Recent reports have shown yet another failure within our system of care for those who are mentally ill, with more than 400 adults currently being forced to receive treatment more than 30 miles from their homes. Receiving treatment close to home is something many of us take for granted when we have a physical illness, however this comfort isn’t always afforded to those who are mentally ill.
Immediate support from family suddenly becomes problematic, visits home are a wish too far and friends are further away than ever. I know from personal experience how vital it is to be close to home in order for an effective recovery.
The promises of Parity of esteem for mental health services in the Health and Social Care Act of 2012 have yet to be realised. Despite mental health problems accounting for 28% of the burden of disease in England, only 13% of spending goes towards mental health services. While 400 people is a small minority within the system, indeed it is only 4.9% of current inpatients, it is 4.9% too many. For every patient who has to travel more than 30 miles in order to receive inpatient treatment the system has failed them, their friends and their family.
Being close to home at any vulnerable time in your life is important, none more so than when you’re ill and need the support of family or even friends. Being so ill you have to go to hospital is quite possibly one of the most vulnerable and dangerous times of your life, especially when you are suffering from mental health problems. It is a strange reality when the most vulnerable are flung into a haze of confusion, where they may not necessarily know where they are in the country, and are placed in a daunting new environment. Being denied easy and readily available contact with your family and friends is a basic failure of a system cracking at its seams.
Not only can being moved from your local area disorientate you initially, it can also be discomforting during a patients stay in hospital. Depending on the patient you can go out, whether that is with an escort or on your own, if you are staying close to home then you can visit family, go to the local shops and keep in touch with your community. It is a vital link which shouldn’t be severed unless absolutely necessary.
However it isn’t simply a matter of comfort, contact with people close to the patient is also vital. Family like mine often provide valuable information to the clinicians which patients may not wish or may not be able to communicate.
Not only this but parents or guardians can be involved in the decision to discharge patients and often advocate on their behalf about certain things while in hospital. Some people like my parents are able to travel 30 miles or more, indeed mine made triple digit round trips for a month; however many cannot and this needs to be presumed.
My parents were an essential part of my voluntary stay in hospital; they talked to clinicians relentlessly, brought me home comforts and advocated on my behalf. I am confident without them things would have been immeasurably worse and I don’t want any inpatient to be without essential tools to help them get better.
This short term thinking has been a key feature of this dangerous Conservative government. They’ve cut over 2,000 mental health beds since 2011, and now according to the King’s Fund bed occupation is routinely exceeding recommended levels which is leading to patients being moved around the country.
While they’ve been cutting beds there has also been a growing issue within community care. According to the King’s fund only 14% of people in a crisis felt they received the right response that helped to resolve said crisis – this is a statistic that obviously has consequences on the availability of hospital beds.
Indeed, rather than resolving the problems that many face in a non-clinical environment, cuts to services have ensured that too many become inpatients; which of course takes up more resources than if they’d funded community care properly. A perfect storm of bed cutting and cuts to community mental health services has led to these unacceptable conditions for mental health patients within the NHS.
Taking people outside of their own environment can be damaging and disorientating for inpatients, and makes access for friends and family inevitably more difficult – leading to a more difficult recovery. It is a policy born out of necessity, however it is misguided and harmful for those involved whether that is people who know the patient or the patient themselves – it should be avoided at all costs.