Transforming mental health
Consistent, well-funded services are needed to make Transforming Your Care’s plans a reality, BBC Health Correspondent Marie-Louise Connolly writes.
Comedian Ruby Wax has it. So did the poet Sylvia Plath. Even the astronaut Buzz Aldrin suffered from bouts of the disease. But despite the litany of familiar names, being famous isn’t a pre-requisite for struggling with depression.
Our local Health Service can testify to this. More so than ever, the demand for mental health services is at an all-time high. It’s estimated that one in four people will experience a mental health problem in the course of a year. Around 10 per cent of children have a mental health problem at any one time while depression affects one in five older people. They may not reflect the actual problem as so many continue to suffer in silence.
Never has there been a stronger case for mental health services to be available in the centre of communities. The impact of the Troubles is still being felt and, with disorder in Belfast again this summer, an entirely different generation is building up a case for ensuring those services into the future.
As the stigma around mental health fades, the demand for services grows: a fact recognised by Northern Ireland’s health commissioners. While on paper the Transforming Your Care plan sounds promising, putting it into practice is an entirely different matter. We know this from experience. The Bamford review was completed in 2007 but despite Northern Ireland having higher mental health needs than other parts of the UK, it still hasn’t been fully implemented.
By their own admission, the authors of TYC recognise that “tangible services on the ground are the touchstone by which those using the service can judge its success.” Despite that commitment, too much time has already been wasted: precious time that patients requiring care simply don’t have.
On a positive note, Health Service managers and patients have one thing in common: they both believe mental health services should be based away from hospital and instead in the community.
Step forward GPs. For most of us, the local doctor is the first point of contact with the Health Service. They’re also the gate-keepers to a wide range of services but these should not be dependent on your postcode.
That’s not the case for two men whom I recently met at a conference. While both were of the same age, their experience of the health system was entirely different.
Joseph lives in the north west. When he was 20, his GP gave him anti-depressants to “help him over” a difficult period in his life. His mother had died and soon afterwards he lost his job. In desperation, he turned to alcohol. After 14 years of taking medication, he was put in contact with a counsellor. Through talking, Joseph revealed he’d been sexually abused; he’d also spent years grieving for his mother. When Joseph finally got in contact with his GP, he was offered 16 cognitive therapy sessions; a local community group stepped in when those sessions finished. He’s now off the tablets and the drink, and after 14 years is talking his way to recovery.
Just over a hundred miles away in Belfast, Richard tells me that he’s “wrestled with demons for years.” He withdrew from society and suffered a nervous breakdown but his GP was aware of his history and stepped in almost immediately. Through a combination of medication and counselling, Richard “emerged from the black tunnel.” He attends his local health centre twice a month where his GP and counsellor are under the one roof.
This latter model of care (a so-called stepped approach) is being rolled out across Northern Ireland. At least six psychiatric in-patient units will also be in place to support patients.
On paper, it reads straightforwardly but didn’t Bamford promise much of the same? For TYC’s mental health plan to work, cash is needed and fast. The plan also needs to be consistent and co-ordinated. The voluntary services are required to play a much bigger role and need to be involved in the planning process. This is again promised by those commissioning the services. Let’s hope the public aren’t let down.
