“Anger is a fuel. Anger is meant to be listened to, Anger is a voice, a shout, a plea, a demand. Anger is meant to be respected. Why? Because Anger is a map. Anger shows us where our boundaries are. It lets us see where we have been and let’s us know where we want to go. Anger points the way, not the finger. Anger is meant to be acted upon, not acted out.” Julia Cameron, 1993.
On Wednesday 20th January 2016, I attended an evening featuring a keynote speech by Mr Oliver Letwin, MP for Dorset West, Chancellor of the Duchy of Lancaster and responsible for the oversight of the Cabinet Office. I decided to use the opportunity to once again raise the call for mental health.
The event, hosted by Tory-funded ‘liberal conservative pressure group’ Bright Blue, was billed as a discussion focussing on “Opportunity For All”. When booking my tickets, I assumed (correctly) that the event was likely to involve examples of how the government was working to ensure equal opportunities for all people regardless of background. This was undoubtedly organised as a way of winning over middle ground voters, and maybe even as part of an effort to clean up Mr Letwin’s recently marred public image.
The 45 minute speech on conservative ideals was an eye opener to me, as I had never heard it straight from the source. If you aren’t aware, the concept is that we should all be striving to write the “story of our own lives” and that no-one should be held back from achieving their dreams and thus we “liberate the human spirit”. I agree, working hard and being ambitious is awesome, however, I find it even more liberating when I am also conscious to the many incredible “stories” being written around me, and indeed the greater story that we play a small part of. Conservatism, I discovered, is a little too ego-centric for my liking. I guess that makes me “left-leaning”?
Takin’ it to the man
After this speech, I was the first of the audience to raise my hand to ask a question. I put it to Mr Letwin that the government was failing to deal with our rising mental health issues. Despite the government’s numerous promises for increased investment, all the evidence (below) is showing us that vital funding and support is not being made available to mental health services on the NHS, and that these issues are being largely neglected. That combined with the fact that the government has now stopped publishing how much it spends and where this spend is allocated (information only accessible via Freedom of Information requests), means it is now even harder to hold the government to account, when it shouldn’t be.
Mr Letwin replied typically (and disappointingly) by heralding all the great achievements done in the past for addressing mental health, and that there was still a lot more to do. You can listen to the full exchange here.
What is actually happening…
The ideas of “big society” and “opportunity for all” are noble, however they can only work in practice when we all have the same access to basic and necessary healthcare. After 6 years of Conservative led government, the signs are bleak where our NHS is concerned. Indeed, when telling us to focus on our individualistic aspirations, one has to ask where a collectivist institution like the NHS fits? Is that why we are seeing increasingly more of it sold off and privatised?
Just some of the depressing facts about our collective state of mental health:
- The number of people becoming so ill they had to be detained under the Mental Health Act leapt by 10% in the past year.
- The number of children being treated on adult mental health wards – something that the Mental Health Act rightly says should not happen at all – rose again in 2015.
- Suicide is the highest it has been since 2001.
- We are in the midst of a psychiatry recruitment crisis: there has been a 94% increase in vacant and unfilled consultant posts.
What the government is (or not) doing:
- Government has pledged to spend £600million in mental health services. However, that is only a returning on spending levels we had in 2010.
NHS trusts’ income for mental health services has actually dropped by 8.25% in real terms over past five years.
The Government committed to £250m on child and adolescent mental health services or CAMHS for 2015/16, but the Government has admitted there will be a £77m shortfall on what they have pledged.
- In 2014/15 funding for mental health trusts was cut by 20% more than that for other hospitals.
- A King’s Fund report published in November 2015 found that just 14% of people felt that they received appropriate care in a crisis.
There is even mounting evidence that government policy is harming our collective mental health:
- The Journal of Epidemiology and Community Health recently concluded that the programme of reassessing people on disability benefits using the Work Capability Assessment was independently associated with an increase in suicides, self-reported mental health problems and antidepressant prescribing.
- 83% of people surveyed by the charity, Mind, reported that the Work Programme made their mental health condition worse.
- The latest statistics reveal that less than 9% of people with mental health problems receiving Employment and Support Allowance have been helped into a job by the Work Programme.
I was also very saddened to read just yesterday the miserable story about Frances McCormack, the latest to take her own life after the added pressures brought about by the government’s controversial “bedroom tax”.
Accountability (lack of)
Lack of accountability is also a big problem: we still have no clarity on the promised government spending. In fact you have to use a Freedom of Information request to find out how much Clinical Commissioning Groups were allocating to mental health. The findings are alarming: 67% of CCGs spent less than 10% of their budget on mental health. This is despite mental health accounting for 23% of the total burden of disease.
In 2011/12 total investment in mental health dropped for the first time in a decade. Perhaps unsurprisingly, that same year the Government stopped publishing how much it invests in mental health.
It simply is not good enough. One has to wonder at what point will this government start taking our health seriously.
My question to you: Can individualistic/ capitalistic ideologies work when managing the public sector industries, like our National Health Service, where our quality of healthcare, safety and well-being (not profit) is the “bottom line”?
The latest results of a poll I started on YouGov:
I look forward to reading your comments below.