Rethink calls for changes to community mental health care

Rethink Mental Illness is pressing for a change in the way we treat those who experience severe mental health problems. Instead of focusing all our resources and attention on traditional care settings, the charity wants to see the creation of robust communities of care organisations that can support those people who need their help. In its new report, Building communities that care, the charity sets out a compelling vision for the future of care

Once a person has been diagnosed with a severe mental health condition, and treatment has commenced, the things that matter most to them are levels of social connectedness, financial stability, employment and housing, Rethink says. It’s from this start-point that Building communities that care begins.

The things that matter most to them are levels of social connectedness, financial stability, employment and housing, Rethink says.

For people living without access to services like supported housing, help with employment and debt advisors, the care that’s delivered by the NHS in any setting could be wasted, the charity believes.  “It’s too easy to fall into the trap of believing that diagnosis and treatment is the end of the journey,” says Mark Winstanley, CEO of Rethink Mental Illness. “The reality is that the opposite is true. Even with treatment, our mental health can be affected by so many other aspects of day-to-day life, like the availability of social support networks and financial stability.”

Rethink Mental Illness believes that the importance of community care has been overlooked for decades by successive governments – a situation that has only changed with the publication of the NHS Long Term Plan. The charity has set out its vision for improvements that could be made by 2024.

“With so many contributing factors, it’s only right that the treatment of mental illness receives a societal-wide response,” Mark continues. “We’ve been guilty of overlooking the expertise that others can offer. Today is the first step towards changing that; bringing experts together to work towards a common goal.”

What makes a world-leading community model of care?

The rise in access to rapid interventions like IAPT (increasing access to psychological therapies) has made psychological therapy easier for those with less severe mental health conditions to get. In the report, Rethink Mental Illness is calling for a similar approach to be adopted for those with more complex health challenges. It wants patients to experience:

  • shorter waiting times for assessment;
  • access to NICE-approved therapies as and when people need them, delivered through a multi-disciplinary team;
  • trauma-informed care;
  • appropriate and informed discussions about medication and potential side effects;
  • connecting people to wider provisions such as care navigators; and
  • integration with sufficiently funded addiction services.

The charity wants to see a greater focus on social connectedness, with patients being offered access to peer support groups based around shared interests and the expansion of social prescribing projects.

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Primary care has a key role to play in supporting physical wellbeing, says the report, and efforts should be made to publicise annual physical health checks. Across the health and social care system, physical exercise should be made more accessible; the report calls upon local authorities to put reasonable adjustments in place for people with mental illness.

The things that matter most to them are levels of social connectedness, financial stability, employment and housing, Rethink says.

Systemic support

A safe and welcoming home, an income (or access to finance) and the opportunity to work and thrive are key components of a rewarding life, Rethink says. Here are the improvements to support and services the charity would like to see.

Housing

  • Making sure everyone has access to a safe environment to live in.
  • Co-operation between clinical teams and supported housing staff.
  • Community mental health services to record how living situations may negatively impact mental health.

Finance

  • Better communication between clinicians and providers of financial advice.
  • Better tracking by the Department of Work and Pensions (DWP) on the impact its policies have upon those with mental illness.
  • DWP to create environments that are more comfortable for those with mental illness, such as offering a private meeting room.

Employment and volunteering:

  • Support from the DWP when transitioning into work.
  • Collaboration between clinical staff, the voluntary sector and the private sector to develop workplace skills.
  • Local mental health hospitals to offer volunteering opportunities whilst people are in hospital
  • Making reasonable adjustments in job applications.

Working together

Transforming the way that the health, social care and welfare systems work isn’t going to be easy, but Rethink Mental Illness believes that the impetus – and financial support – created by the NHS Long Term Plan is a ‘once in a lifetime’ opportunity that we can’t pass up.

The report concludes with a ‘call to arms’, calling for an end to a fragmented system which often means experts and services are not able to work together to deliver the best care for individuals. It wants to see the development of a national mission to change the way we treat severe mental illness, led by the NHS. The report puts primary care on the frontline, encouraging the greater incorporation of lived-experience into the ways that services are designed and delivered.

The charity has set out a bold, and vital, vision for mental health care and support that transcends organisational and professional siloes. Its success could transform care and support for some of the most vulnerable in our society, giving them greater hope for a better future.

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