THE OTHER, LESSER HEALTH SERVICE

‘She was bright, kind, caring – and had a real sense of justice and wanting the world to be a fairer place.’

Moira Durdy is remembering her daughter Jess – a talented young engineer who died by suicide aged 27. Jess had a history of mental health difficulties but kept her struggles to herself. ‘She loved us, and we loved her to bits, but I kind of always had a feeling there was a bit of her that was hidden,’ mum Moira says.

Jess died on 16 October 2020 while at a mental health crisis house in Bristol, having moved in five days before. She was referred there rather than to a scarce psychiatric inpatient unit bed because she was struggling with increasingly intense and intrusive suicidal thoughts. Jess had previously been prescribed medication in general practice and had a private counsellor.

A serious-incident report found failings in her care, including that demand on services had ‘exceeded human capacity to perform all tasks’.

It also found ‘poorly defined’ strategies around escalation of risk and a care system ‘losing clarity under pressure’. It also reported a lack of links between primary and secondary care.

Ms Durdy says Jess felt no one or nothing was helping her and ‘pushed around from one person to another, having to repeat herself all the time and not really getting anywhere’ until she was eventually in absolute crisis.

For Ms Durdy, her daughter’s interactions with health services before her death expose a crisis in mental health services which can now be seen across the country: GPs managing patients too complex for primary care, a lack of communication between primary and secondary care, underfunded specialist services with workforces whose training hasn’t been invested in and insufficient inpatient beds.

Problems are exacerbated in a health landscape in which institutions have been through countless reorganisations and restructures, where reform has infrequently been followed by investment and where oversight and responsibility have been fractured or lost.

The Doctor has spoken to patients and families unable to access specialist support until they are in absolute crisis and often forced to break the bank for private care. Doctors describe a system and workforce stretched to