Mental Health Provision in Primary and Secondary Care

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I am increasingly concerned about the deterioration in services provided for mental health patients in primary and secondary care in the U.K. The government talks about increasing the funding for mental health but there is no evidence of this. The NHS is suffering and children and adolescent services in my area of SE England, Kent seem particularly bad, There is very little family therapy provided in adult services and I am aware that this is also the case in young people’s services. Behavioural Family Therapy is provided by the Early Intervention in Psychosis Service and the Older Adults Services, but secondary services rarely provide family therapy and there is only one therapist working in our local mental health trust which covers the whole of Kent and a population of 1.5 million.

Locally substance misuse services which often see dual diagnosis clients with multiple mental health and social problems have had funding cut year on year. The contract for East Kent has been reduced by £800,000 this is reflected in staffing which is the biggest cost. It is also reflected in the qualifications of the staff, they no longer provide family work or one to one therapy although most service centres have the resources and equipment for family interventions which they did in the past provide under different contracts. This is a tragedy because the benefit of family interventions are well recognised and most rehabs have a family service as does Alcoholics Anonymous which have services for children and partners. CAMHS who also used to provide some family work including systemic family therapy rarely now employ family therapists therefore obtaining this intervention in a timely and appropriate fashion is a rarity.

I see young people every day whom have been bullied at school and are experiencing anxiety and depression yet have received no psychological support in their school setting or from young people’s services. The absence of these interventions results in their mental health issues becoming more serious as they have been left untreated and what could have been resolved if dealt with promptly becomes a larger and more debilitating issue. Children whom should be enjoying their life and their school days are not enjoying either and often start to self medicate on illegal substances particularly cannabis which compounds the problem and detracts from the young persons ability to function. Often cannabis being a drug that introduces the user to a vista of new substance use experiences and to the range of products on sale on the “Dark Web” which is an extremely accessible shopping area.

The absence of joined up thinking in relation to services and the impact of this Tory governments austerity measures have resulted in a postcode lottery in relation to services. Early treatment prevent major mental health illness later in life. Thus saving the taxpayer money and assisting the individual in leading a productive and worthwhile life. This is why Open Dialogue availability across the country is so important.

About Author: I am Jane Hetherington Principal Psychotherapist with KMPT currently working in Early Intervention Services n Kent. I trained as an integrative psychotherapist and have worked in substance misuse, primary care and psychosis services. I have completed the Open Dialogue training and will be involved in the new Open Dialogue Service.

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