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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