Our new campaign: In sight in mind
At Rethink Mental Illness we know that the people who are the most unwell often get the worst care and treatment. In our new campaign, In Sight In Mind, with the Royal College of Psychiatrists, we want to make sure that some of the most marginalised people in society have access to the local services they need to get better.
Whether you have a physical condition or mental illness, it’s your basic right to have the treatment you need close to where you live. And that’s what most of us would receive.
Yet for people living with the most severe forms of mental illness, it is too often the case that they can be sent away from home to receive treatment. This takes people away from the places they know and the people they love at a time when they're most vulnerable.
Mental health rehabilitation services - not to be confused with drug or alcohol rehab - are for people with the most long-term and enduring mental health conditions. The majority of people in these services will have a diagnosis of severe psychosis.
Referrals to rehabilitation services generally come from acute hospitals, where most patients in need of emergency mental health treatment will go first. If the people responsible for their care believe they aren’t well enough to be discharged back to their community, they will probably be referred to a rehabilitation service. These are designed to help people become well enough to return home to live in their community.
This means it’s vital that rehabilitation services are based in the communities of the people they serve. When they are in the right place, rehabilitation services can be very effective. However, over the last decade or so the availability of local rehabilitation services has fallen and out of area rehabilitation placements have become far more common.
Around 5,000 people are currently in rehabilitation services. Two thirds of them are placed out of area, often in completely different parts of the country. As well as the emotional burden this places on patients and their carers, it also causes practical difficulties.
If people are sent away from home for long periods, it makes it harder for people to access the services they need back home when they are ready to be discharged. It might be that they lose eligibility to housing support, or struggle to access the clinical services they need back in their own community to sustain their recovery.
Given all of these obstacles, it is unsurprising that people placed out of area stay in hospital for around twice as long and that their placements cost twice as much. The status quo doesn’t serve the best interests of patients or achieve value for money for the NHS. Delivering services locally is a better use of resources and achieves better outcomes for patients.
We know that when the right services are available for those living with the most severe forms of mental illness, most people can recover to live independently. For some people this will mean living in supported accommodation, whilst others will be able to recover to the extent that they live in a private flat and are able to work. The severity of someone’s condition should not stop them having the chance to get better.
The moral case for treatment being delivered close to home has already been won - a commitment has been made to end out of area placements in acute mental health services, but this does not include rehabilitation services. Our new campaign aims to ensure that this principle also applies to the care recieved by people living with the most severe forms of mental illness.
The vast majority of rehabilitation services are commissioned by Clinical Commissioning Groups. These are the organisations that pay for local NHS services and it is at this level where we’ll need to see a commitment to end inappropriate out of area rehabilitation placements and investment in local services instead. Leadership at a national level will also be needed to ensure that there is a plan in place to achieve these aims. We hope our In Sight In Mind campaign alongside the Royal College of Psychiatrists can help deliver both.
We need your help to achieve this. While we’ve been preparing for this campaign we’ve met patients and carers who have been affected by out of area rehabilitation services. We’ve heard stories of patients being cut adrift from their families and mothers having to drive through the night after receiving distressed calls from their children, not knowing if they will be alive when they get there.
These personal stories are the best way of articulating why things have to change. If you or someone you love has been sent to an out of area rehabilitation service then we want to hear from you. Please join our In Sight In Mind campaign and if you or someone you love has been affected by out of area rehab, please take a few minutes to share your story with us.
With your help, we can end inappropriate out of area placements in rehababilitation services and ensure that people living with the most severe forms of mental illness get the care they need close to home.