Hullo and happy Monday. Unless you are a Liverpool or Burnley football fan. I would imagine today is far from happy if you are! Anyway, I digress…
What has inspired todays, ‘vaguely linked to psychology stuff’ rant today I hear you ask… Well, here I go!
I have read a few articles over the last week or so that were focussed around the mental health of our young people and the state of provision for them in the CAMHS (Child and Adolescent Mental Health Services) system run by the NHS.
I am sure you are aware of such articles, they seem to be across all platforms and newspapers regardless of their political stance (the populist press have picked up on it as it concerns children which always encourages them to whip up their readership into a frothing frenzy! I always think of the Simpsons character Helen Lovejoy exclaiming “Won’t somebody please think of the children?” when seeing the headlines of some of the more far right publications we unfortunately have in this country). This kind of hysteria always makes sure the focus goes away from the children and onto grown ups making political points and fermenting anger rather than opening a reasonable debate about how to resolve the issues we have though which seems to rather undermine their efforts.
I can understand why they do this however. The problems are deeply entrenched and there is no simple or quick solution to them and therefore It is much easier to rant and rage rather than attempt to understand through listening and then working with others towards positive change. Much easier to rant like Piers Moron, sorry Morgan, and make money through nepotism, hypocrisy and lies than to listen to those suffering and feel empathy and care for them. It is much easier to be angry than sad.
Sorry, I digress slightly. Mental health provision and services have been under valued and under funded for as long as I have been in the field (18 years this year). For as long as I can remember money has actually been removed from every aspect of mental health service and diverted in more headline grabbing things such as A&E waiting times and our seeming eternal obsession with bloody lists and waiting times!!
So, in real terms, funding has gone down and what were good, reliable, but quite expensive 1-2-1, intensive and residential support services for people with mental health issues of all flavours and intensities, have gone forever and never really been replaced. Indeed some bright spark suggested to politicians that CBT could fix every person with depression through to personality disorders at some point and they believed them. As a result the IAPT (Improving Access to Psychological Therapy) service was born around the same time that funding was slashed for the established services and hundreds, maybe thousands of services that had been there for people for years, were suddenly gone and replaced with a service that gives you a workbook and 12 weeks to figure out why you struggle the way you do and then to sort things out so you aren’t depressed or personality disordered anymore.
I am paraphrasing slightly here, but what I state above isn’t a million miles away from what has happened.
So, what happens when you underfund a speciality service like mental health for 20 years and then a really stressful global pandemic hits which has a massive impact on every person in the country? Well, what is happening now happens. Lots of people start to struggle, ask for help and the already overwhelmed systems in place break down completely.
This is as sad as it is predictable and nobody, from government, the NHS or the senior people in the fields of psychiatry, psychology and psychotherapy has done anything to plan for it or mitigate it.
I have found myself pondering what more I could have done or now could do around this dire emergency and it shames me to admit, I feel powerless and clueless about how we fix this. Everything appears to be so broken I have no clear idea how to make things better in the short term.
One thing I am sure about though is that the treatment that people and in particular our young people receive in the near future needs not to be the cheapest, most convenient, most quantifiable or easiest. I needs to be what that individual actually needs, even if that means funding for three or four years of 1-2-1 therapy or similar.
Too often people are offered 12 or 16 weeks of something which helps in the short term, but means they start to struggle again in time and then come back to their GP and more money needs to be found to treat them again.
If we offered good, long term support to all the people that needed it we would actually save money in the long term and people instead of being off long term sick or not as productive as they would be were they not depressed or incapacitated by anxiety, they would be in work, happily contributing to the world in action and in taxation!
I have been saying those words now for nearly 18 years and it genuinely pains me that I am still saying them now. It feels ridiculous that successive governments of all flavours have failed to understand the simple premise that to save money in something like mental health services, you have to actually invest and spend some.
What is already happening as well is that some people are waiting so long to receive support with their mental health, that when it arrives, they are too unwell or too angry or too distrustful that they struggle to engage with the support that is offered. This will mean they miss an appointment or are not actively engaged straight away with the support and as a result they risk being dismissed or having the support withdrawn because they are ‘not engaged with it’.
All things considered, it is a bloody mess out there at the moment and we really need some strong guidance and support from the people at the top of the tree about how we can all work together to support the health professionals needed on the ground as well as the millions of people needing support at this time.
I hope we get it sometime soon. I wont be holding my breath though. In the meantime if anyone has any ideas about what I can do to help more out there, please let me know. I am too close to everything and cant see the wood for the trees either at the moment.