How to tackle the crisis in mental health
Today (2 November 2015) a letter signed by hundreds of prominent people including Frances O’Grady, General Secretary of the TUC and politicians from all major parties, calls for the autumn statement to ensure that mental health is treated on a par with physical health (requiring much greater investment). Ten areas of concern are set out. The conclusion is that those experiencing mental ill health “suffer discrimination in our publicly funded NHS.”
The call is timely and the breadth of support is welcome evidence of a higher level of public understanding of the crisis in mental health. The benefits to society of early and effective intervention (reflected in people being able to continue in employment or education) are rightly argued. The benefits to the individuals and their families are equally critical.
Discrimination against people with mental health issues has been around since time immemorial, but awareness has grown recently reflected in the increasing numbers of high profile figures who have spoken out about their own experiences.
Unfortunately, this awareness has coincided with a worsening of the numbers affected. This results from a combination of developments . The cuts in NHS mental health provision stand out as the sharp end of the problem. Less accepted are the causes. Mental ill health has a multitude of causes, but unions have highlighted the negative impacts of stress at work resulting from cuts, redundancies, restructuring, increased workloads, pay restraint and in-work poverty, zero-hours contracts and casualisation. Some early intervention solutions were identified at a TUC seminar in February (read the report) but the case studies presented there painted a bleak picture of the problems. While better NHS care is vital, preventative action is better. But that depends in part on changes to wider government policies.
Those not in work fare little differently but people’s experience of the benefits system can also be a source of stress. The charity Mind has just published its finding that people receiving Employment Support Allowance (ESA) are “more likely to be punished than helped into work” by a factor of three, and that 83% of those on the Work Programme said the experience had made their mental health worse.
The letter recognises disparate impacts on some communities, with a disproportionate over-representation for African-Caribbean and African communities needing adult services. The analysis could be extended. The Equality and Human Rights Commission report “Is Britain Fairer” (published last week) added in the vulnerability especially of young lesbian, gay, bisexual and trans people to mental ill health and a heightened risk of suicide: despite the real advances in acceptance of LGB and T people this statistic is raw proof that the job is far from done.
Stigma continues to be associated with mental health. It means that most people are unwilling to admit to it – especially in the workplace where they know they risk losing their job and struggling to be re-employed in a discriminating employment market. Let us campaign for equality for mental health in the NHS but recognise that wider changes are needed if the numbers needing NHS treatment are to be brought down in the first place.