Mental Health - The decline in provision and increase in need Jackie Sawford is Head of Counselling at Northamptonshire’s Teamwork Trust, a charity which has been providing a counselling service to its local community for over 12 years. Here, Jackie talks about mental health, the decline in provision, the increase in need and the bleak reality that means people in desperate need of help are having to be turned away … Mental health provision is declining, need is increasing and people in need of support are being turned away. In the last decade alone mental health services in Kettering have deteriorated and in some places completely disappeared. Community Mental Health teams have declined and people who used to be supported by these teams are being discharged without support into the community. Therapy and counselling services are struggling to cope with demand and, due to a lack resources are reducing their capacity or closing altogether. There also appears to be few psychotherapy services available for those with enduring and complex needs. Meanwhile, demand for mental health support continues to increase. Society has become an increasingly stressful environment, breeding poor mental health. In addition, growing public awareness of mental health issues, encouraged by high profile figures such as HRH Princes William and Prince Harry, are making people ever more aware that mental distress can be acknowledged and support sought. So, how are people to get support? Our Kettering counselling service is routinely overwhelmed by the sheer volume of people being referred, or referring themselves. Having closed our books for several weeks in order to reduce our waiting list, within four weeks of opening again we had over 60 people waiting to be assessed. We are again faced with closing the books, thereby turning away local people in desperate need of help. We have a team of 16 qualified counsellors at Teamwork Kettering, of whom 14 are unpaid volunteers. This team, dedicated as it is, cannot anywhere near meet the current demand. Who are the people being referred to us? They are people experiencing mental distress for reasons including anxiety and depression, trauma and abuse, severe or chronic mental health issues, relationship challenges and bereavement. We see over 18-year-olds who are experiencing stress due to exams, social media and transitions to work and further education. People in crisis are also referred to us and the percentage of people presenting with suicidal intentions has significantly increased. For the first 11 years of our service we experienced no client suicides. This year we have heartbreakingly experienced two. Here is what we are doing at Teamwork Trust We provide talking therapies for around 90 clients a week, at least 60 of whom are receiving a service at our Kettering centre and live in the Kettering area. 4,672 therapy sessions were provided by us in the last year. Our clients receive an average of 16 sessions each, and longer if needed, although some do require far less. This far exceeds the average of six offered by the statutory sector and many other services. The author Jeanette Winterson said in her autobiography, ‘Why be happy when you could be normal?’ “There is no place for madness nowadays. Crucially there is no time for it. Going mad takes time. Getting sane takes time.” But time is expensive and we as a society cannot afford to offer it. At Teamwork we go the extra mile. We pick up a large number of clients for whom the Changing Minds IAPT Service and guided self-help is not totally effective. Local wellbeing teams refer their own clients to us. Most of our clients could genuinely not afford the £40 to £50 a session required by private therapists. At Teamwork we ask for a donation, which can be as small as £5 a session. As elsewhere within Teamwork, volunteers are our lifeblood and we offer student placements for counsellors who have reached a certain level in their diploma training. We are currently developing a service to complement our counselling provision, offering longer term monthly or six weekly support sessions to clients who have completed their therapy but require a lighter touch, less intensive form of support in order to prevent the revolving door syndrome. We also work closely with Teamwork’s wellbeing and education team to refer clients into classes and groups which complement their therapy. These wellbeing classes also support clients who are on the waiting list for therapy while they wait to start. So, what are the challenges we face at Teamwork? First and foremost is the sheer volume of demand in relation to our very limited resources. Secondly is the complexity of issues that some clients are presenting with. A percentage of people we assess are requiring much longer-term support or a specialist psychotherapeutic input, which we cannot offer. There is nowhere to refer these inappropriate referrals on to. We may refer them back to their GPs knowing that there will be little else on offer to meet their needs. Thirdly is the lack of joined up services and our inability to directly refer clients into the services that are out there. Most mental health provision is only accessed through GPs, which gives clients more hoops to jump through and takes time. Why does this all matter to you, in this place, today? There is real mental health suffering in Kettering and, we therefore suggest, the wider county and the UK as a whole. Mental ill health is no respecter of people. These are your children, your siblings, your parents. They are your friends, your colleagues, your neighbours. If a society is judged by how well it cares for its vulnerable members then society as a whole is failing. It is time to act and we ask that the voluntary sector be empowered to be a more equal partner in a more integrated mental health service. There needs to be a wider variety of options out there and the ability to refer into those so that our clients get the holistic and seamless support they deserve and need. Before it’s too late.