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This blog post was published under the 2010 to 2015 Conservative and Liberal Democrat coalition government

Changing mental health for the better - what would you do?

Posted by: , Posted on: - Categories: Events, Mental health, News, Viewpoint

Today, Norman Lamb, Minister for Care and Support and Nick Clegg, Deputy Prime Minister launched a new set of measures to do more to help the one in four people who will suffer from a mental health problem at some point in their life.

Closing the Gap: Priorities for Essential Change in Mental Health outlines 25 areas in which the NHS can make a difference to the lives of people with mental health conditions. It represents another step towards the ultimate goal of parity of esteem for mental and physical health and places patient choice and control at the heart of the mental health agenda.

Speaking at the headquarters of the Coin Street Community Builders, a social enterprise and development trust near London's South Bank, the Ministers used the launch to encourage opinions, questions and debate from a panel of pioneers and leaders in the field. They asked: what does parity mean to them and how  might it be achieved?

Share your views

So what would you do? As stakeholders and professionals working in the health and care system, your support, advice and enthusiasm are vital to make this enterprise a success. Please use the comment facility at the bottom of this post to share your views and join the debate. We look forward to hearing from you!

Read the Deputy Prime Minister's speech

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  1. Comment by Nick Woodhead posted on

    For a start I would stop using the trite and misrepresentative statistic that 1 in 4 people will suffer from a mental health problem.

    • Replies to Nick Woodhead>

      Comment by Mark Osterloh posted on

      I apologise if you find my use of the statistic trite. This was not my intention, but rather an attempt to de-stigmatise the issue - emphasising just how 'normal' it is to experience a mental health crisis.

  2. Comment by Helena Horwath posted on

    As someone who has used mental health services in the past and also works in health care, I would support any strategy that improves access to services. However, the strategy must be holistic. It must facilitate easy access with short waiting times to high quality services. It must be patient-orientated and not "one size fits all". It must be supplemented with employment legislation, anti-discrimination legislation, and training for GPs.

    • Replies to Helena Horwath>

      Comment by Tom Dunne posted on

      @tommytommytee18 as a service user alz I totally agree you cannot have one cap fit all. We must ensure that GP training is brought up to the highest standard an not just a tick box exercise.
      We must also ensure that the health & welbeing of carers receives the same priority as us service users otherwise that could turn out to be a bigger problem.

  3. Comment by Dean T posted on

    Mental health should not be just nurse/health led, it should be a joint approach with social care. The medical and social model of mental health both has it's pros and cons, but working together will only benefit the people we are meant to support.

    Putting mental health nurses in custody? I don't think that's the way forward. Let the police lead on criminal activity and refer to the appropriate service if needed. Otherwise, our custody suites will turn into a respite facility for the most vulnerable.

    We need proper, less beauricratic preventative mental health service. Sending opt in letters to an individual with psychosis, no insight and cannot read or write is oppressive in itself.

    We know prevention will ensure beds are left for the people who need it the most, not because services have let them down.

    If you want advice, an opinion, talk to the people who deliver this care, not just senior management.

  4. Comment by Euegene Thomson posted on

    My career has been on the 'edge of the precipice' since the day I started 40 years ago!
    I've developed coping skills but why do I have to live in a toxic society in which employers do not truly value staff. Employee friendly faces are just that - faces with a paper thin integrity- 'we seek to, in reality, - cover our backs'.
    Employees rarely feel valued, South Staffs, 'what went wrong' notices on the back of toilet doors, no you've done well - the teacher being told 'you've more authority in here than I have' by the policewoman ithe classroom.
    Take it further down the line to the people more obviously challenged by psychological well being. What chance of building self esteem when we have such an negative employment environment, splice that with housing issues. There is no perception of the genuiness of the initiatives

  5. Comment by Shurleea posted on

    The only guarantee you get with a psychiatrist s that you will get a prescription, they have no time to talk, they use the ICD10 and the BNF to diagnose and manager (but not treat) patients. everyone gets the same group of drugs regardless of cause..

    It is time we done away with psychiatrist and paid GP's more to support the mentally ill. My GP makes time for me, he listens, he understands and when the chips are down, he makes sure he if there to support me.

    To get help from a psychiatrist you have to be 'sick by appointment' and will then get an appointment weeks ahead, long after your crisis started.

    All the promises sound wonderful in theory but they just don't happen.

    It is time they stopped looking at what folk can't do and value what they can do, build up their self confidence and give proper support.

    I have yet to meet a psychiatrist that has offered me anything that looks at my cause / need for support. They haven't got time to talk so why do we need them?

    Psychiatrists treat from the neck up and on the general sector, the minute they know you have a mental health history, every ailment is attributed to that.

    We are not stupid, we do have a brain but get the poorest support in the NHS.

    My GP deserves a medal fro the care he has given me, it could not be bettered. after a lifetime in the mental health system, he has supported me and kept me out of it … and I got better!

    • Replies to Shurleea>

      Comment by Tom Dunne posted on

      I was lucky I had both a good GP & psychiatrist so we cant tar either with a brush. I do believe there are some GPs who send some people to see a psychiarist just to get them out because they dont understand dementia.
      Every case of dementia is different, if youve met one person with dementia youve met one person with dementia.


  6. Comment by Carolyn Collyer posted on

    Our organisation supports clients with mental health issues and the main issues they share with us is that they are given a diagnosis by letter after an assessment without a proper consultation. I feel that these clients are dealt with indifferently and are not properly followed up via the psychiatrist or psychologist that undertook the assessment. The clients are diagnosed with different personality disorders, bi polar, etc. They do not get a proper explanation of what this means, what can be done to support them or how they can manage it. They feel really angry that this happens when someone has only met them for the 1st time for about 30 minutes. With physical diagnosis there are better explanations of symptoms, treatments, medication etc this does not happen with mental health clients and they feel lonely, isolated and scared.
    Much better follow up is required with good signposting to support groups or at least another chance to speak to the team that diagnosed them.
    Also clients that self harm sometimes do not feel listened to and are sometimes seen as attention seeking. There will always be a reason for self harm and this needs to be looked at and followed up.
    The other issue that really upsets clients that are sometimes chaotic is that they are closed down from therapy if they miss more than one appointment. We appreciate that spaces cannot be left open indefinitely but it must be understood some flexibility is needed for clients whose life does include lack of confidence to pick up the phone, leave the house or reply to letters. Coincidentally this happened to my son of 18 who tried to commit suicide 3 times he was really getting somewhere with his therapy and then missed 2 appointments and was closed down. This detrimentally affected his mental health and caused it to deteriorate.

  7. Comment by Charles Lowe posted on

    It is good to see the word 'online' appear three times in the text, however in each case the context is primarily aspirational, for the future. Telehealth is a brilliant way of regularly monitoring people's mental condition through short questionnaires like PHQ9, HADS & GAD-7. It has also been shown to be a great way to change behaviour through techniques such as electronically-delivered cognitive behavioural therapy. The widespread ownership of tablets and smartphones makes delivery to many people extremely low cost, too (some would need an equipment loan to avoid health inequalities being created)..

    Sure in a perfect world, everyone would have their own personal therapist on tap. However where resources are severely constrained, what I would do differently would be to give far greater prominence to making electronic assessment & treatment delivery a significant part of as many people's mental health treatment plan as was appropriate for them. It would certainly merit a commitment on its own, and not be buried in the text with no further explanatory adjective than 'online'.

  8. Comment by Bob posted on

    Take time to explain diagnosis' and treatment. I have a mental health issue, that doesn't mean that I am an idiot; I understand clinical issues, but it's rare to have them explained rather than just written in to my medical records.

    I've had to request my patient records to work out what's going on and that records have been witheld for no good reason just because I have a mental health issue.

    Stop trying to treat everyone with the same illness with the same treatment, we're individuals, not robots - veterans don't respond to the same treatment as civilian PTSD sufferers.

    Don't try to treat a serious mental health issue with the trainee; they have to train, but they need either work up to that, or be coached in the session with an experienced practitioner.

    Provide more practitioners with visits to groups like Combat Stress as a professional development activity rather than the individual practitioner doing it off their own back. My best mental health services have been provided by practitioners that have come to a couple of group therapy sessions organised by Combat stress.

    • Replies to Bob>

      Comment by Tom Dunne posted on

      As a service user I can endorse this, everyone in the medical proffession should sit in on groups like this would open a few eyes, and even the impossible may happen MPs & health ministers sitting in.

  9. Comment by Miss Hamp posted on

    I work with a client group who have learning disabilities, and many of them have additional mental health problems. These type of people who have dual diagonisis seem to continually fall through the cracks. Trying to get support for people who are often unable to speak for themselves is like smacking your head against a brick wall... no one appears to understand that that mental health issues affect them differently, you are pleading for help in the middle of the night saying the person is self-harming and because they aren't using a knife or threatening to jump they don't take it seriously. Training is in dire need for the front line crisis teams to understand this complex problem.

  10. Comment by Anthony Forte (retd) posted on

    Psychiatry as a solution to ALL mental health issue is a suspect proposal.
    We have brought up a lazy group of doctors (GP'S) in this country who do not try or spend time on Causative issues with Patients at an early stage of illness.
    If the government or those responsible for forward planning do not have realistic understanding of what is in the community on a day to day basis how can they allocate funds where they will do the most good productively.
    We have containment centres where no attempt at understanding patients issues is undertaken apart from rudimentary befriending and time allowed per stay is limited before they are booted out once more to reoffend and reappear.
    and so it goes on.
    Multi occupancy houses with live in support might be a solution if applied on a larger scale.

  11. Comment by Lise posted on

    put three psychiatrists in a room the only thing two of them will agree with is that the third is wrong in their diagnosis!

    and that is just what has happened to me - I was misdiagnosed and no amount of trying to tell them they were wrong helped because once labelled with a mental health label you are seen as dilusional and mad and once a diagnosis is made no other medic will even consider questioning the integrety of the psychiatrist that made the diagnosis even though in private them may not agree. Finally after twenty years it has been recognised that I have a physical condition causing my symptoms and it isn't all in my head but only when they condition is so bad that not alot can be done to improve it but merely manage it. i blame my depression on this misdiagnosis and all these years I have felt I have been charged with a crime I never committed but no amount of trying could prove my innocence because just as a criminal is precieved to be deceitful so too is someone with a mental health diagnosis.

    then when u make a complaint about a psychiatrist who gets to investigate the complaint only the very psychiatrist in question - how flawed is that!

  12. Comment by Alison posted on

    As a professional who works with Deaf, Hard of Hearing and Deafblind people in the community and as someone who runs a Deaf Chairty on a voluntary basis - the numbers of people who have a hearing loss and mental health issue is significantly higher than those who have normal hearing. The National Mental Health Charity for Deaf People Sign Health are able to confirm these figures. However, I believe that specialist prevention services for this client group are so important particularly as mainstream services are prove to be inaccessible due to their individual specific communication needs as well as their lack of understanding around issues linked to deafness. The problem I have found with mainstream mental health services (trust me I know as I have used them as a deaf person myself) is that they focus on the mental health issue and not the root cause of it. My charity which is deaf-led has been able to prove that the support we provide to our members supports them in managing their mental health and deafness as a holistic part of the "treatment". Addressing the issues around deafness means one can learn to "cope" and address some of the issues and barrriers. The other difficulty is that it is not just mainstream services i.e. statutory / primary / secondary health services but those in the 3rd sector such as MIND, Dove Bereavement, etc etc - do not ensure they have a communication budget for BSL Interperters or Lipspeakers - thus making their services inaccessible. This is a huge issue that needs to be addressed by the Government. Poor provision of specialist sensory services leads to deteriorating mental health by not addressing the issues around their sensory loss in the first instance. Prevention services are the key word for supporting those with mental health needs.

  13. Comment by Cairn Magill posted on

    What about people with a learning disability who have mental health issues? The Bamford report recommended access to main stream services. In reality the diagnosis of learning disability seems to outweigh any other presenting needs and people with learning disabilty are signposted back to LD services. Even in the document "closing the gap" there is no reference to the needs of people with learning disabilities in the section addressing equality of opportunity for accessing mental health services. Yet again people with a learning disability seem to be ignored or not valued/recognised in the same manner other sectors of our community are....the more vulnerable ...the more marginalised!

  14. Comment by Christine B posted on

    I to have been on both sides of the fence, working in health care and having utilised the MH service for myself. I have found the GP and MH counselling services helpful while also benefiting from short term medication. I have also known friends who have been supported well by the services in our county. I agree with a previous comment that I have found it is primarily the work environment that contributes to mental stresses. The climate of constant change which contributes to uncertainty and indistinct lines of responsibility, management and support in a complex industry contributes heavily to MH casualties. I also believe that there is a massive under reporting of MH issues in the healthcare setting as people disguise their problems under physical ailments due to the labeling and stigma that still exists even amongst the supposedly enlightened healthcare professionals. I believe the current trend of disclosure of MH problems by people in the public eye is helpful also insightful disclosure from those suffering from dementia and other conditions.
    The recognition by us all that people are a complex mix with physical, mental, spiritual, emotional and social needs and sometimes require permission to fail is a far reaching cultural issue.

    The need for friends at a time of crisis and ongoing support to recover is essential, so opportunities for safe interactions are necessary and projects that facilitate this require support from government. The support needs to be financially and with cohesion of policies to support projects and make the bureaucratic and legal navigation as simple as possible.

  15. Comment by Jolanta Strong posted on

    In my experience of supporting various groups of vulnerable adults, I observed that one group of clients who I feel don't receive the treatment and help they need, are clients with dual diagnosis. Those with mental health problems who at the same time are alcohol or drug dependant will not receive treatment to adress their mental health before they achieve some level of abstinence. As mental health and substance abuse are so closely linked together, for those clients there is often no real offer of help at all and they fall through the gaps in the system.

  16. Comment by David Smith posted on

    Yesterday Nick Clegg, the Deputy Prime Minister, launched the Governments new action plan on mental health. Ambitiously entitled “Closing the Gap”, this document sets out a series of positive and welcome targets that if achieved will vastly improve the lives of people living with mental illness and poor mental well-being.

    You’ll notice that I say “if” in the paragraph above quite deliberately. This is not done through cynicism or malice but through experience and the weight of history that will fight against the fundamental change we need to make this shift in thinking a true reality for us all. The Retreat has been delivering mental health services for more than 200 years and knows first-hand how difficult fundamental change like this can be.

    I suspect that some of Mr Clegg’s pledges will surprise many people. Most people will already assume that mental health is treated like physical health and that if you need care, and in particular urgent care, it is available consistently and to a high quality. Sadly that is not the case.

    For these changes to work and for us to truly ‘Close the Gap’ between mental and physical healthcare we need a seismic shift in the way we think about illness, allocate our resources and understand mental well-being. Over the many years I have worked in mental health I have seen too many people let down by the system, had their wishes ignored and been left to deteriorate without the help they need to become well again. If the same were true in cancer, heart disease or almost any other physical condition there would be a national outcry.

    The only way we can change this is to take the party politics out of the debate and for all providers – mental, physical, voluntary and private sector to realign and change their model of delivery. This requires leadership from the top and I eagerly look forward to seeing how Local Authorities and Clinical Commissioning Groups up and down the country respond to today’s news.

  17. Comment by judith haire posted on

    I've experienced mental health problems and used mental health services. At the moment people are expected to fall ill between 9-5 Monday to Friday and although there are so called Crisis Teams these do not (in my experience) have crisis orientated response times. So this element of patient care needs urgent attention. Waiting times for talking therapies such as Cognitive Behavioural Therapy are woefully long(up to 18 months where I live) and even if you apply for counselling you will be told you have to be *about to jump off a bridge* to get rapid assistance. Further, anti stigma campaigns such as Time to Change need more funding. GPs ALL need specialist training in mental health care. Mental health units must be more available for in patient care and our local one is closed and the nearest is over 20 miles away. From experience homesickness is magnified greatly when in mental health crisis and it's paramount that there's a mental health unit local to everyone. Staff in mental health units need training in how to be kind and compassionate rather than shut themselves in the office to have a cigarette. These units are under staffed at night and during the night it is essential patients can call on staff to talk to for reassurance. More money to research kinder medications without the raft of debilitating side effects. Just more money more staff more awareness, less fear, less stigma and what I've suggested is so long overdue it's not funny and current proposals should have been in place years ago. Mental illness has implications for physical health too and this needs funding and addressing. The Government must get a grip and really focus on improving mental health services which are in a critical state.

  18. Comment by Dominique Thompson posted on

    As a GP I would like more psychologists trained to provide the therapy required, such as DBT, as well as them having time for proper assessments. I can manage most mental health in the relaxed environment of my consulting room, but for complex cases such as Borderline Personality disorder etc long term psychological therapy is required, which I cannot provide. I also despair of the constant down grading of the providers of NHS care, so that services that should be provided by psychologists are provided by much lower grade nurses, as a ruse to save money. There's a reason we all train to do different jobs, and such skills should not be underestimated. Patients deserve the most appropriately trained and skilled professionals for each stage of their assessment, diagnosis and treatment, so let's provide that, and within a short time frame.

  19. Comment by Liz England posted on

    Great comments and all very relevant. I would like to add as a GP who attended the launch of this document, a whole host of people were invited to say 'What parity of Esteem meant to them?' including Public Health England, RC Psych, NHE England, Mind etcThere was a distinct absence of the mention of General practice amongst all of this. I note that a number of the comments above identify primary care (not just GPs but practice nurses, health care assistants, district nurses, case managers etc) and emphasise the hugely important role it has in supporting people with mental health problems. Mental health is primary care core business and as generalists it permeates through all areas that we work in BUT requires resources in terms of time, money and training to deliver this care. So I would ask all the people in the room on Monday morning when this document was launched: 1. Where is the investment in primary care? and 2. When will primary care be recognised for the part it plays and has to play in mental health care?

  20. Comment by Francis Varley posted on

    I haven't wasted my time reading your document. The most basic needs for adequate funding and timely treatment are not being met, and in fact funding for mental health secondary care is going steadily down and waiting times steadily up just at the time when even more people need this service as a direct result of appaling policy and decision making by this government. No amount of fiddling about round the edges is going to solve that!

    I'm an NHS patient who has spent the past three years being unable to access the treatment I need to improve my mental health. The consequences are worsening of my mental and physical health, and drastic reduction of my productivity. Taking money away from something as essential to our nation's wellbeing as mental health care is a false economy indeed, and you are fools for doing so. I suggest you take a look at how many working age citizens are having to claim ESA because of mental health problems, and how much money you could save by investing in timely, effective treatment for these problems that would enable many to work and/or contribute in other ways to our society instead of sit on waiting lists getting more ill. A sight more money than your attempts to bully sick people out of benefits I bet!

  21. Comment by John Preston posted on

    The impact of austerity and benefit changes is causing more people to have episodes of mental distress. Cuts in services mean that non health agencies are often the primary source of support, they are not funded or trained to do this.
    There has to be easy to access support in emergency, and that has to work at 3pm on a Friday. We all need to help people support themselves and learn how to recognise the signs of impending crisis and seek help early.
    Collectively we have to help address the triggers that cause the issues.
    How do we help build confidence in those finding it hard to seek work and how do we make all employers more accepting of those who aren't 100% a full 100% of the year.
    Keep the debate going.

  22. Comment by Lyn Renn posted on

    I find this extremely interesting, as I work in a FE college alongside a team of amazing professionals, assisting young adults with diverse issues every day. We are swamped with young people seeking support with issues such as low self esteem, self harm, suicidal thoughts, poverty, mental and physical abuse...and so many more. These are all huge factors which cause mental distress and which will lead to continuing mental ill health in adulthood if not addressed. My colleagues and I feel we are treading water at this time, as so many valuable services that we rely on for counselling and other professional referrals, have and are still being closed due to 'withdrawal of funding'. This is widening the gap, as once young people leave education they are often left floundering and alone with their illness. If we want our future generations to be mentally well and able, then we must support them and prepare them for what is at this time, at the least a very disappointing and judgemental society. We can then hopefully change the current climate of negativity, division and self interest to a sense of community, hope and caring. I could go on, but I have another day filled with desperate young people who strive for a decent future.

  23. Comment by Claire Harkin posted on

    As a person who has worked in numerous Mental Health sites across the UK I experience the disparity between Physical and Mental health services on a daily basis. These disparities are of course in part due to the social stigma associated with Mental Health and I feel the NHS and central government can and should attempt to address the social stigma. However the area which I believe we can have the biggest impact is in ensuring we do not accentuate this stigma by ostracizing our mental health services. As someone who regularly travels to inpatient mental health facilities I find the best way to find them is to look for the rather shabby building behind the main hospital - this in itself creates an instant opinion that the mental health service is less important and is something which should be hidden away from view. Additionally our Mental Health clients often have complex physical health needs, in many cases I see the clients handed between mental and physical health teams as if the two are unrelated. We should encourage schemes which bring a true multidisciplinary approach to our clients across Mental, Physical and Social care.

  24. Comment by Janice Clark posted on

    Establish equity of access to social care support for service users and carers by requiring that Local Authorities use their Adult Social Care Teams to carry out community care assessments, where the suser has an eligible social care need but is not in secondary care ie is being treated by the NHS in primary care. For too long (since 1999) access to social care support has been via secondary care and this is actually unlawful. The rights of s users who "appear to have need of a community care service" was established in The Chronically Sick and Disabled Person's Act 1970 and the NHS CC Act 1990. This is regardless of the nature of that disability ie there is a duty to assess people with a mental health concern; a physical disability or both where they appear to have a community care need.

    Carers rights are also established through the NHS and CC Act 1990 and the three Carers Acts (1995; 2000; 2004). The disability and carers legislation will apply until The Care Bill replaces them (other than for parent carers) giving Carers parity of esteem with s.users . The Equalities Act 2010 should also ensure that this discrimination against MH s.users and Carers ends.

    It is time that this discrimination ends and that we have equal access to social care support to people with a physical disability & where we not not meet the eligibility criteria of the local authority - we have equal access to Universal Services such as support via the third sector; information and advocacy etc. This access should apply regardless of the eligibility to a secondary service mainly based on a clinical need. This medical model of care must end!!!

    Also with Personal Budgets - please let us see the end to a service led system that sets up one dimensional services that are supposed to support MH service users yet are not relevant to many. Why is there only a service such as befriending; Community Connections etc when we might not want such a service but in fact need family support and practical help with domestic tasks eg support for parental responsibilities; support within a whole family approach that support the parents and stops children being forced into a caring role.

    Lets drag MH services into the 21st century and require MH services and Local Authorities to implement Closing the Gap - Why haven't they responded to No Health Without Mental Health - or the Implementation Framework of No Health Without MH. I don't think that professionals in the MH trust in my area have any idea that they exist! Shame on them.

  25. Comment by Janice Clark posted on

    Correction to my post - Since 1999 access to social care support for MH s.users and carers has ONLY been via secondary services ( at least in my area and probably most).

    In fact access by Carers to assessment during the implementation of the NSF was limited to Carers providing regular and substantial care to those being assessed via the CPA. There was no such qualification/ limitation in Carers legislation at that time, or since, and this demonstrates how MH services got it so wrong for Carers. Sadly even though recent legislation and strategies have been introduced - they have made little difference to access to social care support for MH s.users and carers. Let us hope that Closing the Gap and The Care Act will make a difference .

  26. Comment by Steve Tormet posted on

    I have survived suicide attempts, self harm and I would not be here today if I left it to the NHS to help me. I used the NHS service 'First Steps' where I started getting counselling for my chronic depression. But when I needed more intense therapy I was put on a waiting list but I was getting more and more suicidal each day. Luckily for me I had joined BUPA as part of a work incentive scheme and I was referred to a psychiatrist who specialised in the sort of care I needed. I was taken in to hospital immediately and while on suicide watch for the next four weeks I got therapy, new medication and a whole lot of understanding from a great team if doctors, nurses and therapists. The therapists were trained specially and had themselves had cone through bad times and this was crucial in the empathy I received combined with the reality of having to deal with my issues one at a time. The private hospital was 'The Priory Adult Mental Health Hospital' in Preston, Lancashire. If anyone needs to knw how to treat people like myself you should go there and learn from the doctors and nurses and therapists there. Not surprisingly, many of their patients are NHS patients because there is no beds available for them. This costs the NHS, over £3K per week and the care the patients get is worth every penny. I eventually got an NHS appointment from First Steps but this was months after I went into hospital via BUPA. If relying on the NHS or similar, is all most patients have, then it is not surprising that deaths will continue to rise due the lack of expertise in dealing with mental health issues. I owe my life to the doctors, nurses, therapist and fellow patients who helped drag me up from despair over an 8 week period. If it were not for having private medical care, I would be dead now and my wife and three children would have been left with no better understanding of my illness.
    If you want to provide a world class service you need to go look at a world class service provider. Good luck and take care.

  27. Comment by Hilary Pitkin posted on

    Strategies and policies are great in theory. What many policy makers seem to ignore is that the service user plays or does not play a significant role in the recovery process. You can have the greatest service in the country, with well qualified, compassionate therapists/doctors but if the service user him/herself is not prepared to work on their problems then no progress can be made.
    This makes it difficult to achieve targets and services are criticised for not achieving the results that policies suggest should be possible.
    In the CMHT I work in, this continues to be an issue that increases case loads and prevents discharge as some service users move from one crisis to another
    Recovery has to be a partnership and more emphasis needs to be placed on service users taking some responsibility for their treatment

  28. Comment by Dan Midwinter posted on

    I think that one of the most important aspects of mental healthcare that often gets overlooked in the ongoing support that people need in the community.

    It seems that the emergency response to people with mental health problems is good, but once people's issues stabilise they can sometimes be forgotten by the health services.
    Dan, Completely Care

  29. Comment by Tim posted on

    Anything that is being done to improve peoples awareness of mental health is a good thing

  30. Comment by Dan Meter posted on

    Its good to see the Goverment taking the lead on mental health issues

  31. Comment by Andy Boxall posted on

    As a social inclusion worker on a psychiatric ward I think that it is critical to not only expand what the day resource centre's in the community provide but also to involve people that are not necessarily attached with 'the services'. Create community hubs and social centre's for the general population to access whether they have a need for education, support or just to be signposted in the right direction. Allow more influence from external agencies that aren't focussed purely on mental health but also education and employment. Look at aspects that keep people out of hospital in the community instead of focussing on medication and the cost of putting people in hospital. Long term goals need to be established with a vision for the community as a whole not just the individual.