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Addiction psychiatry could be wiped out in the next 10 years unless urgent measures are taken to tackle the dwindling numbers of doctors training in addictions, according to a landmark report published by the Royal College of Psychiatrists.

It reveals the number of higher training posts across England have fallen by 58%, from 64 in 2011 to just 27 in 2019, leaving some regions without a single trainee.

The College is calling for urgent government funding to protect existing places and to create training posts especially in England, as the falling numbers cannot be solved by the current funding arrangements.

The findings come at a time when both drug-related deaths and alcohol-related hospital admissions in England have reached record levels.

“This report reveals the meltdown that has occurred within addiction psychiatry across the UK, but especially in England,” said Professor Julia Sinclair, chair of the addictions faculty at the Royal College of Psychiatrists and co-author of the report.

“Without urgent investment from government, training in the specialist skills that are an essential part of the treatment system could be wiped out in a decade, depriving thousands of people with this life-threatening condition access to the specialist help they need to recover and rebuild their lives.”

“Assessment and treatment of people with complex medical and social needs arising out of addictions are the essential skills of the addiction psychiatrist. Helping bring people back from the brink of death and turn their lives around are just two of the many reasons why addictions psychiatry is such a vital career.”

The report – Training in Addiction Psychiatry: Current Status and Future Prospects – found in 2019 there were just 16 people in higher training posts that would give them a qualification in Addiction Psychiatry in England, with five out of 12 English Regions – South West Peninsula, Severn, Wessex, Thames Valley and Kent Surrey and Sussex –  having no such posts.

This means there are no opportunities to gain skills needed to equip psychiatrists to improve patient care, nor are there opportunities for a trainee to gain an endorsement in addiction psychiatry and work as a specialist addiction consultant.

Full article: Mental Health Today

Outcome, Islington Mind’s client-led LGBTQ+ service, has been shortlisted for Charity or Non-Profit Organisation of the Year at the British Diversity Awards.

The British Diversity Awards promote the values of equality, diversity and inclusion by rewarding those individuals, organisations and unsung heroes who help to make the world and the workplace a better place for others.

Outcome is one of eight nominees shortlisted for the Charity or Non-Profit Organisation of the Year award for 2019. The winner will be announced on 26 March and will automatically be shortlisted for the European Diversity Awards in November.

Responding to Making The Grade, a new report by the Children and Young People’s Mental Health Coalition, Emily Graham, Senior Policy and Campaigns Officer at Mind, said:

“Schools are a key part of life for most children and young people, and have a big role to play when it comes to mental health for both pupils and staff. The education system must focus on more than academic achievement and value everyone’s mental health and wellbeing. Young people today are facing significant pressures, and we’d welcome a review on the impact of the exam system. We also want to see Ofsted and other inspectors assessing schools on their efforts to promote wellbeing and development.

“With two in five pupils surveyed by Mind saying they wouldn’t know where to go to get support within school, it’s clear that there’s far more to be done to make sure all young people get the help they need.

“But it’s not just down to schools to make the changes needed to enable all young people to thrive. Young people’s mental health services should work in close partnership with education providers to ensure problems are identified and addressed early on. Schools and colleges cannot be expected to address children and young people’s mental health by themselves, and support cannot stop at the school gate.”

Source: National Mind

Mind has issued a response to the CQC’s State of Care report, which this year focuses particularly on inpatient mental health services, which have seen a reduction in quality.

Findings include:

  • 7% of child and adolescent mental health inpatient services were rated inadequate (2018: 3%)
  • 8% of acute wards for adults of working age and psychiatric intensive care units were rated inadequate (2018: 2%)

The report also outlines how the majority of mental health inpatient services rated inadequate or requiring improvement also had a lack of appropriately skilled staff.

Responding to the report, Paul Farmer, Chief Executive of Mind, the mental health charity, said:

“It is disturbing that the CQC continues to highlight the same issues with the quality of mental healthcare, time and time again, just when people need them the most.

“We have repeatedly said that additional investment needs to reach the frontline to counteract years of underfunding and increased demand for mental health services. But the report shows access to community mental health services is not keeping pace with demand. The promise of more money at a national level is not enough – people are still reaching crisis point because they are aren’t getting the help they need.

“We know that even when people are able to get help, it is delivered in sub-standard facilities which limits the quality of their care. It is deeply unsettling that inspections repeatedly reveal outdated and dangerous infrastructure. We cannot expect people with mental health problems to be treated in these conditions, nor should we expect NHS mental health staff to work in them. And yet the Government has barely given mental health a mention in recent capital spending announcements.

“The Government must also urgently address the diminishing workforce, which is driving the overall decline in the quality of mental healthcare. As demand increases, under-supported staff are leaving in droves. This report shows that understaffed and under-resourced services don’t deliver quality care.

“Though investment through the NHS Long Term Plan is welcome, it is clear that in real-terms mental health services have been left languishing at the bottom of the pile, including, worryingly, those for children and young people and psychiatric intensive care units. The public rightly expects mental health services to be as much of a priority as those for physical health but this message isn’t getting through to local decision makers. The Government must invest in infrastructure and workforce, and the NHS Long Term Plan must be delivered in every local area if we are to see meaningful change for people trying to access support right now.”

Source: National Mind

On 30 September the Government pledged a large amount of investment for hospital projects across England, at the start of the Conservative party conference.

The plans include a £2.7bn investment for six hospitals over five years but no mention was made of mental health buildings.

Responding to the Health Secretary’s speech, Vicki Nash, Head of Policy and Campaigns Mind, the mental health charity, said:

“Pressing risks caused by sub-standard mental health facilities have been completely ignored in today’s funding announcement for NHS hospitals.

“Long-neglected NHS mental health buildings are interfering with people’s recovery and putting them at risk of suicide. The continued use of mixed sex and dormitory wards puts people in danger of sexual assault. It can’t be right we expect people with mental health problems to continue to use inadequate and often dangerous infrastructure, and we should not expect NHS mental health staff to work in these conditions.

“When the Prime Minister first announced money for building projects, we called for the mental health estate to be among the first to benefit. Its omission in the Health Secretary’s speech makes it seem like mental health has been pushed to the back of the queue. This follows previous announcements around building projects which have seen mental health barely get a mention.

“Having a key government announcement of funding for hospitals with no inclusion of mental health is woefully out of touch. The public now rightly expect mental health facilities to be as much of a priority as those for physical health.

“There is no time to waste, the Government must urgently bring the NHS mental health estate into the 21st century. Unless, of course, it has now decided that mental health is no longer such a burning injustice.”

Source: National Mind

Caroline, who is 10 weeks pregnant, clutches a colourful antenatal zip-file folder from the NHS. It has pregnancy advice written all over it, telling her to eat healthily and stay active. But she is in an unusual position for a soon-to-be mother – she’s a rough sleeper.

The 28-year-old is one of many who have been getting food, but also mental health support at the Soup Kitchen at the American international church on Tottenham Court Road in central London.

The project is the first of its kind, with no other soup kitchen having ever opened up a mental health clinic on site.

Alex Brown, the director of the Soup Kitchen, first made the suggestion. He felt that by giving free mental health support to homeless people you could help them get off the streets.

Michael Brown, a Soup Kitchen trustee and the founder of the advertising company MKTG, helped by setting up a crowdfunding page to raise money for a part-time therapist. They needed £30,000 and it exceeded this target in late 2017. There were further steps to take before launching but they opened their doors with a party last week.

Last week Caroline was being helped by Dr Dobrochna Zajas, a cognitive behavioural therapist. She and her colleague Dr Brett Grellier have been offering specialist therapy, using techniques tailored for those who have been through trauma.

Full story: Guardian

Three in five young people (59 per cent) have either experienced a mental health problem themselves, or are close to someone who has, according to major new research by Mind that shows the sheer scale of the pressures faced by young people.

The survey from the mental health charity also shows that one in seven (14 per cent) young people say their mental health is currently poor or very poor and outlines the breadth of the challenges they face. It also highlights how secondary schools are promoting and supporting their wellbeing.

When it comes to accessing support within school, there were problems with knowing where to go, and then getting the right kind of help. Mind’s survey also found:

  • Almost two in five (38 per cent) of all pupils said they wouldn’t know where to go to access support within school and half (52 per cent) said they wouldn’t feel confident approaching teachers or other school staff if they needed help.
  • Around one in five young people (21 per cent) had accessed support for their mental health within school. Of these, almost one in two (43 per cent) said they didn’t find the support helpful and two in three (63 per cent) said they weren’t involved in decisions made about that support.

In terms of receiving help outside the school gates, less than one in three pupils (28 per cent) who had experienced a mental health problem had used mental health services. This means a huge gap in the numbers of young people needing help and those actually accessing support from the NHS.

Louise Clarkson, Head of Children and Young People at Mind, said:

“We spoke to thousands of young people to try to better understand the scale of poor mental health across secondary schools in England and Wales. There were some really positive findings, with most pupils saying that, on the whole, they thought their schools believed good mental health was important and promoted wellbeing. But we also heard from many young people experiencing problems with their mental health. Despite the high levels of poor mental health among young people, many are not accessing support and those that are aren’t always getting what they need.

“It’s not schools at fault – we know they are under increasing pressure to provide wellbeing support for pupils at a time of rising demand and gaps in NHS mental health services. We know that many are doing the best job they can with limited resources and staff need the right expertise and support from other parts of the system. The Prime Minister’s recent announcement about training for teachers is welcome but it’s only one part of the picture – school staff need to know that if they are starting conversations about mental health with a young person, there are services in place to refer them onto.”

The surveys were carried out as part of a pilot project in 17 secondary schools in England and Wales. Funded by The BRIT Trust and WHSmith, Mind has been working with secondary schools since September to pilot a new approach to improving the mental health of the whole school community, including pupils, all school staff and parents.

Mental health information for young people is available for free from National Mind’s website. Mind is inviting young people from England and Wales to share their views and help better understand the barriers they face to accessing support and what some potential solutions might be. Anyone interested in taking part can click here.

Full story: National Mind

A £14.5m programme to help reduce the number of student suicides at universities and colleges in England has been unveiled by the higher education regulator.

Nicola Dandridge, the head of the Office for Students (OfS), has said too many students are having their experience “blighted by mental ill-health” and more should be done to tackle the issue.

One of the projects awarded funding includes an Early Alert Tool, led by Northumbria University, which will identify students at risk of mental health crisis by mining data sources, like social media.

The scheme, which focuses on early warning signs, has been launched in response to figures showing that only one in three people who die by suicide are known to mental health services.

The OfS the sector’s watchdog, has awarded £6m in funding to universities and colleges, with co-funding of £8.5m, to combat a rise in student mental health concerns.

The proportion of full-time UK undergraduate students reporting mental health concerns when they enter university has more than doubled over the last five years, according to recent figures. 

At least 95 university students took their own lives in the 12 months to July 2017 in England and Wales, the most recent figures from the Office for National Statistics (ONS) show.

Ten projects have been given funding as part of the collaborative programme, which includes a scheme at the University of Nottingham that will focus on international students.

Full story: The Independent

So many young people are self-harming that it risks becoming normalised and increasing the number who kill themselves when they are older, a study reveals.

One in five girls and young women in England aged 16 to 24 have cut, burned or poisoned themselves, according to research that mental health experts said was “very worrying”.

The findings, published in the Lancet Psychiatry journal, show that self-harm has risen across both sexes and all age groups since 2000. In the population as a whole it almost trebled from 2.4% then to 6.4% in 2014.

The number of people overall cutting themselves jumped from 1.5% to 3.9% over those 14 years.

Growing numbers of people are harming themselves as a way of coping with feelings of anger, tension, anxiety or depression. However, a lack of NHS services and people’s unwillingness to seek help means that more than half of those who self-harm do not receive any medical or psychological care.

Full story: Guardian

The Care Quality Commission (CQC) is calling for an independent review of every person who is being held in segregation in mental health wards for children and young people and wards for people with a learning disability or autism. These reviews should examine the quality of care, the safeguards to protect the person and the plans for discharge, the regulator says.

CQC makes the recommendation in its interim report published today, in which it shares early findings from its review of restraint, prolonged seclusion and segregation for people with a mental health problem, a learning disability or autism.

The review, which was commissioned by the Secretary of State for Health and Social Care Matt Hancock, also highlights the need for a better system of care for people with a learning disability or autism who are, or are at risk of, being hospitalised and segregated.

From an information request sent to providers CQC was told of 62 people who were in segregation. This included 42 adults and 20 children and young people – some as young as 11 years old. Sixteen people had been in segregation for a year or more – one person had spent almost a decade in segregation. The longest period spent in segregation by a child or young person was 2.4 years.

CQC has so far visited and assessed the care of 39 people in segregation, most of whom had an autism diagnosis.

Reasons for prolonged time in segregation included delayed discharge from hospital due to there being no suitable package of care available in a non-hospital setting. For some, the commissioners had found it difficult to find a suitable placement.

The safety of other patients or staff and inability to tolerate living alongside others were the most common reasons providers gave for why people were in segregation. In some cases, staff believed that the person’s quality of life was better in segregation than in the less predictable environment of the open ward.

Some of the wards were not suitable environments for people with autism and many staff lacked the necessary training and skills to work with people with autism who also have complex needs and challenging behaviour.

Full story: Mental Health Today

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