LLast summer, a young man, let’s call him Daniel, walked into the emergency department of a hospital in England. and told the doctors that he suffered from schizophrenia. She had struggled with his mental health for years and now he wanted help. But after he was briefly seen by an early intervention team, he was released. A few days later, he stabbed a stranger whom he considered a threat to his life, and now he is locked in a prison cell. “I am devastated for him,” his mother tells me, “and worried for others in similar situations.”
This is not a broadside against the army of overworked and underpaid NHS staff, overwhelmingly doing the best they can in unnecessarily challenging circumstances. Instead, it is a call to action to resolve one of modern Britain’s great, little-discussed crises: the mental anguish blighting the lives of millions of citizens, and the lack of means to address it.
According to the charity Mind, there are not only 1.6 million people languishing on mental health waiting lists, there are another 8 million who would benefit from treatment, but cannot get on those oversubscribed waiting lists due to high eligibility thresholds. The Guardian recently revealed that England’s NHS pays £2bn a year to private hospitals to care for mental health patients due to a lack of their own beds, another startling example of flashing red lights on the dashboard. For those who shrug it off, believing that using the private sector is just a pragmatic solution to help those in need, consider the fact that one in four non-NHS psychiatric facilities have been deemed “inadequate” by the inspections of the Care Quality Commission. “If taxpayer money is being spent on poor quality care in some cases,” says Mind policy chief Vicki Nash, referring to recent deaths in private mental health services, “we have to ask ourselves: is it better spend that money elsewhere? ?”
Our rulers will certainly refute these criticisms. After all, the Conservative-led coalition government announced that mental health would be held in the same esteem as physical healthcare more than a decade ago, and more has been invested in the sector. including £500m last year in response to the pandemic. As the King’s Fund think tank has argued, while requiring parity of esteem is useful, especially in a country where suicide is the Biggest killer of men under 50 – must be combined with adequate financing and better joint work between different NHS services.
What we do know is that increased investment has been offset by growing need. Calls to the suicide charity Campaign Against Living Miserably’s helpline, for example, increased by 40% when the pandemic began, while there has been a 100% increase in the number of people aged 16 to 24 years old accessing your website. . The trauma unleashed by the pandemic and the drastic measures needed to contain it cannot be underestimated: according to the World Health Organization, cases of anxiety and depression jump by a quarter worldwide in the first year alone.
The testimonies of those who work in crisis mental health services tell their own story. A mental health professional with decades of experience tells me, “You are now in the worst time I can remember due to a staffing crisis that has been an issue for over five years, and probably closer to 10 years.” Staffing issues led them to start locking patients up at night, they told me, and while the construction of a new unit should be a cause for celebration, it is causing them fear as staff are leaving en masse.
Another worker tells me about a child patient with a history of abuse who fell off a waiting list because his working mother had missed a call from mental health services. One of his patients who was abused by her parents and then her partners is suicidal, they say, but waiting lists mean waiting months to get an evaluation and then another 18 months before getting help. . The mother of a suicidal teen was forced to make a written referral to child and adolescent mental health services, was told it would be two weeks before an urgent appointment was possible, and felt there was no choice but to take him to a chaotic center. Busy A&E department. “My son feels that his life is not worth worrying about and he feels even more hopeless,” she tells me. If he talks to anyone who’s been through our struggling mental health system, he’ll hear the term “waiting lists” come up over and over again.
Why do we tolerate such chronic and systemic failures, many of which no doubt lead not only to needlessly prolonged misery, but in far too many cases to loss of life? Perhaps the sheer number of crises afflicting modern Britain is running out of room to talk about it. Whatever the answer, avoidable misery is imposed on the lives of millions due to a recurring failure to match need with provision, and the human cost is incalculable.
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In the UK and Ireland, the Samaritans can be contacted by calling 116 123 or by emailing [email protected] or [email protected]. In the US, the National Suicide Prevention Lifeline is at 800-273-8255 or chat for help. You can also text HOME to 741741 to connect with a crisis text line counselor. In Australia, the Lifeline crisis support service is 13 11 14. Other international helplines can be found at www.befrienders.org
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Owen Jones is a columnist for The Guardian.
