Why Does it Keep Happening?

Whilst service users are left without a care co-ordinator, services are undermined and trusts enact even more cuts these events will become more and more common.

Care co-ordination was set up as one of the responses to the Jonathan Zito murder and the Mitchell murder at St Clements in Ipswich among other, similar killings. It was and is, a primary defence to patients falling through the net and at its best, establishes a system of clinical and managerial responsibility at all levels. It should mean that any health or social professional associated with a client/service user can access clear signposted info as to the nature of their care and what is going on.

In my trust, (NSFT), service users remain unallocated and without a CC, they wait months for a first appointment for assessment and are placed in units hundreds of miles away when they inevitably go into crisis. The suicide rate for people known to the service has risen for the first time in years- an absolutely clear indication that we are in deep deep trouble.

The NSFTCrisis was established to campaign against our trusts 'Radical Redesign' (a euphemism for destroying services) and is now the largest grass roots service user and staff led campaign. They would gladly liaise and speak to anybody wishing to establish a similar campaign although I totally get the 'Why the hell should we?' frame of mind. It is exhausting enough keeping body and soul together if you have MH issues or care for somebody with them without having to campaign as well.

The members of our trust board who have HCP qualifications are in clear breach of their professional registration as they have failed to provide effective,safe and appropriate care. They should be facing disciplinary measures and even criminal ones in my opinion. How they sleep at night I will never know.

The mental health services in this area are abysmal. They are run by a trust called "2gether" or something equally facile.

I have had a depression problem in the last few weeks and one of my concerns was that there might be a need for a referral, and I knew that this would involve a very long wait, then a visit to someone who can barely speak English, let alone be able to empathise culturally. This is not a racist statement, just a recognition of the problems that can arise in a cross-cultural consultation in psychiatry where the need to pick up subtleties is paramount. Thankfully my GP is dealing with things for me.

A friend of mine with severe reactive depression (and believe me she had plenty to be depressed about - more than anyone should be required to cope with) was put on a whole raft of drugs and a high dose of anti-depressant, and was then referred for CBT. She waited about a year - by the time her name came to the top of the list, she had moved to another part of the country!

The mantra of care in the community for those with mental health problems is fine if the services to support them are properly funded and professionally staffed. And critically the supervision (particularly of taking medication) of those whose illness sadly causes them to be a potential threat to others has to be flawless.

In the context of our severely underfunded and creaking mental health services, the sad scenario outlined in the OP will continue to happen.

There truly was something to be said for asylums properly used for the few for whom it is appropriate. There they could receive proper care in a safe setting where both they and the public were secure.

Mishap

In an area that is totally focused upon subtlety of language and non verbal language it is VITAL that staff members speak the dominant language. That isn't racism. I agree. They do, after all, use talking therapies which rely on being able to communicate.

I agree with everything said by all the previous posters. Why are mental health services the Cinderellas of the health service? As someone who is on the point of retiring from work in this field, I despair when I think back to what we used to be able to offer people compared to the "care" available now. The old institutions were undoubtedly riven with problems but, as originally envisaged by the Victorian philanthropists, were potentially places of safety, calm and kindness. Naturally this was subverted over time. Sigh.
Please don't blame current practitioners. We are all desperate to help the people referred to us but our hands are tied by lack of resources. Money really. I would say that "modern" afflictions seem to eat up a lot of funding eg substance misuse, alcohol problems and eating disorders. I know they have always been around but the money that goes into drug rehab is huge and this is a relatively recent and , bottom line, self inflicted, ailment. People with Schizophrenia, Paranoid Schizophrenia and their families need much, much more support than seems available. Just my opinion though.

I seem to remember that the policy of care in the community was to copy the Swedish system. So, a lot of hospitals closed down. However, no one bothered to build the special housing that they have in Sweden, therefore people with mental health issues were just thrown out into the streets [I could be completely wrong about this; it was a long time ago and I'm just going by my interpretation of events]. At least Nick Clegg has said that we must do something about the problem [not that I believe anything he promises these days].

Talks cheap. Good quality care isn't unfortunately. We must keep pushing this agenda but its wearying

Exactly jane - I was working for SSD when the whole care in the community thing came in and it was clear that the government thought it would be a cheap option - we just kept on saying that in order to do it properly it would cost more. No-one was listening then and they are not listening now.

Cancer, paediatrics and dramatic stuff like heart surgery grab the headlines and make the government listen - but we must never ever forget that mental illness is serious and can be fatal just as these other illnesses can. And it is so prevalent, at best reducing the quality of life of millions of sufferers and their families and at worst ending lives prematurely.

We have a gentleman in the village who is bi-polar and schizophrenic (I believe that is his 'label') and he is housed in a bedsit with no oven in case he damages himself and/or his neighbours. He wanders about, feeding himself badly on whatever he can manage to cook in a microwave, then periodically he has an episode as he messes up his medication and is likely suffering from malnutrition and all kinds of vitamin and mineral deficiencies. He crashes and is taken into emergency care, dosed up and set off out on his own again. What a bloody disaster. I am not one to yak on about the so called good old days, but this is one soul who really does need asylum in the true meaning of the word, somewhere to be looked after, fed three meals a day and given medication of the right dose at the right time. I am sure there must be thousands like him, poor lost souls.

As Jane10 says, the old Victorian hospital system had some advantages, as places of sanctuary for the severely mentally ill, who are often terrified of living "outside".
As a student I worked in the old Colney Hatch hospital, and it was like a village with all facilities. Shops , chapels, even a synagogue.
But there's still the stigma of mental illness, and because treatment is time-consuming, there's always going to be a waiting list.
Surely it would be more economical to open a few small secure hospitals for the people with severe problems, like the young man in the OP.
Even so things can go wrong in there too - there was a horrific case in a secure hospital ward in Pau, France, near us, in 2004.