Manchester City Council are planning massive cuts to services which help maintain positive mental health and resilience and cutting all services that support people recovering from severe and enduring mental health conditions. At the same time the NHS in Manchester is planning to discharge (step down to primary care) up to 800 people from community mental health services. (This is something that is also happening in other areas across Greater Manchester as beds and staff have been cut over the past few years) .This is a group of people who statutory mental health services say they can no longer afford to support, that are perceived to be fairly stable, and mainly receiving support with their medication.
In the context of existing and further proposed cuts to a range of VCS advice and support services along with the unwanted impact of welfare reform on disabled people and their families the questions are stepping down to what and do GP and primary care services have the capacity and capability to manage on their own? GP’s already indicate that one in three consultations are for a “mental health” issue and most recognise that they have a limited response to this.
Social care services have an important and well evidenced role in making people and communities more resilient and helping people to recover from episodes of mental illness. It is beginning to look like all that will be left is a crisis mental health service with increasingly high thresholds for access, no community support services to step people down to and very limited social support networks on the ground. This is completely contrary to best practice and the city’s vision around living longer living better- it will place increasing and unsupportable demands on primary care and A&E services and ultimately it will cost more to rebuild these essential services which are needed to steer people away from expensive clinical health services.
In my view there is an urgent need to go beyond standard consultation processes and use mechanisms like the
Mental Health Recovery Network
and the
Mental Health Charter Alliance
to bring together all parties and develop more sustainable proposals. In many ways this crisis provides an opportunity to innovate and build more sustainable kinds of community support to facilitate recovery and resilience for individuals and communities by including them in the design and running of services; however this means that we need the whole system to work together including those people with responsibility for allocation and cutting of resources.