Are People With Mental Illness Getting Proper Treatment?

It would appear that they are not according to the newly appointed president of the Royal College of Psychiatrists.Professor Simon Wessely of King’s College London in his first interview since taking up the post told the Guardian newspaper that less than a third of people suffering from mental health problems get any treatment at all. This is something the public would not tolerate if the patients concerned had cancer said the professor.The gap is now so bigAlthough the current health secretary, Jeremy Hunt, has promised to deliver “parity of esteem” for mental health patients, Professor Wessley says the gap is now so big it may not even be possible to close it.”Parity of Esteem” can be described as valuing mental health equally with physical health. The Royal College of Psychiatrists reckons that this would mean:Equal access to the most effective and safest treatment options available
Equal effort to improve quality of care
Equal status within healthcare education and practice
Equal status in the measurement of health outcomes
Equally high aspirations for service users
Allocation of time, effort and resources on a basis commensurate with needHowever, according to Professor Wesley, people can be routinely waiting for up to 2 years for any sort of treatment in some parts of the country and some children are not getting any treatment at all.”So although we have the aspiration, the gap is now so big and yet there is no more money,” he said.
What if they were cancer patients?Professor Wessley highlighted what would happen if these were cancer patients and not mental health patients that didn’t have access to treatment. Imagine if I gave a talk, he told the Guardian, which started like this.”So, we have a problem in cancer service at the moment. Only 30% of people with cancer are getting treatment, so 70% of them don’t get any treatment for their cancer at all, and it’s not even recognised.”Right enough, there would be public outrage if that were the case.There is no more moneyWhen Professor Wessley asked Simon Stevens, the NHS England Chief Executive how the gap between treatment would be closed, Stevens told him that it would involve a “much longer conversation with the public”.”I think what he means is basically, if people really want true parity in the sense of actual 90% of mental health patients treated within 18 weeks, just like they are for other disorders, that is going to have to mean money will have to move from acute to mental health. Genuine money.”As there is no more money, that would mean significant losses in other sectors. I think he was saying we would need a pretty good political imperative – we would need to know that people were actually on board for that – and I don’t know the answer.”More Mental Health TrainingWessley told the Guardian he believes that doctors, nurses, midwives and social workers should have more mental health training for better integration of diagnosis and treatment. This may help prevent patents being referred for suspected heart complaints which turn out to be panic attacks that haven’t been picked up, said Wessley.So despite the fact that there have been attempts to put mental health care on the same par as physical care but that just isn’t happening, indeed the entire health system is against it according to Wessley.”The whole of our healthcare system is about separating mental and physical. You couldn’t devise a system better suited to separating the mental and the physical if you tried,” he said.At Kings Hospital psychiatrists have been working in general medical wards and this has worked well, according to Wessley, patients don’t have any resistance to it.Is it cost effective?”Certainly when you look at the cost of investigations, when you look at the cost of treatment that isn’t necessary, when you look at the cost of lost working days, when you look at the cost of additional care, actually it does become cost effective. The problem we always have is those savings are not always made to the health service.”But we know people with physical health problems who also have mental health problems cost about 45% more than those who don’t. That’s absolutely and unequivocally clear. The cost of their care goes up. They comply less with treatment, they come back more often, they have lower satisfaction and they have more complications.”