Mental health is the condition of an individual with regards to their psychological and emotional well-being.  According to mental health charity Mind (England and Wales) there are approximately 1 in 4 people in the UK who will experience a mental health problem each year.  In England 1 in 6 people report experiencing a mental health issue in any given week.  Mental health is a huge issue within society with many sufferers roughly 16.5 million people are affected in the UK (2017 figures).  There are various types that include depression, anxiety, schizophrenia and Post Traumatic Stress Disorder to name but a few.  These conditions are categorised under the umbrella term of ‘mental health’.  According to figures in 2016 mixed anxiety and depression is the most common disorder affecting 7.8 in 100 people in the UK.  According to Dr Lucy Acheson (A chartered counselling and coaching psychologist) ‘insecurity is a form of anxiety – a fear of the self; and although symptoms are sometimes milder than those of ‘conventional’ types of anxiety, I think that insecurity can be more debilitating and have a greater impact on the quality of our lives’.

Depression is a mental disorder that causes many symptoms which include loss of interest in something or feelings of guilt or self-worth to name but a few.  According the mental health foundation of 70 years, in 2013, depression was the second cause to those with a long-term disability.  Due to a GP conducted survey this has shown that mental health tends to affect those who live in the North of England, particularly Liverpool, Halton and Knowsley more than those in the South East including more affluent areas such as Surrey Heath.

The cause for mental heath issues is unknown, however, there are many likely reasons such as unemployment, as figures from 2011 to 2015 suggest the highest unemployment was in the North of England (particularly the North West) whilst the lowest was in the South East.  Unemployment can be the cause of varying mental health issues, when people don’t have a job to go to or nothing to get out of bed for and no routine as well as no fixed income they then can turn to alcohol and drugs as a way of escapism, If this leads to long term abuse depression can kick in.  In the North East after the closure of the steel industry and coal mines this resulted in mass unemployment and depression became a huge problem, some individuals were unable to cope with this and took their own lives.  Generally, the south east of England is more affluent area with better opportunities and higher paid jobs providing a better quality of life, this has an impact on mental health in a positive way.  However, there are other factors including homelessness, being unable to get the right care and treatment when needed.  With no fixed abode, obtaining benefits or registering with a GP is extremely difficult.  Having no money, no food and living outdoors can have a massive affect, not only on mental health but also on physical health, well-being and hygiene.  Homelessness also has strong links with alcoholism and drug use or dependence.  Drug users generally suffer with mental health as a result of long-term abuse.

(North East prescribes twice the number of antidepressants per person as the South East and London)

Mental health has always been around, however, it is more openly discussed now.  Today there are greater demands and pressures in a much faster pace of everyday life causing more and more people unable to cope.  There are more facilities for mental health in the south of England, thus reflecting the allocation of funding being received greatly in the south of the country i.e. the more affluent areas of England, where perhaps it is not necessarily needed as much.  A survey that was conducted by the worlds university rankings shows that the north west of England has the highest percentage of students who are so worried about their finances and how they are going to survive financially that it is having an effect on their mental health, compared to the lowest in the south west of England.  According to 2014 figures, 19.7% of people in the UK who are 16 plus showed symptoms of anxiety or depression, which has risen by 1.5% since 2013 and was higher among females (22.5%) compared to males (16.8%).

The awareness of mental health started in the 1600’s but not fully developed until around the 18

^th

century.  More recently records were found by the National Health

Service which proved that in 1670 that ‘madhouses’ existed.  In 1774 the madhouse act was put into place and was the legal structure behind the way they were run and to regulate and legalise them. As research into mental health developed doctors began looking at the functioning of the nervous system and the brain to try and establish reasons as to why people suffered with mental health and to help them find a solution or appropriate treatment for their patient.  Mental health affects so many people today, the aim of this assignment is to look in more depth as to the reasons behind it and how it has developed and the different factors that contribute towards the mental health of an individual.  According to studies of the house of commons library briefing papers, mental health is on the rise and has been since 1993, this is thought to be partly as more people have the courage to step forward and admit that they have a problem and that they need help.  Financial problems, social media and one’s sexuality are all thought to contribute to the rise of mental health.  Research by the BBC suggests that mental health campaigners and psychiatrists are questioning social media and if this is increasing social bullying and peer pressure.  Figures show that females aged 16-24 declare their mental health issues, however, males are more likely to commit suicide, this is the biggest killer in men up to the age of 49.  There are 6000 suicides in the UK every year, problems sometimes start as a child maybe from a trauma, physical/emotional abuse and develop as life goes on.  It is extremely important that we look after our mental health and that of others.  There are many charities that have been set up that support people with mental health issues, there are dedicated helplines, online chats and drop in centres where anyone experiencing a mental health issue can attend.

Mental health is extremely relevant to the Paramedic profession, not only for the patient in question but is also that several Paramedics may be able to relate to themselves due to the nature of the role.  The role of a Paramedic has changed along with the changes in society.  There is a massive increase in the amount of mental health cases that are regular part of an everyday workload.  These situations can be extremely challenging and sometimes dangerous as Paramedics are usually the first on scene, this can compromise the safety of the crew if the patient is suffering from an acute mental health episode.  Often these patients can be agitated, violent and occasionally carrying a weapon, Paramedics must be aware of their surroundings, alert and ready for any quick change in eventuality.  Cases can be time consuming whilst trying to build a rapport with a patient who may be hallucinating or hearing voices, this can take a long time trying to keep them calm and reassured also finding the correct care pathway for that patient.  There maybe situations where a Paramedic must liaise with a GP or mental health worker this can then have an impact on the resources being used over a longer period than usual and sometimes contact not being made if it is an out of hours case.  A survey was conducted by the College of Paramedics, it revealed that Paramedics across the country do not feel confident that they have the skills and knowledge necessary when dealing with a mental health patient and the services that are set up are not effective.  98% of paramedics believe there should be more training and education of how to manage a mental health patient effectively and safely. 83% of Paramedics stated they are put at risk when dealing with patients with a mental health illness and 94% believe mental health cases are on the rise.  Ambulance staff including call handlers are more susceptible to mental health issues usually Post Traumatic Stress Disorder due to the traumatic things they have witnessed or heard during an emergency call.  Blue light champions in partnership with mental health charity, Mind, has been put into place to help those staff that need to talk to someone about their feelings after all they are only humans too.

Unfortunately, there is still an underlying stigma attached to mental health and those who suffer with it making much more difficult to manage.  People can be discriminated by society and in all areas of their life this can lead to things like unemployment, homelessness, being socially excluded and relationship problems, this can make people feel trapped or isolated and can have a massive impact.  The social needs of mental health sufferers can be made worse by the press or media as people can be assumed as violent, dangerous or evil, this can lead to social isolation as nobody wants to be linked to these people. There is a law in place that to discriminate against those with mental health is illegal which is the equality act 2010.    There are community mental health teams in place that help with supporting individuals with mental health disorders, these include social workers, community mental health nurses and psychiatrists that go out to visit patients in their own home or the patient can drop into a GP surgery or outpatients department.  There are various charities set up including Mind and Rethink, which offer advice and guidance to those in need either online or over the phone and can put them in touch with the relevant departments they need.  They also do a fantastic job of raising awareness of mental health, without these charities there would be so much more pressure on the NHS.  On a national level the government has failed in providing promised budgets to the NHS and in turn the best care possible to mental health patients.  According to figures, NHS England planned to spend 11.9 billon on mental health 2017/2018, the NHS five-year forward plan was written in February 2016 and has advised that there will be key improvements in mental health by 2020.  The mental health workforce will be expanded gradually and will be rising to 1500 by March 2019.  There will be a reform of health which will allow a redirection of funding of around 350 million, more support and an increased access to specialised peri natal care, reduction in the out of area placements making the provision of care closer to home and relatives, increased access to crisis care liaison services in emergency departments and on patient wards and suicide prevention.  Between 1955 and 1994 roughly half a million patients were discharged from mental health hospitals as they were closed by the state resulting in many people left untreated and going on to live with severe mental health issues.

As previously stated, mental health disorders affect many types of people and one of the biggest contributors to accessing health services are language barriers.  Many migrants that enter the UK suffer with mental health problems as they do not speak English this will then require an interpreter, which in turn, costs more money.  This is the same scenario for people who are deaf, according to Sign health, deaf people are twice as likely to experience mental health issues such as depression compared to hearing people, this makes it harder for services to be accessed.  Sign heath began a therapy service for the deaf, using fully trained therapists who are also deaf and able to sign to the patient.

It is clear there is an ever-increasing demand on the NHS services to provide adequate acute and long-term care for all.  Providing up to date service and solution for patients suffering from many different physical and mental health problems.  However, the workload could be greatly alleviated by fast tracking mental health patients through the required immediate mental health care that they are known to.  The system in place, however, only allows them to be directed through the usual Accident and Emergency department route before they can be filtered through to the relevant, available mental health team, even then they can only be offered the service or treatment that is available as apposed to their long term mental requirements.  The only obvious answer seems to be increased funding in all areas of the National Health Service, especially the mental health budget where by perhaps patients were treated quickly and long term in an environment that is sufficient for their needs which looks back to the now closed established care in the community supervised housing or hospital rather than leaving the most vulnerable people alone and fending for themselves often without family in an ever increasing ignorant and thoughtless society.  At the moment, It is a sticking plaster that is trying and failing to stem the flow of a massive wound, however, the proposed NHS five year forward plan proposes that 2.3 billion pounds per year by 2023/2024 will be spent on mental health services, it will be interesting to see if this is successful and gives patients with mental health disorders the treatment they deserve.

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