1. Investing in Your Mental Health Why Things are going Wrong Chris Reynolds Herts Parts Patient & Public Involvement Forum Prepared for Hertfordshire County Council Health Scrutiny Committee, 12 June 2007 ITEM 2 PPIF PRESENTATION

2. Why Mental Health is Expensive You have a mental illness If at first you don't succeed in making a recovery... You become more depressed... The next time you try it is even harder... You become even more depressed... You can become a long term “institutionalised” mental health patient in the community

3. Investing in Your Mental Health PROBLEM 1 Too many expensive long term patients who didn't get appropriate treatment in time SOLUTION Better prevention, early diagnosis, and community support to catch new cases before they become a serious long term problem INVESTMENT Better Community Services NOW means less long term patients IN FUTURE.

4. Investing in Your Mental Health PROBLEM 2 There are many long term patients on who could recover given better support. SOLUTION There needs to be a network of community facilities to allow individually tailored recovery pathways. INVESTMENT Provide better and more appropriate community support NOW to aid patient recovery in FUTURE

5. What has Gone Wrong IIYMH strategy says: ONCE better community facilities are in place there will then be less need in the FUTURE for long term expensive treatments In 2006 NHS management said: IIYMH predicts saving on expensive treatment so lets cut the expensive treatments NOW – and improve community facilities when money is available sometime in the FUTURE These are diametrically opposite - Result Serious degradation in overall service

6. Some Areas which need Monitoring Community Support Organisations Delayed Discharge Numbers of Sectioned Patients Non-emergency first time admissions A & E - Suicides – Police – Prisons Social Services, Welfare Payments, etc Use of Tranquillizers The Right Care in the Right Place Goodwill and patient/staff moral, etc

7. The Importance of Confidence To maximise recovery from mental illness a patient, his carers, and professional support staff all need confidence in the future and in the relevant support organisations. Last year many organisations said changes proposed by the NHS would damage patients and the whole IIYMH Strategy. These objections were summarily dismissed as misguided by NHS management but evidence now suggests many were well-founded. Confidence in NHS management at the PCT level and above has been shattered. To restore the confidence needed to make IIYMH work senior NHS management need to show that they are professional enough to apologise for the damage that has been done to patients and IIYMH.