11 Other observations
11.1 Early intervention and prevention
Many people felt that a preventative approach to mental health care is needed. Family members felt that they are relied upon to fill gaps in care and treatment in the community but are not listened to when they offer advice or need help. They spoke of health services failing to respond to their warnings about deterioration in a family member's mental health and of people only gaining access to services once they had committed an offence. They argued that a reactive approach is a false economy and that earlier interventions would not only reduce victims but reduce the need for specialist care in the future. There was support among staff for embedding preventative models into mental health care.
11.2 Scepticism about change
There were people with lived experience, family members and staff who held out little hope that this review would result in any change. It was noted that several previous reviews have not led to the substantial and co-ordinated change that people feel is needed. People with lived experience and their family members said they had been telling people about the same issues for years and nothing had changed. Staff also said that plans to address known issues, such as lack of capacity, were talked about for years but never came to fruition. Some felt that this was because plans were made without the right people around the table.