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Billy Boland: What is the point of reaching out, if only to get knocked back by an ineffective system?

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There is no doubt that raising awareness about mental health is a good thing. We’ve campaigned to break down stigma, carried out research, and developed policy. We’ve encouraged people to come forward, and many have found the courage to do so.

But herein lies the problem; as more people come forward, more and more wait to be seen.

Although “hidden” waiting lists are known to be an issue in the NHS, the lack of data mean that it is difficult to track progress. It’s why the Royal College of Psychiatrists commissioned a poll of over 500 adults across the UK who had a diagnosis of a mental illness.

Shockingly it found that two fifths of those waiting for their second appointment ended up contacting emergency services, and 11% ended up in A&E.

Furthermore, nearly two thirds (64%) wait more than four weeks between their initial assessment and second appointment. One in four (23%) wait more than three months and one in ten (11%) wait longer than six months.

And behind these data, there are often harrowing stories—the patients who tell you that waiting becomes a cruel game especially after the initial assessment. One tells of experiencing “false hope,” and that it got so bad that she was sectioned and sent to an inpatient ward. Her abiding view is that it wasn’t necessary, and that somehow, she isn’t important enough.

This is certainly not what we should be expecting from a caring and effective health service. Most importantly, it could put people off ever seeking help from the system again. What is the point of someone reaching out, if only to get knocked back by an ineffective and slow system?

Targets for waiting times already exist for some mental health services. However, although some of these are technically being met, it does not always mean that patients get quick access to the critical interventions they need.  Limbo can kick in when the person is left waiting for the particular health and social care support they desperately need to get better.

Part of the issue could be down to ineffective planning and a lack of resourcing. But what we really need to highlight here is rising demand and the fact that there simply are not enough specialists to support and treat everyone.

It’s why the Royal College of Psychiatrists has launched the Choose Psychiatry campaign. We are calling on the Government to commit to a multi-year settlement for workforce training and education to allow for the growth in the mental health workforce—including via new roles—and to double the number of medical school places in England by 2028/29.

With a dedicated, sufficient workforce we can help those who desperately need it, when they need it.

Billy Boland, chair, faculty of General Adult Psychiatry, Royal College of Psychiatrists, and a consultant psychiatrist and deputy medical director, Hertfordshire Partnership University NHS Foundation Trust.

Competing interests: None further declared. 

The post Billy Boland: What is the point of reaching out, if only to get knocked back by an ineffective system? appeared first on The BMJ.


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