Thursday, 28 November 2013

Income Support and Mental Health Patients: Room for Improvement

Orchard House is an Acute Admission Unit. It acts as an inpatient service for adults with an acute mental health problem requiring hospitalisation. It is based in St Saviours. It provides 24hr care to people whose mental health care cannot be provided safely in the community, and offers an intensive assessment period covering mental health, physical health and psychosocial needs.
The unit has 14 beds. It has capacity for a dedicated psychiatric intensive care unit which can provide flexible accommodation for people who need high levels of care. Over the last 5 years 1172 patients have been admitted to Orchard House. 362 were admitted under Orders under Mental Health (jersey) Law 1969, and 810 were admitted voluntarily.
On a Facebook Group which I belong to, one of the individuals who accesses the services at Orchard House had some comments about income support, and the problems that people with mental health problems have making ends meet. It's quite an eye-opener, as most of us have little or no experience of people with mental health issues.
My own experience is limited to some friends in the 1980s, who were then in and out of St Saviours, and one of whom had schizophrenia. So that's very limited, and some time ago. This is an up to date account of someone who suffers from mental health problems.
I thought this kind of personal testimony should be more widely heard by a larger audience than one Facebook group; it's a voice that we don't hear very often, but should hear. So I asked the individual poster, who I am not going to name, and got permission to put his personal account of some of the trials and tribulations here.
I hope it will have a wider readership here, and I also hope that some politicians take up the matters presented here, and look into ways in which matters can be improved. As the reader will see, this is not an account which is critical of the professional help given at Orchard House. It is, however, very critical of the financial problems which beset people accessing mental health facilities under Income Support.
Personal Testimony of Mr X.
Today I found out that recently the Jersey government have seen fit to dock income support by 11 pounds a day from individuals that are in Orchard house respite centre for longer than four weeks. The poor have no political representation at this moment, as the church has taken a back seat and has been marginalised from politics since the war and nothing has replaced their involvement.
The majority of individuals hit by the above decision are vulnerable people who are not good at balancing their meagre income at the best of times and are generally heavy smokers as nicotine intake offsets their lack of ability to concentrate that is induced by the medication that they take (a sort of dark ages cure, in my opinion). I suspect that in the fullness of time major domestic catastrophes will occur with at least some people in the mental health community reduced to homelessness due to this decision.
One of the significant problems in situations like this is that the mental health community make up a tiny percentage of the electorate and theirs is not a situation in which supporting them will amply reward the politician involved, unless they are seen to be championing the needs of the poor of the community and few members of the electorate, in my opinion, currently are capable of empathising with that sub-section of the poor, mental health service users as they cannot imagine themselves ending up in that situation. It is often said that one in four people will experience mental health problems but that statistic hides a gross exaggeration in the sense that only one in a hundred people may go on to experience enduring mental health problems.
As public toilets are removed, water is metered, health insurance exemption is removed, it cannot be stated truthfully that these are caring times in which we live. Increasingly the poor with no real political representation are being shafted as scapegoats. Inaccurate and rhetorically exaggerated statements about benefit fraud are bandied around by politically guileful people riding the back of the zeitgeist of lack of transactionable money in the currency. What to do?
This is after health insurance exemption was removed. Before it was removed, as mental health service users we were able to go to the doctor for free. When its removal was discussed we were told that there would be a replacement scheme.
When it was taken away, ostensibly to help pay for free prescriptions, a scam health insurance scheme was foisted upon us. We, if we opt in, are to pay a component of our income support into a fund for ourselves as long as we go to the doctor no more than 4 times, which we pay for in full over the course of a year. Any more than 4 times and we have to find the money ourselves. A complete CON!!!! and we weren't able to complain at the time anywhere in public as Facebook wasn't as evolved as it was, and we are not generally politically aware as we are with Facebook etc. (currently I am developing a mental health forum for mental health service users locally, so we may have a better ability to organise to complain in the future). But it serves to illustrate how people with no real political representation are so easily fobbed off as the government look to cut costs.
This is all above a backdrop where our rent has been increased and our income support and Long Term Income Allowance has not increased to match it, with rising prices of basic staples and all forms of relaxation taxed to the hilt.
We receive somewhere in the region of £250 per week, which I am very grateful for. Most of us are single due to the isolation that goes hand in hand with mental health issues and live in states accommodation, generally studio flats. The rent is about £115 per week. Most of us smoke due to the attentional burst in the region of at least 40 a day, spending about £200 per month on cigarettes/tobacco. A certain percentage self medicate with alcohol and drugs mostly either as an addiction or as a coping strategy. Largely all of us experience depression to one degree or another, which has the tendency of preventing us from motivating ourselves to the extent that we are not as capable of organising our personal finances as members of the general public.
I have recently spent some time in respite and by the time I was released, I had gotten out of the delicate balance of budgeting. Currently I have 60 pounds for the next three weeks.
I am not unusual in this respect. It means staying in permanently, spending money only on milk and bread and finding something to do to pass the time.
I am fortunate in that my dad pays for my internet connection. If I did not have that I would have virtually nothing to do. I cannot afford a television license and so do not have a television. All of us are in the situation where having nothing to do means that the level of stress that we live with is greatly increased. Contributing to us not recovering properly.
One of the further problems that we often face is that we have to establish routines due to our situation and a stay in Orchard house takes us out of our routine and when we return home we have to train ourselves back into the routine we had before. After an 11 week stay recently, I have lost all of the budgeting skills that I had learnt and where I was just about getting by by the skin of my teeth, I am now struggling. I am lucky in that my mental health situation is not comparatively that bad, but it will be another month of managing my time and expenditure very carefully before I am back on track. Plus I have given up smoking. Those that smoke are really up the creek with the increases on tobacco.
The Health Insurance Exemption was lost. As the states removed free doctors, they gave the voting electorate free prescriptions. The doctors have, of course, seen fit to raise their consultation charge by the amount the electorate were paying for their prescriptions anyway so all of us lose out, the government seems like its done a good thing and many mental health patients who gained a great deal of help from free doctors lost out completely.
And all with no real ability to complain. There is a patient advocate provided by the helpful local branch of the charity mind, but she doesn't seem to get involved in political issues per se, instead her role is taking the legal side of the patient, a massively important step forward for us.
We try not to go to the doctor. Each visit costs a little under half of our weekly income. I want to point this out, though. I understand that there are a lot of people paying off mortgages and loans and don't earn so much that their situation is entirely different to ours. We are luckier than patients in many other countries to have an income at all, but every inch we give is a mile to take back.

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