A new report from NHS Providers, Mental health services: addressing the care deficit, looks at the levels of demand for mental health services reported by frontline leaders and the reasons behind the growing pressures.
The report identifies widespread concerns about benefits cuts and the impact of universal credit. It also indicates that loneliness, homelessness and financial hardship are adding to pressures on NHS mental health services.
Responding to this, Mind’s chief executive Paul Farmer said:
“Changes to the benefits system in recent years, and austerity generally, have had a devastating impact on the lives of many people with mental health problems. It’s clear that difficult life circumstances and mental health problems are closely linked, yet the relationship between them isn’t taken into account enough. If you have a mental health problem you are more likely to need support from the benefits system, experience poor housing and may struggle to stay in work without the right support, while the enormous challenges of dealing with difficult life events and trying access support can take a huge toll on mental health.
“The punitive, complicated benefits system in particular is making people unwell. People tell us they are treated with suspicion about the nature of their health problem and how it affects them, by someone who lacks expertise, knowledge or sensitivity when it comes to mental health. They are then having their support cut when they’re not able to do the things that are asked of them.
“Unsurprisingly, demand for NHS mental health services has gone up and while we welcome the long-term plan and the funding attached to it, this should be seen as the start, as a down payment for future investment, and as only one part of the solution. We need a cross-governmental plan for mental health that looks at all aspects of people’s lives and recognises the part that all government departments can play in helping people live mentally healthy lives.”
Source: National Mind
He was known for his “wicked sense of humour” and his dedication to help those with mental health issues.
John David Oliver, known to those close to him as David, has died aged 77. Mr Oliver founded Islington charity Islington Music Forum, which has helped hundreds of people suffering mental health crises through the power of music.
He founded the band Déjà Vu with that aim. They played gigs across the borough, including at Sotheby Mews Day Centre in Highbury East.
David started Islington Music Forum, now known as Key Changes – an organisation which marries music with mental health recovery. Rick and David held music sessions for patients at Highgate Mental Health Centre in the early 2000s.
“We met all kinds of people who were skilled and talented,” said Rick. “We had a fantastic reaction from patients.”
David first joined in activities at Sotheby Mews Day Centre a decade ago, and led a session on Fridays with Rick where they turned poems into songs.
In September, the centre held a festival for its users where Déjà Vu performed.
Rosie Litterick, who helped organise the Sotheby Mews festival, said: “David was a huge personality in this community.
“His dedication to his work with Déjà Vu was second to none. Right until the last he was planning for the future and thinking who we could reach, how and where. His Liverpool humour and endless one-liners made him the centre of many jovial conversations.
“The day I met him, he orchestrated a song on my behalf. It was about the warmest welcome I have got anywhere in my life.
“He had a heart of solid gold and will be sorely missed by myself and everyone who knew him. Rest in peace, David.”
Nigel Williams, older people’s service manager at Sotheby Mews, said: “David as we knew him was a cheeky Scouser with a friendly smile and a distinct sense of humour.
“His connection with the centre precedes me. He was part of the furniture when I arrived.
“He was passionate about the power of music and its restorative ability. He often challenged cuts and closure of provision. He had a lovely way with people that often managed, through charm and persistence, to find funding for projects he championed.
“We will miss his drive, enthusiasm and challenge.”
David attended Islington Mind events and the day centre in Archway.
John Coppock, finance worker at Islington Mind in Archway, said: “We were saddened to hear of David’s death. He will be missed.”
David died at the Royal Free Hospital, in Hampstead, on November 30 after suffering from heart complications.
Full story: Islington Tribune
Nearly three in five teachers in only their first year in the profession are already not convinced that they will stay in teaching – and rising mental health problems are partly to blame, research finds.
The survey, of more than 275 teachers in their first year of teaching, by a Leeds Beckett University academic, found that only 43 per cent have definite plans to stay in the profession long-term.
It found that 29 per cent do not plan to stay in the classroom and 28 per cent were neutral.
Experts say a growing number of new teachers are experiencing mental health problems. And cuts to mental health services and a relaxation of the government’s teacher recruitment requirements, as well as existing pressures from senior staff and high workload, have contributed to the rise.
Professor Jonathan Glazzard, from Leeds Beckett University, who conducted the poll and who leads research at the Carnegie Centre of Excellence for Mental Health in Schools, said: “It is worrying that they have invested so much money and time into training to be a teacher and they are not staying.”
Full story: Independent
Patients coping with severe mental health conditions that mean they are afraid they could harm or kill themselves are being discharged from NHS care, unprepared and without support in the community.
Psychiatrists said falling numbers of mental health beds and the loss of specialist units for more complex patients have created pressures to discharge, which cash-strapped community services have not been able to meet.
“When I was in the hospital, they were chucking people out at a rate of knots when they were clearly unwell,” said Jenny, who has spent more than two decades in and out of the mental health system and asked to stay anonymous.
“They didn’t prepare for me being discharged at all. Then I self-harmed really badly because I wasn’t safe to be home yet. I still don’t feel safe now, I’ve got no care plan, nothing.”
She has a complex diagnosis including personality disorder, depression and alcoholism, and tells The Independent she doesn’t feel the services offered in the community benefit her condition.
“They are telling me that I am not engaging [with treatment] which is the new buzzword that they use along with recovery,” Jenny said she is now considering discharging herself from treatment entirely.
“I have finally had enough, they are actually causing me more stress and anxiety,” she said.
Dr Ranga Rao, a consultant interested in addiction and dual diagnosis and the Royal College of Psychiatrists’ lead for acute inpatient care, said a lack of support outside hospital could increase pressures elsewhere.
Full story: Independent
Any woman who has experienced workplace sexism will not be surprised to find out that new research shows it can take a serious toll on mental health.
A study of 190 women working in male-dominated environments showed that organisational and interpersonal sexism were associated with a lesser sense of belonging in the industry, which was in turn associated with poorer mental health.
Examples of sexism cited in the study include: “Women receiving unwelcome sexual advances, being touched inappropriately, receiving inappropriate comments about their body or appearance, being exposed to sexist jokes and comments, and being exposed to pornography.”
The researchers predicted that a sense of belonging could increase job satisfaction and mental health, but that workplace sexism would decrease women’s sense of belonging because it represents a form of bullying, rejection, and ostracism by men against their female co-workers.
The study, published in the Journal of Applied Social Psychology, showed this to be the case.
Full story: Independent
GPs are giving too many older people antidepressants when they are struggling with depression, and should prescribe talking therapies far more often, according to new research.
Family doctors too often avoid talking to patients over the age of 65 about depression and do not have the time to explore and treat the condition properly, the study found.
Almost one in 10 over-75s are thought to suffer from depression, while almost four in 10 (37.4%) exhibit some symptoms. However, the vast majority, 87%, are treated with medication, even though it often does not help, according to the findings.
Too often GPs dismiss talking therapies as a way of tackling depression in older people, partly because there are long waiting times to start treatment, according to the paper, which has been published in the British Journal of General Practice.
NHS Digital figures show that although 1.4 million people of all ages were referred for help to NHS Improving Access to Psychological Therapies (IAPT) in 2017/18, just 91,117 of them (6.3%) were aged over 65.
Similarly, while 1 million of all those referred started talking therapies treatment, only 74,503, or 7.4%, of those were over 65.
Even though evidence shows that talking therapies help older people with depression, they are twice as likely as younger people to be treated with antidepressants.
Full story: Guardian
The Legal Aid, Sentencing and Punishment of Offenders Act 2012 (LASPO) is a piece of legislation that made changes to the types of legal problem covered by legal aid and to the financial eligibility threshold for applicants.
Mind’s research found that changes made by LASPO have disproportionately impacted on people with mental health problems who are likely to face legal issues in several areas.
The long-awaited first part of the post-implementation review has now been published and highlights the impact these changes are having, along with the ‘Way Ahead’- an action plan accompanying the review.
Responding to the review, Vicki Nash, Head of Policy and Campaigns at Mind, said: “We are pleased to see this review finally published after much delay. Mind submitted evidence which showed how people with mental health problems are more likely to be affected by changes to the scope of legal aid. It was positive to see this research recognised in the publication, but it’s frustrating to see no explicit Government commitment to lessen the negative impact this legislation is having on people with mental health problems. We are also disappointed that the review seemingly dismisses much of the sector’s evidence of the impact on vulnerable people as anecdotal. After all, it is the real experiences of people that should be taken into account, for example, people who are severely unwell facing the prospect of representing themselves in court without a lawyer or advocate.
“It’s shocking to see the extent of the cuts, particularly that there has been a 99 per cent reduction in welfare benefits cases getting legal aid. We know that well over half of people appealing decisions about their disability benefits get the outcome overturned in court. But too often people with mental health problems tell us that they’re too unwell to face the lengthy and onerous process of taking an appeal without support – leaving too many people locked out of the benefits that they should be entitled to. More positively, the Ministry of Justice has committed to reviewing means tests, piloting early advice, and scrapping the mandatory telephone gateway for debt and discrimination issues – two of the more common legal problems facing people with mental health problems.
“What we now need to see is the Government urgently put these recommendations into place, given that in the meantime vulnerable people facing multiple legal issues are having to go through a stressful process without support, often making them more unwell. Limiting legal aid was a cost-saving exercise, yet costs are being felt elsewhere – as people’s mental health worsens, the impact is being felt by our NHS too.”
Source: National Mind
Nearly 65% of prisoners at a women’s jail may have suffered traumatic brain injuries at some point in their lives, a study has found.
Research by the Disabilities Trust and Royal Holloway, University of London, found that of the 173 women screened at Drake Hall prison in Staffordshire answering questions about blows to the head, 64% gave answers consistent with having symptoms of a brain injury. The symptoms of 96% of the women suggested that these arose from physical trauma.
The work adds to a growing body of research on the over-representation of people with brain injuries in the prison population. In 2012, a university of Exeter report described traumatic brain injury as a “silent epidemic”. In 2010 a study of 200 adult male prisoners found 60% had suffered a head injury.
Research has suggested that traumatic brain injury (TBI) could increase the likelihood of violent behaviour, criminal convictions, mental health problems and suicide attempts.
“The needs of somebody in prison with TBI are likely to be complex, and the lack of understanding and identification of a brain injury results in a higher risk of custody and reoffending,” said the Disabilities Trust.
Full story: Guardian
With toilets falling apart, poor soundproofing, and uncomfortably hard flooring, mental health facilities can often feel more like prisons than actual hospitals.
In December 2018, the Independent Review of the Mental Health Act made a clear and unequivocal statement about the need for far-reaching improvements to the inpatient environments the NHS offers to people who are in hospital for mental health assessment and treatment.
It concluded that “people are often placed in some of the worst estate that the NHS has, just when they need the best,” and it called for major capital investment in renewing the mental health NHS estate to put this right.
The review noted that “the physical environment of wards… can create the kind of institutional atmosphere that psychiatry has been trying to move away from for the last half century because of its negative impact on patient experience. For example, rimless toilets, heavy wipe-clean armchairs, hard flooring, and bare walls that are easier to clean, but absorb little sound, make buildings oppressively noisy.
The review noted: “Poorly designed and maintained buildings obstruct recovery by making it difficult to engage in basic therapeutic activities (getting outdoors or social interaction with others) and contributing to a sense of containment and control.
Wards are experienced as cold and impersonal places that some say are more similar to a prison than a hospital – making a return to the community, with all its everyday stimuli and risks, more challenging.”
The review acknowledged that creating a safe, therapeutic, and effective environment is about much more than the physical fabric of an inpatient ward, or indeed any other place in which mental health care is provided. It exaplained: “Wards become people’s home, often for many months, and so should offer a positive community for the patient where they can build new relationships.”
“They should also support patients to keep connected to their communities and relationships outside of the hospital where that is appropriate. Ward culture should promote therapeutic benefit and minimise institutionalisation. Recruitment and retention of permanent staff at the right grades needs to be improved, and with ratios identified to ensure safety, a positive ward culture, and the development of meaningful therapeutic relationships.”
Full story: National Health Executive
Children who lived in areas with higher air pollution when younger are significantly more likely to have developed major depression by the age of 18, according to research.
In the first analysis of how common air pollutants affect teenage mental health, researchers found young people were three to four times more likely to have depression at 18 if they had been exposed to dirtier air at age 12. Comparison with earlier work indicates that air pollution is a greater risk factor than physical abuse in raising the risk of teenage depression.
The scientists said their findings are particularly significant because 75% of mental health problems begin in childhood or adolescence, when the brain is developing rapidly. The work also suggests a link between toxic air and antisocial behaviour, but more work is needed to confirm this. A larger study is expected later this year.
The study, published in the journal Psychiatry Research, combined information from a group of children in London with high-resolution data on air pollution levels.
Of the 284 children studied, those who lived in the top 25% most polluted areas at age 12 were found to be three to four times more likely to have depression at 18, compared with those living in the 25% least polluted areas. In comparison, previous work has shown that children who suffer physical abuse are one and a half times more likely to develop depressive disorders.
The researchers took into account other factors that could affect mental health, such as a family history of mental illness, level of income, bullying and smoking habits. They also looked at levels of anxiety and ADHD, but found no link to air pollution.
The increase in risk of antisocial behaviour was three to five times higher. But unlike the link to depression, the result was not statistically significant, potentially because the number of adolescents in the study that behaved badly was small.
Levels of nitrogen dioxide pollution are at illegal levels in most urban parts of the UK and small particle pollution exceeds World Health Organization guidelines in many places. The government accepts dirty air shortens livesand harms children, but its latest action plan on roadside pollution was described as “pitiful” by environmental lawyers.
Prof Chris Griffiths, a founding member of the Doctors Against Diesel campaign, said: “Further studies are needed, but the urgency to reduce dramatically the exposure of young people to toxic air pollution remains.”
Full story: Guardian