Today I attended a strategic planning meeting for the Norfolk and Suffolk Foundation trust. Now the NSFT doesn’t even mention mental health, if you’ve not had experience with them, you wouldn’t know who they were! They are in charge of all mental health services in Norfolk and Suffolk, everything from eating disorders and dementia care to learning difficulties and depression, they cover it. It is a huge area, and still sad that there is so little budget and emphasis on good mental health and well being in comparison to physical health. The statistics are quite shocking when it comes to mental health in this country, and despite this, budgets are still being cut by the coalition government.
– Only 25% of adults with mental illness receive care – 92% of people with diabetes receive care
– Poor mental health is responsible for for the largest proportion of disease burden in the UK at 22.8% MORE than cardiovascular disease 16.2% OR cancer 15.9%
– Mental health problems are estimated to be the commonest cause of premature death
Harsh facts that really hit home. To make a real impact on this there needs to be a clear route forward, essentially fighting the cuts being imposed. Today brought together NHS workers, managers, service users, carers and planners to begin looking at how this seemingly impossible task can be tackled. We had some interesting discussion on our table and I came away feeling fairly positive. Its a difficult beast, unlike physical health outcomes cannot always be successfully measured, there is no black or white.
I learned a lot, for example the organisation and structure of Suffolk is different to Norfolk despite being part of the same trust. In Suffolk more responsibility falls to Suffolk County Council and voluntary organisations. Mental health spend per head in Suffolk is just £90, the lowest in the trust and way below the national average at £166 per head. Acute spend per head in Suffolk is then the highest in the trust at £783, to me this screams more need to be done to prevent people becoming very unwell, more action in the early stages of their illness. Prevention is better than cure, but this is not happening or even being addressed in mental health yet.
My thoughts are based on my experience as a service user. I’ve been in secondary mental health services for about three years and during that time have had excellent care and also some upsetting experiences.
Staff – I know that the recent reshuffle of staff at NSFT has had a massive impact on the staff. I’ve heard a lot of negative comments around this and staff morale seems to be significantly affected. The reassignment of many staff has meant that many who worked in certain specialisms for example, the elderly, have been put into new roles they have no experience of. Now I’m sure they have the basic training for the job, but not the years of experience. So the person who worked with the elderly, could now deals with young adults. Do the have training on benefits? Housing? Getting into work or education? No, and this has been and issue for me.
They need to be retrained, if you are going to redeploy them!
Signposting – To continue to improve the service there needs to be better relationships with other bodies for example, Suffolk County Council and Suffolk Mind. NSFT need to get better at referring people to other places for help, as with cuts, they will be offering less themselves. Now that could be for Social services, housing, benefits, disability issues or care issues. All important things that on their own can impact on peoples health. Also directing people to further help or treatment via voluntary organisations and charities like MIND, Suffolk carers, SANE, Relate and Suffolk councillors. I feel very strongly that this is going to be the future of the service.
Employers – We need to educate employers so they know more and understand mental health. Only 8.9% of adults in contact with secondary mental health services are in paid employment. Now of course a lot of these people are very unwell, or have long term disability so they are unable to work. But, I also believe the lack of understanding from employers stops people with mental health issues looking for work or returning to work from a long term absence. It very difficult to return to work after any absence and it should be made as easy as possible. Mental health is not often seen as an ongoing disability, but for some people it very much is. This needs to be understood in terms of the equalities act and reasonable adjustments, consulting the individual every step of the way. Companies, councils and organisations need to be encouraged to sign up to the Mindful employers charter, as a starting point for educating staff. There needs to be an emphasis on looking after employees, in the long term this means they will do a better job!
Stigma – We laughed at the fact that NSFT doesn’t even mention mental health, neither does their proposed mission statement. Yet, they want to battle stigma! Well I say fight it head on, people can have good mental health as well as bad, its something we all have. Lets not be afraid of talking about different conditions and illnesses, medication, therapy, being unwell and getting better. Sharing experiences between staff, service users and carers could be a very positive thing here and really help towards accountability and outcomes. Also so others can understand our experiences good and bad, the ups and downs that we know will happen. Getting better would be better put as a battle to keep well, its on going, its medication, its therapy, its understanding.
But, if we are all afraid to talk about it we cant go forward. I kept my recurrent depression under wraps for many years, until I became so unwell I had to come out. It was scary but liberating. I want to talk about it so others can see that life can continue, you can get better, you can achieve, you can become part of society again and be needed and valued by those around you.