If you ask most people how the crisis in the NHS has had an impact on their lives, they will recount stories of a horrifying 12-hour wait in A&E, a cancelled operation or a delayed cancer diagnosis. Politicians know this: it explains the obsessive focus on the waiting list or guaranteeing a quick GP appointment.
The decline in NHS mental health services has been more subtle, but just as devastating. Last year, the NHS Confederation warned that mental health care in England had become a “national emergency” amid a post-Covid surge in people needing help. We have become a country where millions suffer in silence, with many abandoning hope of treatment.
Anyone in doubt about the gravity of this crisis should read the Care Quality Commission’s (CQC) report into Nottinghamshire Healthcare NHS Foundation Trust’s care of Valdo Calocane, who brutally killed Barnaby Webber, Grace O’Malley-Kumar and Ian Coates in Nottingham last year.
Community mental health services have been gutted, with a severe shortage of both psychiatrists and nurses
He had been diagnosed with paranoid schizophrenia, refused to take his medication and was experiencing ongoing, persistent symptoms of psychosis during the attack.
Calocane had been under the care of the Trust for two years prior to the stabbing, but the report found that clinicians had “minimised or omitted” details of the risk he posed to others. He was inexplicably discharged back to his GP after not engaging with the service.
The failures identified in the report echo those of past tragedies: a complete disregard for concerns raised by a patient’s family and a lack of continuity of care. Community mental health services have been gutted, with a severe shortage of both psychiatrists and nurses. Beds for patients are also in short supply. In June, a coroner warned that a shortage of mental health beds in London posed “a genuine risk of future deaths” after a man took his own life after escaping from Springfield Hospital, in Tooting.
It is important to stress that schizophrenia and psychosis are deeply misunderstood and remain stigmatised, despite progress in educating the public on other mental health issues. Most people with schizophrenia do not harm others. Influential psychiatrist R.D Laing wrote that schizophrenia “cannot be understood without understanding despair”. The basis of our discussions into improving psychiatric care must be based on empathy, not fear.
The families of the three people killed by Calocane have accused the NHS of having “blood in their hands”. Their frustration and anger must be heard by the health service and by Health Secretary Wes Streeting. Failing to address the crisis in mental health care will put patients and the public at risk.
