I wrote the following article for the House Magazine, which produced a special supplement to mark the 60th anniversary of the NHS
I cannot claim to have 60 years of experience of NHS mental health services but my first encounter was in the 1950s, so not too far off! Visiting my father in Hollymoor, one of the large asylums for psychiatric patients on the outskirts of Birmingham, was very daunting for a young child. I remember the long wide corridors and strange people shuffling along but I liked the large, well-kept gardens, where we sometimes met my father at work. Little seemed to change over the next 20 years though there was the introduction of music therapy where my father used to play his clarinet.
The visits to Hollymoor and the neighbouring hospital, Rubery Hill (well known to locals as the “loonie bin”) usually took place after a traumatic period for the whole family culminating in my father being “sectioned” – I remember the word but had no idea what it meant! Another strange expression was ECT and I recall conversations about the improvement now that anaesthetics were used and my father describing how, when he first received this (electric shock) treatment, he was strapped down on the stretcher and was fully aware of his twitching body.
My overwhelming opinion of mental health services was that they cut in at a crisis and, in between, usually when my father was in his depressive phase, the general attitude was “out of sight, out of mind”. This could never be the case for us as a family, of course, but I did not share my feelings outside the home because I felt ashamed. It was difficult to explain to friends why my Dad didn’t go out to work and sometimes behaved rather weirdly. He often felt that people were talking about him and would say that he was the only one who was really sane. Another symptom was the complaint that his head didn’t belong to him and he would sit with his trousers rolled up rubbing his legs as if checking he was all in one piece. He was very demanding of my mother, who only kept her own sanity by going out to work. When she had a day off, to get some time to herself, she would have to set off as if going to work. It has been easier to talk about these things since my father died.
Once I became an elected representative, first as a local councillor, my experience of mental health issues expanded beyond that of my own family. This has been mainly through contact with relatives or neighbours of patients, troubled by the effects of similarly poor services and the lack of co-operation between health and local authority housing and social services departments. Contact from people who recognise they have a mental health condition is less frequent which, in itself testifies to the stigma associated with mental illness. People with other medical conditions don’t hesitate to contact their MP when dissatisfied with the NHS! We will know we have made progress when the same can be said for “users” of mental health services. Thus I was absolutely delighted when it was proposed that the brand new psychiatric hospital to replace Rubery and Hollymoor was going to be located on the same site as the “normal” hospital.
Expecting mental health services to be more like other health services seemed a good idea until I visited the new hospital. I was shocked. Gone was the light and space provided by our Victorian forbears and the concept of asylum. Utility, rather than therapy, was the order of the day. The building, with its narrow corridors and cramped wards soon became known as the pizza hut. Though we had new investment, mental health services remained the “Cinderella” of services and the emphasis was on reducing in-patient beds and “care in the community”. Soon it became clear that expecting to reduce costs by such measures was counter-productive and, towards the end of the last Conservative Government, the talk was of a need to provide a co-ordinated spectrum of services. However, it took the incoming Labour Government to significantly increase resources to enable this idea to begin to become a reality.
As the expiry of the first 10 year National Service Framework approaches, the improvements are palpable. The World Health Organisation has judged the UK’s mental health services to be better funded, structured and supported than anywhere in Europe –nevertheless, when NHS Trusts face financial difficulty, it still seems that mental health services are the first to be trimmed.
The priority now being given to the role of patients and carers in the development of mental health services and to introducing a choice of therapies is particularly heartening. Extra money was made available for psychological therapies largely as a result of sound economic arguments. The latest “big idea” is social inclusion and getting people in to work but this could backfire if inappropriate pressure is placed on people as soon as they start to feel better.
The truth is we have a long way to go before we achieve mental health services of which we can be truly proud but I can end with the good news that demolition has just started on the pizza hut, which has been replaced with three new purpose built hospitals. The Barberry, the Oleaster and the Zinnia Centre have names derived from traditional medicine, heralding a new holistic approach to treatment and a respectful approach to patients. The facilities are superb!
Click here for further information about my policy work on mental health and to read about my work as co-Chair on the All Party Parliamentary Group on Mental Health
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