Kate Lovett: Waiting times for mental health treatment costs jobs, marriages, and finances

Long waiting times are detrimental for patients and healthcare workers

One of the most difficult parts of my job as a psychiatrist is speaking to patients who have had to wait a long time for treatment.

All of us working in frontline mental health teams are keen for patients to have the best possible experience. Sadly, when people have to wait for the help they often desperately need, it is hard not to feel that we are letting them down. I would be lying if I said this wasn’t stressful and that it didn’t detract at times from the huge sense of job satisfaction that goes with being a psychiatrist.

Research by the Royal College of Psychiatrists carried out by ComRes this September found that 1 in 4 people with a diagnosed mental illness had to wait over three months to receive any help.

For some people, when help did arrive it was in the shape of an appointment for assessment, but this did not mean that they were automatically given a treatment programme.

In the words of one respondent “I was seen quite quickly, but then the follow up didn’t happen for six months and during that time my condition (OCD) got so much worse that I had to leave university and that had a real impact on my life. I lost my friends, I had to go back to my parents and that triggered a downward spiral.”

Another man told us that waiting for treatment for his mental illness meant he attempted to take his own life several times. In total, he had to wait 13 years to get the help he needed.

Where their health deteriorated, respondents also pointed out the much more wide-reaching impact this could wreak on their lives. 37% said they had relationship difficulties including divorce, 32% said they had financial difficulties, and another 34% said that they had lost their job.

Unfortunately, these stories aren’t a one off. Healthcare professionals working in mental health services hear this repeatedly.

It’s no secret that we need a stronger mental health workforce in the NHS to be able to help. Within the mental health workforce, we need more psychiatrists.

Given that it takes several years to train to be become a psychiatrist there are no simple quick fix solutions to plug the gap.

We have been working tirelessly to promote this incredible branch of medicine to attract more doctors to Choose Psychiatry as a career. We are starting to see green shoots as a result. This year we had the highest number of applicants to core training in the last five years.

There are likely to be several contributing factors including the success of our social media campaign, longer term outreach work in medical schools, and the societal revolution around mental health which has undoubtedly helped reduce the stigma historically associated with mental illness.

However, despite this success there remains much to do. We can work as hard as we can to attract people to the specialty, but we need to make sure that the landscape of mental health becomes attractive enough to keep them there.

Patients waiting without support is one of those morale-zapping issues that deeply affects workers in the NHS. We need to make sure we are recruiting to posts around the country so that patients don’t wait unfairly for an appointment or have to travel miles for treatment.

We need to ensure the money promised for CCGs is going on workforce and isn’t getting diverted elsewhere. At the moment, this varies and in turn creates a vicious cycle, putting existing staff under increasing pressure. That means it can be really hard to recruit and retain staff. And that is why we need to continue to scrutinise those who have control over planning our NHS workforce and commissioning and delivering mental health services to ensure they’re keeping their promises.

We want the Government and Health Education England to work with us to ensure medical schools have plans in place to give students more exposure to psychiatry through high quality placements and curriculum to encourage more of them to pursue it as a career and for school students to be aware of the career opportunities in mental health so that the younger generation’s growing interest in the field can be harnessed.

When I look back at my career and all its challenges would I have chosen differently? No way. I believe that as a psychiatrist I have the best job going and the utter pleasure of seeing people recover from the ravages of mental illness day-in day-out never leaves me. It’s a message we’re keen to shout from the rafters—psychiatry is immensely rewarding, we can and do help people get better and enable them to get on with their lives. In my book, it doesn’t get much better than that.

Kate Lovett is a consultant psychiatrist and dean of the Royal College of Psychiatrists.

Competing interests: None declared.