'No responsibility for mental health'

For those not familiar with the Primary Mental Health Service, your first contact is a questionnaire. Questions such as, 'are you considering ending your life'. It wouldn't take a trained psychiatrist to confirm my GP's observations that my mental health was not at its best. After a few long months' wait, the desperately needed appointment arrived. At last I was going to receive some help.

After more form filling, it was decided I suffered from severe anxiety and depression. Equipped with my folder of self-help tips and an invite to a group session at the PEH, I was sent on my way. The list for therapy was too long, get back to us if you really want to be on it. Well I didn't have the strength to argue with anyone or push for services and didn't want to sit in a group of strangers discussing my woes. I wanted one-to-one help.

A year later, having unsuccessfully tried to help myself, I decide the situation is increasingly intolerable and present myself at the GP, 'please can you refer me again'. The questionnaire arrived, still not a pretty picture. The lady who subsequently telephoned me had obviously looked at my file for my previous results as she commented how I'd further declined. I'm now told my situation is too serious to be addressed in eight sessions, so I'm being discharged back to my GP.

There is much talk of Mental Health Services being deemed as important as physical health. Hopefully patients aren't told, 'no rehab for your knee sir, it's going to take more than two months'. 'Hmmm, a stroke, no that requires lots of support, speech therapists, physios, occupational therapists – I think it's best you go back to your GP'.

I often think my GP should wear a superhero costume to work, expected to be the master of everything and the gatekeeper to services which are increasingly impossible to access, unless blessed with private medical insurance or a healthy bank balance.

Health & Social Services are obviously working very hard to tighten their purse strings, but at the expense of common sense.

Serious mental health issues do not disappear if you ignore them, the symptoms get louder, alcohol or even drugs may become involved, families break up, the physical health deteriorates, sick notes get longer, employability vanishes.

The woes snowball as your life literally runs away down that steep hill. All of this at a cost to individuals, families, businesses and the States themselves.

You would think that being deemed too serious for primary care, I would be referred to secondary.

However, unfortunately it seems you need a major diagnosable mental health condition to seek their help – bipolar, schizophrenia etc.

Who knows, maybe I have one of those – I'd need to see a psychiatrist to find out.

So, Health & Social Care, where would you like those of us who need the care in the middle?

Fortunately the Primary Care did provide me with an answer – I should proceed to church and contact their counselling services. I've only heard wonderful things about Philippi, but they are apparently incredibly busy, no doubt dealing with those people who Health & Social Services are failing. No accountability by the Mental Health Services, just a goodbye, go seek help with the third party sector. Just how many people deemed sick enough by their GP are being rejected by the mental health teams, because that's exactly how I feel, let down and abandoned.

In my experience the third sector is being increasingly expected to bridge the gaps in health care provision.

However, how can the Primary Care Mental Health Service call itself a success when they cherry pick who they treat and reject those of us who don't fit the bill, suicidal or not?

Meanwhile the fabulous GPs are left trying to manage our mental health in their surgeries. No doubt A&E and the police are left handling the fallout too.

I can't think why recent headlines remarked on the increase of anti-depressant prescriptions, what else is there to offer?

So Emilie and the Health & Social Care Committee, what exactly is your responsibility? How many people are the service turning away? Will you be accountable when some poor person decides to go further than ticking the 'I'm experiencing suicidal thoughts' box?

Name and address withheld.

Editor's footnote: A spokesman for HSC responds: Thank you for providing HSC with the opportunity to respond to your reader's letter.

HSC does not consider mental health to be secondary to physical health and has made significant financial investment in facilities and resources to provide mental health services over recent years.

The committee has made it clear through the Policy & Resource Plan that mental health should be given equal consideration.

HSC recognises the importance of ensuring that people do not fall through the cracks of the health and social care system and strategies such as the Mental Health & Wellbeing strategy are designed to prevent this.

HSC has partnered with KPMG to progress the design of the future model to deliver health and social care services. This will include much greater integration between primary care, secondary care, community services and the third sector, together with the various private and commercial businesses involved in the provision of care.

Moving on to the specific issues raised in this letter, without knowing the full circumstances it is difficult to offer an informed reply and your reader is encouraged to make contact to discuss their concerns.

However, HSC wishes to clarify that routes into secondary mental health services depend on the nature of the clinical presentation and professionally assessed need.

GPs are fully aware of the referral process and this is not dependent on patient self-assessment.

In relation to the Primary Care Mental Health and Wellbeing Service, this is a service that was developed to meet the needs of those with mild to moderate anxiety and/or depression. This was a previous gap in service provision. The service is based on the UK NHS Improving Access to Psychological Therapies model. The service offers a variety of short-term evidence-based interventions on a stepped care basis. The service does not offer longer term therapies and is not set up to help those who are at risk to themselves.

The service is in high demand and has previously held long waiting times. However, there have been significant improvements made to the service this year and we are pleased to say that there is no longer a waiting list for this service.

If anyone has concerns about the mental health services provided by HSC or wishes to find out more about access to these services, contact The Oberlands Centre, tel. 725241 ext 3561.