Mental health challenges, parity of esteem and reflection on latest suicide findings

Published: 10 Oct 2016

Today (10 October 2016) is World Mental Health Day and as a junior doctor in child and adolescent psychiatry, a fitting time to pen my first HQIP blog.

In my professional role I am all too aware of the issues facing people with mental health challenges in the UK.  It was a desire to advocate for my patients on a wider scale that led me to apply for my role at HQIP, a National Medical Director’s Clinical Fellowship with the Faculty of Medical Leadership and Management.  I really wanted to try and do something about the stark fact that people with severe mental illness are dying up to 20 years younger than the general population due to their physical health. I am therefore very pleased to be leading on a project initiative that will increase ‘parity of esteem’ between physical and mental health problems and helping to ensure they gain equal value within the National Clinical Audit and Patient Outcome Programme (NCAPOP), a HQIP programme commissioning over 30 audit projects.

Included in the NCAPOP programme is the National Confidential Inquiry into Suicide and Homicides by people with mental illness (NCISH). Last week I felt privileged to attend its 20th anniversary conference and hear Professor Louis Appleby discuss its 2016 report and 20-year review. We were presented with some very important findings that will hopefully drive change in clinical practice for the better. It was encouraging to learn that inpatient suicides have decreased by 70% in England from 2004-14, however concerning, that in comparison, the suicide rate was three times higher in crisis resolution/home treatment (CHRT) teams. This, in my opinion, highlights a need to target future suicide strategies in this area to optimise those teams as effective and safe alternatives to admission.

NCISH has produced an infographic (see below) illustrating the report’s key recommendations on how to improve safety. This seems like an excellent first step and I look forward to being able to reflect on the positive changes in a year’s time.

I feel there is still some way to go before mental health care receives the full recognition, respect and funding it so deserves. However I feel inspired by events such as World Mental Health Day, and am hopeful that it will will one day achieve true parity with physical health problems.

I’d be really interested to hear other people’s viewpoints on the issues raised here. Join the conversation using #WMHD16 and find me @saffronhomayoun.

– Dr Saffron Homayoun

ST5 in Child and Adolescent Psychiatry at South London and Maudsley NHS Foundation Trust

National Medical Director’s Clinical Fellow at HQIP