There has been plenty of fine words but this has been undermined by cuts in funding and lack of progress in delivering this legal obligation particularly for severe and enduring mental illness and those needing secondary care.
We are a long way from Parity of Esteem. Too many places where CYP can't get MH treatment until/unless they are 'critical'. We wouldn't run physical health care like this. Why run MH services in this way?
Measures like GAD-7 and PHQ-9 are alarmingly simplistic and give little indication of long term recovery. IAPT reporting may include WASAS (work and social adjustment scale) measures, but my understanding (which may be out of date) is that it's the clinical measures which are used when publishing success rates. I would argue that this gives an exaggerated view of success and skews interventions towards short term clinical outcomes rather than longer term recovery.
The CCG & LA in the area that one lives in is charged with securing heathcare service to that population, Commissioning plans has to be produced, from the JSNA and Health & Wellbeing Strategy, In my personal experience lay representation on CCG Govening Board, HWB's SCN & Clinical Senate Citizen Assemblies ( with the exception of East of England) is populated with well meaning individuals that are not focused enough. In the South West only Healthwatch members need apply to SCN's, I rest my case
How will the NHS he CCGs to meet their legal obligations. Also how will standards be raised across mental health to meet best practice across services? Patient voice needs raising and long term care and support needs to be addressed for those who need it. Too much change to short term support which just means it is a revolving door for many in and out of secondary care and lives lost or living with no hope a decent quality of life.
Parity of Esteem is the phrase coined to mean that Mental Health issues should be as much of a priority to the NHS as those of physical health. Currently, as many will testify, this is not the case. I work for a Strategic Clinical Network (East of Eng), which has projects on its workplan to try to address this in the medium-long term. However, little can happen without resource, and decisions must be made on how and where that comes from.
The policy of 'No health without mental health' should be fully honoured. The mental health of all patience and staff should be a base line priority.
It is well established that good psychological health results in better physical health. In addition, there is a growing body of evidence that appropriate use of tailored psychological interventions, particularly talking therapies, can both provide effective treatment of medically unexplained symptoms, reducing repeat presentations, and improve outcomes in the treatment of long term conditions. Short term mental health budget constraints are preventing long term health savings.
Common Mental Health Disorders i.e. Anxiety,Depression or mixed with respect to the patient reported severity would be assessed by use of GAD-7 an PHQ-9 questionnaires and then depending on the score a treatment pathway offered from lealfets to 1-1 individual/group CBT should be offered. Where this is the case then patients and carers can be confident the their CCG is compliant with NICE Clinical Guidelines 123, Common Mental Health Disorders ( 2011).
Unless we pay more for our health services then they will continue to decline. There must also be frank and open public accountability of all services including NHS financial accounts for all areas.
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