What’s the real cost to the NHS and society?

By Ashley Phillips

With NICE currently recommending Clozapine and Cognitive Behavioural Therapy (CBT) for persisting (positive and negative) symptoms of psychosis and specifically art therapy for negative symptoms (NICE, 2014), why is there no access to proper art therapy or any real therapy in the NHS psychiatric hospitals apart from 10 sessions of CBT with outpatient mental health support?

The Royals #HeadsTogther campaign has done amazing things in the last year in terms of  raising people’s awareness of mental health, getting people to talk to the five main mental health charities and working to dispel the stigma by getting royals and celebrities to talk openly about their own mental health struggles.

What is the real long-term cost to the NHS and society to not properly deal with and treat people with mental health issues? From what I have seen and experienced first-hand, it’s a broken, revolving-door system that benefits very few people and keeps most in a perpetual state of destitution, reliant on the state.

Real innovation in developing antipsychotic medication has stagnated. Treatment-resistant psychosis is a common clinical problem, leading to significant individual disability and costs to society. Clozapine remains the only medication licensed for treatment-resistant schizophrenia, a form of chemotherapy for schizophrenia – the most effective but possibly also seen as the most toxic in its class. “Clozapine: dangerous orphan or neglected friend?” Saeed Farooq, Mark Taylor. The British Journal of Psychiatry Mar 2011, 198 (4) 247-249; DOI: 10.1192/bjp.bp.110.088690.

A few people have asked how my recovery suddenly took such a sharp trajectory acceleration. It was a perfect spring. The opposite to a perfect storm, which had me 30 seconds from death on December 15th 2016, after a very serious suicide attempt.
I spent four weeks in two NHS hospitals with no real therapy. No art therapy, no CBT. Constant sirens going off. Bad airplane food. Being woken in the night every night. Five minutes of fresh air every couple of hours. Very little occupational therapy. Utter hell. Then, by sheer determination and persistence my wife secured generous funding from our CCG (Clinical Commisioning Group) to subsidise an inpatient stay at the Nightingale Capio private psychiatric hospital in London.

I had eight weeks of group therapy twice a day and art therapy once a week at The Capio Nightingale. I did my own art therapy in my room in the NHS hospitals (as there was no therapy on offer there), and in the Capio. My psychiatrist, Dr Craig, trying drugs that the NHS does not try: being on Zyban for two weeks, which was like a defibrillator (registered as an antidepressant and for ADD in the US, but as a stop-smoking drug in the UK). Doing CBT hypnosis privately with an external guy. Felix Economakis, and quitting vaping suddenly and easily after years of it being a negative crutch. Starting working as a volunteer for a great mental health charity; Massive will-power resulting in new self-belief = perfect spring. And it was lovely spring weather-wise in March, which has helped me a lot.

I’m not sure it’s easily replicated. But that’s my ‘secret recovery combination’. There hasn’t been a magic bullet; it’s been a horrific, tortuous, ambivalent struggle but things have improved exponentially in the last four weeks.

I was a high-functioning, middle-class teacher who suffered a serious and debilitating clinical depression for a number of years which resulted in me almost killing myself. If I had stayed in the NHS psychiatric hospitals would I ever have become as well as I am now? Would I ever have become a useful and dynamic functioning member of the community again? I really don’t think so.

I have been in several of these hospitals now and they just don’t have the resources to make people better. Other than give them medication and send them back out into the community once it is deemed safe enough, or the patients are low-risk enough from harming themselves.

But a very high proportion of these patients are ‘regulars’. They are the ones that do not have an amazing wife determined to get me the help, the therapy that I needed to become well again.

How much does it cost to have these regulars in and out of the psychiatric hospitals? What is the cost of their regular visits to A&E? The cost in loss of productivity as a useful member of society? To social services? To housing benefit, to incapacity benefit, disability benefit, x 10 or 15 or 20 years? It must be more than it cost the NHS to pay for me to get intensive private therapy for eight weeks.

As our society is becoming more aware of mental health, as we start to breakdown the stigma; as the Government is being petitioned by 103,544 people to make mental health education compulsory in primary and secondary schools. The increasingly high cost of lost productivity due to mental illness is now recognised: one in four people will suffer with mental illness. Perhaps the average inpatient stay will increase with far more appropriate facilities, therapies and funding. The funding for outpatient care needs to similarly climb, and patients will then have a greater chance at wellness.

I hope my experience and work in mental health can in some small way change how we are treating people with mental health issues. Patch Adams the movie is an inspiring true story of a doctor who wanted to change how mental health was treated. He used laughter, humour and humanity to help heal people. Robin Williams played Patch. I had the honour of meeting the real Patch Adams last week.

I did a whole-day workshop with him and Lottie on ‘living a life of joy,’ using laughter-yoga therapy. Patch at 72 still travels all over the world with his humanitarian clowns, bringing laughter and joy to some seriously sad and bleak places on earth.

I feel better than I have for years and I’m going to use my experience to help others and be a force for good and change. As John Belushi said in the Blues Brothers: “I’m on a mission from Dog,” and I’m dyslexic.

Ashley Phillips 3.5.17 volunteering for JAMI

Reproduced with permission, originally posted here

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