Unlocking the door to greater access to mental health care

There was much in the news last week that made me stop and think. For example, the recently published outcomes from a study undertaken by researchers in Taiwan and the US. This looked at the link between medication (Viagra and Cialis) used to treat erectile dysfunction and the increased risk of blindness. Specifically, the development of glaucoma, a condition that affects over a million people in the UK.

Possibly because of the way my mind is wired, I thought about the work of Ivan Illich, and his notion of iatrogenesis. This concept can be found in his seminal work ‘Medical Nemesis’ published over 50 years ago. Essentially, he posited that in the case of health care, iatrogenic consequences (harm) can happen even where there has been the ‘correct’ application of medical interventions. In modern terms, maybe think protocols.  Thankfully the researchers were keen to note that their research could not point to a definitive correlation between taking the little blue pill and going blind.

Turning a blind eye appears to be what the great and the good might have been doing at Cambridge University. I don’t know if that is the case or not, but you can’t have helped noticing the plight of Jason Arday. He’s the Cambridge professor accused of plagiarism and embellishing his CV. It is not for me to say anything about these allegations; that is for others to work through. I was more concerned about the way in which he has been treated by both mainstream and social media.

I puzzle over the motivation for such behaviour from these keyboard warriors. Indeed, no sooner had his letter of resignation been published, than folk on social media had run the script through ChatGPT announcing that there was a 90%-100% certainty it had be written using AI. Whatever the truth regarding the allegations against him, to be hounded day after day must have had an adverse on his mental health and wellbeing. I sincerely hope he is able to get the help and support he might need to regain some welcome equilibrium back into his life.

The big announcement last week, which will impact upon anyone seeking help for their mental health was the £343 million investment in neighbourhood community hubs and mental health emergency departments. It is welcome news for sure. Across England, mental health services have always fared badly compared to physical service provisions. In recent years there has also been a reduction in the resources for mental health care, yet the demand for such care has steadily increased.  

This announcement is significant and follows a number of recent and important changes to mental health policy. A new national mental health strategy is being developed, alongside a Modern Service Framework for severe mental illness. Earlier last month, the Mental health personalised care framework: the modern care programme approach was published. This is aimed at improving services for all people with a severe mental health problem. There are clear new expectations of service providers, around the assessment and management of risk. It needs to be an approach that ensures better quality and safe care is provided, both for hospital care and when people are discharged back into the community. These are not and should not be changes in policy that lie dormant on a shelf somewhere. Responding to these changes will require improvements in what we currently do and the future transformation of the services being provided.

The new money, announced last week, brings with it opportunities and challenges. Not least of which is how such centres could be run; what operating model is likely to be the most effective in bringing about change; and where will the staff come from? All of which, we are currently looking at in our organisation.

Fundamentally, anyone with a mental health problem should simply have just one front door to pass through to gain help. This can be a physical or a ‘virtual’ door (just have a look here at what they are doing in Singapore). Deciding on how to best meet a person’s needs should be a joint endeavour and not one determined simply by a professional or care group response. New buildings are always welcome, but how these are used is probably more important, if we are to avoid future iatrogenic consequences for our service users and their carers.