Tag: mental health services

Psychologists Against Austerity: mental health experts issue a rallying call against coalition policies.

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I wrote an article in March about the government plans to make the receipt of social security benefits for those with mental illnesses conditional on undergoing “state therapy.” I raised concern about ethical issues – such as consent, the inappropriateness of using behaviour modification as a form of “therapy,” and I criticised the proposed Cognitive Behaviour Therapy (CBT) programme on methodological and theoretical grounds, as well as considering wider social implications.

The 2015 budget included plans to provide online CBT to 40,000 claimants and people on the Fit for Work programme, as well as putting therapists in more than 350 job centres.

Since I wrote, over 400 psychotherapists, counsellors and mental health practitioners have written an open letter, published by the Guardian, about the broader, profoundly disturbing psychological and quality-of-life implications of the coalition government’s austerity cuts and policies. However, the letter was particularly critical of the government’s benefits sanctions scheme, which has been condemned by many of us – human rights advocates across the state – as brutal, unjust, ill-conceived, ineffective and inhumane.

In particular, the letter stated that the government’s proposed policy of linking social security benefits to the receipt of “state therapy” is utterly unacceptable. The measure, casually coined “get to work therapy,” was discussed by Chancellor for the Exchequer George Osborne during his last budget.

The letter’s supporters included psychotherapist and writer Susie Orbach. She called the Conservative proposals “beyond shocking.” Echoing the concerns I raised earlier this year, she said:

“It undermines the fundamental principles of one’s right to physical and mental care – that you have to be able to consent and that the people you go to have to be highly trained and have your best interests and aren’t meeting targets.”

The letter’s signatories, all of whom are experts in the field of mental health, have said such a measure is counter-productive, “anti-therapeutic,” damaging and professionally unethical. The “intimidatory disciplinary regime” facing benefits claimants would be made even worse by further unacceptable proposals outlined in the budget.

Among the groups represented by the signatories were Psychologists Against Austerity, Britain’s Alliance for Counselling and Psychotherapy, Psychotherapists and Counsellors for Social Responsibility, the Journal of Public Mental Health, and a range of academic institutions including Goldsmiths, Birkbeck, the University of London, the University of Amsterdam, Manchester Metropolitan University, the University of Brighton, Disabled People Against the Cuts and others.

More generally, the wider reality of a society thrown completely off-balance by the emotional toxicity of social conservatism combined with economic neoliberalism (which I have argued is manifestly authoritarian) is affecting Britain in profound and complex ways, the distressing effects of which are often most visible in therapist’s consulting rooms.

This letter sounds the starting-bell for a broadly based campaign of organisations and professionals against the damage that neoliberalism is doing to the nation’s mental health.

The letter said that for now, we call on all the parties in this election to make it clear that they will urgently review such regressive, anti-therapeutic practices, and appropriately refashion their commitment to mental health if and when they enter government.

Andrew Samuels, an Essex University professor, and immediate past chair of the UK Council for Psychotherapy, said he believed there was “a bit of a public school ethos” behind the work-capability regime introduced under the conservative-liberal democrat coalition and new conservative plans.

Characterising the government attitude as “Pull yourself together man, for heaven’s sake,” Samuels added: “It is wholly inappropriate. It symbolises a society that has lost all moral compass.”

Absolutely. Public schools are notorious for a culture of bullying. However, it’s one thing to be treated as a privileged and insulated public school boy by a peer from an elite background to “character building” rhetoric, but quite another to adopt that same bullying approach towards the ill and most vulnerable citizens. All to justify an ideological drive to “shrink the state” and remove support from the poorest.

All of this said, public schools are regarded by many as institutions that inflict a particularly British form of child abuse and social control. I also think it has to be said that soul trauma and pain don’t respect social status.

Samuels insisted the open letter was not “pro-Labour” but was aimed at getting a review of measures taken and proposed over the past five years.

He said: “If Labour decides afterwards all this is in order, it will go on. But I don’t think it will.”

The Labour Party does value professional opinion and rational discourse. The Conservatives, on the other hand, are not widely recognised as a party that welcomes democratic, open debate, transparency and accountability. The Tories simply exclude critical professionals and representative organisations that may challenge and disagree from the discourse.

A spokesperson for Labour said mental health “is the biggest unaddressed health challenge of our age.”

“It’s essential that we give mental health the priority it deserves if we are to thrive as a nation and ensure the NHS remains sustainable for the future,” he said.

The Labour Party have pressured the government to “write parity of esteem between physical and mental health into law,” and in the response, Labour have stated that the party is committed to implementing this policy if elected in May.

The spokesman pledged the Labour will bring an end to the “scandal of the neglect of child mental health,” indicating a welcomed return to a comprehensive preventative approach. He said: “It is simply not right that when three-quarters of adult mental illnesses begin in childhood, children’s mental health services get just six per cent of the mental health budget.”

Richard House of the Alliance for Counselling and Psychotherapy, the letter’s main organiser, said there had been a mounting groundswell of concern: “When one hears story after story of dramatic negative health impacts, psychological and physical, after people are subjected to these back-to-work practices, the time has surely come for an ‘emotional audit’ of the impact of what, to many, appear to be heartless, un-thought-through policies that are merely penalising and punishing the already disadvantaged still further.”

Yes, the time has come for a change of government. On May 7, we must ensure that the regressive, oppressive regime of the past five years is replaced by a progressive, inclusive and democratic alternative.

Related

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Cameron’s Nudge that knocked democracy down – a summary of the implications of Nudge theory

Rising ESA sanctions: punishing the vulnerable for being vulnerable

Suicides reach a ten year high and are linked with welfare “reforms”

Mental Health Services in crisis because of Coalition cuts to funding

The Psychology of Austerity

A group of mental health professionals have come together under the banner of Psychologists Against Austerity (PAA) to highlight the psychological impact of austerity.

Now, with only a few weeks to go before the general election, PAA have started a campaign calling for a Parliamentary Inquiry into the psychological damage austerity has wreaked across the UK.

You can read more and sign our petition here: 38degrees/psychological costs of austerity inquiry.


 

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Mental Health Services in crisis because of Coalition cuts to funding

 

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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:

2010 2011 2012 2013
Total 14815 16711 17946 23053
Average 511 576 619 795

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.

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Picture courtesy of Robert Livingstone scroll2

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