Organised chaos: Cuts leave lives in crisis

It's s a tale of hidden and not-so-secret closures, jobs axed or not filled and service users left without the support they rely on. Annie Makoff investigates the hidden agenda behind the Government’s mental health strategy

Government plans for mental health trusts are just smoke and mirrors,” says Chaminda Jayanetti, public sector cuts campaigner and activist. Part of the Falseeconomy.com team which officially launched earlier this year, Chaminda has been closely monitoring the full scale of public sector cuts for several months, using Freedom of Information requests and foundation trusts’ annual plans. It was through his research for Falseeconomy.com that the real scale of NHS cuts became apparent: 53,150 job losses are expected between now and 2015. Of this, 6,346 jobs are at risk across 53 mental health services.  

“Most trusts gave me their five year plans,” he says, “but there is a decent chance that these figures are going to significantly increase over the next few years.”

The figures were announced some weeks after the unveiling of the coalition Government’s mental health strategy, which pledged £400m to talking therapies with a focus on early intervention.

At the time, the Government’s own independent national health adviser, David Richards (since sacked) suggested that the pledged money was not new and actually tapped into an existing NHS budget. Others have voiced concern over the focus on early intervention and short-term talking therapies in the strategy, which would undoubtedly be at the expense of adult mental health services.

Disability Now has uncovered further evidence which indicates that vital mental health and social care services throughout England and Wales are already experiencing significant cuts.

A mental health social worker who does not want to be named, told Disability Now that 20 per cent of jobs will go in her Community Mental Health Team (CMHT) and several psychiatric wards were closing.

“They’ve already closed several adult wards in the area. We were told they were being refurbished but they never re-opened,” she says. “And to save more money, unqualified staff are slowly replacing qualified staff, trainee mental health workers are replacing community psychiatric nurses (CPNs) and psychology graduates are replacing nursing posts. They are even down-grading most posts to lower skill levels.”

Already the CMHT is massively understaffed and according to our source, some of her team have been told not to see certain service users due to the paper work and expense.

“The picture that I’m giving is not particular to my London borough,” she explains. “It is indicative of what is happening everywhere. The reductions, the redundancies, the lowering of skill levels, it’s all the same. It means that service users won’t be getting the care and support they need, it’s going to reach boiling point. But these boiling points are peoples’ lives, their lives will be changed completely.”

In Leeds, over 200 service users who attend one of three mental health day centres are about to have their world turned upside down. Both the Vale and Stocks Hill Day Centres are due to close despite fierce opposition and campaigning from attendees, staff and local GPs.

Lynn Payler, who set up the Facebook pressure group, Save Leeds Mental Health Services!! has been going to the Vale Day Centre for over two years.

“Before I discovered the Vale, I couldn’t have a conversation without crying because I was so anxious. I have severe depression and anxiety and I suffer from panic attacks. But the Vale has been a lifeline for me and so many people.”

Lynn and others first found out about the closure by accident because it was posted online. Since then, there have been five suicide attempts and the majority of service users are experiencing severe depressive relapses.

“It’s heartbreaking,” Lynn says.

“The news has absolutely devastated us. Since we found out officially in December, we’ve done nothing but campaign against these closures. I can’t express how affected we are by this, they are taking away something that is so important to us. “

The three centres – known by locals as the “tri-centres” – the Vale Day Centre, Stocks Hill Centre and Lovell Park offer city-wide residents with mental health problems a chance to socialise, take part in activities, get support from staff and peers and go out on trips in the community. As many service users attend three days a week, it is a vital part of their routine and as Lynn explains, attending gives many a sense of purpose to their lives when they are otherwise too ill to work.

The smallest centre, Lovell Park is not intended for closure, but is apparently so small that it will not have the space to take on the additional service users from Vale and Stocks Hill.

Lynn who has not worked for 18 years due to a range of complex physical problems, is adamant that the closures will cost the council more in the long run.

“It costs around £33 a day to send us to a centre,” she insists, “but if we have to go to hospital because we’ve had a breakdown, it costs over £3,000 a week. How can they justify that?”

According to figures released by Falseeconomy.com, the Leeds Partnership NHS Trust which runs mental health services in the area, is not the worst affected region in England and Wales for mental health service cuts.

Trusts such as Coventry and Warwickshire Partnership, Mersey Care NHS and Derbyshire Mental Health Services have revealed over 15 per cent of cuts to job posts alone.

Even those areas with “lighter” cuts aren’t immune to the drastic actions local authorities are taking in attempts to save money.

Berkshire Healthcare Foundation Trust expect to cut 400 posts within five years and Nottingham Healthcare are intending to cut as many as 700.

Nottingham have also opted to close 130 supported housing projects as part of these council cuts. Two of the axed projects were specifically for women with mental health problems, some of whom have lived there for as long as 17 years.

Staff at the projects have been given just a few weeks to help social workers find alternative placements for the women as well as looking for new jobs themselves.

One of the projects is home to just five women. 15 dedicated staff who work in shifts offer them round-the-clock care and support.

One tearful member of staff who has worked at the project for 13 years, has spoken anonymously to Disability Now: “They’ve given us such short notice. We were sent an email telling us to move the ladies out – it was the first we heard of it. Everyone is so confused, it’s chaos. One woman has been moved to a care home for the 70s and 80s when she’s 35. It’s just not right.” Another woman was moved to another project of 21 residents, 17 of whom are men. “You can’t treat people like that,” says the staff member. “They are putting money before people.”

Back in London, service user Gemma O’Connor under Camden and Islington NHS Foundation Trust has found that the services she once relied on are no longer available to her. The local crisis team now refuse to step in during a crisis unless a suicide attempt has been made. “It’s no longer a preventative measure,” Gemma says. “And my psychiatrist told me recently that because of the changes to the NHS, they won’t be able to continue treating me. I’ve even been told I have to pay for my own psychotherapy! I’m on benefits, how can I possibly afford that?”

Gemma’s story is not unusual. Even before the cuts, there have been stories of service users having to finance private treatment because of lack of funding.

Sheffield student Leon Kowalski is one such person. Diagnosed with dissociative identity disorder (DID) in 2006, Leon had to fund his own treatment using his DLA because there was no NHS help available. “The treatment for DID is long-term psychotherapy,” he explains. “But I was offered just 21 sessions and then discharged, even though I was told my condition was serious. Medication doesn’t help DID, so I am viewed as untreatable. They don’t know how to treat me so they don’t treat me at all.”

To add to Leon’s concerns, Sheffield recently announced a £1m cut to its mental health services. “I’ve been hospitalised and I’ve had interventions from the police and the crisis team,” he says. “But they say they can do nothing. I honestly don’t know how the mental health system can cope with any more cuts as it is failing to provide support for people as it is.”

It is becoming all too clear that these documented cuts are just the very tip of the iceberg. With many mental health trusts yet to announce their reduction plans and hundreds more services awaiting imminent closures, the future of our vital mental health services looks grim.

London-based Gemma agrees. “It’s a scary time,” she says. “The mental health system is becoming more unstable by the day: it’s a deck of cards.”

• Some names have been changed.