Helping mental health patients to support each other through peer support services could both improve outcomes and save money, according to clinical psychologist Dr Rachel Perkins. She spoke to Jeremy Dunning
(picture: posed by models, Rex Features)
The government will set out its vision for the future of mental health early in the New Year, against a backdrop of cuts.
Accounting for 10% of the £100bn health service budget in England, mental health must help the NHS deliver £15bn to £20bn of efficiency savings over the next four years to avoid cutting provision for patients.
One possible solution is peer support, which involves the use of people with personal experience of mental illness to provide mutual support or to be paid to provide services to others.
There is a growing evidence base showing peer support services have the potential to reduce hospitalisation and demand for other mental health services by helping patients recover from illness. A recent King's Fund report on mental health productivity found that, while further evidence was needed of its cost-effectiveness, peer support could both improve outcomes and reduce costs.
One of the leading advocates of peer support is clinical psychologist Dr Rachel Perkins, now a freelance consultant and formerly director of quality assurance and user experience at South West London and St George's Mental Health NHS Trust.
Perkins, who has suffered mental health problems herself, says: "Treatment is only a very small part of rebuilding your life. Professionals don't hold the key to helping people rebuild and get their lives back again. I would say that peer support has been central in helping people recover."
Earlier this year, the charity Together produced a report, Lived experience - Leading the way. Perkins wrote the foreword.
It cited cases of the potential of peer support to save money, such as the Leeds Survivor-Led Crisis Service, which was set up by service users over a decade ago to provide an alternative to hospital admission. It supports people at a cost of £180 per day per person while a stay at an acute hospital as an in-patient is about £259 per day, providing a saving of £28,000 each year, the report says.
While the report found peer support services were already growing, Perkins says the current economic context provides the opportunity for further expansion as providers and commissioners examine the costs and benefits of existing services.
"If you think about the last major change in services, when we closed the asylums, it would be difficult to argue it was done by radicals; it happened because people took a look at the cost of maintaining them," she says.
Looking at existing service provision means questioning whether "statutory mental health services the best place to be providing ongoing support" for service users, and, potentially, examining the number of psychiatrists and psychologists that mental health trusts need to employ.
A focus on peer support is in line with the government's emphasis on patient and user empowerment, as set out in its NHS White Paper, and its vision for adult social care.
This suggests that it could form a significant part of its plans for mental health, through this will be confirmed in the forthcoming strategy.
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