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
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
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: