We’re in for a double whammy when it comes to severe pressures on the NHS this winter.
Every year seasonal demands like flu and colder weather mean our hospital wards get extremely busy. But lack of appropriate funding means our health services are now at boiling point.
Understaffed and underfunded, many of those working in mental health services will no doubt be finding it hard to cope. I work on the frontline in liaison psychiatry which is busy and challenging but also extremely rewarding.
Our services in A&E and on the wards provide a lifeline to vulnerable patients – some of whom have self-harmed or arrive at hospital with a physical problem but also have complex and severe mental health needs.
But despite our services being vital and under the emergency bracket, recent research by our faculty revealed stark variations across Scotland when it comes to liaison provision. Some NHS boards do not have any liaison service at all, while other areas have just one consultant psychiatrist catering to 1000 hospital beds.
Meanwhile, in resource-rich areas there are more than nine consultants to address the needs of similar populations.
The problems are even more bold in outlying areas such as the Western Isles, Highlands, Shetland and Orkney - where there is no specific liaison service, with hospitals having to rely on ad hoc cover.
This geographical variation for such an important service is extremely disappointing. But not only that, it is becoming increasingly impossible to justify.
Just like other emergency settings such as police stations, A&E deserves the correct funding for mental health provision. Without it we can’t meet the needs of the vulnerable people we trained and joined this profession to help.
When the Scottish Government’s Mental Health Strategy was first published in 2017, promises were made to work with NHS boards across the country on provision for liaison psychiatry.
But despite all our vital work, the newly-worded Scottish Government document published in June barely mentions liaison at all.
And while much has been made of the importance of our specialism in England, the same cannot be said for the situation north of the Border.
A recent YouGov poll commissioned by the college showed an overwhelming majority of the public (85%) said they see mental health equally as important as physical health; 58% think that not enough is being spent on mental health from the Scottish Government’s health budget.
That’s why we want to hammer home the message to the Scottish Government that it must honour the original promises made for at least 10% of the frontline NHS budget to be for mental health.
Even at 10% this is a modest figure compared to other areas of the UK.
We’d also urge those in charge to take steps to ring-fence that money, otherwise we will continue to see a postcode lottery of care across Scotland.
Winter only serves to remind us that we have an NHS cracking under pressure. Our patients and their families deserve better.
Dr Murray Smith is vice-chair of the Liaison Faculty at the Royal College of Psychiatrists in Scotland
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