‘I know I’m an anomaly. I’ve known that for a long time.’
So said a chap I speak to from time to time whose budget to provide flexible counselling for people in distress comes to an end this year.
As a result from April 1 the service he currently provides to vulnerable people through GP surgeries will be accessible only through formal mental health referral pathways.
As he put it to me his setup is anomalous, and its ending and aligning with normal referral pathways is effectively a correction in this day and age.
From what he says it’s unusual to have the degree of freedom to treat people that he has had for the duration of the budget, which appears to have been several years. He implied that the money was found through older funding channels that no longer exist since NHS cash flows were restructured.
A consequence of the change, he said, is that local service users will now be required to enter the formal ‘mental health system’ (of which this chap is a card carrying member) rather than being able to access help without it necessarily coming with that additional emotional and bureaucratic baggage.
As a result, everyone will go through the conventional and narrowly process- or toolkit-based mental health approach, and his views on this were clear: that it’s not a suitable approach for those that may need a bit of help but not so much that they should be triggering formal mental health procedures; that may need to discuss issues outside the narrow scope of formal processes; and who will now probably simply be put on medication in the first instance as is that sector’s way.
This chap (a seasoned professional) may be right or wrong about who needs what level of support and when, but the story is familiar: our institutions appear increasingly to have neither the appetite nor the ability to fund more than formal minimums guided by strict processes designed to filter out rather than to include.
Cynically, the American model also teaches us that it’s much easier (and more profitable for private interests) to just medicate the patient to even out their moods and get on with it.