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‘Debilitating and Dehumanising’ Say Users of Surrey’s Mental Health Service

Published on: 29 May, 2021
Updated on: 31 May, 2021

By Julie Armstrong

local democracy reporter

“Dehumanising experiences” of being passed around the system, after waiting too long for help, characterises Surrey’s mental health services, a peer-led review has found.

Alan Downey, independent chair of the report published this month, said it “sets out a number of issues, weaknesses and, to be blunt, failures that have impacted on the lives and wellbeing of Surrey people, in some instances to a distressing degree”.

The Surrey Mental Health Partnership Board found the system cannot effectively deal with an overwhelming demand because of insufficient funding but also because of the way funds are being used, with unsatisfactory joint working.

A task force was set up in mid-2020 by the Surrey Heartlands Integrated Care System (ICS), a partnership between local NHS services, the county council and others, in recognition that mental health services were not coping and were delivering poor outcomes for people.

Its chair, Mr Downey, who is a former chairman of an NHS trust, did confirm “the desire and commitment of everyone involved to improve the situation”.

A peer-led review gathered evidence from more than 150 people, including users of mental health services and staff working within them.

Service users and carers did not feel well served and spoke of more positive experiences of services elsewhere.

They felt “levels of awareness, knowledge and understanding of emotional wellbeing and mental health across Surrey” is generally low.

“Users experiences of being passed around the system felt debilitating and dehumanising,” the report said.

“Services are overwhelmed by demand and service and system weaknesses, resulting in long waiting times, high services thresholds and multiple referrals.

“Support and services often appear complex, with multiple front doors, often not readily evident and don’t feel accessible or joined up.

“Being passed around from one service to another is a common and highly damaging experience for service users, especially for those with multiple needs.”

The report said referrals both within organisations, such as GPs and Surrey & Borders Partnership NHS Foundation Trust, and between clinicians across organisations, must be subject to a “no bouncing” rule, so that a referral “cannot be deemed closed by referring the patient to another service”.

It said there is “limited satisfaction in the quality of joint working between organisations”.

Problems with housing could delay discharges and affect mental health bed capacity; this depends on the borough and district councils.

There is a need to review support for people coming out of hospital to ensure capacity is better aligned with need.

Because of low levels of assessed deprivation in Surrey, the county receives the lowest allocation of mental health funding anywhere in the country.

The report said it was “not acceptable or appropriate” that when a Surrey child experiencing a complex mental health condition needs a bed, they have to go out of the county to Sussex or southwest London. There are no in-patient beds for children anywhere in Surrey.

Target groups identified as being underserved or experiencing inequality are those with multiple needs and conditions, Black and minority ethnic communities, people with eating disorders and 16 to 25-year-olds.

Investing more money and attention in prevention could avoid “greater severity in mental illness and need”.

The report recommended adopting a “prevention and early help first” approach, a collective vision system-wide, with effective communication between and within organisations and better collection, analysis and sharing of data.

What has been the response to the findings?

Cllr Alun Jones

Caterham Valley councillor Alun Jones (Lib Dem), who sits on Tandridge District Council, said: “Mental health services are letting people down all over the place.

“Because there’s multiple agencies there’s no one accountable. We need to actually integrate health and social care, not just talk about it.

“Police pick up the pieces because social care isn’t sufficient and they are left to fix a problem they’re not specialised in.

“There’s no drug and alcohol misuse supported accommodation in Tandridge so you go elsewhere – and then you lose your support network.”

He added: “You need more than a shared vision; there’s a big crack in the base of society with people falling into it. What you need is a plan to deliver.”

Cllr Tim Oliver

Surrey County Council leader Tim Oliver (Con, Weybridge), who chairs Surrey Heartlands Integrated Care System (ICS), said: “This positive new approach of bringing together all key partners will make it everyone’s business to deliver the improvements we’re seeking.”

He added: “Just as the pandemic put a strain on the wellbeing of many, it also made it harder for people to seek help, and we must all now work together to tackle the mental health legacy that Covid-19 is leaving.

“We as a system set up this review and our focus now is acting on those insights to make a real difference for our residents.”

Graham Wareham, chief executive of Surrey and Borders Partnership NHS Foundation Trust and senior responsible officer for the improvement programme, said: “The NHS’s Long Term Plan for mental health recognised the need for accelerated spend on mental health.

“This report’s recommendations focus not only on the funding of the system, but also on how it can be better organised through user-led design to provide Surrey residents with the service they expect. 

“Partners have all accepted the recommendations; as a system we are keen to get on with the work and have already started implementing a number of these.”

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Responses to ‘Debilitating and Dehumanising’ Say Users of Surrey’s Mental Health Service

  1. Martin Elliott Reply

    May 29, 2021 at 7:57 pm

    I don’t see anything about the interface with the benefits system the Department of Work and Pensions or the councils.

    Poor support for those with mental health issues, the long delays in assessment for job-related support are still forcing those too ill to work to use web journals, apply for jobs, and attend inappropriate training.

    I’m afraid this inquiry seems too narrowly focussed while the NHS and county councils seem as pressurised and disorganised as ever.

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