Depressed? Join the queue, please

    Despite the independent sector having the expertise and resources
    to help people with mental health problems, the NHS continues to
    ignore it. With NHS beds so heavily used by patients with
    schizophrenia and other psychotic disorders, patients with other
    chronic mental illnesses are losing out.

    Common non-psychotic mental illnesses, such as depression, anxiety
    and addiction, can be as debilitating as psychoses. The NHS’s focus
    on assertive outreach, early intervention, and crisis resolution,
    mainly for people with psychotic disorders, leaves many sufferers
    in a treatment limbo, unable to function effectively in many areas
    of their lives. Swift referral to appropriate secondary care can
    make a dramatic difference by relieving symptoms and helping with
    practical matters.

    The World Health Organisation predicts that by 2020 depression will
    be the second most common cause of ill health in the developing
    world. As it is, in the UKnearly half of all cases of depression go
    unrecognised and untreated, and about 10-15 per cent of depressed
    people end up taking their own lives. And depression accounts for
    up to 15 per cent of the work of primary care.

    Yet depression is one of the most treatable mental illnesses, so
    many people are suffering unnecessarily. Unless patients are
    suicidal they often wait more than a year before starting
    psychological treatment.

    In physical health care patients are routinely referred to the
    independent sector if waiting list targets are missed. But that
    doesn’t happen in mental health care, making it the only major area
    of disability discriminated against in this way – bewildering,
    given that mental health has its own national service framework and
    is one of the government’s top three priorities.

    And where is psychiatric treatment in the choice agenda the
    government is consulting on? In the same way as delays for hip
    replacements and other procedures automatically trigger a referral
    to the independent sector, the time is right for the same thing to
    start happening in mental health. The independent sector has the
    resources, the clinical governance and the will to provide the care
    that can be so rare in the NHS.

    Chris Thompson is director of health care services at the
    Priory Group.

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