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Mental health advisor sacked for speaking out

The Guardian - 7th February 2011 1:28 pm

The government has sacked an independent national health adviser for questioning in the Guardian whether the money for its mental health strategy was new or came from the existing NHS budget.

When Nick Clegg announced £400m to improve access to modern psychological ‘talking therapies’ last Wednesday, David Richards, professor of mental health services research at the University of Exeter, told The Guardian that the money was not additional. Instead of being spent on training therapists, it could end up used to plug other gaps in the NHS, he said.

The case has echoes of that of Professor David Nutt, who was sacked by the then Labour home secretary Alan Johnson for publicly questioning drug policy.

Richards has been involved since 2006 in efforts to increase the numbers of trained therapists who can help the substantial numbers of people with anxiety and depression. For the last two and a half years, he has been a national adviser to the Department of Health’s improving access to psychological therapies (IAPT) programme.

New mental health strategy is only the start

By Professor Dinesh Bhugra, president of the Royal College of Psychiatrists - 10:05 am

So here we are with a new mental health strategy - the second in 14 months.

Cast your minds back to December 2009 to the much-anticipated publication of New Horizons: a shared vision for mental health, a cross-government programme of action to replace the ten-year National Service Framework for Mental Health. While we welcomed New Horizons as an important step, we had concerns that the broad agenda would not be translated into concrete actions.

Fast forward to May 2010, and the arrival of a new coalition government determined to stamp its mark. New Horizons was pushed to one side, and a new mental health outcomes strategy drawn up.

I was delighted to sit on the steering board for developing the new strategy. This allowed the college to be actively involved in commenting on drafts as they were produced, and has ensured that the voice of our profession was heard at the very highest level in government.

The result, as you saw this week, was No health without mental health, a strategy setting out six shared objectives to both improve outcomes for people with mental health problems and improve the mental health and well-being of the nation.

The college, along with 28 other professional bodies and organisations (including the Royal College of General Practitioners and Faculty of Public Health), has signed a Call to Action statement. By signing this document, we are pledging to work together to deliver the objectives contained in the outcomes strategy.

Co-incidentally the new strategy shares its title, No health without mental health, with a slogan we have used to promote the college’s work over many years. We believe this motto perfectly illustrates the inextricable link between physical and mental health - and are delighted that the government has formally recognised this too through the naming of the strategy.

But although our wait for the strategy is now over, this is where the real work begins. It is absolutely vital during this time of austerity for the NHS that mental health services are given the resources they so desperately need. If this does not happen, we are in danger of reversing the gains that have been made in the quality of care in mental health over the last decade and the hope for recovery that has been possible for those who have benefited from them.

The huge upheaval currently taking place in the NHS will have a large impact on the way that the strategy is delivered. There are concerns about how well the new commissioning arrangement will work for those mental health patients with particularly complex difficulties - a group of patients for whom care is costly and about whom GPs will have relatively little knowledge. It is essential that GP consortia develop the skills and expertise necessary to support mental health commissioning, and this means that we as psychiatrists have to be engaged from the outset.

Although significant progress has been made, there is still a long way to go for mental health patients to receive a satisfactory standard of care and treatment throughout England. And the challenge set out in this strategy now needs to be taken up by commissioners and providers in health and social care.

Tags: Mental health
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Mental health strategy adopts preventative approach

The Guardian - 3rd February 2011 5:37 pm

Family doctors will be entitled to share in a £150m bonus pot for identifying problems in adults and children that would reduce the risk of depression and other mental health problems, the government has announced.

With mental health already costing the NHS £10bn a year - a figure forecast to double in real terms over the next two decades - ministers are calling for a new approach that tackles the underlying causes of the illness which represents a third of GP cases.

By 2013 the government says 15% of the £1bn financial incentives that hold family doctors to “account for high-quality care” will be focused on prevention, especially in mental health. Given the state of the economy there is rising concern that unemployment and job insecurity could cause a rise in such problems.

In a paper accompanying the strategy released yesterday the government says that implementing seven mental health early intervention programmes - ranging from dealing with children with “conduct disorders” to talking therapies to new debt advice schemes - would cost £2.55bn but create £4.54bn in savings and another £4.85bn in benefits over a 26-year period.

TV dramas mislead over mental illness, claims report

The Guardian - 22nd November 2010 5:36 pm

Television dramas too often portray characters with mental health problems as “dangerous”, according to a study of peak-time programmes.

Almost half (45%) of fictional characters with mental illness have storylines depicting them as violent or posing a threat to others, says a report by Shift, the campaign to tackle the stigma associated with mental issues.

In addition 63% of references to mental health in TV soaps and drama were “pejorative, flippant or unsympathetic”. Terms included: “crackpot”, “a sad little psycho”, “basket case” , “where did you get her from, Care in the Community?” and “he was looney tunes”.

The study, by the Glasgow Media Group, examined three months of drama programmes on British terrestrial channels between 4pm and 11pm from 1 January this year. It found 74 episodes from 34 different programmes contained mental illness-related story lines.Of those story lines, there were 33 instances of violence towards others

New vision for mental health services

By Mike Broad - 8th December 2009 6:49 pm

The government has launched a new vision for mental health services in England aimed at improving services.

New Horizons: a Shared Vision for Mental Health will tackle depression, reduce suicides, improve outreach and tackle the stigma around mental health.

Professor Dinesh Bhugra, president of the Royal College of Psychiatrists, welcomed the strategy as an important step towards improving the quality and provision of mental health services.

Bhugra said: “We are particularly pleased to see the focus on early intervention in schizophrenia and psychosis, better transition services for young people, public mental health, and a reduction in out-of-area treatments. We also welcome proposals for a cross-departmental approach to services for people with personality disorder.

“The challenge now is to translate this broad agenda into concrete actions that will, in a consistent way, make a real difference to people’s lives.”

Increasing job opportunities for people with mental health conditions is also part of the approach. A new network of mental health coordinators will be created in every Jobcentre Plus area to improve employment support at a local level.

Andy Burnham, health secretary, described the plan as a “radical new approach to mental health”.

“New Horizons follows a decade of record investment in mental health services – there are now more consultant psychiatrists, more clinical psychologists and more mental health nurses than ever before.

“This strategy includes a national roll out of our successful talking therapies programme, NICE guidelines, new action on suicide prevention and a plan to tackle the stigma shrouding mental illness

Mental ill-health is the most common reason for claiming health-related benefits and costs the economy between £30bn and £40bn through lost production, sick pay, NHS treatment and the costs of being out of work.

Read the full plan.

Tags: Mental health
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Doctors don’t access mental health services

By Mike Broad - 10th August 2009 9:47 am

Three quarters of doctors would rather discuss mental health problems with family or friends than seek professional help.

The survey of over 3,500 doctors, in Birmingham, reveals that doctors are reluctant to access mental health services because they fear being tarnished by its stigma, with potential damage to their career and professional integrity.

Key among the findings, published in the journal Clinical Medicine, is that only 13% of respondents would choose to disclose their illness to a GP or another health professional and that when it comes to inpatient treatment, 79% would opt for treatment in either a private or distant facility, rather than be treated by local NHS services.

In both cases, the decision appears most often to be based around concerns that personal information would not be kept confidential and that this may compromise career and/or reputation.

Lead researcher Dr Alfred White said: “Doctors who are reluctant to seek professional advice for mental health issues may be putting themselves, and possibly also their patients, at risk and we are concerned that there are a lack of options for doctors who feel they are mentally unwell.

“Doctors suffer higher levels for depression and substance misuse, as well as higher rates of suicide than the general population. The apparent lack of confidence in the current system protecting doctors’ confidentiality may exacerbate these trends.

“Greater emphasis is needed to educate doctors on mental health and to improve and extend the options open to them for accessing mental health support.”

The study had a response rate of over 70%, indicating that this is an important issue for doctors. And, controversially, 8% of doctors said they would either self-medicate or opt for no treatment at all.

Meanwhile, Dr Samir Dawlatly, a GP trainee in Birmingham, writes in the BMJ this week about being bipolar. “It is such a guarded secret (until now) that I instructed my GP not to link my summary care record to the “spine,” the national system for making data available to NHS organisations. My fear was that other colleagues and potential employers could find out about my diagnosis,” he says.

“However, how can I encourage my patients to be open about their mental health problems and support them in any battles against discrimination if I am not also as open? Surely I would be a hypocrite?”

Tags: Mental health
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