A clinical negligence lawyer’s ‘spin’ on the Mental Health Taskforce Report

Sharon Allison has been campaigning for improvements in mental health care, particularly in East Anglia, for several years and is working closely with families whose tragic stories about failure in care have been in the press over the past week. This is her take on the taskforce report.

As a lawyer who has been litigating mental health cases for nearly a decade, the taskforce report is a significant read for me. The long awaited weighty report has been a long time coming for many, but none more so than patients’ families who have paid the ultimate price in losing a loved one to suicide following failures in their mental health care.

The report contains a considerable number of statistics which demonstrate quite starkly the abysmal state of our mental services provision, following neglect by previous governments.

First and foremost, the report tells us that mental health care should be accessible 24/7, seven days per week. The reality is that anything outside of Monday to Friday is going to fall to Accident & Emergency departments who we hear are massively overstretched, under resourced and completely demoralised. Our current Health Minister has a mutiny on his hands at present while trying to achieve his seven day NHS care for physical conditions, which he doesn’t accept needs extra pay or staff incentives. In light of this, I don’t think that access to specialist mental health care 24/7 in the current climate is likely any time soon.

Referrals for first experiences of psychosis should take place within two weeks. This is a serious mental health condition, however as Fiona Bruce pointed out to David Cameron in a recent BBC interview, in reality the waiting time is more like 32 weeks. If demand on resource is truly that high, which I have no reason to question that it is, there is a significant bridge to gap. It is not going to happen overnight, so what happens those who need that care now?

For me, as a lawyer who has dealt with countless cases of mental health care failure leading to suicide, the anomaly is the comment that mental health problems disproportionately affect people living in poverty, who are unemployed or who face race discrimination. In my experience, it is the young adults who come from loving, well supported families and who function at a high level who are often misunderstood and their true state of mental health is never acknowledged. Mental health illness has no stereotype and, in my view, by identifying certain groups of individuals, you are ostracising the others further.

The report also comments on the importance of families. However, it seems to me that a small amount of additional funding could address the significant problems faced through parties working in isolation from one another. I understand that for mental health support to be effective, there needs to be triangulation of care between the individual, the family supporting the individual and the mental health service. You wouldn’t ask a nurse to care for a patient with a physical condition in hospital 24/7 without giving him/her a medical history and care plan going forward. Why is it that we can leave families of highly vulnerable young adults to be cared for in the community due to lack of inpatient beds, with little or no information whatsoever to deal with a complex mental health condition?

For me, whilst the Taskforce report gets us all talking about mental health, the reality of this vision is pretty unlikely in the near future. There is too much to do with a limited pot of money.

David Cameron quite clearly accepted the recommendations from the report but would not commit to delivering them. He simply stood by his pledge of £1 billion funding to improve services and simply tells everyone that we must do more to put mental health on an equal footing with physical health.

My view is that there is an easy win by reshaping the way we learn from mistakes that have already happened. For years, when something goes wrong such as a suicide in a mental health matter, the Trust conducts its own investigation and produces a report with an action plan. These reports are often shared with the family too, but I remain unconvinced that anything happens as a result of it thereafter.

How can you properly peer review yourself? Often these reports either will tell you that they have got it 100% right and then an independent report will tell you otherwise. Or they will identify some shortcomings, produce an action plan and then nothing happens. Either way, it is hardly satisfactory for patient safety.

Unless and until Trusts outsource such investigations to an independent body and remain open to suggestions for change, there will be continued loss of opportunity to ‘do things better’ for patients. There is no greater price to pay than the loss of a life. In my view, we have lost enough already. It’s time to start making that loss count.