It’s time to take mental ill health seriously


 

There was something depressingly familiar about the coverage this week of the government’s latest defeat to its controversial health and social care bill.

At its heart was an amendment which made explicit on the face of the bill that both mental and physical health should enjoy parity within the health system.

It was an important step, a moment that Peers recognised that mental ill health should no longer be treated as the hidden problem it once was, but be right at the heart of the health promotion agenda. Yet despite this, coverage on the amendment focussed not on the issue at stake, but about the political ramifications it had for the government.

When 1 in 4 people will suffer from a mental health problem, ranging from stress, anxiety and depression through to full blown psychophrenia mental ill health will at some point touch us all, be it suffering ourselves or having a friend or family member who suffers.

More startling still, the Prison Reform Trust has outlined that 72 per cent of males and 70 per cent of females sentenced to prison suffer from two or more mental health problems.

And the cost? On a crude, financial level, the Centre for Mental Health has put the figure in England alone at over £100 billion. But more seriously is the personal cost to those who suffer. Alistair Campbell for example, writing of his own depression has put it:

I had a pretty heavy nervous breakdown in 1986, and I’ve had depression on-and-off ever since. With the help of friends and family, sympathetic bosses, a good GP, a psychiatrist, sometimes medication, I have learned to manage it better than I did once.

At its worst, it is like an invisible dark force that first approaches, then envelops, then appears to fill every waking thought. You can escape via sleep, but you wake and find your eyes won’t open, you lack the energy to brush teeth, shave, speak, think anything other than thoughts of emptiness and despair.

When it’s bad, my partner Fiona says it is like living with somebody from a different planet. When you get into that mode it’s very dangerous and corrosive. People ask, “what’s wrong?” and you don’t really know. “What triggered it?” and you can’t answer that either. One thing you do know, there is no way you would wish to have it.

You would not wish to have it. It is that sentence that sums it up. It might not be seen by the naked eye in the same way an operation scar might be, it might be not be as visible as a plaster cast, but it is an illness every bit as serious as being physically ill. Any idea that anyone would want to feel that way is simply absurd.

Yet the sad truth is that the across all sections of society, the stigma remains, the attitude that mental ill health isn’t a real problem remains rife, putting fear into the hearts of those who suffer about coming forward to admit their sense of vulnerability.

Janet Street-Porter’s declaration in the Daily Mail in 2010 that depression was simply the new “trendy illness” and the media’s woeful lack of coverage of Andy Burnham’s important speech on mental health just a few weeks ago demonstrated both an ignorance and reluctance to discuss mental health problems across our mainstream media, a reluctance very rarely shown when discussing issues such as heart or cancer care.

Employers remain in a state of denial about the impact of mental ill health, with research published just before Christmas by the Chartered Institute for Personnel and Development showing that just 25 per cent of respondents to a survey said that their organisation encouraged staff to talk openly about mental health problems with only 37 per cent saying that their employer supports employees with mental health problems well.

Summing the findings up, Paul Farmer, chief Executive of the mental health charity Mind, explained:

This research shows that there is still a long way to go until workers feel able to discuss their mental health openly in work, enabling them to get the support they need.

“With 1 in 4 people surveyed having experienced mental ill health, this is an issue that will touch almost every workplace in the country.

“Supporting staff through a difficult period does not have to cost the earth and can have huge benefits for any organisation.”

All this as stress in the work place continues to increase, with many now finding themselves competing with valued and close colleagues as they face the daunting prospect of having to re-apply for their jobs.

And across society as a whole, the stigma continues. Research points to a partner being four times more likely to leave someone because they have a mental health difficulty as compared to a physical disability. And 27 per cent of sufferers report facing discrimination, with one telling Mind:

“When I was a teenager, I spent time in a child psychiatric unit and when I came out, the kids near where I lived found out. Over the next few years, every time I left the house I would be attacked and have abuse shouted at me. As a result, I started to go out less and less. This led to over a decade of having no social life.”

And the result? A fear within those who suffer that telling other or seeking help will result in being misunderstood and stigmatised, could result in losing their jobs or face mockery and being the butt of jokes.

Sad though it sounds, it is a reality. As a society we need to establish a climate in which those who suffer have the confidence to admit their problem early on in the knowledge that admitting it, being upset, indeed crying, even for men, is a sign not of weakness but of strength, admitting that help is needed.

And at its heart there is an urgent need to halt those cuts which are serving only to embed mental health services as the Cinderella service. Predications last year pointed to over 50,000 mental health posts in the health service being shed, whilst the Independent, writing last year noted:

Mental health services for society’s most vulnerable people are unfit for purpose, according to the findings of a damning independent inquiry published today.

“Seriously ill patients are subjected to assaults, taunts and overcrowding in over-stretched hospital wards where containment rather than recovery is the priority. Meanwhile, others on the verge of suicide or a manic breakdown cannot access help because crisis teams are too busy or closed outside office hours.

“A combination of rising demand and government cuts is leaving the services at breaking point in some areas.

“The year-long inquiry by the charity Mind found huge variations in the quality and availability of hospital and community crisis services across England and Wales. Evidence from 400 patients and staff found that innovative, humane and responsive services do exist, but only for a lucky minority.

With economically turbulent times serving to drive up workplace and household stress, loneliness increasing and mental health services stretched to their limit, there has never been a more important time for society as a whole to send a clear message to those who suffer that there is no shame in suffering from mental ill health.

It is time therefore that all sections of society – patients, the medical profession, the media and the politicians form a commission to address once and for all how each can play their own important role in stamping the discrimination out once and for all.

As a society, it is imperative that we are judged by how we treat out most vulnerable. Never have those lines be as appropriate as they are today for the 25 per cent of us who at some stage will suffer from mental ill health.

See also:

ConHome: Neuter the Health BillDaniel Elton, February 10th 2012

The Financial Times comes out against the NHS billAlex Hern, February 9th 2012

Don’t believe the spin – the health reforms are Cameron’s just as much as Lansley’sShamik Das, February 8th 2012

Miliband goes on attack as fight to save the NHS stepped upShamik Das, February 6th 2012

GP in Cameron’s constituency: “Nobody supports the NHS changes”Shamik Das, February 1st 2012

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  • fourbanks

    The main problem with David Cameron and co is that they are very far removed from life in the UK and are a menace to all who cross their path
    The damage they are likely to cause to the welfare reform bill and that of the NHS is vast
    They are supposed to be educated and yet i have not seen any common-sense from them at all therefore how the hell are they running the country
    All i see of them is deception and spin and will never be taken seriously by the people of the UK only the wealthy

  • Kevin

    The great danger is the country moving to the far right once all the damage done by the tories finally hits home. Mass psychosis happened before to a seemingly advanced society driven off the rails by money woes.

  • http://www.facebook.com/HaywoodsVoice Haywoods Voice

    My Father was a paranoid schizophrenic, local GP’s left him undiagnosed all through my childhood, you may be able to imagine what that does to a family, you may not. One of the things it did was to leave the family in grinding poverty. I am now 47 I have been my fathers main carer for much of my childhood and all of my adult life, I received no pay for this, no benefits, he was my Dad and that’s what a good son does, Last year he was mercifully released and died suddenly of a heart attack. Only now can I speak out about a system which despite what Camerons aims are regarding community based care tried tooth and nail to lock him away in a hospital, he was never and had never ever been a danger to others, his ideas were no more odd than those held by Eric Pickles, the lack of fiscal and practical support available not only to the sufferer but the carers was palpable and hit you every day. I cannot imagine what it would be like under the new regime, forcing the mentally ill into work schemes, cutting their benefits, turning their homes into a prison with the carers their warders it is a disgrace. I am now a foster carer looking after the problem children no one else wants. This is my full time job, my wages have been frozen for two years the allowances to the children have been cut, the amount of money now available to spend on each child has been cut by 15% in real terms, these children are supposedly the lucky ones, they are in foster care, this government is trashing the welfare support for even those who are not old enough to understand why the answer to the question has to be NO more times now than at any time before, when they ask for help with getting their life back on track

  • Dr. Malik Abdur-Razzaq

    I could not agree with you more-that psychiatric and general medicine must collaborate in the treatment of mental illness. Mental health patients are being neglected at the expense of a society’s failure to recognize the ramifications of their illness. I direct you to my book: “Psychiatric triage and screening:Trends, parameters, and limitations when evaluating patients in an emergency room” where I have attempted to address many of the issues raised in this article.
    Dr. Malik Abdur-Razzaq

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  • Patrick

    Which one?

  • Patrick

    Are you sure that the rise in mental illness isn’t partly down to the medical profession creating more and more classifications of ‘new’ spurious mental illness, to aid the revenues of drug companies?

    Shyness, and ‘internet addiction’, ‘oppositional defiant disorder’ (that’s basically a child saying no to it’s parents) are all set to appear in DSM-5. Once people have been categorized in these groups they can then be prescribed drugs.

    Additionally, patients like being given labels because it confers upon them a bona-fide medical condition to explain their behaviour. “It’s not my fault I’m bad-tempered and argumentative, I’ve got ‘Oppositional Defiant Disorder'”. “I’m not being anti-social, I’ve got Internet Addiction.” “My son isn’t badly behaved. No, he’s got Attention Deficit Disorder -but it’s easily solved, we just give him mind-altering drugs twice a day.”

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  • Anonymous

    Its not about mental illness, its about the problems in a persons life that causes the worry that creates the problem, feel ok, think ok, full stop.thats the reality, so rather than tag people and poison them, how about doing the right thing, and getting them to talk about what it is that is causing them their concerns and mind problems, and then informing and educating them so as they can feel ok. psychiatry is an evil force not helping, but debilitating in most cases for profit, and their own esteem and importance, and rather than looking at the victim, how about looking at their family , where the root of the problem usually comes from, rather than focusing on an imbalance that is only there because that person is in trouble in their mind at a given time in their life, and thats usually in youth when they’re in the process of learning who they are, and what has been the cause of their concerns, and what that means, and how to deal with it all, so as they can feel the ease they need to feel, and not have a serotonin or chemical imbalance only there because of the despair they feel over unresolved thinking and feeling.

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  • Anonymous

    I appreciate that Ed Jacobs has written with good intentions but the situation with regard to employment is more complex than he suggests. There is an organisation called Mindful employer – http://www.mindfulemployer.net/. This is an outfit set up by employers who want to be responsible and create good working conditions for their employees. Also by chance I read a reference to mental health in a Financial Times guide to business start-ups. This book contained a pretty good discussion of the pressures involved in founding a small business. The situation could be better but some employers and employer organisations, trade unions and professional and trade organisations are developing their own ways of dealing with occupational health.

    I first developed an interest in this area in the early 90s because I lost my job. I have worked in Parliament on this subject. I won a Financial Times prize in 1997 for an essay on welfare reform. I could say more but I hope I have said enough to convince readers that I have watched this area for a long time. We have a long way to go but progress has been made.

    I have encountered prejudice from certain employers but on occasion I have had to realise that I have also been guilty of prejudice. One big employer took me totally aback by offering me a chance. Initially I was mighty suspicious. It took me some time to accept that the offer was genuine. So I’ve had to learn to overcome my own hangups.

    Employers aren’t my biggest problem. The two biggest sources of institutional prejudice come from the Department of Work and Pensions and the NHS. The benefits system isn’t set up for people with episodic illnesses and NHS staff don’t understand the vocational needs of people with mental health problems. Even today I come across NHS staff who treat me as incapable.

    I echo the concerns of Haywoods Voice. Compulsory work schemes won’t make good workers as they will be bound to involve people who aren’t fit to work. Far better to give people the chance to assess their own health and potential. I dare say a few people might abuse this opportunity but the majority of people will not do so and the process of working out your own capability is a skill which people need to learn for themselves. To learn how to take responsibility you need to give people the chance to make their own decisions.

    There is also a problem with unemployment. Right now job opportunities are very scarce. No amount of compulsion will make that better.

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  • Mr. Sensible

    I think it is important we discuss this issue more, and I think to put all mental conditions down to something happening in someone’s life may be slightly simplistic.

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  • Ed’s Talking Balls

    I’m inclined to agree with you on some of the points you raise. Not everything needs diagnosis. Some people are simply inconsiderate and/or stupid.

    However, I strongly agree with the general tenor of the article. It’s extremely important that society treats mental health seriously and that no-one is expected to suffer in silence. I find it deeply worrying that, in the 21st century, a serious illness like depression is stigmatised by some simply because it doesn’t bring you out in a rash or induce a cough. It shouldn’t ever be trivialised: it can destroy lives.

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  • Judystenger

    Parity for mental and physical health within NHS and social care provision is of course vital and fair. And it seems timely and necessary to remind the Government of that: only weeks have passed since the proposed scoring system for the new ‘Personal Independence Payment’ – Disability Living Allowance’s successor – was unveiled. In one sweep, it reverses the parity that mental health and physical health previously enjoyed within the Care Component of DLA – parity won through the House of Lords’ ruling in the Mallinson case back in 1994.

    In that case it was established that ‘verbal’ care – e.g. taking 15 minutes to encourage someone to get out of bed – was ‘worth’ the same as 15 minutes of physical care helping someone out of bed. Proposed PIP scoring largely gives emotional support – along with the associated emotional cost – around half the worth of physical help…

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