How we can solve the mental health crisis? With a Mental Health Manifesto!

I have spent nearing a decade working with local government and the NHS on mental health however it is my experience as a mental health patient that drives me to produce my mental health manifesto. After first coming into contact with mental health services over ten years ago little has change and in-fact I believe things have got worse.

In a blogpost  I have outlined my frustrations with how “the system” is the biggest problem and that the system from my perspective is still the biggest barrier to change in mental health services.

So here we go:

 Accountability in the system

One of the biggest problems with mental health in general is that in localities up and down the country there is not one government entity that takes responsibility for it, a wise psychiatrist once said to me “When CAMHS [Child & Adolescent Mental Health Services] became everyone’s responsibility it became nobodies’ responsibility.” I think there is a considerable amount of truth in that statement and it is completely applicable to mental health services as a whole.

When something goes wrong with the mental health system in a locality, talking to a brick wall is more productive than trying to find a solution and quite frankly I do not believe that is good enough. So, let’s establish a statutory body in every appropriate locality that will take ownership of “mental health” as a whole.

This body could be given the teeth to intervene when other bodies are failing to deliver on the countless strategies and implementation plans as well as bring together the fantastic work that is already inherent in the mental health system. This body also gives the public an entity to hold to account when their tax is not invested correctly in mental health, it would give people a “go to” place to share their concerns, thoughts and ideas on mental health as a whole.

Money talks.

I keep threatening to buy a t-shirt that says, ‘don’t forget district councils’ and the reason is for years organisations such as the NHS and The Police have relied on district councils to deliver “community interventions” that provide a real mental health benefit, things like youth clubs, meals on wheels, community transport, activity co-ordinators all contributed towards good mental health. In case you have been living under a rock, district councils have had savage cuts to their budgets over the last few years which has resulted in many of these community interventions having to be scaled back or cut completely.

Now it is fair to say district councils didn’t always do a good job at collecting the mental health outcomes of these community interventions however I often find district councils have been left out of the picture when talking about mental health services which has put real pressure on mental health services. To illustrate this I want to provide a scenario:

XYZ Council run a youth club that costs £10 a year to run and a bin collection service for £10, the council have to make £10 worth of savings from the youth club because a)it is impossible to run the bin collection service for less than £10 and b) the council by law have to provide the bin collection service.

The problem is that this youth club was saving the NHS £50, The Police £25 and The Fire Service £2.50. However, none of those services will fund the youth club because they have no extra money and just have to hope that the experts that calculated the savings were wrong.

The above scenario is one that is happening and has happened across England and I am going to suggest something quite radical. That the government legislates every locality to establish a “Joint Community Intervention Commissioning Board” where relevant statutory parties are forced by law to sit around a table and jointly manage a budget to build community capacity in a locality.

 

… more to follow