Psychosis patients 'not getting best care'
Summary: A key government target for caring for people with severe mental health conditions in England is being missed due to underfunding, research suggests.
People experiencing a first episode of psychosis should be seen within two weeks and get a quality care package.
But Liberal Democrat research indicates that while more people are being seen on time, few get the right treatment.
NHS England said "the analysis inevitably gives only a partial and dated picture of progress".
New care and treatment standards for psychosis were introduced by the Department of Health in April 2016.
The rules state at least 50% of people experiencing their first episode of psychosis should start a package of care recommended by the National Institute for Health and Care Excellence (NICE) within a fortnight of being referred.
Norman Lamb, the former Mare Minister who established the care standards, said responses to Freedom of Information requests he had made suggested "the treatment programme is not being properly delivered" in most parts of England.
While official figures show 72% of patients started their treatment within the two-week target in November 2017, Mr Lamb's figures indicate that fewer than a third of mental health trusts in England were able to offer patients the full NICE package of care.
Of the 45 mental health trusts that responded:
- 12 said they were able to provide the full NICE approved treatment
- 24 said they were not
- five said they were making progress
- Four didn't provide the information
The typical treatment involves a combination of anti-psychotic medication, psychological therapies such as cognitive behaviour therapy (CBT) and family or social support.
"Could we ever imagine a situation where a cancer patient doesn't get the full treatment that the evidence says they need?" asks Mr Lamb rhetorically.
"The impact on peoples' lives of not making this investment is profound.
"You are left with - potentially - a miserable life, a life on benefits, a life with difficult relationships. And yet if we make that investment, we can transform lives."
Ali Mousa's first episode of psychosis lasted a fortnight.
"I thought musicians were trying to induct me into some sort of secret society," he says.
"I thought I was the next Messiah. It felt bizarre, but very real."
His behaviour, including walking down the middle of busy road, led to him being arrested and spending six months in a psychiatric hospital.
The 28-year-old praises the hospital, but says what made the real difference to his recovery was the support of his local early intervention in psychosis (EIP) team.
"If it wasn't for them, I wouldn't have been able to stand up on my own two feet again," he says.
"I didn't think I'd get support, to get housing, to get me a job, for someone to help build relations with my mum."
Ali says he is now fully recovered, and has been in a job, proof, he says, of the value of good care.
NHS England has calculated that a proper care package will cost about £8,250 per patient.
But of the 17 trusts that answered Mr Lamb's question on funding, all but two (Rotherham, Doncaster and South Humber, and Oxleas) said they were spending less than that amount.
The pressure on budgets indicated by the responses is reflected in a report looking at the performance of EIP teams in the south of England.
The draft report says that of the 16 trusts providing EIP services in the region, not one is receiving the recommended level of investment.
If the expected investment in the service had been realised, says the document, an extra £15m would have been spent in 2017-18; the real increase has been £3.5m.
"There continues to be a gap between the rhetoric and investment reaching the front line," says the report.
The increasing demand for EIP services and the pressures it's putting on staff "is demoralising and driving many away from joining and staying within the clinical workforce", it says.
A member of Dorset Healthcare NHS Trust's Early Intervention Team was recently assaulted, the BBC has learned, after assessing a new patient alone.
The standard is for two staff members to initially meet new people, in part to protect them.
Evidence seen by BBC News indicates the trust is struggling to provide EIP services - with staff carrying higher caseloads than other nearby trusts and, in a number of areas, delivering fewer types of treatment such as CBT sessions.
Mike Kelly, Dorset Healthcare's head of mental health services, said: "We know there is work to do and we are recruiting staff to fill the vacant posts to enable the team to provide more support to people who use the service.
"Additional funding will also be required going forward to keep pace with demand."
An NHS England official said: "10,000 people each year are now receiving treatment through the early intervention in psychosis programme, with over three-quarters of patients getting treatment within two weeks.
"The analysis inevitably gives only a partial and dated picture of progress in these services."
Other recent news items:
- Doctors’ union finally agrees to spread the word
- Disability Politics UK: call to prioritise step free access
- Children with disabilities: targeted violence and hostility
- Dementia care: how social enterprises are developing products and services
- Adass spring seminar: four things you need to know
- The Disability Audit: the eight coalition policies that have hit disabled people
- DWP told to publish ESA deaths report, after two-year delay
- The struggle to find work when you have Down's syndrome
- PIP Delay Crisis Over, Claims DWP
- Meet Justin Tomlinson MP- New Minister For Disabled People
- A quick guide to new care minister Alistair Burt
- How to use your disability as a strength when applying for jobs
- Devastating impact of cuts on disabled people
- NHS ‘has wasted more than a year’ on latest bid to improve wheelchair services
- Five Thousand Disabled Adults Sexually Abused In Last 2 Years Says NSPCC
- ESA Claimant Takes On Maximus And Wins
- One in five benefit-related deaths involved sanctions, admits DWP
- Manchester United tell family with disabled son to watch Stockport instead
- Joint mental health commissioning strategy
- New parliament sees number of disabled MPs plunge
- Motability under spotlight over cuts to grants… despite £190 million reserves
- Disabled people ‘should come together in new national body’
- 'It's a great honour': Selby appoints UK's first mayor with learning disabilities
- Voluntary Community Social Enterprise Review website
- Cameron downgrades minister for disabled people
- Poor UK cancer survival rates linked to lack of GP direct access to scans
- Charity highlights role of siblings in supporting adults with a disability
- Queen’s Speech fails to mention social care funding
- Queen’s speech ‘suggests the worst is yet to come'
- TV industry must improve representation of disabled people
- The bionic suit helping wheelchair users get back on their feet
- New project to tackle mental health issues
- Equality watchdog contradicts football’s Premier League over access
- Schools 'must improve support for diabetic children'
- National Theatre plans shows on issue of disability
- Rise in mental health bed occupancy
- Watchdog writes to Man Utd after stewards confiscate walking aids from fans
- Government cuts ‘could see disabled people slide back to the bad old days’
- Disabled payment delay unlawful, judge rules
- The 'dragons' who want to help disabled people start their own business
- Boy, 12, wins £120,000 in damages after swine-flu jab left him 'severely disabled' by narcolepsy
- DWP ignores watchdog’s deadline over benefit-related deaths
- Man who cannot walk or talk called for jobcentre 'back to work' interview
- UK woman can ride bike for first time with 'world's most lifelike bionic hand'
- GPs to refer more patients with low-risk cancer symptoms under new NICE guidance
- Disability campaigners clash with police inside parliament over benefit cuts
- Indefinite Award DLA Transfer To PIP Will Start From July In Certain Postcodes
- Disabled children less happy with hospital care than peers
- ILF closure: Process has caused ‘fear, stress and anxiety’, say researchers
- Disability poverty rose sharply in fourth year of coalition
- UK services failing patients with dementia
- Shadow disability minister admits backing assisted suicide bill
- Disabled people's rights threatened by government cuts, campaigners warn
- BBC Three’s ‘Defying The Label’ Season
- From 'bloodied knees' to the House of Commons as a disabled MP
- Mental health patients sent hundreds of miles for beds as out of area placements rise 23 per cent
- Systematic over-medication blights learning disability care
- The Superhumans return to Channel 4
- Accessible Information Standard Approved
- Doctors demand return of lung cancer awareness campaign
- David O’Mar, 58, Found Fit For Work Two Weeks Before His Death
- World First Bionic Eye Gives Hope To Millions
- Seven-day NHS to include child mental health services, minister confirms
- Court hears appeal on ‘unfair’ PIP 20 metre rule consultation
- New report by Business Disability Forum cites lack of skills in line managers as major barrier to retention of disabled employees
- Tanni says 10,000 signatures could finally transform wheelchair services
- BBC3 presenter and journalist crowdfunding to transform the lives of people with disabilities in Ghana
- Disabled voters take pioneering legal action over election access
- Has disability sport lost its London 2012 Paralympics momentum?
- NHS Announce New Care Guidelines For Learning Disabilities
- Fresh evidence that ‘benefit scrounger rhetoric’ is causing hate crime
- Sanctioned Jobseekers With Mental Health Problems Are Not ‘Vulnerable’ Says DWP
- Clubs “Neglecting Responsibility” To Disabled Fans
- Latest Figures Show Massive Rise In ESA Sanctions
- ‘Bizarre’ figures raise fears over ministers’ plans for ESA
- School nurses ‘need better mental health training’
- Number of people developing dementia 'stabilising'
- Boy, nine, fitted with first prosthetic hand that can change grip with gestures
- Iain Duncan Smith criticises employers over disability employment gap
- Disability benefit sanctions soar by 30% in a year
- Thousands have died after being found fit for work, DWP figures show
- Goths at risk of depression or self-harming, research says
- Elderly 'ripped off' in mobility scooter market
- GPs are missing cancer in children - because they 'don't have enough training'
- IDS announces 'fitness for work' U-turn that was five years in the making
- People with autism and learning disabilities excel in creative thinking, study shows
- Starbucks apologises for telling woman she was not 'disabled enough' to use the toilet
- DLA Lifetime Award PIP Transition Started from 1 September in 29 New Areas
- Successful 'Fit for Work' Appeals at Highest Ever Level, Show DWP Stats
- Why is our justice system failing vulnerable people?
- UN investigating British Government over human rights abuses caused by IDS welfare reforms
- Coroners 'ground breaking' verdict: Suicide was 'triggered' by 'fit for work' test
- Schoolboy calls for more disabled characters in children's books
- The quadruple amputee who needs the correct prosthetic
- Welfare to work programme failing disabled and ill jobseekers, say charities
- Disabled fans 'delighted' as Premier League finally acts on access
- Two-thirds of adult social care requests rejected by local councils
- Independent Living Fund: Government silence 'suggests something to hide'
- UK employers report rise in mental health problems: CIPD study
- UN inquiry considers alleged UK disability rights violations
- Parliament's own disability group picks first non-disabled chair in nearly 50 years
- Dementia drug 'keeps patients out of nursing homes'
- Disability benefit cuts will actually make it harder for disabled people to find work,coalition of 60 charities warns
- Problems with the care and treatment provided by the NHS and/or difficulties in accessing health services?
- Consultation on the proposed new adult social care strategy
- The Leicestershire Advice Service for Social Care is here to guide you
- Minister: MPs must help 'open doors' for disabled jobseekers
- 'Homes not hospitals': learning disability care to move to community
- Equality Act 'simply isn't strong enough' for BSL-users, peers are told
- Disability Hate Crimes Rise 41% In A Year
- Companies fear employing people with learning disabilities, survey reveals
- DWP cuts specialist disability employment advisors in jobcentres by over 60 per cent
- Watchdog 'must do more to support disabled people to fight discrimination'
- ‘We must keep banging the drum,’ says bus campaigner after five-year fight for justice
- 2,000 disabled people wrongly declared ‘fit to work’ by DWP in just three months
- Local authorities 'spend close to nothing on mental health'
- Rock band with learning disabilities release first single
- NICE seeks to improve diagnosis and treatment of cerebral palsy
- Premier League clubs face legal threat unless disabled access is improved
- UK’s progress on disability rights ‘patchy and tortuous’, UN told
- Peer pressure sees minister finally announce date for taxi access laws
- Stop the NHS slashing vulnerable people’s care packages in and around Leicestershire
- Minister tells industries to increase representation of disabled people
- Disabled children in England 'finding it increasingly hard to access council care'
- Wheelchair Rugby Loses Funding Appeal
- Plans that could force people into institutions could be ‘front line’ of national problem
- Young people 'fear stigma' if they ask for mental-health help
- Disability benefits process is 'inherently flawed', MPs told
- Businesses woefully ill-equipped to deal with Britain's rapidly growing mental health crisis
- Cash boost for pupils with special needs and disability
- PIP investigation: ‘Horrific’ suicide question sparks fresh assessment inquiry calls
- Disability report: Being disabled in Britain
- Stop PIP reassessments for patients with progressive diseases, campaigners say
- Patients with learning disabilities missing out on health checks
- Thousands have disability vehicles taken away
- Aspire announces GLL and LCiL as first partners to lead InstructAbility
- Easy read guide to voting by post
- Online campaign ‘could enable disabled people to affect election outcome’
- Health Committee inquiry and report: Brexit and Health and Social Care – People and Process
- Women’s Resource Centre report: the Impact of Austerity Measures on Women’s Voluntary and Community Organisations
- Disabled people ‘forced into dangerous workfare that breaches health and safety laws’
- Mental Health Foundation report: Surviving or Thriving? The State of the UK’s Mental Health
- Stirling University to launch home dementia app
- General Election 2017: What are the parties promising disabled people?
- Anger, resignation… and optimism in wake of general election result
- New disabled MPs pledge to fight for rights in parliament
- Queen’s speech: May ‘abandons’ election pledge on access
- The waiting time for a vital disability benefit has risen hugely in 6 months
- Almost 6,000 mental health patients sent out of area for care last year
- Patients increasingly forced to crowdfund their own wheelchairs as NHS provision not enough, doctors warn
- Years of austerity have left personal assistance in ‘very fragile state’
- Over Half Of Foodbank Users Are Households With A Disabled Person
- Prince Harry launches brain injury card in Suffolk
- Iain Duncan Smith says work capability assessments don't work and are 'too harsh'
- PIP investigation: 200 cases of dishonesty… and still DWP, Atos and Capita refuse to act
- Global blindness set to 'triple by 2050'
- My disability abortion bill could halt Britain’s slide towards eugenics, says Tory peer
- Jobcentre Staff Have An Alarming Lack Of Confidence Dealing With Disabled Claimants
- BBC initiative for disabled actors is a ‘wake-up call’ for producers
- Bus industry set to face fresh legal action over access to wheelchair space
- Government accused of breaching UN convention in its treatment of disabled people
- Theresa May admits UK mental health services are 'patchy'
- 2,000 children with learning disabilities left without a school
- UK faces UN examination: Government cuts caused ‘human catastrophe’
- Half of parents of disabled children forced to reduce working hours due to 'unlawful' cuts to school transport
- Summit meeting will aim to bring movement together on independent living
- Have you got the wrong impression about schizophrenia?
- Quarter of 14-year-old girls 'have signs of depression'
- Council’s review finds PIP ‘not fit for purpose’
- Epilepsy medication impact not shared
- What is universal credit - and what's the problem?
- Calls for Amazon to ban 'anorexia hoodie'
- Green man crossings 'too fast' for people with arthritis
- Mental health patients being failed as services face 'potent mix' of workforce cuts and rising demand, shows report
- Universal Credit helpline charges scrapped
- Hate crimes against disabled children rise 150 per cent in two years
- Modelling debut for boy, 11, with Down's syndrome
- Wheelchair access at Premier League grounds improved after campaigning
- Mental health sees 300,000 people leave their jobs each year
- Care Quality Commission report: Annual State of Health Care and Adult Social Care in England 2016/17
- Access to Work: ‘Scheme’s future in jeopardy through cuts and incompetence’
- Tailored treatment study aims to improve prostate cancer care
- Government admits disabled people have been receiving too little financial support from DWP
- Disabled people worry about telling employers of their condition
- Disabled woman takes DWP minister to court over PIP mental health changes
- Women and disabled people hit hardest by years of austerity, report confirms
- New year’s honours recognise campaigners, inventor and Paralympians
- Esther McVey makes disability benefits U-turn over payments
- Educational support for deaf children in England 'in complete disarray'
- Blue badge scheme could be extended to cover autism and dementia
- More than 220,000 people scored zero on disability benefits test
- MPs launch inquiry into online abuse of disabled people, following Katie Price petition
- Open letter from mental health activists probes charity’s links to DWP
- UK sick pay is found to breach international legal obligations
- Psychosis patients 'not getting best care'
- DWP promises no-one will lose out in huge review of 1.6 million PIP cases
- Majority of disability benefit claimants being left with not enough to live on, campaigners warn
- Suffragettes needed? The women still struggling to vote
- New 'miracle jab' promises to ease arthritis pain - and save the NHS billions too
- Antipsychotic drug found to relieve symptoms suffered by millions of people with Alzheimer's disease
- Government’s suicide prevention boss refuses to call for action on ESA risk stats
- Disabled peer raises ‘deep concerns’ over impact of Brexit bill on rights
- PIP assessments: 'Lack of trust' in benefits systems
- Anti-depressants: Major study finds they work
- More than a million benefits sanctions imposed on disabled people since 2010
- Thefts of disabled blue badge parking permits quadruple in England
- High Court rules Tories' disability benefit changes ‘blatantly discriminate’ against mental health patients
- Echolocation could help blind people learn to navigate like bats
- Call for government to ditch ‘discriminatory’ PIP rules for NHS care home stays
- Mystery over shock fall in disability benefits paid to older people
- Disabled passengers' champion unveiled
- Wheelchair users in UK to be given enhanced rights for bus travel
- Spring statement ‘shows disabled people will continue to bear brunt of austerity’
- House of Commons could replace benches with fold-down seats to improve access for disabled MPs
- NHS must prepare for `huge´ demand for new Alzheimer´s drugs, experts warn
- Access to work: Funding increase for disabled workers
- Doctors hope for blindness cure after restoring patients' sight
- New initiative to address ticketing barriers for deaf and disabled fans
- NICE: 'Care providers must ask people with LD what they want out of life'
- Disabled people struggle to afford food and heating, study says
- Government faces legal action over election access fund
- Disability-led ensemble to play BBC Proms
- Women across UK denied mental healthcare around childbirth, say doctors
- Robot helps Jack McLinden, 14, to be Everton mascot
- Cystic fibrosis: Company urged to lower cost of life-changing drug
- Disabled people split over personal health budget expansion plans
- Benefits applications forms to be made more accessible
- Government response to damning inquiry into disability benefit system 'falls short', say MPs
- EHRC appoints eight disabled people to advisory committee
- Sharp rise under-11s referred for mental health help
- Feel the beat: deaf fans fight for access to live music
- Health and Social Care Committee report: The Government’s Green Paper on mental health: failing a generation
- Disabled people face ‘hidden crisis’ in accessible housing
- Equality watchdog ‘considering legal action against government’ over rail access failures
- TUC Disabled Workers’ Conference: ‘Critically-flawed universal credit must be scrapped’
- Call for national research as fears grow over loss of DPOs
- DWP is failing ‘vulnerable’ claimants of universal credit, says watchdog
- US approves UK-grown marijuana-based epilepsy drug
- A Better Understanding of Chronic Pain in CP Patients Is Needed, Review Study Suggests
- Student mental health support must improve, universities told
- Minister lauds £600,000 for rail access… after her department confirms £47 million in cuts
- Scientists have discovered a new type of depression: Finding will pave the way for new treatments for 30% of patients who do not respond to drugs
- Penny Mordaunt becomes first ever government minister to use British Sign Language in Parliament
- Could psychedelics transform mental health?
- Disability Confident employers promise less than one job each on average
- Patients face autism referral and assessment 'lottery'
- Government will pay arrears to thousands of benefit claimants
- Antidepressant prescriptions for children on the rise
- Watchdog’s ‘issues of concern’ over regulator’s treatment of PIP complaints
- Blue badge scheme to provide ‘lifeline’ for mentally ill people
- Seven-year-old double amputee is cast by River Island to model its new active wear range - as the little girl's proud father says there's 'no stopping her'
- Thousands of mothers left to cope alone with mental illness
- International disability community sign up to progress
- Disabled children waiting too long for NHS wheelchairs
- DWP repeatedly breaches FoI laws ‘in bid to hide secret jobcentre reports’
- Quarter of 14-year-old girls in UK have self-harmed, report finds
- Scientists 3D-print a 'bionic eye' that could soon let blind people see again
- Autism dogs: Call for regulation as demand quadruples
- Minister snubs DPOs – and ‘breaches UN convention’ – by refusing meeting
- 'Black hole' in youth mental health support
- Anger over government’s ‘pathetic’ election access report
- Extreme Dwarfanators Wrestling organisers threaten to SUE Leicester arena for cancelling event
- 'The right trousers': Wallace and Gromit inspire artificial muscle clothing
- Are we really on the brink of a cure for Alzheimer’s?
- Parents in England seek legal action over special needs funding cuts
- Waiting times for disability benefit claims soar by three weeks in three months
- Many disabled people hide their impairments to avoid awkwardness, report says
- England amputees thank Premier League for World Cup funding after FA snub
- Police work on disability hate crime is ‘unacceptable’, say watchdogs
- Pregabalin and gabapentin to be controlled as class C drugs
- Government could pay out more than £1bn due to benefits 'shambles'
- Young people with special needs 'being failed in 44% of areas in England'
- Government ‘blocked’ involvement of user-led groups in mental health summit
- Two in five people with learning disabilities not diagnosed in childhood
- Call the Midwife actress Sarah Gordy becomes the first woman with Down's syndrome to receive an MBE
- Regulator sets out ideas for better assisted rail travel
- DWP ‘plans to move more benefits onto troubled universal credit IT platform’
- Retailers Need To Be Doing 'Purple Tuesday' Every Day Of The Year, Not Just A One-Off
- Watchdog calls on government to act ‘before it’s too late’ on impact of cuts
- Builders criticised for lobbying against accessible homes
- Put universal credit on hold to protect disabled claimants, say MPs
- New cervical cancer test could 'revolutionise' screening
- Exoskeleton suits: can 'superhuman' frames cross into the mainstream?
- Mental health: target to boost staff numbers by 21,000 set to be missed
- Being bullied permanently SHRINKS part of the brain 'which raises the risk of developing anxiety later in life'
- AUTISM COULD BE DIAGNOSED AT BIRTH WITH A HEARING TEST
- Changes to disability benefits cost £4bn in extra welfare payments
- Brits with mental health problems TWICE as likely to lose up to £140 a week in benefits
- Benefit appeal recordings not possible at nearly half tribunal venues
- Teenage boy with rare brain cancer among first in UK to receive proton beam therapy
- Amputee Marine Lee Spencer in Atlantic row record bid
- Mental health: UK could ban social media over suicide images, minister warns
- BFI’s free film collection shows 100 years of disabled people on film
- Genetically modified chickens lay eggs with cancer-killing chemicals inside lay eggs with cancer-killing chemicals inside
- ‘This is another crack in the glass ceiling’: RSC casts disabled actors in new season
- Carers quitting jobs from pressure
- Disability-themed emojis approved for use
- UK surgeons hail ‘world first’ op to tackle leading cause of sight loss
- ‘Smiling depression’: it’s possible to be depressed while appearing happy – here’s why that’s particularly dangerous
- Barbie introduces dolls with wheelchairs and prosthetic limbs
- Radical Parkinson's treatment tested in patients
- Bipolar patients 'could be on the wrong drugs'
- Motor racing - Disabled team set sights on Le Mans 24 Hours entry
- Esketamine: US regulator approves nasal spray to treat depression
- Prof Stephen Hawking commemorated on new 50p coin
- DVLA U-turns on autism disclosure policy after uproar
- 'Misleading' DWP letter causing ill and disabled people to lose benefits
- Some claims that London 2012 changed the world are nonsense, says disabled peer
- 'Blindness and mental health can come hand in hand'
- Deaf poet Raymond Antrobus wins Ted Hughes prize
- Drop in type 2 diabetes diagnoses in UK, charity reveals
- Jack Carroll: ‘I was treated with derision and suspicion in my PIP assessment’
- Prostate cancer and death rates have plummeted worldwide, study reveals
- Disabled access improvements at 73 railway stations
- Parkinson's results beyond researchers' wildest dreams
- Almost 2m people will lose £1,000 a year with universal credit – study
- Tomlinson becomes latest ‘shoddy, shameless’ disability minister
- Scientists create decoder to turn brain activity into speech
- Most GPs ill-equipped to diagnose one of the deadliest cancers
- Half of sick or disabled people on low incomes experienced food insecurity in 2016, study shows
- Nursing body failed to deal fairly with PIP assessment complaints, says regulator
- Call for poor and disabled to be given NHS fitness trackers
- What is Mental Health Awareness Week? Why 2019’s theme is body image, and how to get involved
- Doctors must warn patients of ‘severe’ side-effects of quitting anti-depressants
- Disabled people ‘driven to breaking point’ by cuts, says UN expert
- Families rally against special educational needs funding cuts
- Self-harm in girls and young women rising at 'alarming' rate
- Drug which helps woman survive breast cancer can also stop prostate cancer spreading in men, new study finds
- Students want parents to be told in mental health crisis
- The worst places for cancer care waits revealed