As a carer for a wife with a mental illness, I knew that life would change for both of us… I also knew it was not going to be easy. It was not going to be easy for me, not easy for my wife.
Now, there is an understatement for you!!! I couldn’t believe just how hard it was going to be for both of us, and all the family, all our friends… so called friends, they tended to run away. Friends I am making now however are of a different sort… they know the situation we are in, they accept it, as I accept their situations… with compassion, understanding and no little humility… there are people suffering beyond my wildest imagination, and my heart is with every one of them.
Sadly, I don’t think that the people who are supposed to be looking after vulnerable people see it that way. They seem to see mental health patients and carers, the most vulnerable of people, as an easy target to neglect, abuse, punish and cast away as an old dress.
Locally, the Adult Mental Health Service are designing a new Acute Care Pathway, defining how people should be treated from initial diagnosis through all aspects of the Service, both as an in-patient and a n out-patient. I have to say that the pathway has a lot to commend it, the Trust is making great efforts to understand patient and carer requirements from the service, and I believe that once finalised this Acute Pathway will make a huge difference to all of us, will be a major step forward.
At least, that is the theory, I genuinely believe that the Adult Mental Health Trust is trying to understand its shortcomings, trying to work to put them right, and you have to commend them for that, but, as they say, the proof of the pudding will be in the eating.
They can only achieve their goals if they have the resources to do so, and increasingly, that is simply not the case.
In my local Trust there are simply not enough acute beds to cater for the demand, to counter this problem, they encourage carers to take patients out on day release, weekend release, and when they come back someone else has taken their bed, which means the patient cannot return to the ward. If they are lucky they will find a bed elsewhere within the Trust, which means turning out someone who may already feel rejected, confused, lost… it is hardly in their interest to be shuffled out is it?
The alternative is for the carer to take them home again… but does the NHS check if the carer is able to do so… what do you do if you simply can’t cope with having them home overnight, or for an extra night… it is a hell of a strain on the carer. Then to be asked, in front of the loved one, can’t you take her home again tonight?. What can you say… it is emotional blackmail and you have no choice but to pay the ransom.
Once discharged, the patient will need support, will need somewhere to go to help to reintegrate into society. The day centres are closing, the support services are losing funding, along with the rest of the world are suffering cuts, and like most organisations, the easiest commodity to lose is staff… not cut out the waste within the service, then adjust the further cuts based on that. This means that the support, who already have case books too large to deal with them effectively have to take on even more, reducing there efficacy even more… not their fault by any means… but they are the front line, so they get the blame.
As for respite care for the carer… well, if you are really lucky you can get 8 hours a week, 2 half days. It is already a monumental task for a carer to look after someone with mental illness, but if you have to cope around the clock, seven days a week, it quickly grinds you into the ground… I have seen too many carers become service users because of this situation. Of course this is an additional cost to the NHS, probably far more expensive than employing the people needed to look after the original patient to start with, and of course someone still has to care for the original patient.
I am delighted that the Adult Mental Health Service is bending over backwards to understand and accommodate improvement, nothing but credit for them, my fear is that ill-advised cuts instigated by a government who seem intent on punishing the most vulnerable will prevent them achjieving their aims, and make the situation even worse for carers and their loved ones.
Once again the blame will fall on the local health trust, but in our case they are doing so much to improve things, but it seems they are going to be thwarted for a political expedience… This cannot be acceptable
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