Improving access to services

You may have noticed my absence these past few weeks and wondered what was happening, or you may not. Household work meant that I had no internet connection at home and much as I had every intention of writing my pieces and then uploading via other sources I fell short of my goals. Not really of interest to my blog but then it made me ask if such a little upset in access to a resource would result in my giving up and not writing then did I really have any commitment to writing it.

 Not really relevant to my blog?

Well maybe not directly but still as I read about Scotland’s suicide services (http://www.guardian.co.uk/commentisfree/2012/jul/22/scotland-suicide-services) where it seems a large number of people who are seeking help because of their suicidal thoughts/ tendancy’s are being told they are not acceptable ie don’t meet the criteria to access NHS services and are being locked in a police cell for their own safety. Being locked up seems an odd answer to the situation of accessing services and prone to causing more harm than good, something that was the topic of a recent Scottish BBC programme. (sadly due to my internet problems I have not been able to see it).

But being unable to gain timely access to appropriate services for treatment of mental health issues is far from uncommon. If you look at the Community mental health survey 2011 you will see that of the people who are in contact with the service who had not received a talking therapy in the last year 14% had asked for it to be arranged. (full report found here http://www.cqc.org.uk/public/reports-surveys-and-reviews/surveys/community-mental-health-survey-2011). However much as many would argue that you cannot give what you do not have I’m convinced that there are far more factors at play, not least the amount of stigma involved in asking for help.

 The Adult psychiatric morbidity survey in England, 2007 quoted that of the 7.5% of people considered to have a common mental health issue that warranted treatment 24% were actually receiving any (http://www.ic.nhs.uk/webfiles/publications/mental%20health/other%20mental%20health%20publications/Adult%20psychiatric%20morbidity%2007/APMS%2007%20%28FINAL%29%20Standard.pdf page 11&12). The question of whether they were actively seeking a service is an important question and if not why not?

Part of the reason I feel sure is because they are actively in denial that they have a problem, either because they have no idea what constitutes a problem or because they cannot face doing something about it. And it is that part that I am interested in.

When people cannot face trying to do something about the problem.

There can be many, many reasons why people might shy away from getting help and societys stigma has it’s part to play however so too do other things.

The government and the NHS are trying to improve access to services whether it be talking therapies or hospital treatments for those groups that appear marginalised. I only wish that services such as those for deaf and blind and for lesbian, gay, bisexual and transgender (LGBT) young people (http://www.guardian.co.uk/healthcare-network/2012/jul/25/specialist-mental-health-lbgt-people) were being rolled out across the whole country, however they are not.

 I guess I was somewhat niave in my belief that services for blind and deaf came as standard in each PCT as to me it seemed obvious that they would need them. In the same way it seemed obvious that those of LGBT would also need them. Let alone people on the autistic spectrum, those with mental retardation and ethnic minorities/ poor English speaking minorities, however I do wonder how far their understanding of the problems faced by people reaches.

The reality for me is this that is only 25% of those who need treatment are seeking it then there is a more severe issue than the obviously marginalised groups. And this is where my story of the internet comes in. It’s about the extra effort to achieve what is needed.

 It might seem odd to most to use it as an example but then I don’t find it any odder than knowing how many people with mental health issues cannot or do not answer the telephone, or open their mail, or cannot fill forms in without descending into a panic, crying or anger fit. And I feel compelled to point out that actually it is not just those with poor English skills that suffer from this, that bureaucracy is a big cause of angst for many regardless of how smoothly they can negotiate their way through it.

Simply I find it amazing that people do not seem to understand that having a male or female doctor/ therapist may be a problem. That meeting in an office/ hospital or having someone in their home may equally be a problem, even having a doctor writing whilst you’re talking or not making eye contact enough can discourage vulnerable people from getting the help they need.

If people want to improve access to services they need to incorporate some adaptation to the needs of the patient for these things because really having people available to help in a timely fashion is only part of the battle of helping people and to me this means having therapist who can sign, who can speak different languages, who do not have offices but less formal settings within the community to which they serve, people who are trained in appropriate behaviours for those on the autistic spectrum etc. Not a small job to be sure but maybe as was suggested in the article about LGBT use of volunteer service providers and their facilities.

The proof of the pudding of course is in how many people are using the service and the services both for deaf, blind and LGBT are seen to be thriving isn’t it about time that the lessons learned on those projects are rolled out for everyone. And when I say everyone I really mean in all areas not just health care because although for many NHS treatment is a big problem, there are other areas that have just as many if not more problems. For instance schooling and education, work, benefits system and although for many these areas may be much better it seems for those with mental health issues these areas are lagging far, far behind.