Posts tagged ‘mental health’
Cuts to mental health care are costing the NHS millions of pounds long-term, a report has said.
More cases of psychosis and schizophrenia now end up in hospital rather than being treated in the community, it said.
Rethink Mental Illness published the report with the London School of Economics.
Cuts mean fewer people have access to early intervention treatment, such as talking therapy, Rethink said.
It said the NHS could save more than £50m a year by shifting its focus.
We recognise we must work to ensure that in everything we do mental health has parity of esteem with physical health”
Dr Martin McShaneNational director, NHS England
Britain’s recession in 2008 led to cuts across the NHS, as the government struggled to deal with ballooning deficits.
The report said it costs on average £13 a day to support someone with psychosis or schizophrenia in the community.
It said this compared with the £350 average daily cost of keeping a mental health patient in hospital.
‘Shift of resources’
Meanwhile, 54% of the psychosis budget was being spent on inpatient care rather than on preventive community services, the report found.
Family therapy, where families of people with psychosis and schizophrenia are supported, cognitive behavioural therapy, and peer support could help cut long-term costs of care, it said.
Health Minister Norman Lamb said early access to treatment in the community was “often the best option” for people with psychosis and schizophrenia.
He said: “Not only do they benefit from being in familiar surroundings among loved ones but they are less likely to need costly hospital stays.”
Mr Lamb called for a “shift of resources” to preventive care and said that the government had given NHS England a “clear objective” to put mental and physical health on a par.
Mental health trust budgets for 2013-14 have fallen by 2.3% from 2011-12.
The cuts have meant mental health trusts have been asked to save almost 20% more from next year’s budgets than hospitals.
Budgets for community mental health teams, which give continuing support to patients to prevent their health deteriorating to crisis point,reached a plateau for 2011-12 but referrals rose by 13%.
‘Parity of esteem’
The report also predicted more than £50m a year could be saved if early detection services could be strengthened.
It said the NHS saved £989 every time people were treated with cognitive behavioural therapy instead of going to hospital.
Rethink said mental health accounted for 23% of the disease burden in England but received only 13% of the health budget.
Dr Martin McShane, national director for long-term conditions at NHS England, said the report was “very helpful” and was supportive of what the organisation wanted to achieve.
He said: “We recognise we must work to ensure that in everything we do mental health has parity of esteem with physical health.
“We have significantly invested in improving access to psychological therapies and dementia care.”
An increasing number of under-18s with mental health problems in England are being treated on adult psychiatric wards, it has emerged.
Using Freedom of Information requests, the BBC and online journal Community Care found the number of under-18s being treated in adult units was in its hundreds – and rising.
Data returned by 51 of the 58 NHS mental health trusts in England showed that 350 under-18s have been admitted so far to adult mental health wards in 2013-14, compared with 242 two years earlier.
Meanwhile, many children are having to travel hundreds of miles to receive hospital treatment, as Michael Buchanan reports.
The Organisation for Economic Cooperation and Development, OECD, is using the World Economic Forum to highlight the issue of stress in the workplace.
The OECD says it is one of the key challenges – in the UK alone, nearly 500,000 people were off work for mental health reasons last year.
OECD Secretary-General Angel Gurria told BBC World that white-collar workers were more prone to stress but there did not to appear to be any further link to type of employment.
“You matter to me. In a way I cannot explain, you matter to me. And you, you are a marvel… you and all the parts of you.”
It’s not the kind of thing you normally write to a complete stranger.
But after graduating from college and moving to New York City, Hannah Brencher was feeling anxious and depressed. She found herself not wanting to be around other people and “just really unravelling”.
Then she started writing love letters to strangers and leaving them all over the city. The first letter she left on a train simply addressed: “If you find this letter then it’s for you.”
Since then she has left letters in libraries and cafes, and even hidden them around the United Nations building.
To whoever finds this letter
You and I don’t know one another. We may never sit and laugh over cups of coffee. We may never dance in the same circles or yawn together by the midnight hour. None of that really matters to me. It is so small and meaningless to the things I wish you would know on a daily basis: that you are lovely. That you are worthy. That those hands of yours were made for mighty, mighty things.
You probably think I am crazy. You are probably sitting here with this letter in your hands thinking, you cannot know that… you don’t know me… you don’t know a stitch of me. Yes, you’re right. But I know all the things I thought I never deserved. I know how very hard it once was to love myself and value myself and even find myself worth the reflection in the mirror. And so I know I am not alone in needing a boost some days, in needing to know that I matter to someone somewhere.
You matter to me. In a way I cannot explain, you matter to me. And you, you are a marvel… you and all the parts of you.
A girl just trying to find her way
“What I noticed was that my sadness and loneliness got backburnered,” she told the BBC. “I found something that allowed me to take the focus off of myself.”
Hannah and her More Love Letters campaign are part of a growing number of organisations shouting about the beneficial effects of random acts of kindness for givers as well as receivers.
It might sound a bit like new-age nonsense to some people, but new research suggests being kind might actually be good for your mental health.
A study published in the journal Emotion reports that performing acts of kindness may help people with social anxiety to feel more positive.
Dr Lynn Alden and Dr Jennifer Trew, from the University of British Columbia, asked volunteers with high levels of social anxiety to commit multiple acts of kindness on two days a week over a four-week period.
“Sometimes people would give a small gift to somebody, or picking somebody up from work, visiting sick people, thanking a bus driver. They were actually fairly small acts,” explained Dr Alden.
They were small acts perhaps, but ones which had a much bigger impact.
More standard treatment for social anxiety disorder is cognitive behavioural therapy (CBT) adapted specifically for people who fear they will do or say something embarrassing in a social situation.
Social anxiety disorder
- It is the most common of the anxiety disorders.
- It is more common in women than men and often begins in adolescence.
- People fear they will do or say something embarrassing in a social situation and avoid those situations as a result.
- Physical symptoms include signs of anxiety such as blushing, sweating, shaking, heart pounding, muscle tension and upset stomach.
As part of this therapy patients are encouraged to face their fears about social contact, by putting themselves into a situation they would normally avoid or initiating conversation with new people.
In Dr Alden’s experiment a comparison group of anxious volunteers were asked to perform small “belief-challenging” tasks similar to these therapeutic ones.
Just like the kind acts group, this group were also increasing their levels of social contact, engaging in unfamiliar behaviour, and paying attention to others’ responses; all things which have been suggested to be important components in overcoming social anxiety.
At the end of the four weeks, participants in the kind acts group avoided social situations less and also reported increased relationship satisfaction. Performing kind acts appeared to have a bigger effect than CBT-like behaviour tasks.
The kindness offensive
A London-based initiative called the Kindness Offensive have been organising give-away events and encouraging kind acts since 2008.
They hold the world record for the largest ever random act of kindness for distributing 39 tonnes of goods in one day.
“It’s practically impossible to do an act of kindness without feeling good about yourself,” said the aptly named David Goodfellow, one of the founding members of the group.
“If you can make someone’s day a little bit better it will actually make your day a little bit better.”
Dr Nick Grey, consultant clinical psychologist and clinic director at the Centre for Anxiety Disorders and Trauma in London, was initially wary of the idea that performing kind acts might have therapeutic value for patients with anxiety disorders.
“I hadn’t seen the paper and I was sceptical from the title to be honest. But it’s a good paper and comes from a well-respected team.
“I don’t think that’s ever going to be a therapy in and of itself, but it could well be the kind of activity that could be integrated as part of a broader treatment.”
Dr Alden suggests that acts of kindness might be an initial step in a longer therapeutic pathway.
“Engaging in kind acts may help the person to get out and encounter other people and then we can use other techniques to help the person change their beliefs about themselves.”
But she urges caution about performing acts of kindness chosen by someone else or just to impress others.
“I think it has be done in such a way that the individual has a sense of autonomy. They are performing the act because they want to and not because it’s required by the group.”
Depression can happen during pregnancy too
More than a third of women who become depressed during their pregnancy have suicidal thoughts, suggests a snapshot survey carried out by the Royal College of Midwives and Netmums.
The poll of 260 mothers with antenatal depression found they were at greater risk of worsening mental health problems then women with postnatal depression.
Only 22% sought help from their GP.
Experts say women with the condition need more support.
The Department of Health has announced that £25m will be made available to improve maternity facilities for mothers and babies, and an NHS information service for parents is to include videos on how to spot signs of postnatal depression.
If we can identify women as early as possible then we could prevent them declining into much more serious mental health problems”
Cathy Warwick Royal College of Midwives
Antenatal depression, which occurs during pregnancy, is less known and talked about than postnatal depression, which happens after the birth of a baby.
This small survey suggests that those who suffer from depression during pregnancy are at greater risk of worsening mental health problems than those who have postnatal depression alone.
According to the survey, 80% of women with depression in pregnancy also went on to have postnatal depression.
About 56% of those surveyed had problems during their first pregnancy but almost 66% said they had problems during their second.
Just over half of the women said their illness had affected their relationship with their baby and 38% said they had problems bonding with their baby.
Only 30% were warned about antenatal depression by midwives and most of the women said it took a few months before they realised that they had a problem.
Just 22% sought medical help from their GP at that point – perhaps because only one in three women were aware of the possibility of becoming depressed during pregnancy.
Just 27% reported being asked how they felt emotionally during their pregnancy.
Hayley was 12 weeks pregnant when she started feeling awful.
“I had bad sickness and I just thought I was really tired, but it was getting worse,” she says.
“I was constantly crying. I didn’t want to talk about being pregnant and I kept imaging things were wrong with the baby.”
Everyone kept telling Hayley she was lucky to be pregnant, particularly since she had been told she would never conceive.
She went to GP for help but was given no support.
“Everyone is so aware of postnatal depression. They give you advice on the warning signs after you’ve had baby.”
Instead, she was crippled with fear and anxiety during her pregnancy and couldn’t get excited about the arrival of her first child.
“I went from being happy to living under black cloud.”
When Toby was born, everything changed and Hayley was on a real high.
During her second pregnancy, Hayley did not suffer antenatal depression, but she was diagnosed with delayed postnatal depression when her son Zac was two.
“I hit the black cloud again – but this time help was there immediately.”
Cathy Warwick, chief executive of the Royal College of Midwives, said the survey showed an urgent need to identify and help women with antenatal and postnatal depression.
“If we can identify women as early as possible then we could prevent them declining into much more serious mental health problems.”
Sally Russell, co-founder of Netmums, said depression and anxiety could make life very difficult for parents with a new baby.
“Midwives can do a lot to help and reassure, so they should be open with mothers and fathers-to-be about the condition and trained to spot the signs.
“Those suffering often don’t know who to talk to, so it’s essential they know they can be open and honest about how they are feeling with midwives.”
Health Minister Dr Dan Poulter, who announced the £25m fund to improve maternity services, said hospitals would be able to bid for en suite facilities, rooms where fathers can stay overnight or facilities like birthing pools.
“A new arrival in the family is a joyous time but can present challenges for mums and families, particularly new families. I want to help women and their partners as much as possible,” he said.
The NHS Information Service for Parents is available to every new parent to sign up to if their chid is under six months old. From next year it will support parents with babies and young children up to 18 months old.
Dr Poulter added: “Women with postnatal depression need care and support, not stigma. That’s why early diagnosis for this traumatic condition and support for parents is so important.”
In May, the government also pledged to recruit an extra 4,200 health visitors and give them training to diagnose postnatal depression.
One in 13 babies are born before 36 weeks
Being born prematurely is linked to an increased risk of a range of mental health problems much later in life, according to researchers.
Bipolar disorder, depression and psychosis were all more likely, the study in The Archives of General Psychiatry suggested.
The overall risk remained very low, but was higher in premature babies.
Experts cautioned there have since been significant advances in caring for premature babies.
Full-term pregnancies last for around 40 weeks, but one in 13 babies are born prematurely, before 36 weeks.
Researchers at the Institute of Psychiatry at King’s College London and the Karolinska Institute in Sweden analysed data from 1.3m people born in Sweden between 1973 and 1985.
They found 10,523 people were admitted to hospital with a psychiatric disorders, 580 of those had been born prematurely.
The academics showed full-term children had a two in 1,000 chance of being admitted. The risk was four in 1,000 for premature babies born before 36 weeks and six in 1,000 for those born before 32 weeks.
I don’t think parents should be worried”
Dr Chiara Nosarti King’s College London
Very premature babies were more than seven times more like to have bipolar disorder and nearly three times as likely to have depression.
One of the researchers, Dr Chiara Nosarti, said the real figures may be higher as milder conditions would not have needed a hospital visit.
However, she cautioned that the risk was low and the vast majority of premature babies are perfectly healthy.
She told the BBC: “I don’t think parents should be worried, but we know that preterm birth confers an increased vulnerability to a variety of psychiatric conditions and perhaps parents should be aware of this and monitor early signs of later more serious problems.”
She speculate that “disrupted development” may affect the babies’ brains.
The chief executive of the mental health charity SANE, Marjorie Wallace, said: “We already knew that premature birth may be linked to schizophrenia, but to see evidence linking it to a range of psychiatric conditions which required hospitalisation is striking.”
The baby care charity Bliss said it was well-established that early birth can affect the developing brain.
However, its chief executive Andy Cole cautioned that some of the people in the study were born “40 years ago and that neonatal clinical practice to limit neurological damage has been transformed over the past four decades, with significantly improved outcomes seen today.”
There have been developments in cooling the brain to reduce any damage as well as improvements in ventilation to ensure enough oxygen is getting to brain.