More investment needed in mental health crisis care

The recent National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCI) found that the number of suicides by mental health patients in England increased significantly in 2011, and this again demonstrates the pressing need for greater investment in mental health services.

The growth in suicides by mental health patients – 1,333 in 2011, an increase of 158 year-on-year – was largely attributed to the current economic climate, and is in line with the increase in suicides among the general population. But, significantly, the Inquiry found that the number of suicides among people receiving home treatment is rising, while the number of inpatient suicides is falling.

This seems to indicate that some people receiving community treatment may not be getting the help they need, when they need it.

Indeed, research by mental health charity Mind has shown that, in many parts of the country, crisis care teams are under-resourced, understaffed and overstretched. As a result, people in crisis sometimes have to wait hours to be assessed or are even being turned away if they’re deemed ‘not serious enough’.

To state the obvious, if people in crisis do not get the help they need from mental health services at the right time, then the effects can be devastating. Obvious that may be, but it needs saying loudly to those in power, when there is evidence that the right help isn’t available.

As Professor Louis Appleby, director of the NCI and professor of psychiatry in the Institute of Brain, Behaviour and Mental Health at the University of Manchester, has said, improvements in home treatment should now become a priority for suicide prevention.

The Inquiry findings demonstrate how important it is that services take a ‘whole person’ approach – that they don’t just treat the person’s mental health issue, but also look for its root causes. If help and advice can be given to someone with debts, housing or employment issues, for instance, then that could help to ward off a mental health crisis.

To me, the Inquiry also shows once again that cutting mental health services can be a false economy. If teams are understaffed and over-stretched, as Mind say, it is not unreasonable to assume services will suffer. Mental health professionals are only human and there is only so much they can do – however hard they may try.

Budgets for mental health services have been cut for two years running and this trend could continue for some years to come. The government’s recent Comprehensive Spending Review revealed plans to further cut local authority budgets from 2015, so it is possible that wider mental health budgets will come under review again, notwithstanding government pledges to give mental and physical health parity of esteem in the health service.

In this climate, services have to be fought for. As this report shows, crisis care and home treatment are both vitally important and need the right investment to help people to recover and to prevent crises escalating. People cannot be allowed to go without the services they need for want of adequate funding.