The media and the public have long been concerned with how to help the most vulnerable members of society. This past year has shown that how vulnerable we all are in different ways, and that threats to the mental health and care of our most vulnerable are often the cause of both a media storm and the regular public airing of family and friends’ concerns. Our mental health is now something we are all acutely aware of, yet how do we tackle the potential to exploit its vulnerabilities?
We have had a couple of examples this year, the most recent of which brings me back to Rosie DiManno, who at 25 was found dead on Christmas Day in Southgate, north London, just days after she absconded from a psychiatric centre. While there have been plenty of questions asked about the care she received, it doesn’t matter whether she had got appropriate care for her mental health needs – the fact she was on a weekend remand order and absconded shouldn’t have raised any red flags for anyone. Of course, one can argue that one never knows, but at least she had had her case reviewed before. Unfortunately, there doesn’t seem to be anything else that can be done by way of family to intervene while a case is still being heard in the system.
But the two cases are very different. Rosie DiManno had bipolar disorder, while at an earlier stage James McCord had schizophrenia, and this was not wholly uncommon as he was first diagnosed with the illness at 18. However, his psychotic episodes were more intense than those of most people with a sporadic strain of schizophrenia. Dr James James McCord MBE, who was on a team specially devoted to treating those with schizophrenia, was found to have suffered from the disorder for about 45 years. This meant that he could not access medication and support for his illness. It was also a tragedy that he had been struck down at such a young age.
For many, and particularly young people, mental health interventions can be too late. The access to specialist treatment is often limited, or entirely blocked, by lack of funding and lack of staff. Diagnoses and treatments can be completely wrong or delayed, and many people do not realise the importance of support until much later on in life. As a result, many people feel it’s too late to help, especially if the disease has started to progress. The impact can be devastating. It can destroy a family’s life, and make relationships deeply dysfunctional.
Over the past few years many providers of mental health services have suggested that increased funding is needed to address the shortage of beds, GPs and nurses needed to meet the needs of people with mental health problems. There are many other examples where, with the right support, people are at risk can break their bonds with family and friends. Our state-run mental health services have fallen behind in providing the support they need. There is a number of different issues at play – but our overcrowded hospital hospitals, changing diagnoses and ineffective care is the most devastating. I am glad to hear that between 2000 and 2012, spending on mental health services grew by £3.7bn but many of those cuts are still here to be felt today.
Public, media and those who care for us will all need to think about how we respond to the stress and mental strain our loved ones can be under. It doesn’t seem possible that something so public should require such a response. But the answer may be that we can’t allow public concerns and empathy to distract us from the need to act. Far too many things – both individual and societal – are still at risk of slipping through the cracks.
• Rosie DiManno’s obituary will appear in Tuesday’s (11 Jan) Guardian Healthcare Professionals Network and theguardian.com