It seems mental health might be getting a fairer hearing right now. According to Dean Burnett in the Guardian, there is a discernible change in the public’s reaction to articles on mental health and that “publicly dismissing, ignoring or condemning mental health concerns is something you can no longer expect to just get away with”. He reckons there might be signs of a sea change and an end to stigma against the one in four people affected by it.
I hope he’s right. Research among Quids in! readers found more than half of them feel ‘anxious, frightened or depressed’ on account of money worries. Meanwhile, mental ill-health, and society’s failure to talk about – let alone deal with – it, is the root cause or consequence of many social problems, including homelessness, offending and unemployment. The reaction is always interesting to me when someone says homeless people don’t deserve support and I explain how breakdowns are one common cause, asking if they’ve ever been in emotional turmoil due to bereavement or relationship breakdown. ‘Imagine that being unshakeable and every day,’ I say, ‘And you’re only just starting to understand.’ That small sliver of insight is often enough to cauterise their antipathy.
We have a long way to go before support services are in a position to respond adequately and if there really is to be a moratorium on mental ill-health, and if everyone affected were to come forward, things can only get worse before they get better. I’m no expert but I’ve heard friends tell various horror stories of shonky advice or dismissive GPs. Professionally, I’ve witnessed support agencies operate a kind of triage that labels people mad, bad or sad – and woe betide anyone wearing more than one, as they’ll be pinballed from one agency to another each claiming the individual is someone else’s responsibility.
The Centre for Mental Health has come up with a 5-point manifesto for change. Among them is a clear ‘business case’ for investing in services to save money in more expensive areas – my kind of enterprising solutions:
- Education in schools on mental health, not only for awareness but to identify children on a path to ill-health, offending or drug misuse, for example
- Mother and baby services to protect pregnant women and parents who, without diagnosis, can impact the life chances of their children
- As with homelessness, 70% of offenders have multiple mental health issues and locking them up only makes matters worse – investing the cost of criminal justice in treating them properly will save the State a fortune and work out better for all of us
- Get them into employment! The Centre rightly points out that often the barrier is put in place by health professionals themselves, although employers are hugely risk averse. Yet the benefits of employment, beyond money, are huge – there just needs to be the right support from the NHS to enable this to, quite literally, work
- The approach to physical and mental ill-health needs to be integrated; conscious that many with one will have the other, professionals need to change tack
All this will cause tremendous strain on the NHS and will require full integration with existing services that are often coordinated by local authorities. Ed Miliband says the NHS needs to become more of one stop shop linking social services, support in communities and medical care. This will be essential if mental health is to get the attention it deserves but the enormity of the task requires leadership that carries the public’s goodwill and asks the unaskable question: ‘You want it? You gonna pay for it?’
By comparison David Cameron told the Andrew Marr Show that the NHS can only grow with a strong economy behind it, which he said should be run like a business. Once the money’s rolling in, the coffers will be full enough to invest in the NHS. The problem is that in his understanding of business, it’s okay that shareholders are satisfied first. I’m not sure it is okay for the City men to take their million pound bonuses before services are meeting the needs of the population.
It may be that we’re on the right road towards taking on mental health but it’s a bloody long one. And, funding-wise, it’s uphill. What we can expect along the way is more debate whenever horrendous crimes are committed by someone who should already be in care; More questions as the homelessness numbers explode; More soul-searching as people all around crumble under the pressure of money worries and suicide rates rocket.
