The UK general election is fast approaching, and for the first time we see Mental Health as a major concern for politicians – well, for some more enlightened politicians at least. For the past five years there has been a decline in mental health services – no doubt about it, more people are suffering as a result of the government’s austerity measures. It is somewhat perplexing that the Liberals are united in the battle to turn things around when they were at the heart of the coalition. Perhaps they tried but were unable to stop the inevitable destruction. And, why focus on mental health and not physical conditions? Has austerity had more of an impact on mental health services than physical health services? Mental health has always been the Cinderella service, so why should it be any different now – before a general election?
This isn’t turning into a party political broadcast – but it highlights a point. That, since the last government, there has been a marked change in the health and social care landscape. Whether this in itself has contributed to the way people with mental health problems and illnesses are supported (or not) can be debated. The reality, however, is that for many of the most vulnerable people in our society there is a lack of appropriate and responsive services.
Recent figures published by MIND suggest that the average distance a patient travels to mental health service is 13 miles (22km). In some areas, particularly in rural parts of the UK, the nearest in-patient bed is 79 miles (127km). The reason? Quite simply it is because of a decline in in-patient beds. How can this be acceptable? The fact that politicians are promising to invest more in mental health is a sad reflection of a failed approach. Mental health, as the Cinderella service, is the first to show cracks when funding and services are cut. It is perhaps only a matter of time before the cracks are seen elsewhere.
And what of the Big Society? Critics would argue it is a not-so-good plan gone horribly wrong. Promoted as a community approach to tackling ‘broken communities’ and how it is our ‘responsibility’ as citizens to help make a difference, and giving us the power and control to do it. Too vague we said, and isn’t it all about the Tories building a responsive community doing for itself in light of the cuts in public spending? To quote Mr Cameron:
“It is not a cover for anything. It is a good thing to try and build a bigger and stronger society, whatever is happening to public spending. But I would make this argument: whoever was standing here right now as Prime Minister would be having to make cuts in public spending, and isn’t it better if we are having to make cuts in public spending, to try and encourage a bigger and stronger society at the same time? If there are facilities that the state can’t afford to keep open, shouldn’t we be trying to encourage communities who want to come forward and help them and run them?” *
Sorry Mr Cameron, but we were right to be cautious, anxious even. Now we find ourselves with little or no services, and the community – through altruism, and not a call to arms through the Big Society – taking up the slack. The Big Society speech was a warning in disguise. The effects of the cuts are worse than even the politicians themselves feel is palatable.
This is evident today, right now. Family, friends and neighbours are providing care and support on behalf of services. And, at what cost to their own mental health? The consequent stress of helping someone who needs more specialist interventions, but is non-existent, is inconceivable.
Recently, I heard a story that was both heartening and disturbing. A friend told me of how they (the neighbours) were rallying round to help care for another neighbour – a friend with severe and enduring mental illness. They saw the signs that she was becoming unwell and joined together (as they have done in the past) to help her receive the help that she needs. Her family is extremely supportive, but live some distance away.
This time, however, is markedly different. There is a lack of responsive services with the specialist support that she needs in order to avoid total mental breakdown. They accompany her to the out-of-hours GP service, book and accompany her to psychiatric appointments and provide meals and a few hours respite in their homes. There is such compassion shown and practical help given, but without the necessary specialist help they have not been able to avoid the deterioration in her mental state. Her behaviour is becoming more erratic, and they are beginning to lose her to the illness. Eventually, she will need to be hospitalized anyway, with many months of treatment and care. In spite of their help, they see an inevitable outcome, and feel a sense of hopelessness.
The neighbours are the new mental health service: unskilled and unpaid, but with the greatest sense of humanity than the Big Society can ever wish for. What we need to complement this is a government that recognises ‘its’ responsibility to provide adequate, appropriate and responsive mental health services – let’s have a balanced approach.