existentialist
Things Done
In light of the revelation that the suspect for the recent murders in Nottingham was known to police, and had a "history of mental health issues".
There is a whole moral argument to be had around whether someone having mental health difficulties is or should be responsible for their actions, but I'm more concerned with the question of whether the responsibility is wider than that.
I have, for over 30 years, had involvement with the NHS mental health system, culminating in my working within it for the last 15 of them
What I have seen has been, at some level, quite shocking. While there's no doubt that it is largely staffed by caring individuals who genuinely signed up to try and make a difference, the system itself doesn't function (I was going to say "barely functions", but that's whitewashing it).
Primary mental health care, in my experience, across two health authorities and 30+ years, has been parlous. Gaining access to anything beyond 6 sessions of solution-focused CBT is well-nigh impossible, and even that intervention often has long waiting lists. Acute care is creaking at the seams, with dilapidated hospitals operating at over 100% capacity, and the treatment pattern for acute patients is, all too often, a revolving door wherein you cannot get admitted until you do something drastic (and a suicide attempt is often not sufficiently drastic), only to be discharged when someone else comes along who needs the bed more than you do.
I have heard countless tales of comprehensive and - on the face of it - reasonable care plans, which evaporate like Scotch mist the minute anyone tries to access them. Patients present at A&E, only to be shoved from pillar to post, often without any kind of result.
There are good interventions, and there are success stories. All too often, they seem to be associated with patients who have someone in their lives prepared to be "the squeaky wheel" and advocate for them. And heaven help any psychiatric patient who is less than completely co-operative - miss an appointment or stop taking your meds, and there's a good chance you'll just get discharged.
I think that - quite apart from being a civilised and decent thing to do - one of the reasons for having decent mental healthcare is so that society is not having to carry such a heavy burden in terms of people unable to function within it, not to mention the consequences on those who end up having to care for them in the absence of decent professional care, and who, all too often, end up themselves succumbing to "deux en fou" as that burden weighs ever more heavily on them, or, as I frequently see, collapse into their own crises following the bereavement of a loved one to suicide, or its slower cousins, drug abuse and alcoholism.
We patently don't do this. A staggering proportion of homeless people have mental health problems, and are even less likely to be able to access the system. Even for people with moderate to acute mental health difficulties, their lives are often chaotic, and do not lend themselves well to getting across town to the mental health unit at the appointed time. And yet, if they don't show (or, as happened recently, dropped dead in their flat, not to be found for 2 years), nobody follows it up.
And we wonder why things like the rampage in Nottingham happen? Is it not possible that, had that man received appropriate help for his condition, that 3 people would still be alive today, and a community would not have been scarred by the terror of that night?
But it's not just about the headline cases. Even if the occasional suicide makes the news, most don't, and for each of them there will be hundreds, if not thousands, of people languishing in misery, unable to access the help they need to be able to start clawing their way back to living some kind of decent life.
Much of mental illness is curable. But it takes commitment on the part of the services supposedly there to do that. We can't expect the patient to make all the running, including having to fight even to access a service in a way which all-too-often resembles the script of a Kafka novel. It is clear to me that the system, as it stands, is grievously and chronically under-resourced, and nobody really seems to think that is all that much of a problem, least of all this shower of clowns who currently govern us.
Or maybe I've got it all wrong, and these are just the maunderings of some bleeding heart liberal who's just making excuses for a bunch of lead-swingers who should just make like a pair of curtains and pull themselves together.
There is a whole moral argument to be had around whether someone having mental health difficulties is or should be responsible for their actions, but I'm more concerned with the question of whether the responsibility is wider than that.
I have, for over 30 years, had involvement with the NHS mental health system, culminating in my working within it for the last 15 of them
What I have seen has been, at some level, quite shocking. While there's no doubt that it is largely staffed by caring individuals who genuinely signed up to try and make a difference, the system itself doesn't function (I was going to say "barely functions", but that's whitewashing it).
Primary mental health care, in my experience, across two health authorities and 30+ years, has been parlous. Gaining access to anything beyond 6 sessions of solution-focused CBT is well-nigh impossible, and even that intervention often has long waiting lists. Acute care is creaking at the seams, with dilapidated hospitals operating at over 100% capacity, and the treatment pattern for acute patients is, all too often, a revolving door wherein you cannot get admitted until you do something drastic (and a suicide attempt is often not sufficiently drastic), only to be discharged when someone else comes along who needs the bed more than you do.
I have heard countless tales of comprehensive and - on the face of it - reasonable care plans, which evaporate like Scotch mist the minute anyone tries to access them. Patients present at A&E, only to be shoved from pillar to post, often without any kind of result.
There are good interventions, and there are success stories. All too often, they seem to be associated with patients who have someone in their lives prepared to be "the squeaky wheel" and advocate for them. And heaven help any psychiatric patient who is less than completely co-operative - miss an appointment or stop taking your meds, and there's a good chance you'll just get discharged.
I think that - quite apart from being a civilised and decent thing to do - one of the reasons for having decent mental healthcare is so that society is not having to carry such a heavy burden in terms of people unable to function within it, not to mention the consequences on those who end up having to care for them in the absence of decent professional care, and who, all too often, end up themselves succumbing to "deux en fou" as that burden weighs ever more heavily on them, or, as I frequently see, collapse into their own crises following the bereavement of a loved one to suicide, or its slower cousins, drug abuse and alcoholism.
We patently don't do this. A staggering proportion of homeless people have mental health problems, and are even less likely to be able to access the system. Even for people with moderate to acute mental health difficulties, their lives are often chaotic, and do not lend themselves well to getting across town to the mental health unit at the appointed time. And yet, if they don't show (or, as happened recently, dropped dead in their flat, not to be found for 2 years), nobody follows it up.
And we wonder why things like the rampage in Nottingham happen? Is it not possible that, had that man received appropriate help for his condition, that 3 people would still be alive today, and a community would not have been scarred by the terror of that night?
But it's not just about the headline cases. Even if the occasional suicide makes the news, most don't, and for each of them there will be hundreds, if not thousands, of people languishing in misery, unable to access the help they need to be able to start clawing their way back to living some kind of decent life.
Much of mental illness is curable. But it takes commitment on the part of the services supposedly there to do that. We can't expect the patient to make all the running, including having to fight even to access a service in a way which all-too-often resembles the script of a Kafka novel. It is clear to me that the system, as it stands, is grievously and chronically under-resourced, and nobody really seems to think that is all that much of a problem, least of all this shower of clowns who currently govern us.
Or maybe I've got it all wrong, and these are just the maunderings of some bleeding heart liberal who's just making excuses for a bunch of lead-swingers who should just make like a pair of curtains and pull themselves together.
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