50,000 people with mental health problems 'left to rot'

April 19, 2004

More than 50,000 people with long-term mental health problems are "left to rot" by the NHS because they do not qualify for emergency psychiatric care, the charity Rethink warned last week.

It identified a "forgotten generation" of middle-aged patients who survive with an abysmal quality of life, often isolated in tower blocks or run-down estates.

Many of the day centres providing them with support were closed over the past few years so that the government could divert resources into crisis intervention and services for younger people, said the charity.

Growth in these areas allowed ministers to claim mental health was one of the NHS's top three priorities. But it should not come at the expense of long-term service users, the charity urged.

However, Rosie Winterton, health minister, told the Guardian newspaper that the government had invested an extra £300m last year to improve services for everyone with mental health problems.

She said: "Reform of mental health services is a government priority. More than 130 crisis resolution teams, over 220 assertive outreach teams, and more carer support networks are now in place to help and support people with long-term mental health needs and their carers."

A Rethink survey of more than 3,000 patients found 16% were over 35 and had been on medication for a psychosis for more than 10 years, but got no hospital care or home support over the previous 12 months. If this was typical of the 400,000 people diagnosed with psychosis in England, the number being neglected by the government's mental health reforms would be 64,000.

Since patients taking part in the survey were likely to be less isolated than average, the true figure was probably larger. The charity said it was being conservative in estimating the forgotten generation at "more than 50,000".

In many cases, they were being supported by parents who struggled to cope as they grew older and were anxious about what would happen when they died.

A Rethink survey of families caring for people with long-term mental illness found 80% did not feel health and social services would be able to provide the necessary support if they were unable to so so. More than half said they had never had a choice about whether to continue providing substantial support.

Cliff Prior, Rethink's chief executive, said: "Lost and Found has uncovered the tip of an iceberg and the government must act now to address the needs of this ‘forgotten generation’, who tell us they are worried about what will happen when family members are no longer able to care for them."

The charity asked the government to pay more attention to people who are stable but experiencing a poor quality of life. Rethink believes annual physical health checks must be available to everyone with long-term mental health problems.

The charity said that, as a minimum, health checks should cover * measurement of blood pressure and weight * regular dental and optical appointments * detection of diabetes and cancer * monitoring of the chest and heart, which may be adversely affected by tobacco smoking * detecting and monitoring the side-effects of medication

People with long-term mental health problems should be able to access holistic support, including * Psychological or talking therapies * access to best medications * choice of professional * choice of treatments * decent accommodation * regular and sufficient income * meaningful occupation * opportunities to build social networks

Andrew Lansley, the Conservative health spokesman, said: "Rethink has called for all mental health patients to be offered effective involvement in planning of their mental health care. The Conservative party agrees entirely, and is currently looking at how our patient's passport can be extended to deliver this."

Rethink's Lost and Found report (pdf)
Guardian article

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