A succession of Conservative governments have demonstrated very clearly that when it comes to funding established and crucial provisions for our most vulnerable citizens, they lack the foresight required to grasp that reducing funding means reducing our public services to a bare capacity for “firefighting” only – crisis management – rather than a much preferred “preventative” approach.
Under the guise of a “policy of deinstitutionalisation”, Thatcher’s “Care in the Community” Bill was about anything but care: it was all about cutting costs, as reflected in the experiences of many people leaving long term institutional care and being left to fend for themselves in the community.
Previous Conservative governments of 1979 to 1997 had been responsible for a series of changes in the conceptualisation and delivery of community care services. . In particular, this period saw the introduction of a series of private sector approaches and terminology, as well as the gradual transition of social workers and social services departments into service “purchasers” rather than necessarily the providers of care. As a result of these changes, the community care landscape changed dramatically.
And now, as predicted by many professionals who have consistently warned of the harmful consequences of the Heath and Social Care Bill, it’s the case that a serious funding shortage for mental health services in England is putting patients (and staff) at grave risk. A lack of resources and staff is severely compromising care in parts of the country, with frontline teams often being left to carry the burden of risk, to the detriment of patients. NHS hospitals are experiencing a massive surge in the number of patients attempting to self-harm and take their own lives, new figures have revealed.
The data, disclosed by UK mental health trusts, following Labour Party freedom of information requests, indicates suicide and self-harm attempts increased by 50 percent in mental health hospitals across Britain between 2010 and 2013. In the past year alone, incidents of patients attempting to take their own lives or inflict self-harm in the institutions has risen by 30 percent.
The FOI requests were tendered by Labour’s Luciana Berger, who is the Shadow Minister for Public Health. Fifty NHS mental health trusts were approached in total, and each was asked for the number of self-harm incidents and suicide attempts on their wards over the past four years. Twenty-nine supplied figures, while twenty one failed to respond. This comes as experts warn that acute mental health services are in crisis and struggling to cope with demand. NHS staff are working very hard in very difficult circumstances. Although the Royal College of Psychiatrists recommends occupancy levels of 85%, figures show that mental health wards are operating over capacity, with some running at up to 138%, and the shortage of beds has forced some mental health patients to travel hundreds of miles for treatment. Figures from the BBC show that minimum of 1,711 mental health beds were closed between April 2011 and August 2013.
A recent investigation by Health Service Journal (HSJ) revealed that there are 3,640 fewer nurses and 213 fewer doctors working in mental health in April this year compared to staffing levels two years ago. Mental health spending has been cut for the first time in a decade, by the Coalition.
The same investigation showed that the NHS’s mental health trusts have lost over £250 million of their funding in the same period.
Number of self-harm and suicide attempts across 29 Mental Health Trusts:
Luciana Berger MP, Labour’s Shadow Minister for Public Health, said:
“This increase in self-harm and suicide attempts on NHS wards is deeply concerning.
“Mental health services have been squeezed year on year, the number of specialist doctors and nurses has dropped and there aren’t enough beds to meet demand. The pressure this is putting on mental health wards is intolerable.
“It is unacceptable that people in touch with mental health services may not be getting the support they need. These are some of the most vulnerable patients in our NHS. Ministers must now take urgent action to tackle this crisis.”
And given that 42 percent of the NHS mental health trusts approached by Labour failed to issue a concrete response to the party’s recent inquiry, the true extent of this crisis may be considerably more serious than Luciana Berger’s recently published figures indicate.
Pressure on mental health beds is so severe that some patients are having to be sectioned to secure necessary care, a survey of doctors (conducted by online journal Community Care) found. Sectioning someone under the Mental Health Act – denying them their liberty – should only be done when a person is a risk either to themselves or others. It is a legal process led by a social worker (an approved mental health professional) working alongside two doctors. A patient cannot be sectioned purely to secure a bed, but the survey suggests doctors are being influenced towards detaining someone if it will make it more likely a necessary bed can be accessed.
Sir Simon Wessely, president of the Royal College of Psychiatrists, said that the figures were “a glaring warning sign” that mental health is “running dangerously close to collapse”. If Wessely is concerned, we all ought to be.
The Government has been criticised for allowing mental health services to be cut disproportionately, as the NHS as a whole undergoes the most severe budget cut in its history.
If you are supporting someone who feels suicidal – you can download a pdf from MIND, that provides information and practical suggestions for what you can do and where you can go for support.
From Rethink – Mental health information – Crisis contacts
From NHS Choices – Mental health helplines
Sane Line: 0845 767 8000 (6pm – 11pm every day) www.sane.org.uk
Samaritans: 08457 90 90 90 (24 hours every day) www.samaritans.org