Professor Dinesh Bhugra claims that many sick patients are being discharged back into society, putting both themselves and others at risk. 14% of consultants’ posts are either unfilled or filled by a locum. Not enough British medics are choosing to train as psychiatrists, but visa restrictions means that foreign doctors cannot meet the shortfall. In addition, 209 are planning to resign or retire soon. Another research paper (to be published next week), shows that many wards are running at a 120% occupancy.
‘inpatient units … are likely to admit only those individuals who are the most disturbed, distressed or unwell. For such people especially, as they are unable to make the choice to leave, the ward is their home’.
Those who are most vulnerable are being put into a position where they are forced to endure even greater stress and upheaval. This is psychologically devastating – but even from a purely pragmatic standpoint, it makes no sense. Those discharged too early or without due care are likely to require more help, at greater cost than would otherwise have been needed. Far worse – they may well take matters into their own hands and harm others or themselves.
One such case was that of Lord Milo Douglas, the 34 year-old son of the Marquess of Queensberry. In 2009, after struggling for ten years with biploar disorder, he killed himself by jumping off a tower block.
A week before he died, Douglas went to his doctor and explained that he was feeling suicidal and wanted to be taken into care for his own protection. Instead, he came under the care of a home crisis team – in line with the Government’s policy of home treatment for the mentally ill. Two days after being assigned the team, he told the psychiatrist in charge that he was going to kill himself. Five days later, he did.
In 1955 there were 155,000 psychiatric beds in the UK. By 1982 that number was 45,000. According to the most recent NHS statistics, the average daily number of available beds for mental illness in England in 2009-10 was 25,503, of which 21,836 were occupied.
These are shocking statistics. What’s worse is that each statistic is actually a person, like Douglas. And behind that person, a family, devastated by their loss or trying to keep it together.
So what is the answer? More beds? More doctors? Sure, these are issues that need to be addressed. But it’s too easy to point the finger at health care provision and too easy to decry the limitations of “care in the community”. Surely the right kind of community is precisely the context for the best caring. So what about our community? As a church, we cannot expect ‘the professionals’ to ‘fix’ all our mental health problems. We’re going to have to figure out how to give gospel care in our community.