Mental Health – Patient centred care not profit centred care

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This week I will be travelling to visit an old friend, someone who I met when in hospital a number of years ago and to say I am excited would be an understatement. My friend was someone who in the dark days of  my hospital admissions was supportive and understanding, it was at a time just before my diagnosis, when I was switching a lot  and I stood out amongst the other patients as rather quirky and an easy target for bullying.

I carried my Ted everywhere in those days and so it was no wonder that I stood out like a sore thumb, others would either ignore me or complain about the fact I was in the wrong place and shouldn’t be in their unit. I remember being quiet, afraid and rather confused, I was losing a lot of time and felt very vulnerable and unable to protect myself.

The staff didn’t understand Dissociative Identity Disorder and would often make things worse instead of helping, they never challenged the negative statements that were said about me nor did they stop the bullying that I endured. But my friend she did and she was always willing to chat with me and sit with me, little things that made a big difference to my life back then. Our friendship developed over time and when I was moving on she was anxious that I wouldn’t keep in touch, but I knew that our friendship had been built in the darkest of times and was strong.  I agreed to keep in touch and so for the past 5 years I have travelled back to the south coast to visit her in the old units where I had once been. In the last year she was thankfully moved north and so the 10 hours of travelling we used to encounter each visit  is now just over 4 hours.

Each visit is special I know that both myself and my friend benefit from seeing each other, but this visit will be extra special because my friend is about to be discharged from hospital having spent far too many years in the hands of the mental health in-patient system. Last year she moved to a more relational based facility whose focus was on recovery and not profit, who didn’t use physical restraint to contain people but additional staffing who could offer support when needed.

Instead of being in the hands of people who could be punitive and punishing, controlling and demeaning she was suddenly in the hands of people who cared and wow what a transformation. In the space of a year she has moved from being a detained person to someone on the brink of living in the community in her own home, she is no longer detained and hasn’t been for many months now. She has become a keen swimmer and enjoys doing  lots of crafts, she now does all her own cooking and shopping, plus lots of other independent activities, this is a vast change for someone who has spent more than a decade in hospital.

This is a person who hasn’t committed any crime, she just happened to have the misfortune to be placed in a unit where profits were key and unlike me didn’t have the family to fight for her that I was blessed to have. Private Psychiatric hospitals which have the power to detain people are often not challenged about their quality of care, how they deal with patients or indeed how they perceive patients. I always felt like a cheque  for the private  unit where we met, a quick easy profit for the shareholders and they didn’t want to lose me or my friend.

Sadly for my friend this particular company held onto her for a decade, her funders rarely visited and never challenged anything they were told, so she remained locked in a unit that was clearly unsuitable and clearly not helping her recovery. Thankfully last year things changed and she can start her new adventure, living life and looking towards her future, something I think she had given up any hope of having.

This week we will celebrate her progress and her impending freedom from psychiatric in-patient units, I am hoping to find out what things she will need in her new home, so I can put together a few things for her new start. I want my gift to be just right this is after all a momentous event and she leaves care with nothing really. Most of all we will have fun catching up on each others news just like other friends do and though she is moving on in her life I have no doubt that we will still stay in touch.

But whilst she moves on, many more women and men will still wake up tomorrow  in units run solely for profit and not for care, for the benefit of shareholders who are concerned about the balance sheet and the return from their investment. I have no doubt some private facilities within the health sector are run well and with the key interest being the care and welfare of the patients, but many sadly are not.

Maybe its time that Clinical Commissioning Groups and other NHS  funding streams were made to set some stringent guidelines for private providers on what constitutes good patient care and a recovery ethos, I would suggest they ask former patients to establish these guidelines and at the same time to also establish a criterion for what we expect from the funders in respect of how they select placements in the first place. Mental health services need to be cost effective and that doesn’t mean cuts to NHS services it means less of our public money going into the pockets of private shareholders and middle men.

Copyright DID Dispatches 2014


2 thoughts on “Mental Health – Patient centred care not profit centred care

  1. Another very moving post.

    And a very important issue: this insidious use of private facilities has been going on for some time and isn’t always well monitored, as you point out.

    Will it improve? Current moves suggest otherwise.

    • Formerrmn thank you for your recent comments, I think with so many bed cuts in the nhs the use of private sector facilities will continue and sadly they won’t be checked as well as they should. Plus financially it will not be cost effective either. My hope is one day the funders and trusts will realise this fact.

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