I am writing this post based on a report I have read from The Centre for Economic Performance and The London School of Economics and Political Science.

he report is entitled How mental illness loses out in the NHS. The report goes through and talks about how mental health does in fact lose out. I am going to highlight some quotes from the report and give my own personal thoughts and experiences to go along with it.

he report quotes 6 remarkable – alarming if you ask me – facts. They are:

  • Among people under 65, nearly half of all ill health is mental illness.
  • Mental illness is generally more debilitating than most chronic physical conditions.
  • Yet only a quarter of all those with mental illness are in treatment, compared with the vast majority of those with physical conditions.
  • More expenditure on the most common mental disorders would almost certainly cost the NHS nothing.
  • …the costs of psychological therapy are low and recovery rates are high. …For depression and anxiety the Number Needed to Treat is under 3.
  • …the Improved Access to Psychological Therapy programme has almost certainly paid for itself through reduced disability benefits and extra tax receipts.

The report asks the following question: Does the NHS give sufficient priority to Mental Health?

The short answer is no! They absolutely do not.

The long answer is still no, but I will explain my reasoning for answering this. In 2007, I finally went to see the doctor about my depression. His first choice was to put me on Prozac. He then asked me to see how I got on with them. I tried them for a few months, nothing seemed to be getting better. I went back and he said that I had to stay on them. During this time, I transferred to another GP. She had me try different meds and also to see a graduate worker at the surgery. I saw the graduate worker and it was for a maximum of 6 sessions. This wasn’t tailored to meet any specific need. It was a one size fits all kind of thing. I wasn’t able to cope with that.

I then asked her to refer me to a psychiatrist. This referral took quite a few months to come through and then quite a while after to get an appointment. Appointment made, I went to see a psychiatrist. He was OK. Checked to see what had been happening and what had caused my referral. He seemed to take an interest in my care. During this time, I saw a psychologist – again for a maximum of 6 sessions. It was somewhat tailored to my needs, but was still a bit of a one-size-fits-all kind of deal. He didn’t want to work too much to find out what the causes of my mental illness were.

My care was transferred from primary care to secondary care. I then went a while without getting help from anyone. The psychiatrist appointments were few and far between. This was not helpful to someone in my condition. I switched services to another psychiatrist due to some misunderstandings with Dr B. This change was not a good one. She wouldn’t take the time to try and fix my issues, she was a ‘throw medicine at it’ kind of psychiatrist. She had me try 5 different medicines in an 8 week period – bear in mind that you need 2 weeks to start one and then 2 weeks to come off one and go onto another one with a gap of about 3 or 4 days in between. I had about 22 weeks worth of medicine changes in 8 weeks.

Fast forward a couple more years and the psychiatrist visits were still few and far between. I saw a counsellor – again for a max of 6 sessions and she didn’t want to focus on the issues that had caused my illness, only how CBT could work moving forward. I am of the opinion if you don’t know what is causing the issue, how can you change your thinking about the issue.

All of this treatment has been over the course of about 5 years up to now. As you can see, my mental health care has not been given the priority that the government thinks it should be.

The report has put in some more alarming facts:

  • …mental illness accounts for 23% of the total burden of disease. Yet, despite the existence of cost-effective treatments, it receives only 13% of NHS health expenditure.
  • Mental illness has the same effect on life-expectancy as smoking, and more than obesity.
  • Nearly a third of all people with long-term physical conditions have a co-morbid mental health problem like depression or anxiety disorders. These mental health conditions raise the costs of physical health-care by at least 45%.
Mental health policies
The government’s announced mental health policies should be implemented on the ground. For example, local Commissioners have been given £400 million in their baseline budgets for 2011-14 in order to complete the national roll-out of Improved Access to Psychological Therapy (IAPT). By 2014 this programme should be treating 900,000 people suffering from depression and anxiety, with 50% recovering. But many local commissioners are not using their budgets for the intended purpose.

Proof if ever that the inequality does exist!

Working for a healthier tomorrow › Dame Carol Black. 2008
From a policy point of view a more important figure is the cost of mental illness to the Exchequer. If we focus on non-employment, this costs the Exchequer £8 billion in benefits for the 1.3 million people on incapacity benefits. And the total non-NHS cost of adult mental illness to the Exchequer may be around £28 billion.

And thus endeth my thoughts and experiences on why there are Mental Health inequalities in the NHS. Click on the link below to read the full report.

CEP & LSE MH Report

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