Little has changed since the death of the Joy Division frontman. In fact, cuts to frontline mental health services are making a chaotic situation even worse
In the 1970s in Hulme, an inner-city district of Manchester, poverty and catastrophic housing conditions contributed to poor mental health. Records show that the six doctors serving Hulme prescribed 3m tranquillisers and antidepressants during 1977. The following year, in the shadow of Hulme’s tower blocks, Tony Wilson and several others took over a local venue to run weekly live music nights, which they named the Factory. Within a few months, the responsibility for booking acts was taken on by the promoter Alan Wise.
Wise was a loyal supporter of many local bands, especially Joy Division, whom he booked to perform. After the closure of the Factory, Wilson went on to concentrate on his record label. Wise also continued in the music industry, later managing Nico, who’d had cult status with the Velvet Underground. Then, in May 1980, the Factory family (for that’s what it was) suffered the loss of Joy Division’s frontman, Ian Curtis, who took his own life.
We dream that as we move on things will improve. The other members of Joy Division regrouped and became New Order; Hulme’s tower blocks have gone. Manchester calls itself “a world city”, but it seems cursed with second-class services to deal with ever-multiplying mental health problems, as recent high-profile cases have suggested.
In December 2015 Craig Creedon was talked away from the edge of a 14-storey block of flats in Higher Broughton, and detained under the Mental Health Act. Later the same day, against the wishes of his family, he was discharged from Meadowbrook mental health unit at Salford Royal hospital. Less than an hour later, he was hit by a train.
In March 2016, Wise’s daughter Natasha fell to her death after a history of depression and 18 months spent trying to get help. She had gone to her GP and been referred to counsellors, but after moving house she had ended up at the back of the queue again. Manchester mental health and social care trust has launched an inquiry into the care Natasha received, and claims its initial findings suggest psychological services responded appropriately. Her father, who knew she had been desperate for treatment, described the system as “a disgrace”.
Last Wednesday night Wise died in his sleep (the exact cause is yet unknown). New Order, deeply saddened at the news, issued a statement. “He died of a broken heart and we will miss him,” they said.
The trust in question, which is wrestling with a £7m deficit [see footnote], recently announced cuts to frontline services of £1.5m. The cuts were condemned by local politicians: Graham Stringer MP called them “the definition of irresponsible”. The trust’s failure has led to the NHS regulator proposing a transfer of mental health services from Manchester mental health and social care trust to a new provider, which could take another 18 months, adding uncertainty to an already chaotic situation.
Many people suffering even milder forms of depression feel numb and powerless, and simply booking an appointment to see a GP can seem like a huge hurdle (once or twice I have needed help, and on the last occasion, in my deadened state, it took me six weeks to make a call to my GP).
In Manchester there is typically a waiting time of three months to see a counsellor. You might feel it’s impossible to get through the night, or the afternoon, without a collapse, and then you’re told you have 100 more days and nights until you can talk to a mental health professional. To be assigned a care coordinator – a mental health worker to steer your individual case – you could wait a further six months.
Without support, it’s unsurprising that at moments of crisis, mental health patients are turning up at A&E. Those requiring inpatient care are faced with staff shortages at units like the one that took in Creedon.
There’s undoubtedly a pressure to discharge patients. In cases such as Creedon’s, you wonder this: would a hospital discharge someone with a cracked skull or a punctured lung and expect them to somehow heal themselves? Creedon’s family say he was “failed by the system”. An inquest this week heard that the trust responsible, Greater Manchester West, had acknowledged failings in communication on their part.
Too often, if explanations for mistakes come, they are full of obfuscation. Who is accountable? Politicians and MPs are critical of local trusts but appear powerless. Can you imagine how the service users feel?
There are dozens of reasons why mental illness can develop or intensify, including bereavement, family breakdown and a predisposition to depression. But the fallout from austerity, which includes homelessness, the threat of benefit sanctions and cuts in drug and alcohol services, have all increased demand for mental health services in Manchester at a time of chaos, demoralised frontline staff, broken systems and a chronic lack of funding.
Bernard Sumner from New Order once told me that just before Curtis died the singer said: “I feel like there’s a big whirlpool and I’m being sucked down into it and there’s nothing I can do.” If someone feels that way but somehow reaches out a hand and asks for help, our health professionals should have a system and the resources to respond.
• In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255.
© David Haslam & The Guardian