On writing a paper about mental health systems, and running in mud

A fortnight ago I blogged about a paper I gave at this year’s Network for Psychiatric Nursing Research conference. My aim in this presentation was to move lightly through a series of completed studies I’ve previously been involved in, with a view to saying something cumulative about the mental health system. I mentioned my ambition of working this talk up into something a little more substantial and enduring, and sending this to a journal for peer review and (hopefully) eventual publication.

Progress has been slow, largely because of competing priorities. But I have at least made  a start, of sorts. One of the points I’m going to make is that, taking the long view, the story of how mental health care in the UK has evolved remains a quite remarkable one. A quarter of a century ago, which is when I first began working in mental health care, untold numbers of people remained resident in outdated institutions. Community services certainly existed, but were relatively under-developed. Many teams were uni-professional, and lacked a clear focus. Ideas of recovery, personalised care and collaborative working with service users were in their infancy.

It’s all very different now. I suspect it’s possible to qualify as a mental health nurse without having many hospital placements at all, and to spend the greater portion of practice time in varieties of community setting. There are locality community mental health teams (still the bedrock of specialist services for working age adults), and similar teams serving older people, and children and adolescents. There are crisis resolution and home treatment teams, assertive outreach teams, primary mental health teams, and more besides. I also think that the values which underpin care have changed. So, whilst it may not be a perfect system, it is much improved.

How much the investment in mental health systems which took place over the late 1990s and throughout the first decade of the new century can be sustained, in the face of crushing public services cuts, I do not know. In Wales, which is far more public services oriented than England, a strong case was made a few years ago for the importance of investing in mental health. Mental ill-health affects individuals, families, communities and the economy. I hope that the Welsh Government’s emphasis on public mental health in its new cross-cutting strategy ‘works’, without pulling vital resources away from dedicated services for people with long-term and disabling mental illnesses.

On the non-work front, this morning’s run entirely lacked the clear, hard, frostiness of recent Saturdays. It was wet, and muddy. Clinging, in fact, and thoroughly energy-sapping. It will take a few days for my (tired-looking) shoes to dry out, so I’m glad to have my second pair to hand (to foot?) should the need arise. Now it’s Christmas tree purchase time.


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