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NHS Psychosis Services Are a Disgrace.

Posted Nov 14 2012 11:24am

Psychosis-cbt-manchester What would you expect from a psychiatric inpatient facility?  Most people would hope for a clean, secure environment, staffed by caring staff with the time to spend to really understanding your problems.  In other words, a therapeutic experience.

The reality in the UK is far from this.  In fact it’s a disgrace.  A recent report by the Schizophrenia Commission reveals NHS facilities that feel unsafe to service users, with overworked staff pushing heavy use of psychiatric drugs as a way of containing and managing psychiatric illness.

It’s hard not to conclude that if you weren’t crazy before you entered an NHS psychiatric ward, you would be by the time you left.  These are the last places people with difficult and frightening psychological and emotional symptoms should be sent.  For most patients though, choice is taken out of their hands.  The Schizophrenia Commission reported year on year increases in forced detention in these facilities.  Given the poor standard of care on offer, it’s unsurprising patients refuse to be readmitted.

How should people with psychosis be treated?  Well the Schizophrenia Commission recommends early intervention and increased access to talking therapies particularly cognitive behavioural therapy .  In fact despite NICE recommending cbt for people with psychotic symptoms, only 10% of patients actually receive bona fide therapy. 

I couldn’t agree more.  As a private practitioner I often see young people who are starting to slip down the road to psychotic symptoms.  Paranoia, mistrust and distorted perceptions of the world are often an early stage indicator of a full-blown psychotic episode to come.  If dealt with early, my view is a psychotic episode can be averted in many people with the result that expensive inpatient (miss) care can be avoided in many cases, for the benefit of the patient and the reduced cost to the NHS (inpatient care currently takes up 20% of the NHS mental health budget). 

If you are reading this and you are concerned about your own mental health or those of a loved one, what should you do?  Early intervention is the lesson of the Schizophrenia Commission .  If you can’t get access to a therapist quickly on the NHS, then a private referral may be money well spent. 

For anybody experiencing borderline or actual psychotic symptoms, however, such as paranoia or delusional thinking, if you’re smoking marijuana stop it!  Dope in these circumstances is a fast track to mental collapse.  Furthermore its highly unlikely you will get a grip on your symptoms if you continue to smoke.  The same also goes for speed and other stimulant drugs.  I know its boring but it’s the truth.


Dr Phil Tyson is a Men's Psychotherapist based in Manchester in the UK.  He offers:



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