The Abandoned Illness.

How outcomes for people with schizophrenia and psychosis can be improved has been reviewed in a new report by the Schizophrenia Commission. The Commission was established by the charity Rethink Mental Illness and headed by Professor Sir Robin Murray. The report, entitled "The Abandoned Illness", states in no uncertain terms that the many who suffer with psychotic illness (some 220,000 in England alone) are being let down by, in the words of Robin Murray, "a broken and demoralised system that does not deliver the quality of treatment that is needed for people to recover".
Among the many shortcomings of the system, Murray highlights psychiatric hospitals, which he states have become "frightening places where overwhelmed nurses are unable to provide basic care and support", and where "medication is prioritised at the expense of the psychological and social rehabilitation which are also necessary." Such is the condition of the hospitals that when people relapse they so do not want to return there that compulsion becomes necessary, so rates of sectioning rise. People with such illnesses also have poor access to GPs and general hospital care and as a result their lives can be shortened by up to 15 to 20 years, and fragmentation of services means that people are often "shuttled from one team to another as if on a factory production line". Early Intervention in Psychosis services, which are described as "the great innovation of the last 10 years", are also currently being cut.
Murray states that this is all despite great advancements in the understanding of mental illness. Gone, he says, are the days of the "ideological disputes", and it is now understood that both biological and social factors are involved, and that a diagnosis of schizophrenia does not mean an inevitable decline. So, he states, there are instances of people going on to recover and then leading productive lives with the help of understanding professionals. It is essential, he states, for the service user to be given hope that this is possible, instead of the defeatist attitude that this is the end of a person's useful life.
The estimated cost of the care for those with schizophrenia or psychotic illness is nearly £12 billion, and Murray says that this could be changed with the right sort of care, turning service users into contributors to the economy. The report goes on to highlight what needs to change if this is to be achieved. I will not go into all of those things here, so I urge you to read the report for yourselves via the Rethink website. One point which did stick out for me, though, was that reinvestment should be made in better community services and preventative programmes, including the provision of, in comparison to expensive acute units, cheaper and more therapeutic "recovery houses". The report states that the ambition of people returning to ordinary lives will not come to pass if such things are "dismantled by short term cost cutting restructures". In the light of what is happening to my own local resource centre in Shelton, which is now set for closure, this is sage advice indeed. With the closure of this centre, the only option available to those who are severely unwell will be a stay on an acute ward, exactly the sort of place that the report states is becoming "anti-therapeutic". So, short term cost cutting is exactly what appears to be happening in my local area, and the Bennett Centre, often spoken of as a place which is promoting the sort of things which the report talks about, will be the victim of such a blinkered approach. The Trust is doing, it seems, exactly what the report says it shouldn't if the care for people with psychosis is to be improved.
I hope that the advice in this report is then heeded, and I also hope that some of the things which have been mentioned by Robin Murray and his colleagues are reflected in some of the entries on this blog. Sadly, the advice contained in the report may have come just too late for the Bennett Centre, and I can't help thinking that more of us, staff and service users alike, should have protested more vehemently at its closure.