Tag Archives: problems

I’m worried about my neighbour who has mental health problems – what can I do to help?

My neighbour has obvious mental health issues, is there anything I can do to help rather than calling the police?

I see this question a lot, so I’m glad you’ve asked it. You say your neighbour’s mental health problems are obvious, but I’m not sure what this means. I assume by your mention of the police that their behaviour is worrying or antisocial. Rachel Boyd, information manager at Mind, warns against making assumptions: “We should be conscious about equating dangerous behaviours with mental health problems. One in four people have mental health problems, which don’t necessarily manifest themselves in concerning ways.”

You want to be supportive without being meddlesome, which is refreshing and responsible. Don’t overthink it. If you are worried about your neighbour or others, you should call the police, regardless of whether you suspect they are having problems with their mental health.

The rest depends on your relationship. If you don’t know your neighbour, open up a discussion: “People worry about the right approach, but often it’s simple. Say hello and ask how they are,” says Boyd. Trying not to make assumptions is important and you should also respect their privacy. If someone’s had a police visit, they may feel embarrassed and visible. That’s why having a regular “how are you?” interaction can be helpful.

You should consider space carefully. “If it’s a housemate, approach gently. Have the conversation in a shared space when things are friendly and there aren’t others around,” says Boyd. But above all, even if you know them well, “Be factual. Stick to what you know, rather than what you think – saying things like, ‘I’ve noticed you don’t come out much any more’, rather than, ‘What’s wrong?’”

It’s great you are thinking about how to support your neighbour, be that through just a small interaction or something more solid. They may not want support; don’t use that against them. Boyd says: “Let them know that the offer is on the table, and will continue to be, regardless of whether or not they want to take it right now.”

What do you think? Or have you got a question for Poppy and readers to consider? Post your responses below or email them to in.it.together@guardian.co.uk

Eight artworks inspired by mental health problems

The Perspective Project hosts art, poetry and writing with the aim of ending stigma and providing an outlet for those with mental health problems. The 24-year-old founder, Mark Anscombe, is already sharing the work of over 30 artists from around the UK, US and Canada, all of whom have various mental health issues. The project accepts submissions in any form, and people can submit anonymously

A royal commission is not the way to solve the problems facing the NHS | Richard Vize

As patients die in corridors and A&E performance drops to its lowest ever level, calls are growing for a royal commission to address the mounting problems facing the NHS. This would be a big mistake.

This week the commission idea was raised in prime minister’s questions and the Centre for Policy Studies has published a remit for one. The attraction of a royal commission is that it offers a chance to cut through the party political noise to allow calm consideration of the issues. But the realities of setting one up far outweigh the potential benefits.

Virtually everything about a commission would harm the NHS. If it was announced on the health service’s 70th anniversary in July, by the time the members had been approved, the remit agreed, evidence gathered and the report written, even the most nimble commission would have taken at least three years. (The last one on the NHS, set up under Harold Wilson, took four years.)

That would put it within months of the 2022 general election. So legislation would have to wait until at least the first Queen’s speech of the next parliament, which means nothing would change before April 2024.

In the meantime, there would be six years of policy paralysis. Questions to ministers on every avoidable death, every missed target, every hospital deficit would be met with the words “we’ve set up a royal commission …”. The government could abdicate responsibility and accountability while hiding behind a mirage of activity.

Agreeing the terms of reference would be fraught and mission creep inevitable. While the heart of the issue would be sustainable funding, this would quickly suck in everything from operational efficiency to payment systems, drugs costs, buildings and procurement. Social care funding would have to be debated. Since the biggest cost is staffing, it would soon spill over into predicting future staffing needs, and therefore training requirements, capital investment in technology and more besides.


Any report would be out of date before it was published, and would sink under the weight of its own ambition.

Any attempt by a royal commission to offer wise words on the impact of technological advances such as gene therapy and artificial intelligence would be risible. The speed of change is so great that their words would be history, not policy.

A commission would inevitably tread on the landmine of NHS structure. The present evolving and rather chaotic setup has one big advantage – however imperfectly, it is allowing local areas to find a way of organising and operating that works for them, rather than having to meet the latest centrally imposed structure.

Greater Manchester, Surrey Heartlands and Cornwall are leading moves towards greater devolution in implementing national goals, including a stronger voice for local government. Eight areas are pioneering the development of integrated population health management under the “accountable care” banner. The rest of England is experimenting with the new care models established in the Five Year Forward View.

Together these represent seismic changes in the culture and operation of the NHS. Each one will have the best chance of success if it is allowed to develop at its own pace. We don’t need a grand plan.

A royal commission has superficial appeal, offering authority, wisdom and consensus. But it is wholly unsuited to tackling a fast-changing, technologically driven service desperate for financial security which needs answers quickly. Any report would be out of date before it was published, and would sink under the weight of its own ambition.

Whatever else the NHS lacks, it is not insight, evidence and analysis. The Nuffield Trust, King’s Fund and Health Foundation produce outstanding material daily on all aspects of care and management. The Institute for Fiscal Studies is piling in with a funding review. The NHS is awash with commission and thinktank reports, and the BMJ, health select committee and National Audit Office provide yet more evidence.

We don’t need a royal commission. The truth is already out there. We need a government with the courage to face up to tough choices and make some decisions – now, not in six years.

Richard Vize is a public policy commentator and analyst

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs

A royal commission is not the way to solve the problems facing the NHS | Richard Vize

As patients die in corridors and A&E performance drops to its lowest ever level, calls are growing for a royal commission to address the mounting problems facing the NHS. This would be a big mistake.

This week the commission idea was raised in prime minister’s questions and the Centre for Policy Studies has published a remit for one. The attraction of a royal commission is that it offers a chance to cut through the party political noise to allow calm consideration of the issues. But the realities of setting one up far outweigh the potential benefits.

Virtually everything about a commission would harm the NHS. If it was announced on the health service’s 70th anniversary in July, by the time the members had been approved, the remit agreed, evidence gathered and the report written, even the most nimble commission would have taken at least three years. (The last one on the NHS, set up under Harold Wilson, took four years.)

That would put it within months of the 2022 general election. So legislation would have to wait until at least the first Queen’s speech of the next parliament, which means nothing would change before April 2024.

In the meantime, there would be six years of policy paralysis. Questions to ministers on every avoidable death, every missed target, every hospital deficit would be met with the words “we’ve set up a royal commission …”. The government could abdicate responsibility and accountability while hiding behind a mirage of activity.

Agreeing the terms of reference would be fraught and mission creep inevitable. While the heart of the issue would be sustainable funding, this would quickly suck in everything from operational efficiency to payment systems, drugs costs, buildings and procurement. Social care funding would have to be debated. Since the biggest cost is staffing, it would soon spill over into predicting future staffing needs, and therefore training requirements, capital investment in technology and more besides.


Any report would be out of date before it was published, and would sink under the weight of its own ambition.

Any attempt by a royal commission to offer wise words on the impact of technological advances such as gene therapy and artificial intelligence would be risible. The speed of change is so great that their words would be history, not policy.

A commission would inevitably tread on the landmine of NHS structure. The present evolving and rather chaotic setup has one big advantage – however imperfectly, it is allowing local areas to find a way of organising and operating that works for them, rather than having to meet the latest centrally imposed structure.

Greater Manchester, Surrey Heartlands and Cornwall are leading moves towards greater devolution in implementing national goals, including a stronger voice for local government. Eight areas are pioneering the development of integrated population health management under the “accountable care” banner. The rest of England is experimenting with the new care models established in the Five Year Forward View.

Together these represent seismic changes in the culture and operation of the NHS. Each one will have the best chance of success if it is allowed to develop at its own pace. We don’t need a grand plan.

A royal commission has superficial appeal, offering authority, wisdom and consensus. But it is wholly unsuited to tackling a fast-changing, technologically driven service desperate for financial security which needs answers quickly. Any report would be out of date before it was published, and would sink under the weight of its own ambition.

Whatever else the NHS lacks, it is not insight, evidence and analysis. The Nuffield Trust, King’s Fund and Health Foundation produce outstanding material daily on all aspects of care and management. The Institute for Fiscal Studies is piling in with a funding review. The NHS is awash with commission and thinktank reports, and the BMJ, health select committee and National Audit Office provide yet more evidence.

We don’t need a royal commission. The truth is already out there. We need a government with the courage to face up to tough choices and make some decisions – now, not in six years.

Richard Vize is a public policy commentator and analyst

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs

The treatment of prisoners with mental health problems is a national shame | Eric Allison

The news that living conditions at Liverpool prison are the worst that jail inspectors have ever seen will come as no surprise to anyone who has spent time there. The gaunt Victorian pile on Hornby Road, in the Walton area of the city, was always known as the dirtiest jail in the system.

Most of the old jails have a cockroach problem, but Liverpool took the infestation to a new low, with cell floors carpeted with them, as they came out at night to feed off the crumbs. I experienced those conditions some 20 years ago. With prison budgets still reeling from the cuts imposed by former justice secretary Chris Grayling, it can hardly be imagined that conditions have improved since my time there. According to a leaked report on Liverpool, some areas of the jail were so filthy and hazardous they were beyond cleaning.

The chief inspector of prisons, Peter Clarke, spoke of a prisoner with complex mental health needs, caged in a cell that had no furniture other than a bed. The cell windows were broken, as was the light fitting. The toilet was filthy and blocked and electrical wires were exposed in his “dark and damp” living space. He had been held in these conditions for weeks.

Conditions such as these would challenge the wellbeing of prisoners in good health. To impose them on prisoners suffering mental health problems is taking punishment to a shameful and degrading level.

For some years now, I have been saying that mental health is the biggest single problem facing a prison service beset with difficulties. I saw it coming back in the 1980s, when the Thatcher government closed many of the old asylums and, supposedly, replaced them with care in the community. We know what happened there. Mental health became – and still is – the poor relation of the NHS, and many of those suffering end up on the streets and in our prisons.


Prisoners miss an average of 15% of medical appointments because there are not enough staff to escort them

And our political masters cannot say they are unaware of the problem. The Commons public accounts committee this month published a report saying that the record levels of self-harm and deaths are a “damning indictment” of the state of mental health provision in jails across England and Wales. The committee found that long-standing understaffing and increased prevalence of drugs in jails have led to deep-rooted failures in the management of mental health.

Shockingly, MPs concluded that, while the prison service and NHS England have a duty of care to prisoners, they “do not know where they are starting from, how well they are doing or whether their current plans will be enough to succeed”.

Incredibly, the most commonly used data, used to estimate the scale of the problem within our prisons, is 20 years old, when the prison population was about half of what it is today. Yet the committee found that governments efforts to improve the mental health of prisoners so far have been poorly coordinated, with information not shared, not even between community and prison GP services. Prisoners miss an average of 15% of medical appointments because there are not enough staff to escort them. Yet the loss of staff continues to outstrip recruitment in many jails.

The chair of the committee, Meg Hillier, said the appalling toll of self-inflicted deaths and self-harm in prisons can be laid at the deep-rooted failures in the management of prisoners’ mental health.

When The NHS replaced the prison medical service and took responsibility for healthcare in prisons in 2000, it seemed a change for the better. Prisoners come from the community and are released back there. It never made sense for them to be treated by a different health service while locked up. But it is no coincidence that a struggling NHS, particularly the mental health sector, is failing to cope with the demands of thousands of prisoners in need of therapeutic care. There are no votes to be won behind bars.

Deborah Coles is the director of the charity Inquest and sees, more than most, the results caused by the neglect of some of the most vulnerable people in our society. She says that alternatives to prison must be found for those suffering mental health problems and a more therapeutic response for those for whom prison is the last resort.

Can we hope her words will be heeded? On Monday, the justice secretary, David Lidington, gave a speech to the thinktank Reform. He said the “overriding trigger” for the levels of violence, self-harm and disorder inside prisons in England and Wales was “the availability of drugs, including new psychoactive substances and other contraband”.

On mental health, the minister had nothing to say.

He should be taken to that filthy cell in Liverpool and made to explain his failure to master his brief to that prisoner with complex mental health needs; to whom, I remind him, he owes a duty of care.

Eric Allison is the Guardian’s prison correspondent

Have you been rejected by insurers because of mental health problems?

If you have a mental health condition it can be harder to get insurance and in some circumstances you have to pay more.

However, this should only be the case if the insurer can provide evidence that you are at a higher risk of making a claim and if the information they used to access your application was applied in a reasonable way.

Earlier this year travel insurance companies were accused of discriminating against people with mental health problems after a young woman was refused cover when she revealed that she had bipolar disorder.

What are your experiences?

We want to know whether other people feel they have been discriminated in this way. Have you found it harder to get any kind of insurance – travel, health, life – even though there is no evidence you are higher risk? Do you feel you were unfairly treated? Does the current system work for those with mental health problems? Share your views, experiences and stories and we will use a selection in our reporting.

  • Your responses are secure as the form is encrypted and only the Guardian has access to your contributions. We will do our best to keep you anonymous.
  • If you’re having trouble using the form, click here

Have you been rejected by insurers because of mental health problems?

If you have a mental health condition it can be harder to get insurance and in some circumstances you have to pay more.

However, this should only be the case if the insurer can provide evidence that you are at a higher risk of making a claim and if the information they used to access your application was applied in a reasonable way.

Earlier this year travel insurance companies were accused of discriminating against people with mental health problems after a young woman was refused cover when she revealed that she had bipolar disorder.

What are your experiences?

We want to know whether other people feel they have been discriminated in this way. Have you found it harder to get any kind of insurance – travel, health, life – even though there is no evidence you are higher risk? Do you feel you were unfairly treated? Does the current system work for those with mental health problems? Share your views, experiences and stories and we will use a selection in our reporting.

  • Your responses are secure as the form is encrypted and only the Guardian has access to your contributions. We will do our best to keep you anonymous.
  • If you’re having trouble using the form, click here

Have you been rejected by insurers because of mental health problems?

If you have a mental health condition it can be harder to get insurance and in some circumstances you have to pay more.

However, this should only be the case if the insurer can provide evidence that you are at a higher risk of making a claim and if the information they used to access your application was applied in a reasonable way.

Earlier this year travel insurance companies were accused of discriminating against people with mental health problems after a young woman was refused cover when she revealed that she had bipolar disorder.

What are your experiences?

We want to know whether other people feel they have been discriminated in this way. Have you found it harder to get any kind of insurance – travel, health, life – even though there is no evidence you are higher risk? Do you feel you were unfairly treated? Does the current system work for those with mental health problems? Share your views, experiences and stories and we will use a selection in our reporting.

  • Your responses are secure as the form is encrypted and only the Guardian has access to your contributions. We will do our best to keep you anonymous.
  • If you’re having trouble using the form, click here

Have you been rejected by insurers because of mental health problems?

If you have a mental health condition it can be harder to get insurance and in some circumstances you have to pay more.

However, this should only be the case if the insurer can provide evidence that you are at a higher risk of making a claim and if the information they used to access your application was applied in a reasonable way.

Earlier this year travel insurance companies were accused of discriminating against people with mental health problems after a young woman was refused cover when she revealed that she had bipolar disorder.

What are your experiences?

We want to know whether other people feel they have been discriminated in this way. Have you found it harder to get any kind of insurance – travel, health, life – even though there is no evidence you are higher risk? Do you feel you were unfairly treated? Does the current system work for those with mental health problems? Share your views, experiences and stories and we will use a selection in our reporting.

  • Your responses are secure as the form is encrypted and only the Guardian has access to your contributions. We will do our best to keep you anonymous.
  • If you’re having trouble using the form, click here

Have you been rejected by insurers because of mental health problems?

If you have a mental health condition it can be harder to get insurance and in some circumstances you have to pay more.

However, this should only be the case if the insurer can provide evidence that you are at a higher risk of making a claim and if the information they used to access your application was applied in a reasonable way.

Earlier this year travel insurance companies were accused of discriminating against people with mental health problems after a young woman was refused cover when she revealed that she had bipolar disorder.

What are your experiences?

We want to know whether other people feel they have been discriminated in this way. Have you found it harder to get any kind of insurance – travel, health, life – even though there is no evidence you are higher risk? Do you feel you were unfairly treated? Does the current system work for those with mental health problems? Share your views, experiences and stories and we will use a selection in our reporting.

  • Your responses are secure as the form is encrypted and only the Guardian has access to your contributions. We will do our best to keep you anonymous.
  • If you’re having trouble using the form, click here