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The dire state of mental health services in the UK
The dire state of mental health services in the UK has really hit home recently. I have been fortunate to work as a private Cognitive Behavioural Therapist since 2009. The money may not be as consistent but the working conditions are far superior, and of course you get to be your own boss. I recently decided to join an IAPT service (on a part time basis) that is run by the National Health Service (NHS) in the UK. IAPT stands for Increased Access to Psychological Therapies and in principle it’s a great step forward in supporting people with mental health issues.
The things is, if you’re going to do something, do it properly. Although the IAPT concept is a good idea, it is clearly under funded and staff are exhausted and burnt out.
Currently where I work, if you want to be seen by a Cognitive Behavioural Therapist you will wait at least one year. In fact, the waiting is so long that in order to reduce the waiting times, therapists are seeing clients fortnightly. I honestly don’t see the value in providing someone with two hours mental health support per month. In my opinion, this could possibly do more damage than good, especially for depressed clients. The mind boggles at how such a great concept, that could do so much good in the community is struggling due to lack of interest/funding from the Government.
Since the founding of the NHS in 1948, physical care and mental health care have largely been disconnected. There is an increasing call on healthcare professionals to consider psychological wellbeing when treating the physical symptoms of a condition and vice versa. Mental Health has always been seen as less of a priority compared to physical health and although this is slowly changing there is a long way to go. It’s common sense to me that if you take care of people’s mental health, they may indeed have less physical ailments.
If you have a chronic health condition and/or a mental illness, it can a be a vicious cycle: Your mental health can trigger physical symptoms, and physical symptoms can trigger mental health issues, and so on.
There are various ways in which poor mental health has been shown to be detrimental to physical health.
People with the highest levels of self-rated distress (compared to lowest rates of distress) were 32% more likely to have died from cancer. Depression has been found to be associated with an increased risk of coronary heart disease.
Psoriasis is an auto-immune condition commonly triggered by stress. It affects 1.8 million people in the UK and can impact on emotional as well as physical wellbeing. Yet, a recent report from the British Association of Dermatologists (BAD) highlighted that only 4% of Dermatology Units have access to a counsellor.
Schizophrenia is associated with:
- double the risk of death from heart disease
- three times the risk of death from respiratory disease.
Irritable Bowel Syndrome
Chronic Fatigue Syndrome
This is because people with mental health conditions are less likely to receive the physical healthcare they’re entitled to. Mental health service users are statistically less likely to receive the routine checks (like blood pressure, weight and cholesterol) that might detect symptoms of these physical health conditions earlier. They are also not as likely to be offered help to give up smoking, reduce alcohol consumption and make positive adjustments to their diet.
Researchers analysed data about more than 160,000 people in the UK, of whom 4,353 died from the disease during a 14-year period up until 2008.
They found those who were in psychological distress had a 32 per cent great chance of later dying from cancer.
One of the researchers, Dr David Batty, of University College London, said: “The results show that compared with people in the least distressed group, death rates in the most distressed group were consistently higher for cancer of the bowel, prostate, pancreas, and oesophagus and for leukaemia.
“Our findings contribute to the evidence that poor mental health might have some predictive capacity for certain physical diseases but we are a long way off from knowing if these relationships are truly causal.”
“Of the biological mechanisms, mood disorders such as depression have been implicated in immune pathways and are known to provoke inflammatory responses,” the paper said.
“Prolonged immune dysregulation can compromise the repair capacity of the exposed cells, potentially contributing to genetic instability and mutations, alterations in DNA repair, and inhibition of apoptosis.
“Immune dysregulation can also lead to a worse prognosis for several carcinomas, including cancer of the colorectum, lung, mesothelium, and stomach.”
I have seen first hand how depression can lead to early death. My mother was ill and managed to stay fairly well until she gave up mentally. Once the depression took hold, the twinkle in her eyes went out. She had given up and it was clear to see that her body was giving up too.
Hopefully, one day the powers that be will wake up and give mental health the priority that it deserves – people who are mentally healthy live longer, are more productive members of society and reduce general levels of stress for everyone (happier, easier to get on with, more laid back, good values and ethics, assertive rather than passive or aggressive).
Further info/resources: https://www.mentalhealth.org.uk/a-to-z/p/physical-health-and-mental-health