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The keys to access

In so many ways, access is the one over-arching consideration in our lives.  Our first thought as we leave the house – “did I get my keys?” our first thought upon returning – “where are my keys?”  During the day, “how do I access this file?”  “How do I access this person?”  “Can I get access to that room?”  “How can the deliveryman access me if there’s a problem?” “Will this phone allow me to access my emails abroad?”. It’s all access, access, access, a never-ending list of questions on how we can gain access to our lives, conveniently typed into our smart phone and accessed at the swipe of a fingertip (provided you have access to your bag). Because, in this increasingly frenetic world, knowing how to access contacts/documents/information/insert-whatever-you-might-need is everything. Access is key (pun definitely intended). So it is unsurprising that, when suffering from a suspected illness, a person’s first worry might concern access – access to information, diagnosis, care and treatment.

With most illnesses, access to treatment is relatively straightforward. Present at the GP’s clinic with a broken leg (or, if certain it’s broken, head straight to hospital); you are whisked away to have x-rays, prescribed painkillers, listed for surgery, given surgery, given more painkillers, taken home, referred for physiotherapy. People know what to do, where to refer you, how you should be treated. The same cannot always be said when it comes mental illness.

There are three major barriers to access that people suffering from mental illness come up against every day: people don’t have the same access to information and education about recognising and treating mental illness that they do for many other illnesses because the systems just aren’t in place yet; hospitals, nurses, GPs, clinicians and care workers don’t always operate in tandem to ensure the best treatments are being recommended and made available for their patients; and there is no guarantee that the best treatment is even accessible to patients due to cost, availability, lack of information etc. It is all too common that instead of a pleasant “system unlocked” tone, patients with a mental illness receive a bright red flashing sign: “Access denied”.

As a rather frivolous metaphor, last year, I gave my sister a digital camera for Christmas, an upgrade to her previous one that has wireless access built in – “upload all your holiday photos to Facebook instantly, straight from your camera!”  “What a timesaver!” I thought. Of course, I forgot that she doesn’t have wireless internet in her flat. She doesn’t even have internet. So, this wonderfully clever little device does her no more good than her old one ever did, because she isn’t able to access any of the features that make it so brilliant.

Of course, if she wanted to, she could install internet access, but she runs into another problem: which companies can do this for her?  Who should she speak to about getting internet installed? What kind of internet does she need? What internet options are even available to her based on where she lives? And then, once she has worked that out and picks up the telephone, she is passed round several departments within the company, none of which seem to communicate with each other, and is told ten different things by ten different people, having been asked to answer the same question ten different times. In the end, she decides not to bother with any of it and settles for using the camera in the same way she used her last one. It’s flashier, but it just takes pictures.

By investing in research into improving access, we could make a significant difference to the quality of life of many people with mental illness.

Improving treatments and developing new ones may be the ultimate goal, but these investments take time and are long-term projects. Any drive to have a significant impact on the mental health field absolutely must include some focus on the short-term, what can be done now.  Improving access is something that will have an immediate effect. It will greatly alleviate the suffering of several people by allowing them to receive faster diagnoses, advice on management and treatment, better, more tailored treatments and appropriate care.  In short, it will allow them to “access” their lives again.

So what can be done?

As a short-term investment, researching ways to improve access is key to reducing the burden of mental illness on society.  However, not all the benefits are so immediate – this will have great impact on any long-term goals as well: Firstly, by improving access to a particular treatment you increase its effectiveness without necessarily having to change anything about the treatment itself. 

For instance, hypothetical treatment A has been proven to work for 40% of the UK population, but only UK residents have access to it. If treatment A were made available to the rest of the world, even if it worked for only 40% of the population, 40% of the world is a much, much larger figure than 40% of the UK. Secondly, the more people who have access to, and follow, treatment A, the larger the data pool available from which researchers can mine information. Researchers can then use this to develop ways to increase the efficacy of treatment A to the point where it works for, say, 60% of the population. That’s 60% of the population worldwide, because people invested in improving access.

Access to information is just as key (pun still intended) as access to treatment. Researchers need access to information from the patients and from their clinical trials. Doctors, GPs, nurses and clinicians need access to information from both their patients and researchers in order to tailor treatment programmes. Charities need access to information so they know where to best direct their funds in order to fill any gaps that may arise. 

Access works as one large feedback loop – it shouldn’t be treated as some exclusive, VIP members only club. The more support we can generate to put funds into researching ways to improve access, the faster we’ll be able to make a real difference to people’s lives.  It’s all access, access, access: “Access key verified: system unlocked”

Last updated: 1 June 2016

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