which virtually turned him into a drooling zombie.
He’s been told by his consultant that there’s nothing else they can do which is quite devastating to hear. We have disputed that diagnosis and are waiting for another assessment by a different consultant.

He did have a support worker who checked on him fortnightly and although I don’t think he did much except listen, we felt at least it was a health professional keeping a regular eye on him and hopefully recognising and helping him when he was in difficulty.

Those visits are reduced now to monthly and a mindfulness leaflet left for him to study.
It is left to family members to support him, as we have all his life, and if/when things get beyond us we’re advised to call the crisis team, who actually only offer advice over the phone unless the situation is deemed dangerous.

I read the comments by So Much For Subtlety to him regarding doing nothing as in Nigeria.
He knows that without medication he’d be very unsafe. We found that to be the case when he was hospitalised for 4 months after a spell of not taking his medication as advised.

5. Dissident

toni, you can’t expect smfs to empathise, or understand. he is in favour of sociopaths being in charge of corporations, and callously leaving people to their own devices is a symptom of something very dodgy about that blogger…

I have suffered depression & ptsd caused by a housemate attempting suicide, he was untreated until it was nearly too late. people have shunned me because of my own depression & ptsd, in the process making me worse. smfs seems to want that as the norm…

cruelty and neglectfully ignoring, the do nothing aproach breeds harm, not help.

6. So Much For Subtlety

4. toni

He tried, but couldn’t tolerate, a stronger drug which virtually turned him into a drooling zombie.

And there’s the problem.

He’s been told by his consultant that there’s nothing else they can do which is quite devastating to hear.

So, for the record, your highly trained expert happened to agree with me?

It is left to family members to support him, as we have all his life, and if/when things get beyond us we’re advised to call the crisis team, who actually only offer advice over the phone unless the situation is deemed dangerous.

Which is probably the best thing that can be done for him. Finland has had some success with treating patients – but that involves no drugs, just sitting down with the whole family and talking. But I am not sure the study is big enough to be confident in it yet.

He knows that without medication he’d be very unsafe. We found that to be the case when he was hospitalised for 4 months after a spell of not taking his medication as advised.

But the drugs are not making him better, they make him quiet. If he needs them, then by all means, he should take them. You don’t need me to tell you that. Yet it is not a cure or even a step on the way to a cure.

7. So Much For Subtlety

5. Dissident

cruelty and neglectfully ignoring, the do nothing aproach breeds harm, not help.

Care to prove that? The evidence from Nigeria is that your claim is not true.

We treat the mentally ill with leeches and bleeding. Some times it does no harm. Some times it may even do some good. Most of the time the evidence seems to say that it makes people worse. You can claim that leeches are better than nothing. That bleeding a patient at least shows your care. But you can’t claim it is helping. We can see it isn’t.

There are things we can do for the mentally ill. We ought to be providing safe, secure, supportive environments. You know, asylums. We don’t have enough since Care in the Community. That’s about all we can do.

@7. So Much For Subtlety

Part of the ‘do nothing’ approach is that it doesn’t serve the tabloids who love their ‘schizophrenic goes mental with samurai sword’ stories. It was the hysteria created by the bogeyman-machine that prompted New Labour’s knee-jerk plans to start locking-up *potentially* dangerous mental health sufferers even if they did nothing wrong.

I think much of what you’re talking about is based on ‘cure’ and because we can’t ‘cure’ mental illness (ie make it go away, not return etc) we should just forget about treatments. An ‘all or nothing’ approach ignore the fact that often treatments help people at least cope at some level; a higher level than if no support is offered. Whilst I can offer no statistical data, I’m 100% convinced that, for all the people I know with serious, recurring mental health conditions that *any* support is welcome, if it only partially alleviates the problem. ‘Only a little bit’ has often been enough and has genuinely saved lives.

Also, earlier on, you say: “Talking cures don’t work by and large” but apparently, in your later comment about Finland, they do.

Also, regarding your reply to 4. toni, I’m not sure how much money is a motivator in terms of “there’s nothing (more) we can do”, from experience it’s a large factor as opposed to running out of ideas in ways we can provide at least some help.

It’s not just about “asylums” but lots of non-residential support has disappeared over the years like ‘day hospitals’ which provided help and some treatments in a “safe, secure, supportive environment”.

A ‘Big Society’ approach to mental health is not going to work. We don’t have the social structure any more. We no longer all live together, work together or even know our neighbours (all factors needed to make such a ‘sort it yourself’ policy work).

@4. toni

You have both my empathy and sympathy. I hear of and see too much of this story these days.

9. the a&e charge nurse

“Our mental health services are in a mess; can Labour change it?” – no, is the short answer.

The treatment of mental illness has never found a model that works – the asylums were shut down due the near inevitability of institutionalisation, while ‘care in the community’, or no-care in the community as some call it has a patchy record at best.

Underpinning these problems is the fact there is no proven biological basis for any psychiatric condition (although there are many theories) while a reliance on pharmacology has taken many a family down a blind alley – sometimes getting it badly wrong, according to some commentators.
http://www.harriman-house.com/products/books/243649/nocat/junk-medicine

Even if we could wipe the slate clean and start mental health services afresh I doubt if anybody could devise a system that would appeal to all, or even most patients (or their families) using those services.

The Labour party like the current lot of neo-cons have fallen for the fallacy that ‘the market’ will find a way – until they remember WHY they invented the NHS in the first place mental health services will remain something of a cinderella service beset by theoretical conflicts?

10. So Much For Subtlety

8. Oliver

It was the hysteria created by the bogeyman-machine that prompted New Labour’s knee-jerk plans to start locking-up *potentially* dangerous mental health sufferers even if they did nothing wrong.

That is certainly true. There was a total lack of both spine and clear thinking from all recent governments. I doubt that has changed.

I think much of what you’re talking about is based on ‘cure’ and because we can’t ‘cure’ mental illness (ie make it go away, not return etc) we should just forget about treatments.

I am not sure I agree that is my position. But there is no point pursuing treatments that don’t work. We don’t have a lot that does. We certainly should not be funding things we know do not work. When Nigeria is better at treating schizophrenia than we are, we have a problem.

An ‘all or nothing’ approach ignore the fact that often treatments help people at least cope at some level; a higher level than if no support is offered.

By all means, we ought to offer what support we can then. But that should not involve drugs that don’t help in the long run. Nor do I see why it ought to involve people in the top 1% of British students who go on to do roughly a decade of medical training. They are by their nature expensive and yet they do not seem to provide any better result than, say, a nun in the old days would have.

Also, earlier on, you say: “Talking cures don’t work by and large” but apparently, in your later comment about Finland, they do.

If that is a talking cure. I would love to think this works, but I think it is still too small to tell. Maybe it works at helping the family. Who knows?

It’s not just about “asylums” but lots of non-residential support has disappeared over the years like ‘day hospitals’ which provided help and some treatments in a “safe, secure, supportive environment”.

Anything but Care in the Community.

A ‘Big Society’ approach to mental health is not going to work. We don’t have the social structure any more. We no longer all live together, work together or even know our neighbours (all factors needed to make such a ‘sort it yourself’ policy work).

I disagree. It is the Government approaches that have failed. Big Society did a better job in 1900 than the government does not. We need to rebuild that Big Society then.

11. the a&e charge nurse

[10] “When Nigeria is better at treating schizophrenia than we are, we have a problem” – when you say ‘better at treating schizophrenia’ what measure are you using?

Nigeria has a population of 120 million with fewer than 100 psychiatrists – I make that less than 1 psychiatrist per 1million head of population – maybe they are very skillful, as well as hard working psychiatrists?
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525107/

10

In 1900, people were sent to asylums in out of the way places, not long before, those same asylums were open to the public to stare at the lunatics. Yep, make them go away and there’s no problem, perhaps we can re-build the old asylums and let the private sector make money by charging an entrance fee.

I’m not sure that Nigeria is a good example of care by the community (note; not care in the community) There are still irrational views on mental illness such as possession. But there are other countries where care by the community does show a better outcome than in most western societies, but note again, we are talking care by the communtiy not care in the community, two totally different things.

13. the a&e charge nurse

[12] “I’m not sure that Nigeria is a good example of care by the community” – yes, that was my reaction (although admittedly I have never been to Nigeria).

This study claimed. “The propensity of psychiatric patients to cause injury or harm to others and to property is one of the strong stereotype beliefs the Nigerian public holds towards psychiatric patients. Psychiatric patients, especially vagrant psychotics, are seen as worthless, dirty, senseless, dangerous and unpredictable. Moreover, it is the belief of most people in Nigerian society that psychiatric illnesses are afflictions caused by supernatural forces and, as such, require care by traditional and syncratic religious healers, rather than orthodox care.
http://www.annals-general-psychiatry.com/content/8/1/19

‘Afflictions caused by supernatural forces’, eh?
Now while there may be ongoing debate regarding the precise neuro-biological basis for psychiatric disorders, at least debate is based on science in the NHS – not even the most radical psychiatrist would suggest the Nigerian approach as a model for our services.

10. So Much For Subtlety

“I am not sure I agree that is my position. But there is no point pursuing treatments that don’t work. We don’t have a lot that does. We certainly should not be funding things we know do not work.”

But that does appear to be your position. You seem to be advocating support that results in ‘cure’ or no support at all. But how do you define “work”? You want a cure, but maybe some alleviation is enough or is to be realistically expected? Even that, in my mind, is worth spending money on.

“When Nigeria is better at treating schizophrenia than we are, we have a problem.”

But is this like for like? One of the issues with schizophrenia, hearing voices etc., is that often there’s cultural differences. It’s one of the points that often raised as to why, at least in the past, there’s appeared to be a form of bias in diagnosing British with an Afro-Carribbean background. Maybe, culturally, Nigerians have a different relationship to mental health problems and therefore society views mental health problems differently resulting in, perhaps, a more positive outcome when things appear to be left ‘alone’. I say this because even when society appears to be doing ‘nothing’, that’s never really strictly true.

We’ve a right wing press that goes out of it’s way to demonise the ‘other’ in this country and, when the unemployed and Muslims have had their turn, it’s the turn of ‘mentalists’ and the disabled. Maybe when that stops, there might be a better outcome for a hands-off approach in this country.

“Big Society did a better job in 1900 than the government does not. We need to rebuild that Big Society then.”

Having also read histories of mental health, I’m not sure that’s necessarily the case. I’m sure it did a better job in the sense of ‘out of sight, out of mind’ but the nature of turn of the century asylums with ‘good, clean air’ and rolling acres would be impossible now. Building more of this kind of thing would fall too easily into the ‘prisons are holiday camps/why do we waste money painting NHS hospitals’ kind of story and why does the state spend so much money on parasites? We can’t even get houses built these days, never mind state asylums. However, making them ‘earn their keep’ would suit a Duncan Smith narrative.

15. the a&e charge nurse

[14] ‘We can’t even get houses built these days, never mind state asylums’ – except when old asylums are converted into exciting property developments.
http://upload.wikimedia.org/wikipedia/commons/b/ba/Housing,_Friern_Barnet_Road,_London_N11_-_geograph.org.uk_-_901219.jpg

@15. the a&e charge nurse

Thatcher narrative: care in the community paves the way for luxury flat conversions. Gentrification’s not in it.

http://www.princessparkmanor.net/

17. So Much For Subtlety

11. the a&e charge nurse

when you say ‘better at treating schizophrenia’ what measure are you using?

I mean a very blunt force – look at them, look at them ten years later, see if they have improved approach.

Nigeria has a population of 120 million with fewer than 100 psychiatrists – I make that less than 1 psychiatrist per 1million head of population – maybe they are very skillful, as well as hard working psychiatrists?

Or maybe our psychiatrists will be regarded as leech doctors are now? That they think they are helping but they are not?

12. steveb

There are still irrational views on mental illness such as possession. But there are other countries where care by the community does show a better outcome than in most western societies, but note again, we are talking care by the communtiy not care in the community, two totally different things.

In other words leaving them with their families, whether or not those families believe in possession, is better for the patients than giving them over to the medical profession. It is a fairly appalling conclusion.

13. the a&e charge nurse

Now while there may be ongoing debate regarding the precise neuro-biological basis for psychiatric disorders, at least debate is based on science in the NHS – not even the most radical psychiatrist would suggest the Nigerian approach as a model for our services.

In what sense is it scientific? The entire basis of complete schools of treatment for the mentally ill are not more scientific than phrenology. You can’t really do many experiments on people so there is little experimentation to be done. They used to give them medicine and waited to see if it worked, but they did not know. Now they can’t even do that.

Perhaps it is time to start importing some of those traditional faith healers. At least most of their “cures” do little harm.

18. So Much For Subtlety

14. Oliver

But that does appear to be your position. You seem to be advocating support that results in ‘cure’ or no support at all. But how do you define “work”? You want a cure, but maybe some alleviation is enough or is to be realistically expected? Even that, in my mind, is worth spending money on.

Not at all. You are excluding the middle. We may have treatment that soothes but does not cure. We should do as much of that as possible. But we should also be making sure it works in the long run. The anti-psychotics we have do make people calm. But they don’t cure. That is not a reason not to fund them.

But is this like for like? One of the issues with schizophrenia, hearing voices etc., is that often there’s cultural differences.

That is true and that I cannot say for sure. I believe so. Wouldn’t the bias be in our favour anyway? Less serious British cases would be correctly identified while more serious ones in Nigeria would not be?

It’s one of the points that often raised as to why, at least in the past, there’s appeared to be a form of bias in diagnosing British with an Afro-Carribbean background.

Except it seems to afflict all immigrant communities. It may well just be an infection that the locals are more resistant to. I like that explanation but I don’t think we know at the moment. However how would a British bias affect Nigerians in Nigeria?

Maybe, culturally, Nigerians have a different relationship to mental health problems and therefore society views mental health problems differently resulting in, perhaps, a more positive outcome when things appear to be left ‘alone’. I say this because even when society appears to be doing ‘nothing’, that’s never really strictly true.

That is true. I am sure they do something. Even if it is just pray. Perhaps a belief it is a curse removes the fear it cannot be cured and any judgement about being so afflicted? Whatever it is I would like to find out.

We’ve a right wing press that goes out of it’s way to demonise the ‘other’ in this country and, when the unemployed and Muslims have had their turn, it’s the turn of ‘mentalists’ and the disabled. Maybe when that stops, there might be a better outcome for a hands-off approach in this country.

I disagree utterly. We have a largely left wing press and all the press goes out of its way to be overly nice to the mentally ill.

Having also read histories of mental health, I’m not sure that’s necessarily the case. I’m sure it did a better job in the sense of ‘out of sight, out of mind’ but the nature of turn of the century asylums with ‘good, clean air’ and rolling acres would be impossible now.

It did a better job in the sense that people who were institutionalised were then frequently let out – and never had any re-occuring problems. The records from asylums in 1900 do appear to show more success.

Building more of this kind of thing would fall too easily into the ‘prisons are holiday camps/why do we waste money painting NHS hospitals’ kind of story and why does the state spend so much money on parasites? We can’t even get houses built these days, never mind state asylums. However, making them ‘earn their keep’ would suit a Duncan Smith narrative.

Well NIMBYs and the usual anti-development rat-bags are a problem. But there is no reason why we don’t just ignore them. We could do this if we wanted. We should. Even if we have to fire every mental health professional to do so.

19. the a&e charge nurse

[17] “Perhaps it is time to start importing some of those traditional faith healers” – so, the day of the ju-ju man has finally arrived for British mental health services, eh, but will shamanism be an improvement on the evidence based approach common place within the NHS medical establishment?
http://www.nice.org.uk/niceMedia/pdf/mental%20health%20EB%20FINAL%2018.01.07.pdf

20. So Much For Subtlety

19. the a&e charge nurse

so, the day of the ju-ju man has finally arrived for British mental health services, eh, but will shamanism be an improvement on the evidence based approach common place within the NHS medical establishment?

When it comes to psychiatry was there any other way? The NHS has moved over to what they call evidence-based medicine, but a lot of older treatments and methods are grandfathered in. Evidence that Freudian psycho-analysis works? Not that I know of. We have been moving towards drugs for brain chemistry for a long time but it turns out they may not be working either. They may not even work the way we think they work. Is there really a lot of difference between what we have been doing and a ju-ju man? An expensive education and a lot of fine credentials I suppose.

17

You really do find it difficult to grasp nuance, there is a difference between care in and care of the community. There are also difference environments operating in ‘communities’

You’ve missed a trick, there are examples of third world and developing countries whereby care by the community has shown a better outcome for psychosis/schizophrenia but not Nigeria.

The fact is, the original authors of ‘care in the community’ also believed that people with mental illness might do better in the community than being placed in large institutions, which, in itself, can create problems that weren’t hitherto there. Unfortunately there are two major problems:- stigma and discrimination, whereby social isolation escalates the problem, it is very difficult for sufferers to follow a normal lifestyle such as work (unless they lie) and it is this area that has been identified as the reason why those in poorer countries do well, they are expected to work and they are involved in all areas of social activity.

Secondly, services are now being run down or closed, as the OP suggests.

Surprisingly, people with mental illness in the western world do not do better within families, the more positive outcomes are when they live independently and/or with outside support. (Familes tend to reinforce the negative and shield sufferers)

Perhaps you can produce evidence about asylums in 1900 and show that there were better outcomes. Indeed they were full of people who may now be considered ‘ecentric’ or do not fall into the ‘normal’ cultural expectations.

22. the a&e charge nurse

[21] “Indeed they were full of people who may now be considered ‘ecentric’ or do not fall into the ‘normal’ cultural expectations” – or they might have simply ‘suffered’ from being female?
http://www.sciencemuseum.org.uk/broughttolife/themes/menalhealthandillness/womanandpsychiatry.aspx

The idea of ‘asylum’ has obvious appeal (tranquility, rest, recuperation, etc) but the asylums in reality were a very different matter – mind you, a grotty B&B in a shitty part of town is not exactly conducive to mental well being either?


Reactions: Twitter, blogs
  1. Liberal Conspiracy

    Our mental health services are a mess; can Andy Burnham do anything? http://t.co/1iduefuO

  2. Jason Brickley

    Our mental health services are a mess; can Andy Burnham do anything? http://t.co/BRJcuud5

  3. leftlinks

    Liberal Conspiracy – Our mental health services are a mess; can Andy Burnham do anything? http://t.co/dXrzocrS

  4. Danulous J

    Our mental health services are a mess; can Andy Burnham do anything? http://t.co/1iduefuO

  5. brendahullah

    Our mental health services are a mess; can Andy Burnham do anything? http://t.co/1iduefuO

  6. Tom Whitney

    Interesting piece on Lib Conspiracy RT @libcon: Our mental health services are a mess; can Andy Burnham do anything? http://t.co/MHRtbaFa

  7. Alan White

    RT @libcon: Our mental health services are a mess; can Andy Burnham do anything? http://t.co/kHBKvgGK < by me

  8. Our mental health services are a mess; can Andy Burnham do … | news update for you life

    [...] here: Our mental health services are a mess; can Andy Burnham do … This entry was posted in Uncategorized and tagged ankles, cut-myself, head-at-night, [...]

  9. Martin

    Our mental health services are a mess; can Andy Burnham do anything? http://t.co/1iduefuO

  10. MARY HALL

    Our mental health services are a mess; can Andy Burnham do anything? | Liberal Conspiracy http://t.co/b0j2VP4p via @libcon #mhuk

  11. Alan White

    @ukmentalhealth i wrote this, thought it might be of interest http://t.co/4mDJosxW

  12. David McMillan

    Our mental health services are a mess; can Andy Burnham do anything? | Liberal Conspiracy http://t.co/b0j2VP4p via @libcon #mhuk

  13. Viv

    Our mental health services are a mess; can Andy Burnham do anything? http://t.co/xOVlTKKc

  14. Youth Mental Health

    'Our mental health services are a mess; can Andy Burnham do anything?' http://t.co/ljbv9wVK

  15. Dee Speers

    Published: May 12th 2012 – at 10:20 am
    Our mental health services are a mess; can Andy Burnham do anything?
    http://t.co/Bspgsqxe

  16. Markoneinfour

    Hmmm. RT @time4recovery 'Our #mentalhealth services are a mess; can Andy Burnham do anything?' http://t.co/8bEZvKot #ukmh #mhuk

  17. Ombudsman Watch

    Published: May 12th 2012 – at 10:20 am
    Our mental health services are a mess; can Andy Burnham do anything?
    http://t.co/Bspgsqxe

  18. Richard

    Our mental health services are a mess; can Andy Burnham do anything? | Liberal Conspiracy http://t.co/4Od1Jieo via @libcon

  19. Lisa Chalkley

    RT @JoinedU1: Published: May 12th 2012 – at 10:20 amOur mental health services are a mess; can Andy Burnham do anything?http://t.co/J17bEIXO

  20. paul and lynn hewitt

    RT @JoinedU1: Published: May 12th 2012 – at 10:20 amOur mental health services are a mess; can Andy Burnham do anything?http://t.co/J17bEIXO

  21. Liza Harding

    “@libcon: Our mental health services are a mess; can Andy Burnham do anything? http://t.co/wyRKOJML” < if anyone can @andyburnhammp can #MH

  22. Matthew Downie

    Our mental health services are a mess. @aljwhite asks whether Andy Burnham do anything about it: http://t.co/44LG7YlC

  23. BevR

    Our mental health services are a mess; can Andy Burnham do anything? | Liberal Conspiracy http://t.co/ecpGyyqi via @libcon

  24. jeffkloy (#OYSlive)

    Our mental health services are a mess; can Andy Burnham do anything? http://t.co/1iduefuO

  25. jeffkloy (#OYSlive)

    Our mental health services are a mess; can Andy Burnham do anything? http://t.co/1iduefuO

  26. BevR

    Our mental health services are a mess; can Andy Burnham do anything? | Liberal Conspiracy http://t.co/ecpGyyqi via @libcon

  27. BevR

    Our mental health services are a mess; can Andy Burnham do anything? | Liberal Conspiracy http://t.co/ecpGyyqi via @libcon

  28. YoungMinds

    Our mental health services are a mess; can Andy Burnham do anything? | Liberal Conspiracy http://t.co/kW2CsN8m via @libcon

  29. Keith Winestein

    Our mental health services are a mess; can Andy Burnham do anything? | Liberal Conspiracy http://t.co/kW2CsN8m via @libcon

  30. Kelly Boylin

    Our mental health services are a mess; can Andy Burnham do anything? | Liberal Conspiracy http://t.co/kW2CsN8m via @libcon

  31. Mark

    Our mental health services are a mess; can Andy Burnham do anything? | Liberal Conspiracy http://t.co/kW2CsN8m via @libcon

  32. Mark Smithson

    Our mental health services are a mess; can Andy Burnham do anything? | Liberal Conspiracy http://t.co/ecpGyyqi via @libcon

  33. YoungMinds Schools

    Our mental health services are a mess; can Andy Burnham do anything? | Liberal Conspiracy http://t.co/kW2CsN8m via @libcon

  34. Patrick O'Callaghan

    "Our mental health services are a mess; can Labour change it?" – Liberal Conspiracy http://t.co/ZFs9rHyO via @libcon





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