We must prepare for the next pandemic – mental illness
I learnt something new this week ... and I taught something to the other participants in the Brain Forum debate. I learnt that our brains may change shape as we adapt to the strange world of Covid-19.
They learnt from me that Nadine Dorries is the minister for mental health in England. As it was an international event, many had not heard of her. Those Brits who had were, to put it mildly, a bit surprised.
In so far as they knew her, she was an ardent Brexiteer promising us all it would be so, so easy, and go so, so well. Even more knew her as a contestant in I’m a Celebrity ... Get Me Out of Here!
The Brain Forum, says its website, “brings together world leaders in science, technology, healthcare and business to advance our understanding of how the brain works and to accelerate the application of that understanding to human needs”. I was there as none of the above, but as a mental health campaigner and advocate.
It was Spanish-born Professor Carmen Sandi, director of the Laboratory of Behavioral Genetics at the Brain Mind Institute, who taught me about how the brain changes form. Over centuries, children have been taught to hug, to contact others, especially those close to us. The brains of children now being taught to be wary of contact with others, including in school and even in the family, will have to adapt to this. It changes them. Wearing masks, not travelling, all of these things can have slight and sometimes even major neuroscientific effects.
The chair of the panel I was on with Professor Sandi was fellow ambassador of the charity Mind, Anna Williamson, who gave another interesting insight into an effect of Covid-19 I had not really thought of. “People with OCD often obsess about cleanliness, and germs, and obsessively washing their hands,” she said. “They have spent their lives being told that their handwashing was a problem. Now it seems it is part of the solution to the biggest crisis in the world.”
You would think people in the mental health world might know who the mental health minister was
You can see more of the debates on the Brain Forum website but, for now, let’s focus on Nadine Dorries, the minister for mental health, suicide prevention and patient safety, to give her the full title. I put her name into Google, and clicked on “news” to see what news she had been making of late. Top came a factcheck story about alleged “discrepancies” in what she said about Leicester’s lockdown when she stood in for health secretary Matt Hancock to explain the government handling. Then a story in which the Liverpool Echo debunked more discrepancies in something else she had said. Then there she is in the Commons “apologising to women” over failures exposed by the Cumberledge review. Then there were the stories four months ago of her being diagnosed with coronavirus, and being applauded into the Commons on her return.
As for mental health? I gave up scrolling. I am patron of the Maytree Respite Centre, Britain’s only sanctuary for the suicidal. I asked Natalie Howarth, who runs it, and who knows more about suicide prevention than anyone I have worked with, if she knew who the minister for suicide prevention was. No. At a time when the need for a proper government strategy on mental health is greater than ever, there doesn’t seem to be one.
Covid-19 has already seen a surge in mental health problems, which will only get worse as the economic crisis follows the health crisis. Does anyone remember the spike in suicide during the global financial crisis? I do. The banks do. It is why more of them are taking mental health more seriously. When I opened the London Stock Exchange on behalf of the Time to Change mental health campaign, they showed me the desk of a man who had killed himself, untouched since his death, as a reminder to his colleagues to reflect on their own stress levels, and state of mind. Not long before lockdown, I did an event at Goldman Sachs in London, to thank them for making a substantial donation to the charity, Mind, to run mental health support for students in 10 universities. Small change for them, but at least showing, as did the event, that they are
taking the issue and the wellbeing of staff more seriously.
In the NHS constitution, there is a commitment to parity between mental and physical health. You would think Boris Johnson and Matt Hancock might give the issue more than the occasional passing mention. And you would think people in the mental health world might know who the mental health minister was.
Oh what wonderful headlines were generated in 2018 when Theresa May appointed a specific suicide prevention minister, as Matt Hancock hosted a “global mental health summit”. I spoke at that too, and came away convinced it was all about making May and Hancock look good on the issue, rather than real meaningful change. I’ll give you something else from 2018. An independent review of the Mental Health Act made over 150 recommendations for reform. Eighteen months later we are still waiting. Get Brexit Done. Build Build Build. Let’s Get Going. Their three words for mental health were “Talk the talk”. And now, even that has stopped.
Yet the need for action is greater than ever. During lockdown, Mind ran a survey of more than 16,000 people.
It found two out of three (65 per cent) adults over 25 and three-quarters (75 per cent) of young people aged 13-24 with an existing mental health problem reported worse mental health.
Over half of under-18s who receive free school meals said their mental health was poor or very poor
More than one in five adults (22 per cent) with no previous experience of poor mental health now say that their mental health is poor or very poor.
Of those who tried to access NHS mental health services, one in four (25 per cent) were unable to get support. A further one in three adults and more than one in four young people did not try to access support during lockdown because they did not think that their problem was serious enough.
It also showed the link between deprivation and poor mental health.
Over half (52 per cent) of people living in social housing said their mental health was poor or very poor, and over two thirds (67 per cent) say that their mental health got worse during lockdown.
Similarly, over half (58 per cent) of under-18s who receive free school meals said their mental health was poor or very poor (versus 41 per cent not receiving free school meals), with three quarters (73 per cent) of this group saying that it got worse during lockdown.
Those who were furloughed, changed jobs or lost their job due to coronavirus saw their mental health and wellbeing decline more than those whose employment status didn’t change.
In addition to the calls for reform of the Mental Health Act, Mind is calling on the government to invest properly in community services, provide a financial safety net, support children and young people, and protect those most at risk, such as frontline workers, people from black, Asian and other minority ethnic communities, people recovering from hospitalisation, and those who have been bereaved.
It is a big agenda, and as one speaker at the Brain Forum put it, mental illness will be “the second pandemic”. Some governments are already onto this. Ours is not even on the pitch.