Professor Geoff Shepherd is a Senior Policy Advisor at the Centre and works mainly on the recovery project with the NHS Confederation.
The recent Schizophrenia Commission report, The Abandoned Illness, has shone a strong light on the way we as a society respond to people with psychosis. It pointed to the shockingly curtailed life expectancy of people who are diagnosed with schizophrenia as well as the low employment rate (at just 7%) and poor provision of NICE-approved psychological therapy. It exposed the continued stigma and discrimination that the vast majority of people with schizophrenia, and their families, experience in their everyday lives. And it drew attention to continued weaknesses in inpatient services for people with psychosis, including secure hospitals and crisis care.
The report, commissioned by Rethink Mental Illness, took a broad look at the lives of people with schizophrenia and the support that is offered to them and their families. It made a number of wide-ranging recommendations. And it is in these recommendations that the report offers not just a bleak picture of the problems we face today but a positive and radical agenda for the future.
The report calls for a fundamental change in the ways people with schizophrenia are enabled to enjoy a fairer chance in life and better health. These include ‘a radical overhaul of acute care…including better use of alternatives to admission’, better prescribing of antipsychotic medication and improved access to psychological therapies. It calls for urgent and concerted action to improve the physical health of people with schizophrenia and for improved support from primary care services.
Underlying many of the recommendations is a strong message about recovery and the importance of putting the recovery approach at the centre of support for people with severe mental illness. The report points to persuasive evidence about the potential of personal budgets to enable more people with psychosis to direct their own support. It offers strong support for the growing role of peer support workers in assisting more people to make their own recovery journeys. And it calls for more access to Individual Placement and Support employment services so that no one is denied the most effective help to gain and retain paid work if they want it.
The report points out that to focus fully on recovery, mental health services need to change on every level: from the individual interactions between professionals and service users to the pattern of service provision and strategic planning. The Centre continues to work alongside the NHS Confederation Mental Health Network in delivering the ImROC programme to support the organisational change that will help to make this possible.
The Commission’s report can now be a catalyst for wide-ranging changes in society’s attitudes to people with schizophrenia. At the base of recovery are the key values of hope, control and opportunity. For too long, people with schizophrenia have been subjected instead to crushingly low expectations, fear and isolation. Having hope for the future is not easy without opportunity for a life outside illness. Belief in yourself is not easy when you live with a condition that is shrouded in fear, prejudice and misunderstanding. But by refocusing mental health services on supporting recovery we can begin to turn the tide, to make hope, control and opportunity a reality for people living with psychosis and to show society that having a mental illness does not stop you having a life.