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BRITAIN'S POOREST CITIZENS TAXED THE MOST!
Britain's poorest families hand over a bigger proportion of their income in taxes than better-off households, research published today (20th December 2014) discloses. They are hit particularly hard by VAT, the Treasury’s second-biggest source of revenue, according to a report by the Tax Payers’ Alliance. It warns that any increase to the 20 per cent standard rate of VAT would pile further financial pressure on struggling households. The worst-off 10 per cent of families pay 47 per cent of their earnings in tax because they are disproportionately affected by flat-rate indirect taxes such as VAT, the council tax and duties on fuel, alcohol and tobacco.
The average household pays £274 a year more in taxes than it receives in benefits and services such as healthcare and education, according to the research. The best-off 10 per cent pay around £30,000 more than they get back in cash and benefits in kind.
The alliance calls for cuts to VAT and “sin taxes” as part of a sweeping overhaul of the tax system to re balance its demands on different income groups. Its chief executive, Jonathan Isaby, said: “This analysis shows how pernicious our tax burden has become. Not only does the tax system hit the poorest hardest, but those at the top are already contributing far more than anybody could reasonably describe as their ‘fair share’. ”The average household in London, the South East, East of England, South West and East Midlands paid more in taxes than they received in benefits and services, the report concluded. All other English regions, as well as Scotland, Wales and Northern Ireland, received more in benefits and services than their residents paid in taxes.
So at Recovery In Action we want to highlight how this added stress on low income inner city dwellers is a definite contributing factor to the increasing numbers of people finding it hard to cope and subsequently using mental health services for the first time in their lives. We see more and more people who are stuck in a perpetual state of mental and emotional turmoil as they try to make ends meet. To add to this negative situation; as more people are forced to stop working due to such stresses it often ends up costing the tax payer 'even more' as people have to claim sickness benefits and in the most dire cases end up in hospital costing on average £600 per day!
The average household pays £274 a year more in taxes than it receives in benefits and services such as healthcare and education, according to the research. The best-off 10 per cent pay around £30,000 more than they get back in cash and benefits in kind.
The alliance calls for cuts to VAT and “sin taxes” as part of a sweeping overhaul of the tax system to re balance its demands on different income groups. Its chief executive, Jonathan Isaby, said: “This analysis shows how pernicious our tax burden has become. Not only does the tax system hit the poorest hardest, but those at the top are already contributing far more than anybody could reasonably describe as their ‘fair share’. ”The average household in London, the South East, East of England, South West and East Midlands paid more in taxes than they received in benefits and services, the report concluded. All other English regions, as well as Scotland, Wales and Northern Ireland, received more in benefits and services than their residents paid in taxes.
So at Recovery In Action we want to highlight how this added stress on low income inner city dwellers is a definite contributing factor to the increasing numbers of people finding it hard to cope and subsequently using mental health services for the first time in their lives. We see more and more people who are stuck in a perpetual state of mental and emotional turmoil as they try to make ends meet. To add to this negative situation; as more people are forced to stop working due to such stresses it often ends up costing the tax payer 'even more' as people have to claim sickness benefits and in the most dire cases end up in hospital costing on average £600 per day!
CALLS FOR BETTER YOUTH MENTAL HEALTH SERVICES!
We at Recovery In Action have welcomed the publication of a House of Commons Health Committee report looking at mental health services for children and young people which criticizes the Departments of Health and Education, NHS England, Ofsted and the Care Quality Commission.Our Chief Executive, Jenny Edwards CBE says;
'The report is a timely summary of the many complex issues which lead to inadequate and fragmented services being provided in many parts of the country which can lead to lifelong mental health problems. Whilst some areas do have examples of good practice, overall the report makes for grim reading. Services are under enormous strain and the system hasn't made them a priority in terms of funding, commissioning or inspection.'
We congratulate the Committee on its thorough work and recommendations, as well as their engagement with the issues raised. We hope that the Committee will continue to scrutinise this area and the issues it raises will be made a priority by ministers and all political parties.
The Foundation welcomes the focus on improved perinatal and infant mental health services and on embedding mental health in the education curriculum. Proper information that drives adequate commissioning will provide a deeper understanding of what services are available now, what is needed, and what the prevalence of mental health problems are. Without understanding the true scale of need, and what it will cost to meet it, these urgent changes cannot be implemented. We must act quickly - within the lifetime of the next Parliament - or we risk losing a generation of young people to mental health problems. This could so easily be avoided, if treatment were to be made readily available.
So we at Recovery In Action are witnessing more young people being affected by mental health issues and although we only work with people over 18 we are time and again hearing from those we support that they have been using services since their teens and to some degree have become institutionalized. There must be something done to help these young people when they're struggling in our communities and we (with others) are gearing up for a campaign to influence positive change in this area!
November 2014
'The report is a timely summary of the many complex issues which lead to inadequate and fragmented services being provided in many parts of the country which can lead to lifelong mental health problems. Whilst some areas do have examples of good practice, overall the report makes for grim reading. Services are under enormous strain and the system hasn't made them a priority in terms of funding, commissioning or inspection.'
We congratulate the Committee on its thorough work and recommendations, as well as their engagement with the issues raised. We hope that the Committee will continue to scrutinise this area and the issues it raises will be made a priority by ministers and all political parties.
The Foundation welcomes the focus on improved perinatal and infant mental health services and on embedding mental health in the education curriculum. Proper information that drives adequate commissioning will provide a deeper understanding of what services are available now, what is needed, and what the prevalence of mental health problems are. Without understanding the true scale of need, and what it will cost to meet it, these urgent changes cannot be implemented. We must act quickly - within the lifetime of the next Parliament - or we risk losing a generation of young people to mental health problems. This could so easily be avoided, if treatment were to be made readily available.
So we at Recovery In Action are witnessing more young people being affected by mental health issues and although we only work with people over 18 we are time and again hearing from those we support that they have been using services since their teens and to some degree have become institutionalized. There must be something done to help these young people when they're struggling in our communities and we (with others) are gearing up for a campaign to influence positive change in this area!
November 2014
BBC SHOW LOOKS AT ERADICATING LONELINESS
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This week sees BBC 1’s James Martin host a five-part series; Operation: Meet the Street. The programme - which airs every morning from Monday 15 December and runs consecutively for five days - focuses on the eradication of loneliness by reconnecting the UK’s communities. It will also feature expert views from our Director of Development and Delivery, Isabella Goldie, on the topic of loneliness and isolation. “Loneliness is different from social isolation,” says Goldie. “You can choose to be alone, but loneliness is a more subjective experience and [is] based on aspects like how you were brought up and how important social connectedness is for you.”Operation: Meet the Street follows celebrities such as retired Olympian Denise Louise, TV presenter Alex Jones, and one half of Hairy Bikers outfit, Dave Myers. Martin James and the celebrities have teamed up with Goldie and other mental health experts who are working to end the stigma around loneliness and isolation.
Our 2010 report, The Lonely Society?, highlighted poverty, unemployment, and physical disability as just a few of the ways one’s life may shift to include fewer interpersonal interactions. “Being older and having mobility issues, having a physical illness or disability that makes it difficult to get out of the house, having poor access to transport, being excluded due to difference” are all factors that contribute to loneliness, Goldie explains. “Many international human rights activists view isolation as the cruellest form of torture, yet as part of daily life we leave many older people confined to their homes on their own.” The report shows that levels of loneliness and isolation rise during the Christmas period, so the airing of Operation: Meet the Street comes at a significant time.
The programme will look into the childhoods of five celebrities but its main purpose is to raise awareness about loneliness. Rather than giving the spotlight to the celebrities and their experiences, Martin will aim to highlight the stories of local residents who may be experiencing feelings of isolation and low self-esteem. No demographic is exempt from feelings of loneliness - according to Goldie, “people who have encountered adversity – such as young people with long-term conditions or those who have experienced trauma or discrimination – can experience both social and emotional isolation.”
The Lonely Society? points out that as the holiday season approaches, the financial and emotional weight of this time can simply add to the burden of loneliness that has been building all year. “Poverty is a big factor – you need money to be able to socialize,” says Goldie. Not having parties to go to or money to shop with, many people already experiencing loneliness this year will shrink further into their isolation.
Watch Operation: Meet the Street on BBC 1 at 9:15 every morning starting Monday, December 15, with the final episode airing on Friday, December 19.
Follow the show: #OperationMeetTheStreet.
LATEST PIP STATS
Today sees the release of the latest personal independence payment (PIP) statistics, giving details of how many claimants are still waiting and how many new claimants and DLA transfer claimants are getting an award.
Today also brings the first mandatory reconsideration statistics. These suggest that DWP dirty tricks have managed to cut the number of employment and support allowance (ESA) challenges by more than half. And they still won’t tell us how many of those challenges are successful.
We explain how to beat the dirty tricks, whether your mandatory reconsideration – the new first step in the appeals process – is for ESA, PIP or another benefit.
The DWP have also announced that a new ESA50 questionnaire is due out early next year which will place more onus on claimants to provide supporting evidence.
Meanwhile, it will come as no surprise to readers to discover that IDS continues to twist statistics, mangle facts and bluster his way out of every hole he finds himself in.
He claimed on the BBC on Sunday that benefits are now paid on time in 96 – 97% of cases compared to 88-89% under Labour.
This contrasts with the reality that only 20% of people who claimed ESA in January to March of this year have had an assessment. 40% are still stuck on the assessment rate of ESA waiting for a medical and another 41% got better or died before Atos got round to them.
It also contrasts sharply with the finding by the Office for Budget Responsibility that the DWP will have to spend an extra £1bn on ESA this year because of delays with processing claims and an extra £1bn on disability benefits because of delays in the roll-out of PIP.
The ‘on-time’ statistic was produced by IDS during his fight-back against a report by the Church of England which found that that benefits problems are one of the main causes of the rapid rise in food bank use in the UK.
IDS also argued that Germany is a much richer country and pays more generous benefits and yet has higher food bank use, proving that the increase in UK food banks can’t be due to benefit changes.
In fact, anyone Googling “German food bank use” will find as the very first result an article by the London School of Economics. It explains in detail how the meteoric rise in food bank use in Germany since 2005 is due to cuts to unemployment benefits which have, in turn, been used to fund tax cuts.
Sound familiar at all?
Still, at least all the fuss about food banks has allowed IDS to distract attention from the revelation last week that the Treasury still hasn't signed off the business case for universal credit and that it is also on the amber/red warning list of the Major Projects Authority.
This is in spite of IDS telling MP's in a written ministerial statement in October that UC had been “assured by the Major Projects Authority and signed off by HM Treasury”.
It seems that IDS can fail in almost every endeavour, twist statistics and lie to his heart’s content yet still keep his job, so long as he continues to convince the press that the Coalition are cracking down on claimants.
Source: Benefits and Work website 17th Dec Newsletter.
www.benefitsandwork.co.uk
Today also brings the first mandatory reconsideration statistics. These suggest that DWP dirty tricks have managed to cut the number of employment and support allowance (ESA) challenges by more than half. And they still won’t tell us how many of those challenges are successful.
We explain how to beat the dirty tricks, whether your mandatory reconsideration – the new first step in the appeals process – is for ESA, PIP or another benefit.
The DWP have also announced that a new ESA50 questionnaire is due out early next year which will place more onus on claimants to provide supporting evidence.
Meanwhile, it will come as no surprise to readers to discover that IDS continues to twist statistics, mangle facts and bluster his way out of every hole he finds himself in.
He claimed on the BBC on Sunday that benefits are now paid on time in 96 – 97% of cases compared to 88-89% under Labour.
This contrasts with the reality that only 20% of people who claimed ESA in January to March of this year have had an assessment. 40% are still stuck on the assessment rate of ESA waiting for a medical and another 41% got better or died before Atos got round to them.
It also contrasts sharply with the finding by the Office for Budget Responsibility that the DWP will have to spend an extra £1bn on ESA this year because of delays with processing claims and an extra £1bn on disability benefits because of delays in the roll-out of PIP.
The ‘on-time’ statistic was produced by IDS during his fight-back against a report by the Church of England which found that that benefits problems are one of the main causes of the rapid rise in food bank use in the UK.
IDS also argued that Germany is a much richer country and pays more generous benefits and yet has higher food bank use, proving that the increase in UK food banks can’t be due to benefit changes.
In fact, anyone Googling “German food bank use” will find as the very first result an article by the London School of Economics. It explains in detail how the meteoric rise in food bank use in Germany since 2005 is due to cuts to unemployment benefits which have, in turn, been used to fund tax cuts.
Sound familiar at all?
Still, at least all the fuss about food banks has allowed IDS to distract attention from the revelation last week that the Treasury still hasn't signed off the business case for universal credit and that it is also on the amber/red warning list of the Major Projects Authority.
This is in spite of IDS telling MP's in a written ministerial statement in October that UC had been “assured by the Major Projects Authority and signed off by HM Treasury”.
It seems that IDS can fail in almost every endeavour, twist statistics and lie to his heart’s content yet still keep his job, so long as he continues to convince the press that the Coalition are cracking down on claimants.
Source: Benefits and Work website 17th Dec Newsletter.
www.benefitsandwork.co.uk
BLACK & MINORITY ETHNIC MENTAL HEALTH
Different ethnic groups have different rates and experiences of mental health problems, reflecting their different cultural and socio-economic contexts and access to culturally appropriate treatments.
In general, people from black and minority ethnic groups living in the UK are:
These differences may be explained by a number of factors, including poverty and racism. They may also be because mainstream mental health services often fail to understand or provide services that are acceptable and accessible to non-white British communities and meet their particular cultural and other needs. It is likely that mental health problems go unreported and untreated because people in some ethnic minority groups are reluctant to engage with mainstream health services. It is also likely that mental health problems are over-diagnosed in people whose first language is not English.
Irish people:
Irish people living in the UK have much higher hospital admission rates for mental health problems than other ethnic groups. In particular they have higher rates of depression and alcohol problems and are at greater risk of suicide. These higher rates may, in part, be caused by social disadvantage among Irish people in the UK, including poor housing and social isolation. Despite these high rates, the particular needs of Irish people are rarely taken into account in planning and delivering mental health services.
African Caribbean people:
African Caribbean people living in the UK have lower rates of common mental disorders than other ethnic groups but are more likely to be diagnosed with severe mental illness. African Caribbean people are three to five times more likely than any other group to be diagnosed and admitted to hospital for schizophrenia. However, most of the research in this area has been based on service use statistics. Some research suggests that the actual numbers of African Caribbean people with schizophrenia is much lower than originally thought. African Caribbean people are also more likely to enter the mental health services via the courts or the police, rather than from primary care, which is the main route to treatment for most people. They are also more likely to be treated under a section of the Mental Health Act, are more likely to receive medication, rather than be offered talking treatments such as psychotherapy, and are over-represented in high and medium secure units and prisons. This may be because they are reluctant to engage with services, and so are much more ill when they do. It may also be that services use more coercive approaches to treatment.
Asian people:
The statistics on the numbers of Asian people in the United Kingdom with mental health problems are inconsistent, although it has been suggested that mental health problems are often unrecognised or not diagnosed in this ethnic group. Asian people have better rates of recovery from schizophrenia, which may be linked to the level of family support. Suicide is low among Asian men and older people, but high in young Asian women compared with other ethnic groups. Indian men have a high rate of alcohol related problems. Research has suggested that Western approaches to mental health treatment are often unsuitable and culturally inappropriate to the needs of Asian communities. Asian people tend to view the individual in a holistic way, as a physical, emotional, mental and spiritual being.
Chinese people:
There is very little knowledge of the extent of mental health problems in the Chinese community.
It has been suggested that the close-knit family structure of the Chinese community provides strong support for its members. While this may be beneficial, it may generate feelings of guilt and shame, resulting in people feeling stigmatised and unable to seek help.
In general, people from black and minority ethnic groups living in the UK are:
- more likely to be diagnosed with mental health problems
- more likely to be diagnosed and admitted to hospital
- more likely to experience a poor outcome from treatment
- more likely to disengage from mainstream mental health services, leading to social exclusion and a deterioration in their mental health.
These differences may be explained by a number of factors, including poverty and racism. They may also be because mainstream mental health services often fail to understand or provide services that are acceptable and accessible to non-white British communities and meet their particular cultural and other needs. It is likely that mental health problems go unreported and untreated because people in some ethnic minority groups are reluctant to engage with mainstream health services. It is also likely that mental health problems are over-diagnosed in people whose first language is not English.
Irish people:
Irish people living in the UK have much higher hospital admission rates for mental health problems than other ethnic groups. In particular they have higher rates of depression and alcohol problems and are at greater risk of suicide. These higher rates may, in part, be caused by social disadvantage among Irish people in the UK, including poor housing and social isolation. Despite these high rates, the particular needs of Irish people are rarely taken into account in planning and delivering mental health services.
African Caribbean people:
African Caribbean people living in the UK have lower rates of common mental disorders than other ethnic groups but are more likely to be diagnosed with severe mental illness. African Caribbean people are three to five times more likely than any other group to be diagnosed and admitted to hospital for schizophrenia. However, most of the research in this area has been based on service use statistics. Some research suggests that the actual numbers of African Caribbean people with schizophrenia is much lower than originally thought. African Caribbean people are also more likely to enter the mental health services via the courts or the police, rather than from primary care, which is the main route to treatment for most people. They are also more likely to be treated under a section of the Mental Health Act, are more likely to receive medication, rather than be offered talking treatments such as psychotherapy, and are over-represented in high and medium secure units and prisons. This may be because they are reluctant to engage with services, and so are much more ill when they do. It may also be that services use more coercive approaches to treatment.
Asian people:
The statistics on the numbers of Asian people in the United Kingdom with mental health problems are inconsistent, although it has been suggested that mental health problems are often unrecognised or not diagnosed in this ethnic group. Asian people have better rates of recovery from schizophrenia, which may be linked to the level of family support. Suicide is low among Asian men and older people, but high in young Asian women compared with other ethnic groups. Indian men have a high rate of alcohol related problems. Research has suggested that Western approaches to mental health treatment are often unsuitable and culturally inappropriate to the needs of Asian communities. Asian people tend to view the individual in a holistic way, as a physical, emotional, mental and spiritual being.
Chinese people:
There is very little knowledge of the extent of mental health problems in the Chinese community.
It has been suggested that the close-knit family structure of the Chinese community provides strong support for its members. While this may be beneficial, it may generate feelings of guilt and shame, resulting in people feeling stigmatised and unable to seek help.
PEER 2 PEER IS GOING FROM STRENGTH TO STRENGTH
At Peer2Peer we recognise the importance of peer support in developing and delivering meaningful and effective services for people experiencing mental distress. Peer2Peer is a partnership between Together and other organisations through which we share our expertise and develop best practice in peer support. The partnership includes the National Survivor User Network, user-led organisations and a network of statutory, community and academic bodies. We work together to share knowledge, develop innovative peer support models, build good practice and create strong partnerships with key stakeholders nationally and locally.
When someone has spent an awful long time being misunderstood in the mental health system, peer support is like a breath of fresh air and can be lifesaving. 90 per cent of the time I just want to talk to someone who can truly understand and can offer solutions they used themselves to overcome similar experiences – it is liberating.” Peer Support Worker and Peer2Peer member.
What is Peer2Peer? Peer support is about people with lived experience of mental distress, supporting each other to achieve our hopes and aspirations.” Peer2Peer member
At the heart of Peer2Peer is a user-led Peer2Peer Steering Group with peer support expertise nationally, regionally and locally. Membership of Peer2Peer includes user-led organisations, NHS Trusts, service providers, charities, community organisation and academia.
Peer2Peer’s vision is that everyone will have access to good quality, authentic peer support. This kind of support is led by lived experience, and based on a mutually beneficial relationship where both people understand and support each other to achieve their hopes and aspirations.
Peer2Peer’s mission is to develop understanding and promote the benefits of authentic peer support.
We achieve this by:
To register as a member of Peer2Peer, please complete the registration form
Peer support mapping project The Peer2Peer Group is currently conducting an exercise to map peer support initiatives across the UK. This will enable networking, sharing and learning in mental health support. We’d be grateful if you could spare a few minutes to fill out our Peer Support Mapping Questionnaire for your area.
Find out more For more information about Together’s work in peer support, please contact:
Elina Stamou
Email: elina-stamou@together-uk.org
Deputy Director – Peer Support
Tel: 0207 780 7358
When someone has spent an awful long time being misunderstood in the mental health system, peer support is like a breath of fresh air and can be lifesaving. 90 per cent of the time I just want to talk to someone who can truly understand and can offer solutions they used themselves to overcome similar experiences – it is liberating.” Peer Support Worker and Peer2Peer member.
What is Peer2Peer? Peer support is about people with lived experience of mental distress, supporting each other to achieve our hopes and aspirations.” Peer2Peer member
At the heart of Peer2Peer is a user-led Peer2Peer Steering Group with peer support expertise nationally, regionally and locally. Membership of Peer2Peer includes user-led organisations, NHS Trusts, service providers, charities, community organisation and academia.
Peer2Peer’s vision is that everyone will have access to good quality, authentic peer support. This kind of support is led by lived experience, and based on a mutually beneficial relationship where both people understand and support each other to achieve their hopes and aspirations.
Peer2Peer’s mission is to develop understanding and promote the benefits of authentic peer support.
We achieve this by:
- facilitating cooperation between service user groups, voluntary organisations, other statutory service providers and commissioners
- sharing information, new ideas, resources, advice and good practice
- building and developing expertise from our experience of peer support
- developing and supporting authentic and effective user-led peer support
- building valuable, strong partnerships with key stakeholders locally and nationally
- expertise on authentic peer support in a variety of settings and with a range of clients/groups
- expertise on good practice and opportunities to shape future peer support
- successes and challenges, problem-solve and learn jointly with others
- networking and partnership opportunities with a range of stakeholders, including user-led groups, NHS, statutory bodies, professionals, academics
- good practice in being inclusive and combating stigma
To register as a member of Peer2Peer, please complete the registration form
Peer support mapping project The Peer2Peer Group is currently conducting an exercise to map peer support initiatives across the UK. This will enable networking, sharing and learning in mental health support. We’d be grateful if you could spare a few minutes to fill out our Peer Support Mapping Questionnaire for your area.
Find out more For more information about Together’s work in peer support, please contact:
Elina Stamou
Email: elina-stamou@together-uk.org
Deputy Director – Peer Support
Tel: 0207 780 7358
AUSTERITY OR OPPORTUNITY?
CAN MENTAL HEALTH SERVICES THRIVE REGARDLESS OF CUTS?
MIKE SMITH AT THE ALTERNATIVE FUTURES GROUP SAYS 'YES!'
The NHS spends more than £12bn on treating mental health issues, yet we feel so poverty stricken. What is even more concerning is that our outcomes are so poor when compared with those of countries that spend much less.
There is no doubt that the financial challenges ahead will have an impact on future mental health services. Whoever is in government after the 2015 general election will still be taking policy decisions to lower the deficit. Andy Burnham MP, shadow secretary of state for health talks of a whole person approach to care and repeal of the Health and Social Care Act 2012. But is this radical enough for the service and/or workforce re-design which I believe is needed within our sector?
Poverty of thinking, poverty of creativity and a poverty of action seem to colour mental health services in the UK. This absence of new thinking along with tradition mean there is an apparent lack of political will to radically change the way we do things. We have a huge amount of money invested in traditional structures and there is much emotional and personal investment in the status quo which is hampering our approaches.
As mental health services adopt an ethos of recovery, growth and aspiration rather than maintenance and stability alone, they are seeing the changes that are needed to transform expectations, services and people. The good news is that some of the best ways of doing things need not be expensive. Hertfordshire partnership NHS trust support family placements, as one alternative to hospital, supporting crisis resolution services.
Alternative Futures Group has a two-year partnership with Mobee, a charity in West Africa that is developing community mental wellbeing practitioners to support the polyclinics in Gambia. The community workers are trained in self-help and in personal and community capacity building techniques. The self-help tools are based on person-centred counselling and solution-focused therapy but use written questions and small group exercises run within schools and polyclinics, as well as community groups and postnatal classes etc.
Two groups of support workers and senior personnel from our organisation have visited Gambia to share good practice and develop new skills and techniques in an environment where there is little resource, financial or otherwise. We've also formed strong links with mental health service professionals in Italy and Denmark to find out how they are dealing with austerity within their countries and communities.
In Trieste, the importance of a whole system response to mental distress rooted in the community not within the patient is highlighted. This approach and the need for strong and effective case management has proved a success.
Another, perhaps even more radical, approach focusing on workforce changes has been adopted at Lyngby Tarbaek Kommune in Copenhagen. Here they have changed the thinking that underpins their provision. They have done away with staff meetings and handover periods in all forms.
In the UK, we should use austerity to look at how we deal with chronicity, avoid creating dependency and a hopeless model of maintenance by learning from other countries and offering alternatives for change.
Article sourced from The Guardian and is written by Mike Smith.
Mike Smith is vice-chair of the International Mental Health Collaborating Network (IMHCN) and clinical director (mental health) at Alternative Futures Group.
There is no doubt that the financial challenges ahead will have an impact on future mental health services. Whoever is in government after the 2015 general election will still be taking policy decisions to lower the deficit. Andy Burnham MP, shadow secretary of state for health talks of a whole person approach to care and repeal of the Health and Social Care Act 2012. But is this radical enough for the service and/or workforce re-design which I believe is needed within our sector?
Poverty of thinking, poverty of creativity and a poverty of action seem to colour mental health services in the UK. This absence of new thinking along with tradition mean there is an apparent lack of political will to radically change the way we do things. We have a huge amount of money invested in traditional structures and there is much emotional and personal investment in the status quo which is hampering our approaches.
As mental health services adopt an ethos of recovery, growth and aspiration rather than maintenance and stability alone, they are seeing the changes that are needed to transform expectations, services and people. The good news is that some of the best ways of doing things need not be expensive. Hertfordshire partnership NHS trust support family placements, as one alternative to hospital, supporting crisis resolution services.
Alternative Futures Group has a two-year partnership with Mobee, a charity in West Africa that is developing community mental wellbeing practitioners to support the polyclinics in Gambia. The community workers are trained in self-help and in personal and community capacity building techniques. The self-help tools are based on person-centred counselling and solution-focused therapy but use written questions and small group exercises run within schools and polyclinics, as well as community groups and postnatal classes etc.
Two groups of support workers and senior personnel from our organisation have visited Gambia to share good practice and develop new skills and techniques in an environment where there is little resource, financial or otherwise. We've also formed strong links with mental health service professionals in Italy and Denmark to find out how they are dealing with austerity within their countries and communities.
In Trieste, the importance of a whole system response to mental distress rooted in the community not within the patient is highlighted. This approach and the need for strong and effective case management has proved a success.
Another, perhaps even more radical, approach focusing on workforce changes has been adopted at Lyngby Tarbaek Kommune in Copenhagen. Here they have changed the thinking that underpins their provision. They have done away with staff meetings and handover periods in all forms.
In the UK, we should use austerity to look at how we deal with chronicity, avoid creating dependency and a hopeless model of maintenance by learning from other countries and offering alternatives for change.
Article sourced from The Guardian and is written by Mike Smith.
Mike Smith is vice-chair of the International Mental Health Collaborating Network (IMHCN) and clinical director (mental health) at Alternative Futures Group.
