Thread by @DrGirishPsych

On Poverty, mental illness and Clinical Commissioning.
The academic paper below has some stark findings. The authors offer profound meaning.
Now, schizohprenia is a severe mental illness with long term disability in those most severely affected by it.
jamanetwork.com/journals/jamap…

The research prompts one to think - if the evidence for schizophrenia is so clear, isn't there also a strong possibility for other MH conditions (anxiety/mood disorders) which are more common (and where there is much more of a Dimensional Approach in its presentation)?

Now link that with the austerity drive in 🇬🇧; the⬆️ in mental health problems in the population - particularly in children and young people; the ⬆️ in primary and secondary school exclusions and we have a perfect crisis that'll continue to affect us well into the next decade.

How?
Primary (+secondary) school excl impact across 3 gen. The (often young) parent loses out on achieving their own potential throughout their lifespan. The child loses out on acad qual which can impact through out their own life span leading to ⬇️earnings and economic output.

For those who want to know more about the link between the two, @MichaelMarmot's review is a good place to start. In summary, we need to stop the ⬆️in school exclusions: instituteofhealthequity.org/resources-repo…

Education and Clinical Commissioning - the hidden link:
Children are usually excluded from school due to undiagnosed / hidden emotional/neurodev factors. Early diagnosis of any emotional / neurodevelopmental factors can help to identify support measures within school - incldg

identifying the child's strengths and anchor(s) that help the child identify school as a safe envt where s/he can excel. The current position where school education and clinical commissioning is de-linked creates siloes of problems when the solution is otherwise in plain sight.

Clinical Commissioning through @NHSEngland can remedy by changing the parameters from Commissing for 'Activity' to Commissioning for 'Impact'.
The latter is a form of commissioning where evidence for clinical input is seen within Public Health parameters.
tinyurl.com/tp54rkx

For #CAMHS, it would mean that any payment is based on the no. of children in (pref full time) education. A child in edu allows the parent to seek/sustain work unleashing their own potential, ⬆️their own self-esteem, hopefully their parenting which, offers the child a role model.

The child is able to achieve qualifications with life-long possibilities of improving his/her social determinants and goes on to provide a stable base for the child's own children.
linkedin.com/pulse/paces-ac…

The task may appear huge. It is less daunting when you consider the #IntergenerationalAdversity caused by not undertaking it. I write from a position of sheer, utter selfishness!
I want the next generation to earn well, pay their taxes and contribute to developing the economic

and social indicators so that I am looked after well when I am losing my memory, doubly incontinent and confused about where I am whilst living in an old age home. (PS: IT has a huge role to play in the success of this, incldg commissioning #LifespanServices, that's anthr blog!

If you don't want to use Threader - this is the link to the blog: linkedin.com/pulse/poverty-…

PPS: The views above are entirely mine and don't represent that of any of the organisations I work into / with.