To find out what was going on in my area I have been undertaking a bit of research. I contacted the Strategic Health Authority, the local Primary Care Trust (PCT), and the local Mental Health Trust (which in my case is South West London) and St. George’s Mental Health Trust. I was pretty disappointed with the responses. Not the personal ones – no, although these were somewhat limited. The authorities were obviously not used to people (such as members of the public) phoning up about mental health policies. In one case I was passed around from pillar to post, until eventually someone took the details of what I wanted and then said they would pass them from the Chief Executive’s office to Marketing for action. In both other cases I spoke to someone who had lead responsibility for mental health, and therefore was able to undertake a discussion around the issue. But what I was looking for (and maybe no such thing exists because I certainly could not find it) was a statement of how to cope with mental health promotion and the services required to prevent mental distress. The Primary Care Trust are actually working on one now, and I’m sure that it is the most important document to be found in the local area, its just that it is not yet available (April 2004). The PCT inherited a policy document from the previous authority – the Area Health Authority (AHA) – and so did not want to distribute it to the public as their document. But it is interesting how long it takes for transfer of ownership of the power of one authority to another group of stakeholders. In the meantime, what happens about mental health?

I have discovered that my local PCT will be bringing out a policy on mental health. I asked if I might have a look at the draft when it is available and perhaps even make some comments on it for their consumption. After all, I am a member of the public who will either benefit or lose out by the policy. However, as the document is not ready for public consumption yet, I do not think that I will be getting a draft copy. The other problem is that there is no other document which the local trust produces that tells me about their policy. So, for this information I have to rely on the annual report produced by the SWL & St George’s Mental Health Trust. Their factual report had a very interesting section entitled ‘Mental Health – The Facts’, I regard it as a useful resume of the known facts about mental health. So, with credit to the trust, I will quote various points made in their report. What I also liked about their work is that they referenced their sources of information; it therefore provided a useful background to the problem.

The South West London and St George’s Mental Health NHS Trust provides specialist mental health services for people experiencing more serious and complex problems such as schizophrenia, manic depression or severe depression. Other people who experience difficulties in their lives can be treated by their local general practitioners. I know for a fact, the trust provides help and support to the local GP’s from my personal experience of working in the sector, but also from being a patient in the system myself. For example, my psychiatrist would write follow up letters to my GP stating my condition and how I was being medically treated, and would send a CC to me too. This ensured that information was communicated to the people who had to know – my GP, me and my carer. Also, I know that if a GP was treating a patient for depression with medication and they were worried about their care or lack of improvement, then they could contact the psychiatrist for advice. Letters of referral were common and kept the circle of communication flowing. The Report quotes a national statistic that in the UK about 24 people in every 1000 are referred to specialist mental health services each year, but only about 6 of these people need to be admitted to hospital. Following on from this, it says that the trust is providing treatment and support for about 14,800 people, but only about 800 of these – 5% – are in hospital. It continues by saying that it is commonly known that people with mental health problems prefer to live in the community rather than in hospital. The report then goes on to consider various mental health topics under the headings of: What Are Serious Mental Health Problems Like? Treatment and Support, and Myths and Discrimination. Altogether, they give a picture of what it is like to be suffering from mental health problems and the extent of known mental health care. ‘Serious mental health problems cause difficulties with thinking and emotions. For many people these are very frightening. But such problems usually fluctuate: only very few people are permanently ill. Some people’s difficulties disappear completely. Most have periods when they are ill, but for most of the time they have few (if any) symptoms. The precise causes of serious mental health problems are not known. Abnormalities of brain chemicals are likely to be involved. Just as some people have a susceptibility to physical health problems like heart disease, some people may have a tendency to develop problems with their brain chemicals. However, social factors also play an important role: we know that traumatic events in a person’s life and other social disadvantages can both precipitate mental health problems and make them worse.’