Mental health: services ground down

In May, a woman was admitted to the acute mental health ward on Merseyside where I work as a full time nursing assistant. She had tried to kill herself using an overdose of prescription medication and a bottle of vodka. We found out that she had been financially supporting her daughter, who has two disabled children and had got into thousands of pounds worth of debt – because the disability benefits had been stopped. Now, without any prospect of getting the money to pay off her debts, the woman had attempted suicide in an effort to get away from the relentless tyranny of telephone calls and letters demanding repayments. She was on our ward as a direct result of poverty and welfare benefit cuts.

Her case shames me, both as a mental-health worker and as a citizen in our so-called society. In a true and functioning society no one is left behind. Not our patient, not her daughter, and not her grandchildren. The disabled grandchildren have been failed due to the cut in the benefits which were there to sustain and support them. Their mother is failed because her needs as the carer of these children have been ignored. Our patient was failed because it fell to her to pick up the bill for the needs of her disabled grandchildren, while her basic needs as a human being had been ignored.

When an individual must attempt suicide in order to gain a temporary respite from their financial problems, this is a complete failure of society on every level. But this conclusion is reached before we even look at the sort of care that this woman received while in acute mental health services. In my job I witness cases such as this on a daily basis. Due to the continuing decline in the provision of social and care services by local councils – a result of drastic cuts in spending – acute mental health workers must now also serve as social workers, amongst the myriad other roles the cuts in NHS spending have forced us to assume.

The entirety of the NHS is beginning to crumble under the weight of the government funding cuts. Month by month the conditions for both patients and front line staff worsen noticeably as more money is saved by slashing Trust budgets. These changes are endemic throughout the country.

In my own experience on the unit, not only are the acute wards continually understaffed with nursing assistants, but some wards, including mine, are now expected to run without a ward clerk to deal with administration. Wards go for shift after shift without a domestic to clean the place. Most worryingly of all in the last year there have been several instances where there have been only three qualified staff nurses on night shift to cover the four separate wards on the unit. Running an acute ward overnight without a qualified nurse to hold the clinic keys, administer medication and take responsibility for decisions about the care of the patients should be unthinkable. Two years ago it would have been unheard of. But now it is becoming more frequent. Standards of care are being lowered dramatically.

The cuts in mental health services are 20% more severe than those to other services. This is happening for two reasons: first, because mental health is still considered separate and lesser than physical health, and second, because the mental health patients who suffer from the cuts to services have no voice in society and are therefore easily ignored. This is backed up by statistics from the Disability Rights Commission: people suffering from mental health problems will die on average 5–10 years younger than those without mental health problems, often from preventable illnesses missed because routine checks were not carried out. People suffering from the most serious mental illnesses, schizophrenia for example, will die an average of 20 years younger than those with no mental health problems.

But to say that those who suffer from mental ill health are a marginalised section of society does not go far enough. The majority of patients I see in mental health services are already from an impoverished section of society that is conveniently forgotten. The issues of poverty, homelessness, drug and alcohol addiction, domestic violence, gang violence and crime are all inextricably linked with mental health in a way that is immediately obvious on an adult acute ward. Patients from more deprived economic backgrounds vastly outnumber those from wealthier backgrounds. No wonder a recent report found that poverty and poor mental health go hand-in-hand: mental health problems are twice as prevalent in deprived areas of London (20%) than in the least deprived areas.

With regards to the patient I mentioned at the beginning of this article: after being assessed by psychiatrists on my ward she was diagnosed as having no mental health problems whatsoever – her attempted suicide therefore a desperate act in response to her impossible circumstances. As she did not suffer from a mental illness, she was discharged back home to her troubles after a week’s respite on the ward, the only support being the contact details of a debt advisor.

Claire

Fight Racism! Fight Imperialism! 239 June/July 2014

 

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