WE CAN’T AFFORD NOT TO INVEST IN MENTAL HEALTH
AT THE end of Mental Health Awareness Week, you don’t need a pollster or a data analyst to tell you that the dial on the debate about mental health has been shifting, and shifting in the right direction.
When a high-profile footballer like Aaron Lennon is sectioned in a state of mental distress, the media coverage is much more understanding and sympathetic than the days when
The Sun could proclaim ‘Bonkers Bruno Locked Up’, and the sport more understanding than the days when manager John Gregory could ask what on earth Stan Collymore ‘had to be depressed about?’.
I am not exactly the world’s most natural Monarchist, but hats off to the young Royals for getting stuck in on this too. The Heads Together initiative headed by William, Kate and Harry is giving a huge boost to the campaign for greater openness about mental health. The republican in me rages a little that all they have to do is say they are interested in something for people to sit up and take notice. The mental health campaigner in me is delighted, was pleased to be asked to make one of their little conversation films with my partner Fiona, and feels their involvement is a big step towards the tipping point we need to reach before the country moves to genuine parity between mental and physical health.
Here is the thing though. We shouldn’t even have to be campaigning on this because that supposed parity is there in black and white in the NHS Constitution. The law of the land. But we are light years away from seeing it delivered. And here is the other thing that worries me – that as we win the fight for greater openness, and more people admit they may have a problem and seek the help they need, they will find it isn’t there.
Theresa May is right to say that the mental health issue is “not all about money,” but a lot of it is. If greater openness leads to greater demand, and the demand cannot be met, we risk matching every step forward with one or two steps back. So just as all the campaigning talk about mental health is leading to improved attitudes, so all the political talk about mental health has to lead to better services.
Mrs May has become the second successive Tory Prime Minister to define mental health as a priority. When she spoke about this shortly after becoming Prime Minister, she pledged that by 2021 no child would have to be treated away from their own area. Just look back at that sentence.
So it is going to take two years for Mrs May to sort out Brexit, and unravel the most complex negotiations any Prime Minister has had to embark upon, which impact over virtually every aspect of our economic and political life.
But twice as long before we can end the scandal of a young person in psychological crisis in Yorkshire, for example, being told that they will have to travel to the North East, or Scotland, to get a bed. Parity? Does it really have to take that long to ensure any young person with a serious mental illness can get treatment close to home? If so, can we really take at face value her claim that this is a ‘priority’?
David Cameron also had a ‘historic pledge’ on mental health – a maximum of two weeks wait for anyone with psychosis. I have had psychosis. I have often reflected on what a physical health equivalent would be. And I reckon flying through a car windscreen at 70mph and ending up in the middle of the motorway might get close. I’m not sure ‘don’t worry, we’ll have someone here in two weeks’ would be viewed as an acceptable emergency services response to that.
In any town or city these days, you will see people living on the streets. Many are clearly mentally ill. Most of the time, we walk by. Would we do the same if the streets were lined with people who were mid-stroke or mid-heart attack, had fallen and broken a hip or ankle, been beaten up, or were gasping for breath in the face of a massive asthma attack? No. We would have the ambulance there in no time. Until the mentally ill are viewed with the same empathy and urgency, can we really claim to have parity?
Mrs May’s first mental health speech was excitedly covered by the media because of her unveiling of her new ‘shared society’ slogan, barely heard since as it has been submerged by ‘Brexit means Brexit’ and ‘strong and stable leadership’. In the same week I had an email from a young man who had heard me talking on the radio about the importance of being open about mental health. He said it was his personal tipping point moment that led to him finally admitting to himself that he had issues of depression and trouble with drink that he needed to address. He went to his GP. The doctor said he would normally recommend he see the surgery’s alcohol services counsellor – but he had been laid off without being replaced. As for the depression he felt CBT would help but it might take six months to get it. So he prescribed him some anti-depressants and said they might help.
I am not blaming the doctor. What else is he supposed to do? But this young man told me the bottom line was that, if anything, he felt worse having finally decided to get help but then learned so quickly how hard it can be to get it.
Many people do get terrific help and support and treatment. But it is patchy. Hardly surprising when we have seen an eight per cent cut in mental health funding in the austerity years. There are 6,000 fewer mental health nurses. The psychiatric bed per capita ratio is lower than comparable countries and the OECD average.
Mrs May’s focus on mental health in the Tory manifesto is welcome. So are the £15m pilots on mental health first aid in schools and the £10m to fund graduates going into mental health work as part of the Think Ahead programme, and the £67.7m for digital mental health services. But by government standards these are tiny sums. Mrs May herself put the economic and social cost of mental illness at £105bn – not far off what we spend on the NHS itself.
This is the key to the change of mindset our policy makers need. To look not at the cost of the mental health services we need, but the price we pay for not having them. To understand how much more we end up spending picking up the costs of suicide, divorce, the courts and prisons, not to mention the additional burden on the NHS when a mental health problem for someone becomes a mental health crisis. If we did invest properly in mental health, and especially young people’s mental health, where cuts have been most severe, we would make massive savings in the future. Visit any prison, or spend a night with any police patrol on what has become the frontline of mental health services, or just sit with someone drowning in despair but unable to get the talking therapy they need, and so unable to work, and you will see what I mean.
Alastair Campbell, who grew up in Keighley, is an ambassador for Time to Change, Mind, Rethink and Alcohol Concern. He is also patron of the Maytree suicide sanctuary, to which Mr Campbell’s fee for this article is being donated.
In any town or city you will see people on the streets who are clearly mentally ill. Most of the time, we walk by.