INTER- SENIOR SECONDARY SCHOOL ESSAY COMPETITION ON MENTAL HEALTH

“SUBSTANCE ABUSE AND MENTAL HEALTH – A CHALLENGE TOWARDS ENHANCING A PRODUCTIVE FUTURE FOR STUDENTS

Winner: Gbatundu Ndeyia Kutubu

School: Sierra Leone Grammar School

Mental Health according to the World Health Organization is: “A state of well-being in which the individual realizes his or her own abilities, can cope with normal stresses of life, can work productively and fruitfully, and is able to make contributions to his or her community”. Today, there are different kinds of mental health problems but the most common and dangerous occurs as a result of substance abuse which is also known as drug abuse.

Substance and drug abuse on the other hand is described as a specific use of a substance (drug) in which the user consumes the substance in a given amount or other harmful methods which is hazardous to themselves or others. The excessive or addictive use of these drugs for non medical purposes usually defines a state; emotional and sometimes physical, characterized by a compulsion to take them on constant bases in order to experience their mental effect. The effect of drug abuse on an individual forms the bases for its cumulative effect on the society and this is the major danger of drug abuse.

A wide range of drugs are susceptible to abuse by youths, these drugs ranges from most common and less expensive such as cigarette to expensive and more deadly ones like cocaine and heroin. The abuse of these substance leads to criminal penalty in addition to possible physical social and psychological harm. There are many cases in which criminal or anti-social behavior occurs when the person is under the influence of a drug. Long term personality changes in individuals may occur as well. Substance or drug abuse is prevalent with an estimated one hundred and twenty Million users of hard drugs such as Cocaine, heroin and other synthetic drugs. Young Sierra Leoneans especially pupils and students develop certain habit, for the sake of acceptance in a group. Some of these dangerous habits such as smoking, alcohol drinking and drug taking are resorted to for the sake of helping them to cope with the problems, fears and pressured of everyday life. Some use this as a means of escape from the realities of life; realities which they do not want to face tackle.

There are various kinds of drugs which are usually abused by young people (mainly Students) in Sierra Leone. They include Cigarettes, Alcohol, Marijuana and Cocaine.

Cigarettes for instance are drugs easily available to youths. They are quite addictive and can cause lasting effects on young people. They are consumed by smoking and could therefore be related to Marijuana which is also very widely consumed. Smoking of these drugs provides a source of pleasure and at the same time posed as menace to health. Most adolescents and students in Sierra Leone smoke because it makes them feel like adults by imitating adult activities or even keeping them “awake”. The various activities connected to smoking provide a way to get over nervous tensions. A heavy smoker craves for tobacco and an addictive habit is often stronger than will and knowledge combined. No evil habit has to enslave the students of this nation as that of using tobacco and marijuana. I sometimes wonder about the universal acceptance and indulgence of tobacco when its effects are only harmful.

Alcohol is another substance which when abused destroys the mental health of students and poses a great challenge towards enhancing a productive future for all. Contrary to the general belief that alcohol is stimulant, it is a drug which is habit-forming. It produces a harmful effect on the behavior of students. Due to social or peer pressure and public tolerance, alcoholism is widespread. The wide range of hazards on the brain hinders the effectiveness of

learning for students and pupils seeking education. Alcohol impedes self control, impairs judgment and affects conscious actions. Drunkenness does not only lead to loss of intelligence but can also lead to death, thereby terminating the very existence and possible future of youths, who happens to be one of the most vulnerable groups to alcoholism.

When young people indulged themselves in the intake of alcohol, they act as criminals doing wicked deeds. Many youths are led into sin while under the influence of alcohol. Those who wish to have full control over their behavior should surely abstain from the use of all intoxicating beverages. Even Solomon, the wise king of old condemned alcoholism. There is also a high rate of suicide in alcoholic and other drug abusers. This is very common among adolescents, with one in four suicide in adolescent being related to alcohol abuse. For instance, approximately thirty percent (30%) of suicide cases in the United States of America are related to alcohol abuse.

Our social skills are significantly impaired by alcoholism due to the neurotoxin effects of alcohol on the brain. It has been suggested that social skills training adjunctive to impatient treatment of alcohol dependence is probably efficacious. The initiation of drug and alcohol use from 2010 “Monitoring the future survey”, a nationwide study on rates of substance use in the United States, shows that forty-eight percent (48%) of 12th graders report having used an illicit drug at some point in their lives. In the thirtieth day prior to the survey, 41% of 12th graders had consumed alcohol and 19.2% of 12th graders had smoked tobacco cigarette.

The World Health Organization estimated that around 140 Million people were alcohol dependants and another 400 Million suffered alcohol related problems. Do all think this statistics describe a better future for students today? Students and those in adolescent as a whole occupy a delicate and sensitive position within the political structure for several reasons. Research have proven that drug barons prefer recruiting their traffickers from the age of fifteen (15) to thirty-five (35)years, most of whom are either unskilled, unschooled or students and even the unemployed. So in reiterating the question, what is the fate of the young generation and what is the assurance of a brighter future for them when such menaces plague our society.

Generally, peer pressure, child abuse, emotional stress, weak parental control, imitation, truancy among young students, the easy accessibility and availability of drugs and the ineffectiveness of the laws on drug trafficking are the factors influencing the abuse of drugs among youths especially students.

It is becoming unhidden and undisputable that illicit drug usage is rapidly becoming a part of students’ lives and for a large number of students it starts in secondary schools. All these we must not forget, affect our mental wellbeing which shapes our personalities and future. Young people and adolescence also end up as drug addicts in their search for fun, joy and a diversion from the real challenges of life.

A piece of advice to all Students:

There should first of all be the strong determination and firm resolve to overcome this evil habit. Drug abuse should be discouraged by the older generation. This plague could be tackled by a proper family upbringing, parental care, guidance and love, parent-teacher co-ordination, awareness raising against the use of drugs through the use of mass media and sustained efforts of religious organizations.

Students should not allow themselves to be overwhelmed by the excessive demands made on them by older folks and society which is also another factor for resorting to the use of drugs.

They should be watchful against the rampant encroachment of western civilization with its attractions and the breakdown of the hold of traditional ways of life and societies which has made drug abuse a custom for most students.

The choice of friends is of utmost importance as “birds of a feather flock together”. By all means, if success is to crown the efforts in keeping students and pupils away from tobacco, the parents, should set the right example.

In conclusion, the dangers of drug abuse should be reiterated to youths and students involved in it.

If substance abuse and mental health is curtailed, then, education could be achieved to the highest peak probably re-establishing Sierra Leone as the “Athens of West Africa”. This will ensure the brightest and most productive future for students and the young generation.

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MENTAL HEALTH AND OLDER ADULTS IN SIERRA LEONE

Mental Health and Older adults was designated as the primary focus of the recently commemorated 21st World Mental Health Day on 10 October 2013 by the World Federation for Mental Health. In Sierra Leone the day was utilised to raise public awareness on mental health issues including mental disorders and the need to invest in the prevention, promotion and treatment services for mental health in general and specifically for older adults as a vulnerable social group.

Globally, the population of older adults aged 60 and above is more than 800 million and this figure has been projected to increase to over two billion in 2050. In Sub-Saharan Africa, the proportion of this age group has increased from 4.7% in 2005 and has been projected to increase to 5.5% in 2030 (Research document on ageing in Africa – Velkoff et al ).In Sierra Leone, the proportion of this age group  was 3.6% of our National Population in 2012 and it has been projected to increase to 7.5 %  in 2050 (Global Age Watch Report card  for Sierra Leone , 2013). It is significant to note that the actual number of people in this age-group in our population is increasing ( 2% Growth rate ) even though the  above proportion is small ( 2004 National Population and Housing Census report).

Older adults as a vulnerable social group are faced with special health challenges including losing their ability to live independently because of limited mobility, frailty or other physical or mental health problems and some may even require long-term care. They suffer more commonly from depression, suicide, dementia, alcohol and substance abuse, misuse of medications and anxiety disorders. At least 20% of these conditions are unrelated to normal ageing process as has been misconstrued by lay people.

Barriers  in our  setting such as  stigma, ageism with myths and misconceptions, limited training of primary care physicians in the care and management of geriatric patients, gaps in service delivery, service disintegration in diverse ways have  ideally contributed to the limited / non- availability of  mental health services  for  our older adults

Mental Health has been recognized has a serious health issue in Sierra Leone based on prevalence rates ( 13% of adult population)  data from the World Mental Health Survey (2004) in which it was indicated that  at least 420,000 people in this country have had a mental disorder in the past 12 months. The country summary report  estimates that  only 0.5% of these people have access to treatment and Severe depression ( 4%),psychosis (2 %), Severe Substance abuse (4 %), Epilepsy (1 %) and Mental Retardation( 1%) were the commonest reported mental disorders.  Severe depression in the older adult is difficult to diagnose  and its commonest complication of suicide is responsible for a significant number of deaths every year.

The Revised National Mental Health Strategic Action Plan 2014-2018 now provides a positive perspective  on action for older adults and other vulnerable groups in our society including age specific services, mobile programs, effective treatment for depression , training sessions of staff an d advocacy packages for policy makers/ politicians on the unique needs of older adults in our society.

Therefore, the National Mental Health Program of the Ministry of Health and Sanitation in collaboration with WHO , Mental Health Coalition and other development partners solicit your  fullest support in the implementation of our revised Action Plan for Mental Health 2014-2018.

Submitted: Dr Andrew Muana, MD                                   Medical Superintendent, SL Psychiatric Hospital                   Head of NCD/Mental Health Focal Person,(Ministry of Health and Sanitation).

Mental illness can be managed.

Persons with mental illness can successfully manage their symptoms, recover fully and may never have any other mental health related challenge for the rest of their lives. This is especially true for mild and moderate conditions, like anxiety and depression. More severe conditions may require longer treatment, but affected persons can live their normal lives and attain their potentials as long as they are regularly taking their medications and treatment.

Are the drugs for mental illness available?

A:Yes, they are available.

What should we do when our family  member or friend has a mental illness?

  • Don’t abandon him/her. No, we should care for him/her, support him/her and courage him/her to receive treatment.
  • Take him/her to a nearest counseling center or institutions that provide mental health care.

Are people with mental illness violent and do they pose a threat to society? 

A: No, research has shown that the most violent people suffer from mental illness. Individuals with mental illness are more likely to be victims of violence and physical abuse/maltreatment than for them to be the perpetrators.

In our Sierra Leonean society, like in most African states, mental illness is most often seen as mysterious occurrences that can create fear in the minds of people. But with scientific advancements today, we now have greater understanding about the cause and treatment options for various types of mental illness. However, the stigmatization of mental illness and individuals/families who suffer from these problems persist in our communities, with various misconceptions still very commonly held.

What is mental illness?

Mental illness is a health problem that causes disturbances in perception, belief, thought, processes and mood. It is a spectrum, ranging from mild conditions, like anxiety disorder, to the more serious psychotic states.

Some common causes of mental illness.

Stress: Stress is your body’s way of responding to any kind of demand. It can be caused by both good and bad experiences. When people feel stressed by something going on around them, their bodies react by releasing chemicals into the blood. These chemicals give people more energy and strength, which can be a good thing if their stress is caused by physical danger. But this can also be a bad thing, if their stress is in response to something emotional and there is no outlet for this extra energy.

Trauma: A person is traumatized when something horrible happens to him or someone around him that endangers safety, e.g., rape, war, torture or natural disasters.

Loss and Death: When someone close to you, either in the family, home, or work place, dies.

Signs and symptoms of mental illness.

  • Difficulties with sleep.
  • Lack of appetite.
  • Abnormal thinking patterns or speech.
  • Extreme ranges of emotions which are persistent (e.g., lasting for more than two weeks).
  • Becoming excessively withdrawn, losing interest in usual activities and so on.

Types of mental illness

Depression: Severe despondency and dejection, accompanied by feelings of hopelessness and inadequacy. A condition of mental disturbance, typically with lack of energy and difficulty in maintaining concentration or interest in life.

Anxiety: A general term for several disorders that cause nervousness, fear, apprehension, and worrying. These disorders affect how we feel and behave, and they can manifest real physical symptoms.

Alcohol and Drugs Dependence: A psychiatric diagnosis (a substance-related disorder) describing an entity in which an individual is  addicted to alcohol, either physically or mentally, and continues to use  despite significant areas of dysfunction, evidence of physical dependence, and/or related hardship.

Schizophrenia: A chronic, severe, and disabling brain disorder that has affected people throughout history.

People with the disorder may hear voices other people don’t hear. They may believe other people are reading their minds, controlling their thoughts, or plotting to harm them. This can terrify people with the illness and make them withdrawn or extremely agitated.

Acute or brief psychosis Characterized by distortion of thinking and perception, inappropriate or narrow range of emotion, incoherent or irrelevant speech, hallucinations, excessive or unwarranted suspicion. It is caused by severe abnormalities of behavior, such as disorganized behaviors, agitation, excitement and inactivity/over activity.

How common is mental illness?

A: It is very common, with every 1 in 5 persons on this earth, at risk of developing one mental health problem or the other, during their life time. However, most of these problems are usually mild conditions.

Are people born with mental illness?

A: No, even though some families may inherit a risk of the illness, they may not be afflicted by the illness. However, problems during pregnancy, delivery and early life may increase the risk of developing mental illness in the future, especially if there is some damage to the brain. It may also develop in adulthood, even without any family history of such in the past.

Mental health is everybody’s business.

Good mental health is when somebody feels good about themselves, can cope with the stresses of life, and can meet their normal day-to-day responsibilities.  When someone is mentally healthy, they can maintain good relationships with those around them and effectively contribute to society.

Stresses and worries are a normal part of life,  but sometimes they become too much to cope with, and we need help from those around us.  When Someone’s life is being affected significantly, we call it mental illness.

Mental illnesses are conditions that affect how somebody thinks and feels. A mental illness can prevent someone from caring for themselves, working and doing things that they find enjoyable. Sometimes their behavior can be strange to those who don’t know what they are thinking.

Common mental illnesses include depression and anxiety. One of the reasons why people can develop mental illness is because they have too many worries or stresses in life, and not enough support and understanding from those around them.A mental illness can affect anyone regardless of age, gender, race or religion.

Mental illness is more common than you think!

– 1 in 5 of the world’s children and adolescents are estimated to have mental illnesses or problems

– Every year, on average, 800,000 people commit suicide around the world

– By the year 2020, depression will be the leading cause of disability globally

Source: World Health Organization, 2012

Mental illness is NOT everything you have heard…

Mental illness is NOT a curse

A mental illness is a sickness. It is not caused by an attack from an evil spirit.

Mental illness is NOT someone’s fault

It is important not to blame someone for having a mental illness. A mental illness can happen to anyone, regardless of their beliefs or things they might have done in the past.

Mental illness is NOT contagious

You cannot ‘catch’ a mental illness from talking or touching someone or eating together with them.  In fact, treating them like anyone else in your community will help their illness improve!

People with mental illness should NOT be chained or tied up

The majority of people with mental illness are not violent. If a person is acting bizarrely and you are afraid for their (or other’s) safety, talk to a trained mental health professional and ask for their help.

There IS hope for people living with mental illness…

 Mental Illness IS treatable

Mental illness can be treated with medications and talking therapies.  These should be offered by somebody trained in mental health care.

People with mental illness CAN contribute to society

With treatment, a person with a mental illness can lead a normal life.  They can go to school, go to work, marry and have children.

People with Mental Illness DO have human rights

A person with a mental illness should be treated like anyone else in your community.  They have the right to food, water, shelter and education. They should not be beaten, made fun of or locked up.

You CAN make a difference

If you, or somebody you know, has experienced mental illness, than SPEAK UP! Bring together a group of other people who have been affected by mental illness and show your communities how to treat people with mental illness with respect!

Tell your community that mental health is their business too!

Mental Health: Your concerns answered

In October 2007, BBC Radio Norfolk’s breakfast show explored the issue of mental health in a series called Head First. Maggie Wheeler, chair of the Norfolk And Waveney Mental Health Trust answers your questions.
Q: How long have you worked in mental health?
A: I’ve been chair of the trust for about four and a half years but I’ve spent the last 30 years or so working as a social worker and social care manager.
Q: According to national figures, Norfolk has a high rate of prescribing anti-depressants. Why is this?
A: Nobody is quite sure why. One possibility is that there are more people with mental health problems in Norfolk, though there’s no particluar reason why there should be. There is another argument that people are getting good access to their GP and that the GPs are responding to that. Anti-depressants are not the only answer. But it’s not an ‘either or’ with medication and other kinds of therapy, I think sometimes you need both. There’s not a ‘one size fits all’.
Q: Some people have said that their doctors were not well prepared for people with mental health problems. What should people do if they are not happy with the service they recieve from their GP?
A: One of the things they can do when they see their dcotor is ask if they can see a link worker. Link workers are people who are trained in mental health, with a nursing or social care background who can work with the individual and also help the GPs to know what more is available out there.
Q: Do you think there’s enough care in the community? Some people have suggested that there should be more help outside the hospital environment.
A: I think the whole future is about caring for people in their communities. I think the phrase ‘care in the community’ has become devalued over the years. What we know is that most people want to carry on living their lives in their own home, carry on working if they can, carry on being a student, a mother, a father…whatever it is that you and I would characterise as being our unique lives. It’s about finding a way to carry on with that while you’re recovering from mental illness, or while living with mental ill-health.
Q: What would you say to someone who’s worried about becoming dependent on anti-depressants?
A: If people are concerned about that, it’s really important they go back to see their doctor. I think most GPs, when they’re prescribing anti-depressants, are asking people to come back regularly to be reviewed. Certainly anti-depressants isn’t something you should suddenly stop taking.
Q: There seems to be a lot of help available for people who live in Norwich – what about those in rural areas? How can you reassure people about the way care in the community is going to develop here in Norfolk over the next few years?
A: One of the reasons it’s important to enable people to have care in their own homes is that the further you live away from a centre the harder it can be to access services. So the more we can do to avoid people having to come to Norwich, or wherever it might be, the more money we can invest in the teams that will go out and treat people in their own homes. We have the same challenge that every agency in Norfolk has, of providing equal services across a huge geographical area. I think our services are good right across the county, but they will feel different in different places.
Q: What’s the future for mental health services in Norfolk?
A: One of the things we’ve done quite considerably is changed the way people are treated. People now spend much less time in hospital, which means that we need fewer hospital beds, so we can invest the money back in the community teams. I can’t quote you an exact figure off the top of my head, but we’re having to have a long hard look at the very best way to spend the money we have.

Source: BBC Website

Mental Health: Your concerns answered

In October 2007, BBC Radio Norfolk’s breakfast show explored the issue of mental health in a series called Head First. Maggie Wheeler, chair of the Norfolk And Waveney Mental Health Trust answers your questions.
Q: How long have you worked in mental health?
A: I’ve been chair of the trust for about four and a half years but I’ve spent the last 30 years or so working as a social worker and social care manager.
Q: According to national figures, Norfolk has a high rate of prescribing anti-depressants. Why is this?
A: Nobody is quite sure why. One possibility is that there are more people with mental health problems in Norfolk, though there’s no particluar reason why there should be. There is another argument that people are getting good access to their GP and that the GPs are responding to that. Anti-depressants are not the only answer. But it’s not an ‘either or’ with medication and other kinds of therapy, I think sometimes you need both. There’s not a ‘one size fits all’.
Q: Some people have said that their doctors were not well prepared for people with mental health problems. What should people do if they are not happy with the service they recieve from their GP?
A: One of the things they can do when they see their dcotor is ask if they can see a link worker. Link workers are people who are trained in mental health, with a nursing or social care background who can work with the individual and also help the GPs to know what more is available out there.
Q: Do you think there’s enough care in the community? Some people have suggested that there should be more help outside the hospital environment.
A: I think the whole future is about caring for people in their communities. I think the phrase ‘care in the community’ has become devalued over the years. What we know is that most people want to carry on living their lives in their own home, carry on working if they can, carry on being a student, a mother, a father…whatever it is that you and I would characterise as being our unique lives. It’s about finding a way to carry on with that while you’re recovering from mental illness, or while living with mental ill-health.
Q: What would you say to someone who’s worried about becoming dependent on anti-depressants?
A: If people are concerned about that, it’s really important they go back to see their doctor. I think most GPs, when they’re prescribing anti-depressants, are asking people to come back regularly to be reviewed. Certainly anti-depressants isn’t something you should suddenly stop taking.
Q: There seems to be a lot of help available for people who live in Norwich – what about those in rural areas? How can you reassure people about the way care in the community is going to develop here in Norfolk over the next few years?
A: One of the reasons it’s important to enable people to have care in their own homes is that the further you live away from a centre the harder it can be to access services. So the more we can do to avoid people having to come to Norwich, or wherever it might be, the more money we can invest in the teams that will go out and treat people in their own homes. We have the same challenge that every agency in Norfolk has, of providing equal services across a huge geographical area. I think our services are good right across the county, but they will feel different in different places.
Q: What’s the future for mental health services in Norfolk?
A: One of the things we’ve done quite considerably is changed the way people are treated. People now spend much less time in hospital, which means that we need fewer hospital beds, so we can invest the money back in the community teams. I can’t quote you an exact figure off the top of my head, but we’re having to have a long hard look at the very best way to spend the money we have.

When does your mental health become a problem?

People often feel sad during difficult life events

Continue reading the main story

What is depression?
Can CBT really change our brains?
One in four people are expected to experience a mental health problem, yet stigma and discrimination are still very common. Myths such as assuming mental illness is somehow down to a ‘personal weakness’ still exist.

How do we define mental health?

A person who is considered ‘mentally healthy’ is someone who can cope with the normal stresses of life and carry out the usual activities they need to in order to look after themselves; can realise their potential; and make a contribution to their community. However, your mental health or sense of ‘wellbeing’ doesn’t always stay the same and can change in response to circumstances and stages of life.

Everyone will go through periods when they feel emotions such as stress and grief, but symptoms of mental illnesses last longer than normal and are often not a reaction to daily events. When these symptoms become severe enough to interfere with a person’s ability to function, they may be considered to have a significant psychological or mental illness.

Someone with clinical depression, for example, will feel persistent and intense sadness, making them withdrawn and unmotivated. These symptoms usually develop over several weeks or months, although occasionally can come on much more rapidly.

Mental health problems are defined and classified to help experts refer people for the right care and treatment. The symptoms are grouped in two broad categories – neurotic and psychotic.

Neurotic conditions are extreme forms of ‘normal’ emotional experiences such as depression, anxiety or obsessive compulsive disorder (OCD). Around one person in 10 experiences these mood disorders at any one time. Psychotic symptoms affect around one in 100 and these interfere with a person’s perception of reality, impairing their thoughts and judgments. Conditions include schizophrenia and bipolar disorder.

Mental illness is common but fortunately most people recover or learn to live with the problem, especially if diagnosed early.

What causes mental illness?

Continue reading the main story
How common are mental illnesses in the UK?

Anxiety will affect 10% of the population
Bipolar disorder will affect one in 100
One in every 150 15-year-old girls will get anorexia, and one in every 1000 15-year-old boys
20% of people will become depressed at some point in their lives
OCD will affect 2%
Personality disorder will affect one in 10, though for some it won’t be severe
Schizophrenia will affect one in 100
Source: Royal College of Psychiatrists

The exact cause of most mental illnesses is not known but a combination of physical, psychological and environmental factors are thought to play a role.

Many mental illnesses such as bipolar disorder can run in families, which suggests a genetic link. Experts believe many mental illnesses are linked to abnormalities in several genes that predispose people to problems, but don’t on their own directly cause them. So a person can inherit a susceptibility to a condition but may not go on to develop it.

Psychological risk factors that make a person more vulnerable include suffering, neglect, loss of a parent, or experiencing abuse.

Difficult life events can then trigger a mental illness in a person who is susceptible. These stressors include illness, divorce, death of a loved one, losing a job, substance abuse, social expectations and a dysfunctional family life.

When is someone thought to be mentally ill?

A mental illness can not be ‘tested’ by checking blood or body fluids. Instead it is diagnosed, usually by an experienced psychiatrist or clinical psychologist, after studying a patient’s symptoms and monitoring them over a period of time.

Continue reading the main story
How ICD-10 classifies bipolar affective disorder:

‘A disorder characterized by two or more episodes in which the patient’s mood and activity levels are significantly disturbed, this disturbance consisting on some occasions of an elevation of mood and increased energy and activity (hypomania or mania) and on others of a lowering of mood and decreased energy and activity (depression). ‘

Many different mental illnesses can have overlapping symptoms, so it can be difficult to tell the conditions apart.

To diagnose a mental health condition, psychiatrists in the UK may refer to the World Health Organisation’s International Classification of Diseases (ICD) system. This lists known mental health problems and their symptoms under various sub-categories. It is updated around every 15 years.

Some experts argue that the current system relies too strongly on medical approaches for mental health problems. They say it implies the roots of emotional distress are simply in brain abnormalities and underplay the social and psychological causes of distress.

They argue that this leads to a reliance on anti-depressants and anti-psychotic drugs despite known significant side-effects and poor evidence of their effectiveness.

For symptoms and more information, visit NHS Choices

Source: BBC Website

England’s Mental Health Services ‘in Crisis’

England’s mental health services ‘in crisis’
By Michael Buchanan
BBC News

Care Minister Norman Lamb; “I know there are problems and I am absolutely determined that we address them”Continue reading the main story

The mental health service in England is in crisis and unsafe, says one of the country’s leading psychiatrists.

Dr Martin Baggaley, medical director of the South London and Maudsley NHS Trust, spoke out as an investigation by BBC News and Community Care magazine reveals more than 1,500 mental health beds have closed in recent years.

Many trusts have all their beds filled.

Care Minister Norman Lamb said the current situation was “unacceptable” and provision must improve.

While there was a drive to treat more people in the community, he said beds must be available when patients needed them.

System ‘inefficient, unsafe’
Freedom of Information requests were sent to 53 of England’s 58 mental health trusts, by BBC News and Community Care, and 46 trusts replied.

The figures show that a minimum of 1,711 mental health beds have been closed since April 2011, including 277 between April and August 2013.

This represents a 9% reduction in the total number of mental health beds – 18,924 – available in 2011/12.

Three quarters of the bed closures were in acute adult wards, older people’s wards and psychiatric intensive care units.

Northumberland, Tyne and Wear NHS Trust has cut its inpatient beds by 157, while St George’s and South West London has removed 155 beds.

Behind the statistics lie the consequences for staff and patients.

On the morning Dr Baggaley spoke to the BBC, he said a severely distressed patient had been transferred from Croydon to Hertfordshire as there were no beds in London.

He has 50 patients in beds outside his trust, some as far away as Somerset.

He said: “We are in a real crisis at the moment. I think currently the system is inefficient, unsafe.

“We’re certainly feeling it on the front line, it’s very pressured, and we spend a lot of our time struggling to find beds, sending people across the country which is really not what I want to do.”

Increased demand

Lucy Bowden sought voluntary psychiatric help, and was told no beds were available
Lucy Bowden ended up in the back of a police van due to a lack of beds after voluntarily seeking help.

The 33-year-old, who self-harms, was left wandering around the grounds of her local accident and emergency unit after being told there were no psychiatric beds available after she’d been treated following an episode.

Eventually the police were called, who had to section her to force her local psychiatric hospital to provide her with care.

She recalls: “They couldn’t find anywhere so they were saying I’d have to go in to police custody, in a police station which would mean I’d have to go into a cell. Eventually they found a bed and I had to go into the back of a police van, in the cage in the back. It was horrible.”

The bed closures are only part of the problem.

There is also increasing demand for mental health services, according to Dr Baggaley.

Dr Martin Baggaley: “There seems to be a genuine increase in demand”
“There seems to be a genuine increase in demand,” he said. “That’s partly explained by a reduction in beds, by resources coming out of the health system, the squeeze on social services budgets, and by the general economic situation.”

Average occupancy levels in acute adult and psychiatric beds are running at 100% according to the FOI figures from 28 trusts.

Half of these trusts had levels of more than 100%; all of them had occupancy rates above the 85% recommended by the Royal College of Psychiatrists.

The problems of running at capacity are highlighted by the tragic case of Mandy Peck. The 39-year-old told psychiatric staff she was feeling suicidal but her local mental health service centre said they had no beds available. A day later she jumped to her death from a multi-storey car park. A subsequent investigation found that a bed had actually been available.

Care Minister Norman Lamb said: “Current levels of access to mental health treatment are unacceptable. There is an institutional bias in the NHS against mental health and I am determined to end this.

“More people are being treated in the right settings for them, including fewer people needing to go into hospitals. It is essential that people get the treatment they need early and in the community but beds must be available if patients need them.”

Dr Geraldine Strathdee, National Clinical Director for Mental Health from NHS England, said the key was to strike the right balance between providing sufficient hospital beds and helping patients to be treated at home, or in the community.

“We need to make sure the people who are commissioning services have the information they need about the level of need in their area. We have to get this right for people.”

Marjorie Wallace, chief executive of the charity SANE, said: “It is all too easy to find the cuts demanded by NHS efficiency savings in mental health.

“If a patient has heart failure or is in a coma, a bed has to be found. But for a person in mental distress, this is not seen to be as necessary.

“Being turned away when seeking help only reinforces patients’ feelings of rejection and hopelessness and can in our experience drive them to suicide.”

http://www.bbc.com/news/health-24537304