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Source: (consider it) Thread: Mental Health provision
Schroedinger's cat

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# 64

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I was watching 999 What's your emergency last night. It was a mental health special. It was very disturbing.

The problem is, the emergency services were dealing with a number of people who have long-term mental health problems. Two people in particular stood out.

One girl who was screaming, had voices in her head, was kicking out and very disturbed. The police took her to hospital, but there wasn't a bed for her. They had to leave her being checked on, because they couldn't stay (they had other incidents to attend to - it would be hours and hours).

This is someone in mental health crisis who CALLED OUT to the services for help. And there was no provision for her.

Another man was distinctly disturbed - he was religiously influenced, but also showed signs of paranoia. He needed a lot of help.

When they picked him up the first time, he was seen for a couple of hours (only because the police had forced him to A&E). Then they let him out again (despite the fact that he was considered inappropriate to be let alone). A few days later he called the services again, having visions. There was nothing they could do.

It highlighted that there is no good and proper provision for mental health crises. In fact, as one woman said, the entire system is on the edge of collapse, because the crisis system is broken.

Of course, the government talk about putting more money into MH provision, dealing with the problems. This is not new information, because this crisis in front-line MH provisions has been highlighted before, years ago. Nothing has changed, at least not for the better.

And this is personal. I could so easily need urgent, crisis assistance. Of course, I would never get it, and have to commit a crime or injure myself to get any attention*. Great, and not good for anyone.

So stop the fucking words, and put some resources and money into mental health provision. Rather than, as they currently are, driving people into more MH problems, pulling rugs from under them.

*And yes, I have known someone who had to do this.

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Posts: 18499 | From: At the bottom of a deep dark well. | Registered: May 2001  |  IP: Logged
no prophet's flag is set so...

Proceed to see sea
# 15560

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In Canada the trend for 30 years is to put them in jail. They medicalised mental health and closed and downsized community mental health and provide mental health to severely ill only in hospitals. Community mental health involves getting them arrested which provides high paying and politically sellable jobs in corrections. Prescription meds given via 10 minute doctor consult every 3 months.

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Posts: 10832 | From: Treaty 6 territory in the nonexistant Province of Buffalo, Canada ↄ⃝' | Registered: Mar 2010  |  IP: Logged
welsh dragon

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# 3249

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There is mental health provision in the UK, but there is a year by year reduction in spend.

Voting conservative is a really bad idea if you want more money spent on mental health - or any kind of health.

Posts: 5349 | From: ebay | Registered: Aug 2002  |  IP: Logged
Schroedinger's cat

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# 64

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The problem is, the provision is all taken. Too many stories of people in need of a hospital place unable to get one. This is not just occasionally, but (it appears) all the time.

What would we do if the same problem occurred for heart attacks. "Sorry, sir, can you just breathe calmly for a few hours, while we try to find you a bed in Bristol, just 6 hours away?" Or trauma injuries. "Yes, if you can hold your leg together for a day or so, we should be able to get a sewing kit to you then."

It is a disgrace.

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Lord may all my hard times be healing times
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Posts: 18499 | From: At the bottom of a deep dark well. | Registered: May 2001  |  IP: Logged
Jay-Emm
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# 11411

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quote:
Originally posted by Schroedinger's cat:
It is a disgrace.

Yes, and worse it's a expensive and inefficient way.
It's not just the banal evil of making people suffer, because XYZ is more important. Apparently the sufferings so desired we're giving up XYZ to inflict it. [Frown]

[ 29. July 2016, 19:55: Message edited by: Jay-Emm ]

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Penny S
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# 14768

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The Dartford area used to be a centre for mental health provision. Hospital where a Friend's mother was cared for in dementia is now a charming housing development. Bexley hospital (once host to Marianne Faithful) now a housing estate with a small unit round the back. Massive Darent Park hospital completely demolished and developed for housing. Joyce Green Hospital on the marshes, which had a psychiatric ward, vanished.

Even assuming that some of the institutionalised residents should never have been there - the women who had been too keen to smile at men, for example, that's a massive reduction in provision - where are they all? The funding of care in the community cannot possibly have been sufficient. And that's without the new patients.

[ 29. July 2016, 20:48: Message edited by: Penny S ]

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Schroedinger's cat

Ship's cool cat
# 64

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Penny S - precisely. The idea that all patients with MH problems should be incarcerated is wrong, but so is the idea that none of them should - they should all be looked after in the community.

Especially when the community provision was NEVER ramped up to cope with it. And, as you say, there are new patients who NEED help - and often this needs to be as an in-patient, at least for a while.

It just seems that there is an institutional dismissal of my illness, and so of my problems. As if I don't matter. That is what it feels like to me, and there are others who feel this far worse. So someone who has low self-esteem is now told they are not really important. That will help.

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Lord may all my hard times be healing times
take out this broken heart and renew my mind.

Posts: 18499 | From: At the bottom of a deep dark well. | Registered: May 2001  |  IP: Logged
Golden Key
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# 1468

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Here in California, lots of psych institutions were closed down, in favor of community care. Good idea, in many cases. But the released people had to go to a central place to get their meds. Sometimes, they didn't make it there. And if you're off your meds, you don't think you need them, or you're too incapacitated to get yourself where you need to go.

So a lot of the released people wound up homeless and on the streets. Here, in San Francisco, very easy to come across homeless people with obvious, severe mental illness. I don't know how many of the ones I've seen were among the released people. Some may have been made ill by homelessness.

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--"Oh bat bladders, do you have to bring common sense into this?"--Dragon, "Jane & the Dragon"
--"I'm not giving up--and neither should you." --SNL

Posts: 17650 | From: Chilling out in an undisclosed, sincere pumpkin patch. | Registered: Oct 2001  |  IP: Logged
Huia
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# 3473

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I don't know about anywhere else, but here when people were released into community care their funding didn't follow them, so the move came across as cost cutting, rather than concern that people were institutionalised.

As my mum said at the time about someone who fell between the cracks, "X was released into community care, and most of the community doesn't. [Frown]

Huia

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Charity gives food from the table, Justice gives a place at the table.

Posts: 9993 | From: Te Wai Pounamu | Registered: Oct 2002  |  IP: Logged
Barnabas62
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# 9110

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"Care in the Community" always struck me as a cynical cost-cutting exercise. As things stand, it looks as though sectioning is used more sparingly than it should be precisely because of the lack of secure places.

This is of immediate relevance to me, indirectly. A good friend who has struggled with mental health problems for years is in urgent need of help in a secure place right now - and is not likely to get it.

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Gee D
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# 13815

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Care in the community sounds a great idea, but seems not to have worked anywhere. Everyone says that the funding is inadequate, but is there some more deep-seated reason? Do those actually doing the care want the new system to work? Do we need to work more on what care is being given? Is it something else?

[ 30. July 2016, 07:57: Message edited by: Gee D ]

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Twilight

Puddleglum's sister
# 2832

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I think lack of funding is definitely a big part of it. People don't vote for extra taxes to build mental health facilities as readily as they do for something like schools because fewer people see the need.

Fear is a big factor. Dr.E Fuller Torrey, who heads the Treatment Advocacy Center says that fear of mentally ill people, and animosity toward them, rises significantly after things hit the news like mass shootings or other violent crimes by mentally ill people. Then the community not only doesn't care, but doesn't want the ill people anywhere near. You would think that such events would emphasis the need for more psychiatric hospitals but the "community," seems satisfied to have them incarcerated.

The release of John Hinckley last week, after 35 years in a psychiatric hospital for shooting Reagan and Brady while having a psychotic episode, caused a flurry of comments from angry people who seemed to think he had been getting off easy all these years. He's been deemed well-enough to pose no threat by his doctors for decades.

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jacobsen

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# 14998

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In the UK, the big psychiatric hospitals such as Colney, Cane Hill and Harperbury, each occupying large and valuable expanses of land on the outer edge of London, were sold for building sites. While these were often places where the residents spent their lives, they were also safe, green areas where residents could go out and about in what was a virtual village. Visitors used to be given a map! To replace these with houses in an urban centre, often with tiny gardens and inadequate social support, was asking for trouble.

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Beauty fades, dumb is forever-Judge Judy
The man who made time, made plenty.

Posts: 7765 | From: Æbleskiver country | Registered: Aug 2009  |  IP: Logged
Schroedinger's cat

Ship's cool cat
# 64

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There is a problem that if you get rid of the psychiatric hospitals, you don't get rid of the patients. They are just a lot less visible. We have 2 housing estates near us that were psychiatric hospitals (I was visiting friends on one yesterday, as it happens).

NOTE: I am NOT under any circumstances suggesting that people with psychiatric problems are more likely to commit violent acts than anyone else:

When you put people with (often severe) psychiatric problems into a non-safe environment; or you fail to provide them with a temporary safe environment; and you question their health problems, take away their money, tell them to find a job; they might feel a need to lash out. They are so oppressed and dismissed by society that violent acts are more likely. And then what happens? Everyone blames the "crazy guy". Nobody want to put money into treatment, because they are "not like us."

And that really makes me angry.

Actually, I think getting rid of many of the old, large workhouse-like mental hospitals was a good idea. The problem is, they were not replaced by other, appropriate facilities. I think not putting people away for minor signs of deviancy from the accepted norm was positive. Failing to provide facilities to treat the seriously ill was wrong.

You know the figures. 1 in 3 people will need psychiatric help in their lifetime. And that is ignoring those who suffer but tell no-one. So it is not an aberration from societies normal - it is a health issue that we are pretending doesn't exist.

--------------------
Blog
Music for your enjoyment
Lord may all my hard times be healing times
take out this broken heart and renew my mind.

Posts: 18499 | From: At the bottom of a deep dark well. | Registered: May 2001  |  IP: Logged
Ethne Alba
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# 5804

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ISTM that the only things going for many people in these situations in the UK right now.....is family & friends. People willing and able to be there, 24/7, because they care for whoever it is who is going through crisis.

And sometimes, even that is not enough.

I just don't have words, even in Hell, for my opinion on this subject.....

[ 02. August 2016, 10:35: Message edited by: Ethne Alba ]

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Fredegund
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# 17952

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Another one who can't find the words to express my fury with the current lack of system. People are being failed all along the line, from those in need of a safe place to those just diagnosed with a MH condition. If you can't be treated by 6 sessions of CBT it's up to you, and if you're lucky, your GP to control it.
Please God I don't get any worse, because all that's available is repeat prescriptions via the GP. Unless I want to play bingo looking for a private therapist, and I'm too depressed to have any confidence in my judement.

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chris stiles
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# 12641

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quote:
Originally posted by Barnabas62:
"Care in the Community" always struck me as a cynical cost-cutting exercise.

Along with diffusing responsibility for that 'Care' in such a way that everyone concerned could satisfy themselves that they had done their job - whilst simulatenously the standard of care was poor at best or non-existent at worst.

It's replicated in other areas and is partly the result of the toxic media culture we have in this country that constantly undermines any form of social solidarity.

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Callan
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# 525

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quote:
Originally posted by chris stiles:
quote:
Originally posted by Barnabas62:
"Care in the Community" always struck me as a cynical cost-cutting exercise.

Along with diffusing responsibility for that 'Care' in such a way that everyone concerned could satisfy themselves that they had done their job - whilst simulatenously the standard of care was poor at best or non-existent at worst.

It's replicated in other areas and is partly the result of the toxic media culture we have in this country that constantly undermines any form of social solidarity.

My distinct recollection is that the idea was initially set out for the best of motives - by and large people would do better outside institutions where they can be supported in their own homes - but, inevitably, the bean counters realised that they could save a shed load of money.

Broadly speaking, in policy terms, if a politician says to you that they are going to disassemble X and replace it with Y, the best response is give us Y and then we can talk about getting rid of X.

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Posts: 9677 | From: Citizen of the World | Registered: Jun 2001  |  IP: Logged
Schroedinger's cat

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# 64

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quote:
Originally posted by Ethne Alba:
ISTM that the only things going for many people in these situations in the UK right now.....is family & friends. People willing and able to be there, 24/7, because they care for whoever it is who is going through crisis.

And sometimes, even that is not enough.

I just don't have words, even in Hell, for my opinion on this subject.....

The thing is, for many people in crisis, they don't have any supporting family or friends any more. So often, their illness (or related problems) have driven them away, which is often why they are in crisis.

Not counting those whose problems are exacerbated by abusive family or associates. People go back to their abusers because there is no other choice. So their abuse continues, and their MH problems get worse.

It is precisely these people who need to support of the system to get through these periods.

--------------------
Blog
Music for your enjoyment
Lord may all my hard times be healing times
take out this broken heart and renew my mind.

Posts: 18499 | From: At the bottom of a deep dark well. | Registered: May 2001  |  IP: Logged
Ethne Alba
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# 5804

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...and IME, it is precisely those people who end up being unceremoniously dumped from whatever services are left.

Or being offered a waiting list so long that one needs to pawn something and go private.

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Jemima the 9th
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# 15106

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And then there's this: http://www.mirror.co.uk/news/uk-news/children-mental-health-problems-forced-8535976

Average wait in South Yorks from referral to treatment is over 6 months. It's a national fucking disgrace, is what it is. Mental health trusts are cutting / freezing budgets, the good staff are leaving.....it's just awful.

And for the person from SW Yorks to say that "Urgent cases are usually seen in under a week" is a good thing, given how dire things have to be in order to be considered urgent, just shows how little priority is given to mh services.

[ 03. August 2016, 21:27: Message edited by: Jemima the 9th ]

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chris stiles
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# 12641

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quote:
Originally posted by Callan:

My distinct recollection is that the idea was initially set out for the best of motives - by and large people would do better outside institutions where they can be supported in their own homes - but, inevitably, the bean counters realised that they could save a shed load of money.

Well yes, the ideas behind the original green/white papers were to deal with the issue of poor institutional care as well as dealing with the issue of people becoming institutionalized.

Unfortunately it then became ideological, as a number of the followups assumed that care provided by the government must by its very nature be poor - and the initial reforms were implemented against the background of Thatcherism.

and these days of course it is hard to get public support for any type of welfare.

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Doublethink.
Ship's Foolwise Unperson
# 1984

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At the moment I don't think it is just about money, I know my local trust is struggling to hire mental health nurses, even though funding has been agreed for posts - likewise there is a shortage of social workers. These shortages are national, and where you can't staff beds or services, then access will end up being further restricted because there are simply not enough people to do the work. It is also the case the local private social care agencies are also struggling to hire staff, this will get worse post brexit as many direct care staff have been immigrants.

Quality also suffers as regular staff will be operating above sensible caseload.

[ 04. August 2016, 00:03: Message edited by: Doublethink. ]

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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell

Posts: 19150 | From: Erehwon | Registered: Aug 2005  |  IP: Logged
Doublethink.
Ship's Foolwise Unperson
# 1984

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The other problem that is badly effecting people with long term severe mental health conditions, and LD, is the dire social housing situation.

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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell

Posts: 19150 | From: Erehwon | Registered: Aug 2005  |  IP: Logged


 
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