In Views

Follow this topic

Bookmark

Record learning outcomes

We need to get to a stage where mental health problems are taken as seriously as physical health conditions, says Peter Kelly…

The quality payment scheme is back! And I can already hear some of you groan ‘oh no, not again!’

The scheme can be a pain in the you-know-what but actually, this year it is not too bad. It is not as complex as it has been in previous years where the hard part was trying to figure out what you actually needed to do.

Quality payments are usually not too bad once you get started and, I have to admit, once you get into the e-learning parts of it. I find them quite enjoyable.

Shout out to the Centre for Pharmacy Postgraduate Education (CPPE) who – and I don’t know if this gets said much – is a really is top notch organisation. Their learning modules are brilliantly put together and I have always enjoy working through them.

Full of fascinating insights and poses some big questions

This year, the main module for experienced pharmacists like myself is on consultations with patients who have mental health problems. It is full of fascinating insights and it poses some big questions.

Do we spend too little looking after young people with mental health problems? I think the answer is an obvious yes. I’m not going to get into the whole ‘what is money, where does it come from?’ debate.

So, let’s just say there is no magic money tree and if you want to spend more on young people and mental health problems, we need to find the money from somewhere else.

Do we spend too much money trying to treat people who are probably going to die anyway? Now, I don’t have the stats and figures on this. I just have a bit of anecdotal evidence, so I’m maybe totally off the mark.

A health system that is too ruthless

My dad died of bowel cancer. He had health insurance and died in a private hospital. During the first time he got bowel cancer, it was successfully treated. The second time, it came back five years later and had spread everywhere.

Nobody believed it was treatable but they gave it a go anyway. Was that a waste of money and resources? Did trying to treat him help the doctors learn that improving treatments in the future might actually work? If not, was it just a waste of money?

A health system that is too ruthless and callous dealing with elderly patients facing death would be distasteful and probably intolerable.

However, on the flip side, a health service driven by a Christian belief that all life is precious and should be preserved at all costs is very wasteful and in a system that lacks adequate funding in other areas, may have a net negative effect on the preservation of life.

The CPPE pack shows figures on how having major mental health problems can reduce life expectancy dramatically. It also talks about parity of esteem, how physical health conditions are taking much more seriously than mental health conditions.

And what we should aim for is parity of esteem, where mental health problems are taken as seriously as physical health conditions.

I had heard the term ‘parity of esteem’ once before. Enter Dr Benji Waterhouse an NHS psychiatrist, best-selling author of the book You don’t have to be mad to work here, stand-up comedian and, I regret to say, all-round nice guy.

As a jobbing comedian, I, like most jobbing comedians, like to think the comedians who break through and find success are not nice people. It’s a comfort mechanism and sometimes it’s true that stars are not nice people. But Benji, I say with great regret, is a lovely fella.

I first heard of the phrase 'parity of esteem' when I watched him on stage at the wonderful Bearcat Comedy Club in Twickenham. Benji regaled the audience with a story of being on a plane when someone needed CPR.

The call went out for a doctor on the plane. Benji stepped forward, as did another doctor. The other doctor was an emergency doctor. After a quick consultation between the two of them, the other doctor took the lead on the CPR and quipped to Benji that once the patient had come through, he could ask him how he felt about his childhood.

It's just a harmless joke but it captures the essence of truth about how mental health illness does not have parity of esteem with physical health illness.

Benji’s book is a perfect companion piece to the CPPE pack as it shows what those stats and figures look like in the real world. If you think pharmacy is overlooked and underfunded, strap in for the stress of working in mental health services.

I’m a dreamer and I hope that in a benevolent artificial intelligence future, we can better figure out how to allocate our resources to maximum effect.

But do you think that will involve more money being directed to mental health services?

Peter Kelly is a pharmacist based in London and a stand-up comedian.