Mental health care demands a perfect approach

Justin Thomas explains why there is no health without mental health

In China in 2010, treatment for a mental health patient involved tying him to a bed. (Reuters)

Every few years I lead an overseas study visit. This year I took six masters students from a health care administration programme to visit Mersey Care NHS Trust in England. Part of the UK's national health service (NHS), Mersey Care is one of the most creative and innovative providers of mental health care in the world.

In the UK, mental health is sometimes referred to as a “Cinderella service”. Just like Cinderella, mental health services can be overworked and overlooked, especially when it comes to resource allocation. However, in recent years, research in health economics has given rise to a radical shift in the way decision- makers view mental health. The World Health Organisation (WHO) recognises mental health problems as the leading cause of disability worldwide. This means such problems account for a huge proportion of lost productivity, which hurts the economy. It hasn't taken the people with calculators long to realise that investments in mental health make sound economic sense.

New ideas, again from the world of economics, suggest that nations might be better served by focusing on gross national happiness (GNH) rather than gross domestic profit. The former is arguably a more rounded indicator of prosperity and how well a nation is doing. Attempts to raise GNH would be foolish to ignore mental health, and wise to look to the field’s experts for ideas on how to shift a society from doom and gloom to boom and bloom.

The UAE has made rapid advances in health care, although mental health care has undoubtedly lagged behind. It is safe to suggest that mental health care remains a relative Cinderella service here too. The WHO is keen to see progress in mental health and has set targets for nations to achieve, including developing a clear national strategy for mental health. Most Gulf countries have yet to publish their strategies, with Qatar being a notable exception.

The students who visited the UK with me were from a variety of health-related specialities, not just mental health. However, these students will soon be health care leaders and unless all the projections are wrong, mental health will continue to be one of the largest and most costly challenges they face.

Mersey Care shared with us an initiative termed "perfect care". This is an idea that sits at the heart of their innovative mental health services. The organisation's affable chief executive, Dr Joe Rafferty, explained: "Perfect care is not impossible. We have to define it, believe we can achieve it and strive towards it."

There was also much talk about living the organisation’s values: compassion, accountability, respect and equity. These words conveniently abbreviate to CARE, but at Mersey Care we got the impression that these are lived values not just hollow words shoehorned into a cool acronym.

The conversation next turned to one of the biggest challenges: preventing suicide. Mersey Care has launched an initiative called “zero suicides”, and the organisation is working with Stanford University in the US on strategies that will greatly improve their ability to predict suicide risk and better prevent suicide attempts.

These days when the team meets to discuss a patient suicide, they place a photograph of the deceased on the table so as to better appreciate the human cost by seeing the person rather than just the statistic. Our visit culminated in a tour of Clock View, Mersey Care's state-of-the-art mental health facility. The physical structure as well as the way services are designed and delivered is driven by research evidence and extensive consultation with service users and carers: experts by experience.

At the tour's end, one of our delegation declared that if she ever happened to experience a severe mental health problem, she would like to be admitted to Clock View.

As we continue to improve in the UAE, we need to remind ourselves that there is no health without mental health.

Dr Justin Thomas is an associate professor of psychology at Zayed University

On Twitter: @DrJustinThomas