Is This The End Of The NHS Mental Health Service?

Introduction

Since the 5th of July, 1948, the UK has been blessed with free healthcare through the NHS, helping to provide critical treatment and medicine for UK citizens. Included in the NHS are the mental health service with psychologists, mental health nurses and many more specialised workers who work to improve the lives of others through some of the toughest times of their life. Unfortunately, after 74 years, I believe the NHS will soon be forced to stop due to mismanagement and sheer lack of focus on what is important.

Currently, I am not an employee in the NHS, but I have and do make use of the mental health service and after only 2 and a half years in their service I can’t believe the changes I’ve seen and heard. So much so that I don’t want to stand on the sidelines anymore. I don’t want the employees in the NHS or any of their patients to be disadvantaged by the lack of coordination and focus put into the NHS.

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I think it is also important to say that although this is free healthcare and we should be grateful, I believe that is literally the bare minimum. I’ll not get into healthcare in America as that would fill another post, but having free healthcare is a human right, not a privilege, and we should all get given the best treatment possible. That is in no way an insult to the work of the doctors, nurses and all the other staff currently working tirelessly to do their jobs to the best of their ability as I know how much work you put in and how much you care. I just feel as though you aren’t given the time or funding that you need to help keep you and everyone else happy and healthy.

It’s time the government listen for once and starts to see the real problem. Here are a few pointers to highlight just a few of the problems I have noticed as a patient:

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Funding (or lack thereof)

I live in Northern Ireland, so the overall quality and perception of the mental health service and NHS is going to be about centred around the NI service, however, the problem can be linked back to the English Government, so don’t be confused if I talk about the two different locations. Also, due to the lack of information and statistics about the NI NHS, I will be providing numbers on England, however, they are still reliable and worth mentioning as the situation is similar across the UK.

The reason the problems can be stemmed back to the English government is that they are responsible for allocating funding to each region of the UK, therefore limiting and taking control of how much money we can spend. From my research, the money is distributed fairly by taking into account the population of the country, so it is safe to say that NI is receiving an unfair share of funding. The problem is that the amount of money being divided out is insufficient.

From recent figures, spending on the NHS in England has increased by an average of 1% per year since 2010. This is not enough to recover services and meet mental health demands and the waiting times’ standards for A&E and elective care. To represent this, this year (2022/23) the government has funded £147.7 billion for the NHS, however, it has been recorded that the amount of money needed by the NHS is around £173.8 billion (2022/23).

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This information leads me to wonder why the government are not fixing this imbalanced budget as they forecast to spend £152 billion on the NHS from (2024/25) despite predicting an increase in the amount of money needed by the NHS to £176.8 billion (2024/25). Don’t get me wrong, they have time to change these numbers, however, I think the Tori party will be unwilling to spend an extra £24.7 billion to help provide a free service to everyone in need because at least the wealthy can afford private healthcare. And if figures have been similar to those above for quite some time, why would they decide to change now?

I’m not stupid, I know that £24.7 billion is an astronomical amount that can’t just be taken out of thin air even if it is the government. But what if we take a look at other projects the government have invested in.

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  1. The Big Ben Restoration
    This £80 million project began in 2017, so we can’t blame the government for starting such an expensive project knowing the economy and healthcare services were going to get hit. However, even throughout the pandemic, they have continued with this project. While Big Ben is a major tourist attraction for them and may help bring in money through tourism, surely during an economic and healthcare crisis which has disrupted tourism, should lead to a change in priorities.
  2. Cross Rail Programmes
    It’s difficult to highlight different programmes as it is true that they are mainly helpful and valuable in terms of advancement and improving the standard of living, however, if we look at the bigger picture and start to focus on the fact that none of this matters without a healthy, happy population, then certain programmes need to be postponed. For example, this program aims to increase rail-based capacities by 10% to provide quicker and more accessible journeys.
  3. Washington Embassy Refurbishment
    Fair enough, maybe your offices aren’t up to standard with the Whitehouse, however, I am certain the employees working there may understand the need to delay the arrival of a new office chair in order to prioritise the health of an entire nation. It isn’t even all about the money, it is about the time spent and the focus aimed towards this project, our mental health
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It isn’t even all about the money, it is about the time spent and the focus aimed towards this project, our mental health. I honestly believe that, even if the NHS had all the money it needed, if management didn’t change, it would still be a useless mess and the situation wouldn’t change much. Waiting lists for emergency services are dangerously long and so many lives could have been saved if the government put their heads together and actually worked on a long-term improvement.

children mental health 2017 2020 since covid 19

Having said that, It is clear that the UK needs this funding more than ever due to such dramatic rises in mental illness cases since COVID. In the image to the right, it is clear that the percentage of children with mental health problems has increased dramatically with just over 1/5th of girls between 11-16 and 15.3% of boys between 11-16. And I bet you these numbers are higher as it only counts up to 2020. The number of children who should be making happy memories and using their imagination has increased from 11.5% to 17.9% of boys, and from 7% to 10.8% of girls.

The lack of stable mental health services has in fact robbed the lives of so many children from the ages of 5 onwards. How could you possibly look them in the face and tell them you tried everything you could to give them a happy, fulfilled life when the most you do is talk about the figures on the NEWS and never make any real change? How can that really show how important and worthy they are?

The causes of this rise in numbers, as seen in the photo on the left, are so difficult to see because it just shows how COVID and isolation are so much more than just the virus. It is killing those who don’t have any contact with others as well. It sucks the life right out of them. There has been a 62% increase in moderate to severe symptoms of feeling bored, 52% feeling lonely and 52% from too much time alone. I agree with the fact that the government did not expect this pandemic and that a lockdown was their last option, however, compared to other countries, having 3 separate lockdowns caused so much uncertainty as seen in the percentage of those experiencing severe worry about the future at 72%. And with so much time alone, has further increased the levels of mental health issues.

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It makes you wonder if the government took that into consideration when they decided on their third lockdown? I know they worried about the economy and they wouldn’t call a nationwide lockdown, for now, reason, but did they consider the mental impact.

Let’s just say that all the lockdowns were unavoidable and the government had no way of avoiding these symptoms from occurring. Let’s imagine they did everything they could to keep the rates of mental illness down. Why are they not doing anything to get those numbers back down again? Why are they doing the absolute bare minimum to help all those suffering? Ok so maybe they couldn’t prevent it, but why can’t they react and take the necessary steps to recover from the pandemic?

Why are we investing so much time and effort into updating buildings and shopping malls when the people who are most likely to use them are too depressed or mentally drained to do so? What will the future look like if we ruin the imagination and creativity of all young people?

It isn’t only children who struggle with their mental health. Not only a small demographic is in trouble, in fact, but it is also every single person who has lived during this period of time. Investing in a service that benefits everyone can’t be a waste of resources, right?

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Just look at the photo. Over 16% of adults show signs of depression. The percentage of people aged 16-39 has almost tripled from 10.9% to 31% from 2019/20. In fact, the percentage of adults aged 70 and over has doubled from 5% to 10.3%. Sometimes we forget that even the older generations need help too. Despite the fact some are older and wiser, nobody has been through this situation before so they also don’t know how to cope or handle this type of disaster.

All these statistics help to highlight just how massive a problem this has become and nobody can comment that the government can ignore it because contrary to popular belief, everyone’s mental health matters and working on it, personally, is one of the best ways we can invest in our future

Now, I haven’t even mentioned any statistics on mental health in different demographics as it was difficult to find reliable information, but I can assure you that this situation is particularly worse among people of colour who have been much more affected by the virus. I don’t know much about the matter, but that just shows how little this is discussed. COVID is much more dangerous for black people and I’m not a doctor so I couldn’t explain why this is, but it is true. So just imagine the levels of mental health issues faced by their families. They already face so much in their everyday life from discrimination and terrible stories on the NEWS.

This pandemic has been tough on me and I don’t know of anyone who died from the virus. I can’t even begin to imagine what it must be like for those who do.

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Problems faced by employees

Stats

Currently, there are 194,000 people employed by the NHS to care for people who require mental health services, however, as I will state later in the post, there are over 1.5 million people who are in need of the service. This includes people who are in contact with the NHS but may not have received any help as of yet due to the long waiting list. Yet, still, this number of patients is way too much for the 194,000 employees to handle.

One of the main problems causing such a shortage in staff is such a high labour turnover with 17.8% labour turnover meaning they lose approximately 100,000 staff each year. It is also stated that 10.3% of the mental health job roles are vacant, showing just how understaffed they are.

Why are so many people leaving the service? Do they not care either? Is it their fault for what has happened? Of course, it isn’t. And as I will explain more in-depth, they have been forced out due to such a lack of respect and ability to further their career and be of more use. They are being controlled in a way that stops them from finding joy in what they do every day.

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It can also be due to new job expectations that the staff would not be trained for or expecting. They are now required to handle more legal and medical projects due to the severity of certain cases. Obviously, that wasn’t what they expected of the job and they decided they weren’t going to make the impact they thought they would have.

With such a high turnover, there is obviously such a high demand for new staff who need to be trained and caught up which some current staff may find distracting. Therefore when people get trained up and are able to be of use by themselves, they have left because they are being made to do things they didn’t sign up to do.

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Working Conditions

I was told once that there was a really good consultant who worked in the NI mental health service in the NHS and obviously in being such a success in his area, he looked for a more senior role. However, he was denied this for whatever reason and told to stay in his previous position. Guess what he did? He quit and now runs a successful private practice where his knowledge and skills are appreciated. It’s upsetting that the NHS lost such a valuable asset to their team, but who can blame him? He has ambitions and dreams too and should be supported in reaching his full potential.

Why should somebody change the course of their life and career due to the government’s inability to manage such a vital service?

I’m sure you have all heard about the hours worked by nurses all over the world, not even just in the NHS and that is similar to other professions. Some find this unmanageable, however, some decide to stay and therefore get overworked and mistreated just because they want to make a positive impact on someone’s life. I’m sure it makes it close to impossible for somebody to maintain such a high standard of care on such long, hectic shifts.

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Training/Expectations

It’s inevitable that there may be long days at work and you may be made to do something you don’t want to do or didn’t sign up for, and that’s ok. But it becomes a problem when that is happening all the time. This can be seen as psychologists are receiving such severe cases (especially in terms of eating disorders) that they are required to handle legal and/or medical components that they weren’t trained or expecting to have to do so much of.

We can blame this on many things. Not just the problem with understaffing that means people are required to do more and complete different roles. Not just lack of funding, training or focus on such an important service. But also the main cause for the spike in mental illness and its severity. As we have seen in the numbers, this is unbelievable high due to the current situation. Why aren’t the government doing more to help minimise the psychological effect on their citizens?

Then they just leave the mess to the limited number of staff as if they don’t know that mental illnesses aren’t as easy to fix as standard medical treatments. It takes time which, sadly, they don’t have much of.

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Private Practices

I think we all know and agree with the fact that the majority, if not all, of those working in the NHS, are kind and caring people who want to make a difference in the lives of others. For many, their kindness is mainly the only reason for staying within the service because a lot of them could easily find better respect, pay and working conditions within a private practice.

So why don’t they do that? Why don’t they leave instead of complaining? Because they know that the point of the NHS is to provide the best level of free care to everyone, no matter who they are. And still, a lot more staff are being seen to open private practises because they have no other option. They see that their kindness is being used against them and they are standing up for what is right for them. And they have every right to do so. I’m not angry at them for leaving the service because I understand what it must be like for them to feel disrespected and unappreciated in their workplace.

I truly believe that if they were given more support and trusted in their work we would not be in this situation. Or at least we would have a chance to get out of this dark time.#

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Problems for those Needing the service

Stats

1,596,853. That is the number of people in contact with the service. It’s important that I highlight the words “in contact” because not all of these people are actually receiving support from the service. They have only been able to get as far as to be on the waiting list which in itself is a draining, frightening time.

Over 1.5 million people need help. And not all of them are getting it. It’s not hard to believe since there are only 194,000 staff who are working in the service. Not all 194,000 staff are councillors either, but even if they were that would mean each member of staff is responsible for over 8 different people. And that is assuming they are all in the same mental health service. There has been a significant rise in eating disorders, especially in younger age groups. I expect they are unable to keep up with the demand for help. And maybe other areas are able to cope with the slight increase in numbers, yet they may not be trained to assist in the other areas.

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This is such a scary number and I don’t predict it falling any time soon. It just makes you think of how different things would be if more time and energy were focused on this area which is, and has been such an important, spoken-about topic. Just goes to show the gov. wasn’t always listening

In 2021, 2,137,760 contacts/appointments were made. From previous experience, these last around an hour each. Therefore, if you do the maths, that’s a lot of bloody time and energy required by the staff. And that doesn’t even include the paperwork and group meetings and other work needed to be done outside of the appointments. Yes, it’s their job, but no matter how much you know about mental health, everyone will eventually collapse under so much pressure.

In April of 2021 alone, there were 352,866 new referrals. That is an unspeakable amount in such a small amount of time. I am putting these figures in just to try and show you how improving mental health services or investing in projects for early intervention could make such a big difference. And it cannot be overlooked. Nobody could say this is a small problem because currently 677,230 children and 506,477 adults are getting help from the service. That is a lot of people in a lot of demographics so we aren’t dealing with a small, temporary issue. It wouldn’t be a waste of time to improve and think about actions to move forward. It could help almost everybody, and that’s priceless.

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Those In The Service

As seen in the photo above, there has been a 38% increase in the number of people feeling like a burden. I have no doubt that some of these people may be in the service already. They may be receiving help from a counsellor, but still have worsening depressive symptoms. Why do I think that? From my own personal experience.

Mental health is weird and messed up in a way that despite there being a positive way to look at things, we always seem to find a way to turn it negative. Sure, I could say that I’m lucky to be receiving the care that I do because others are less fortunate. But the way I see it is that I am taking up a space that somebody else might need right now. So really I am just wasting their time. And now that I feel bad about wasting people’s time and taking up space, I feel bad because I sound ungrateful. I could go really deep into how this downward spiral, but for the sake of your time I’ll stop at that.

I hope that helped to show how, even when you manage to claw your way in, you aren’t escaping from the shambles that is the NHS. You are still being affected by the lack of staff and funding and support.

In no way could I fault my councillor because I know that they are still doing everything they can to give me the best care possible, it’s just that they aren’t able to do so much anymore because of the cards they’ve been dealt. I always hear stories from them every week about how they are trying to manage their work but everything changes so quickly. I can see the frustration in them because there is so much they want to do but can’t.

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Waiting List

What many people don’t realise is that there are 2 waiting lists. Firstly the external waiting list. This can be around 18 weeks depending on the illness and age group. Then, when you finally manage to get an appointment, assuming it doesn’t have to be postponed, you are checked over and assessed. Based on that they then put you on the second list, the internal list, which can be another couple of weeks. Then after that, you will hopefully receive the care you were waiting for.

Look, I’ve been to Disneyland before. I know what it’s like to wait in line for ages. But to wait this long for such an important service is unforgivable.

In the amount of time, it takes them to get an appointment they could have gotten to a point that makes it 10x harder to recover from. They could have irreversible damage that could have been avoided if they had got an appointment sooner.

And, unfortunately, mental health illnesses only get worse over time if not treated. They become so much more ingrained into the mind and life of the person suffering from it that they might just never recover. How many lives are lost by this waiting list? How many more dreams need to be shattered for you to understand the importance of stable mental health services?

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Costs

The final point that I am going to be talking about today is, obviously, in regards to the necessity for free mental health care. Some may wonder why the people needing such urgent, important care don’t just go to one of the private practises because the staff there are just as good. The thing is that it is not cheap. While some families may be fortunate enough to pay or have health insurance to pay for such services, it is not attainable by everyone.

Mental health is also a really big problem among those who are unemployed or maybe unemployed due to mental health reasons. It is reported that 52,191 patients receiving mental health support are unemployed/seeking work. It’s unfair to expect people to pay or go without getting the help they need just because of their financial position or social class.

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Another figure I found shocking was the fact that 76,613 patients are retired. That could be rich people who retire young and may be able to afford such care, but I would say a majority are above 65 years old. These people are out of work and most likely not receiving any extra income so how should they be expected to pay for healthcare which, in reality, is a human right. It doesn’t seem fair to ignore the mental health of older people because that will mean they will spend the last years of their life suffering.

People lose so many loved ones as they get older and some may be completely alone. That has got to take a toll on their happiness and we can’t ignore that. People of all ages deserve to wake up with hope and to feel loved and important. I’m sure you don’t want to be forgotten about whenever you get older.

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Conclusion

To conclude, I want to thank everyone for reading this post because it really is vital. It is important we get this heard and shared with everyone so it can make the impact necessary to bring around change, so I have links below that will allow you to share this post on multiple different social media platforms. You can also just copy and paste the link to this post as well, but even just a like, comment and follow can help to spread the word.

I appreciate every single one of you reading this and I really hope that this will all become a thing of the past someday. If you are someone currently struggling with mental health please make sure to get in contact and if you are still waiting for a response please don’t give up. There are people fighting for you and despite what is going on I still know you can make it to the other side. I hope you have a great day, stay safe and stay yourself PERIODT.


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