Cost and sustainability

rant1
A blackboard with “rant of the day” printed at the top and the letters NHS with pound signs drawn in white chalk

I had a list of things I wanted to blog about so instead I’m going to write about something completely different which came up few days ago.

I’ve been trying to get more into doing work outside of Mind which uses my lived experience of having mental health problems, last week I attended a workshop on Outcomes Based Commissioning (OBC). I’ve learnt that mental health meetings and groups loves acronyms, an alphabet soup of conditions, job roles, legislation and projects.

I’d like to tell you more about exactly what that is but honestly I’m not entirely sure myself. I can tell you that 8 organisations some statutory such as the NHS and some charity such as Mind and Spear are working together to change the delivery of mental health services in Richmond and somewhere in all this they’re looking for contribution and input from service users, carers and people with lived experience of mental distress.

One of aims from the mental health service is to ensure sustainability and deliver cost effective treatment, I have a couple of issues with this. 1) you cannot guarantee sustainability, you can do your best the make services sustainable but don’t make false promises especially to vulnerable people, 2) cost, now unless you’ve been living under a rock you’ll know that the NHS is chronically underfunded and overstretched; mental health has always been refereed to as the Cinderella service and when the going gets tough the tough gets cutting and mental health is often one of the first areas to feel these cuts.

So what’s the problem with pointing this out or looking to save money? well mental health already comes with a nice big serving of guilt for many people, guilt for putting pressure on loved ones, guilt for not working, guilt for being unreliable and it’s hard not to feel the need to justify the cost of treatment as I wrote in my last post I’ve been told by Drs in a&e to consider how long it took to treat me compared to the time it took me to cut myself, I’ve been questioned on why I called an ambulance despite feeling faint from blood loss. I didn’t choose to have mental health problems, my actions may be my choice but having these issues is something beyond my control partly due to my upbringing and home environment growing up.

Having the cost of treatment pointed out or hearing the providers talk about services being cost effective makes people feel guilty for something they can’t help and even puts people off seeking treatment whether that’s for self harm (I know people who will suture or glue themselves) or more long term treatment like psychotherapy or counselling.

The financial situation with the health service is complex but nobody should be made to feel guilty for needing healthcare or social care or feel they don’t deserve the help they need.

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