7 Urgent Changes I’d Make in the Mental Health System

Patients deserve better.

I recovered from PTSD and Schizophrenia after 20 years, yet the mental health system failed me. Both of these statements are true. I see my recovery as being despite the “professionals,” not because of them.

I’m not alone. The mental health system in the UK (and I have no reason to believe anywhere else is better) fails thousands of patients, and many never recover as a result.

Over the years, I’ve fantasized about what changes I’d make if I had all the power in the world. What are patients crying out for? What exactly are the failures?

1. Better qualified nurses.

One of the most common and nauseating phrases from mental health professionals is, “What do you want us to do to help you?”

Is there any other medical specialty where the professional asks the patient what they want done?

Do we get a menu of options for a broken leg?

They ask this question because they have no idea how to help the patient and are hoping for inspiration. But you and the nurse have different motivations for being at the hospital.

You want to be made better. They want to get rid of you as quickly as possible.

I remember one night, I couldn’t take the pain of depression anymore. So my mum took me to the local hospital's Accident and Emergency Department, where I’d been told a mental health nurse was permanently on duty and would help me.

After an hour, I was told no nurse was there, and they would have to find one to call from home.

Total wait time in a busy and loud A&E with crippling depression: 5 hours.

Eventually, the nurse arrived and took me to a side room. He asked my name and age and what I wanted him to do.

When I was en route to the hospital, I’d decided I wanted inpatient care as nothing else had worked. After waiting 5 hours to be seen by this guy, I knew inpatient care was the last place I wanted to be.

I asked him to tell me what HE could do for me, and he sent me home to bed.

2. Recruiting preference should favor nurses with direct experience of mental illness.

Who would you trust more? A fresh-faced recruit straight out of college telling you what you should do to recover from mental illness or someone who combines that with lived experience?

Of course, qualifications are vital — and we need MORE of them so we don’t get stupid scenarios like the one above — but lived experience adds the secret sauce. It’s saying you should trust me, and I have proof because I’ve used these methods to recover.

I’d seen and experienced things these people had no clue about and couldn’t comprehend. I could tell they were out of their depth. It’s why many police only talk to each other.

3. Emphasize treating patients as people.

Shockingly, almost every nurse I’ve encountered has had a severe lack of empathy, yet it’s fundamental to their job.

Once you’re labeled as a patient, you’re dehumanized. You’re no longer an individual. Instead, you’re part of a mass of people seen behaving a certain way, needing things at certain times, and herded around like cattle.

When I was an inpatient at a mental hospital, we were woken up every morning at 6 am. There was no work, education, or assessments. The sole reason was to herd us all into the TV room so that one nurse could monitor us without moving. While in the TV room, we could sleep on the floor or on chairs, as long as we didn’t leave that room.

Apart from the breaks for food, which usually consisted of an undercooked potato and cheese, we sat in this room for 15 hours a day. A psychiatrist would ask a few questions, provided it was a weekday, and then we were allowed back to bed.

This was life behind triple-locked doors. If anyone snapped due to the oppression and claustrophobia, they were held down and forcibly injected in the buttocks until they were comatose.

4. Read notes before consultation.

This is mainly for the psychiatrists. I don’t expect them to read my entire medical history, which is the size of an encyclopedia. I expect them to have brushed up on the basics — who I am, why I’m there, and what happened at the last couple of appointments.

Imagine my shock when a psychiatrist asked me how I was recovering from my PTSD caused by being trapped in a fire.

The shock was that I’d never been in a fire and never seen anyone else in a fire, either. As a police officer, I’d seen death in every way possible, EXCEPT due to fire.

Getting it so breathtakingly wrong is a skill, but it makes me wonder how far back in my history this fire myth has been written about. How many psychiatrists in the last 20 years have had absolutely no idea why I was there?

5. Continuity of care.

My old care coordinator was a social worker called Shirley. She went on holiday one day, and I didn’t see her again for a year. After her holiday she suddenly developed a terrible back problem and did not arrange any cover. The mental health system, being a creaking disaster, couldn’t find anyone to take her place, so my treatment was sporadic for that entire time.

If I was struggling, I had no one to call except the generic 999 system.

When she returned, she asked me to attend a meeting with her and the practice manager. She said we would come up with a plan going forward.

It turned out the plan was to tell me no more help was available and to cut ties entirely.

Throughout my illnesses, I’ve seen a different psychiatrist at almost every appointment. Working in the National Health Service seems so dire that they cannot wait to move on to private practice. So, after opening up to one, I’d have to start again the following month. We never made progress, as I bounced around the system.

6. Increase the number of beds for inpatients.

Imagine the cruelty of being told you are sick enough to need inpatient treatment, but the only available bed is on the other side of the country. When we are sickest, we grasp any stability and comfort. Our family and friends are the most important things that keep us going.

Now, because of a wrecked mental health system, you’ll see them once a week if you’re lucky for the next six months as you enter the unknown. If you aren’t a criminal, you’ve never known what it’s like to be incarcerated and have your movement restricted until now.

Being alone in this state with not even a friendly face for reassurance is a devastating punishment for being ill.

7. Make psychiatrists and mental health nurses work nights.

Most mental distress occurs in the early hours of the morning. As the world sleeps, our demons emerge to haunt us, and our only hope is to cry silently enough so as not to disturb anyone nearby.

As a police officer, I was the only person available to talk people out of suicide at those times. While the professionals were tucked up in bed, I was on top of a high-rise building, trying to stop someone from jumping.

Police officers aren’t trained to deal with such extreme mental illness. We know how to de-escalate and are skilled at talking to people in general, and we have to hope this is enough.

Luckily, in my case, I used to volunteer at a suicide prevention center as part of the Samaritans. I also did several counseling qualifications. But most police officers don’t even have that.

Wouldn’t it be great to call a psychiatrist to the scene instead? Since I was a police officer, some forces have employed a single car with a police officer and a mental health nurse inside. Tentative progress!!!!!!

As of this summer, however, police will no longer be attending mental health calls unless there is an immediate danger to life!!!!!!

Let’s get the psychiatrists out of bed.

Conclusion: It’s all about funding.

Most of the problems I’ve described come down to lack of funding. Mental health is one of the most underfunded specialties.

If, as a society, we took mental health seriously and provided adequate funding, many problems would end:

• More skilled and talented nurses.
• Empathy training.
• Longer appointments.
• Better incentives for psychiatrists to stay in post.
• More beds and hospitals that care.
• Enough professionals to cover all times of day.

Just the comfort of knowing these things were in place would aid many people in their mental health recovery.