Beyond The Ballot is The Huffington Post UK's alternative take on the General Election, taking on the issues too awkward for Westminster. It focuses on the unanswered questions around internet freedom, mental health and housing. Election news, blogs, polls and predictions are combined with in-depth coverage of our three issues including roundtable debates, MP interviews and analysis.
Mental health problems permeate society. One in four people suffer from a mental health problem each year.
It is still largely the poor relation of physical health problems, with associated stigma and a lack of understanding. As a GP I see first-hand what mental health problems do to patients. The emotional impact, the physical impact, how it affects relationships, work, theirs and their families' future. The vast majority of the mental health problems in Primary Care in the NHS are depression, anxiety disorders - panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder; and personality disorders.
The dedicated NHS mental health service is equipped to deal with those problems which I as a GP rarely see. Patients with schizophrenia or bipolar disorder, or with very severe types of the above conditions which need specialist input. These patients should be managed by Consultant Psychiatrists, by specially trained Mental Health nurses; they require extensive monitoring and complex medications.
But the mental health service is overwhelmed. Waiting times are over a year in some parts of the country. Follow-up and initial appointments take too long. Increasing numbers of patients are being diagnosed with Dementia, which also comes under the umbrella of mental health, as well as drug and alcohol addiction services. NICE recommends that the first line of treatment for all common mental health conditions is assessment, then some form of talking therapy. In none of them is medication recommended as the very first treatment option.
This is where the system fails. It fails both patients, and the wider NHS. Talking therapies, which have been extensively proven by evidence-based research to work, are not readily available. When someone walks into my room in tears, and I diagnose them with a mental health disorder, I need to be able to pick up the phone, or write a letter, and tell them someone will be in touch that day or the next. The help needed is instantaneous, and the sooner it is in place, the better the outcome. If a patient is suicidal, that help is available. But for anything less, the wait is months.
What follows is wasteful - medication which does not solve the underlying issues, time off work because things are not improving, long term sickness and reliance on benefits. Physical symptoms worsened by the ongoing mental health issues - patients do not cope with physical health problems well when their mental health is suffering. Multiple GP appointments when all I can do is listen for 10 minutes at a time. Multiple calls to the Out of Hours service, trips to A&E asking for help. Most of these conditions are chronic - they return perpetually, and if the right treatment isn't given, the whole cycle starts again.
What is needed is a long term view. An acceptance that the current service is not providing the best and recommended treatment quickly enough. Can you imagine the outcry if this was a physical condition? If the patient who presented with a broken leg was told that the recommended treatment of crutches and a plaster cast wasn't available for another 12 months, so they would have to make do with some paracetamol and a zimmer frame in the meantime? Talking therapies are more expensive than medication. But short term investment will reduce the long term impact on the finances of the NHS, and most importantly, on patients. Patients will not need repeated half-effective courses of medication. Doctors will not feel pressured to prescribe it. Professionals trained in mental health will have the time and resources needed to provide this care, and not be moving from one crisis to the next. Secondary care services are freed up to return to those with the most severe diagnoses. Recognise that dementia needs its own resources and funding, and cannot be tagged onto existing services.
My question to you is, do you want a sticking plaster, a quick fix? Or a long term solution to a problem which affects a quarter of the population and has a direct impact on society as a whole? It is time mental health stopped being the poor relation, stopped being a gimmick wheeled out to get votes, and started getting the long term investment patients need to benefit everyone.
This needs to be delivered with the doctors, nurses, therapists and patients all involved and listened to. When mental health is seen, and treated, it impacts the whole system. It moves from an endless litany of symptoms blighting lives, to a quickly recognised and treated condition so patients can get on with living. And that is to everyone's benefit.
So my challenge to you is, stop the rhetoric and platitudes, talk to the people who live with it everyday, and help.
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