A debate in the House of Commons will today try to persuade the government to save the acclaimed Henderson hospital in Surrey, one of England’s handful of “therapeutic communities”.
The Henderson treats people diagnosed with personality disorder and residents run the service in partnership with staff.
But referrals to the unit dwindled when commissioning was switched from the NHS nationally to local mental health trusts. In December, the South West London and St George’s Mental Health NHS trust said it could no longer afford to keep it open.
Kath Lovell, a former Henderson resident argues the hospital should be saved as it provides a desperately needed personality disorder centre of excellence.
It is with immense sadness that there is a need to write this piece urging the government to consider the future of the Henderson, given that its closure is a very real prospect.
I feel extremely passionate that the Henderson must survive and I urge the government to consider the following points:
Firstly, the issue of financial outcomes. Although the cost of treatment per person seems very high, most people who go onto receive treatment at the Henderson have spent most of their lives in a revolving door pattern, frequently accessing and sometimes draining the resources of ill-equipped services such as A&E, primary and secondary care and acute mental health services. Indeed in the 18 months before I went to the Henderson I spent 11 months in a drug and alcohol programme that showed no efficacy in reducing my personality disorder (PD) symptoms and seven continuous months as an inpatient on an acute psychiatric ward interspersed with various trips to A&E after overdosing.
In the three years since leaving the Henderson I have neither attended A&E nor needed to be admitted to a psychiatric unit and I firmly believe that the cost of my treatment was recouped in the first 12 months since completing my year at the Henderson.
Secondly, there is the question of “worthwhile’ outcomes: How do you measure if a service is worthwhile? Is it all about how much money will be saved? What difference does a service like the Henderson make to people’s lives? In my case I believe the Henderson saved my life as I am sure that without this treatment, I would have continued with the destructive patterns that frequently resulted in serious self harm and suicide attempts. As a result I would likely be either dead or in hospital or prison.
Instead I am preparing to go back into full-time work, looking towards a bright future rather than at a bleak past. Not only was my treatment life saving, it helped me work towards a future, with optimism and a sense of recovery, something I could not have been able to sustain or even conceptualize five years ago. Many of my peers have gone on to educational opportunities, some completing degrees and professional training courses, others going back to work, and many putting something back into the mental health system through service user involvement. The most worthwhile outcomes for the majority of ex-residents include making significant improvements in social functioning, reductions in destructive behaviours and engagement in meaningful activity, these are not easily quantified by cost or financial saving but mean everything and more to those who achieve much after spending most of their lives socially excluded, disempowered, chronically distressed and labeled as ‘untreatable’.
Thirdly, the Henderson is a centre of excellence in terms of its knowledge base around personality disorder. Many of the newer pilot PD services are influenced in part by the Henderson and the model of treatment it delivers or by training and consultation from the outreach team. Many look to the Henderson as a source of inspiration and expertise and the loss of this centre of knowledge developed over the past 60 years could severely affect sustainability of new and existing services and dilute expertise.
I have worked as an expert by experience with the Henderson for the past two years and have been continually amazed by the innovative involvement and empowerment of service users which is unrivalled by any other initiatives I have been involved with on local, regional and national levels.
Why can’t everyone be treated in the community? Why have residential treatments? It is true that some would benefit from treatment offered in the community, but there will always be some whose behaviours and symptoms are so severe that they could not be contained in a community setting. I was deemed too unsafe to live in the community prior to my time at the Henderson, hence my extended period on an acute ward and this scenario was all too familiar with other residents’ histories. I now live independently in my own flat, an inconceivable thought five years ago. My argument is thus: there are pediatric departments in most hospital trusts, but there will always be need for a specialist hospital like Great Ormond Street, I believe the same to be true with Personality Disorder and the Henderson.
I implore for there to be solution that will secure a future for the Henderson that will ostensibly allow more lives to be changed for the better.
* Kath Lovell was a resident in the Henderson Hospital from September 2003 to September 2004. She is now project development manager for the charity, Borderline UK, and is a service user trainer.