I found yesterday's discussion of mental ill health by Theresa May pretty insulting. It's an issue I know something about. I have had the good fortune to never suffer any serious mental ill health. I have known, and helped, those (more than I would wish) who have. I'm not going to claim specialism as a result. I am not going to generalise either: their are too many causes of mental ill health to do that. But what I do know are two things.
The first is that the current treatment of mental ill health is not just a social injustice as Theresa May would seem to have it: the existence of that mental ill health is the consequence of social injustice.
Second, I know that unless those social injustices are treated increasing mental ill health services, whilst welcome and essential, cannot solve many of the problems at the heart of this issue.
This is why I suggested that mental ill health be considered one of the criteria for the success or otherwise of a society when writing The Courageous State. In that book I suggested we have more areas of need. We need to achieve material, emotional and intellectual well being, but all only support our achievement of purpose. This comes when we have a feeling of worth. It's absence is indicated all too often by mental ill health.
Do not get me wrong: I am not saying those who suffer mental ill health are not of worth. My argument is the exact opposite: what I am saying is that many who suffer in that way have something, someone or some event that denies them that sense of worth that comes from the achievement of their purpose which they are entitled to.
I am not for a moment suggesting that all such problems are the responsibility of the state. That would be absurd. Of course they are not. But equally I am suggesting that the state does have a big role in tackling the environment in which mental ill health flourishes. And so too does economics.
An economics, backed by the state, that says that a person does not have the right to secure employment but can be treated as expendable at will is one designed to foster mental ill health. It disrespects the person at the most fundamental level. But that is what we have.
A state that does not guarantee a person enough to meet basic needs does not value the well-being of those it is meant to serve. And this is our reality.
A state that denies a person a right to secure accommodation in a community where their support network lives is fostering ill health. And yet we have the bedroom tax.
A state that threatens the income of those already in poverty can destroy every shred of worth a person has, and cause untold stress that harms almost every capacity the person has to enjoy life. This is what the benefits cap will do to some.
A society that lauds those who have tells those who have not that they are not of worth, and the message is heard, everyday.
A society that makes the least well off suffer austerity has chosen to victimise people and they know it. And yet austerity is still on the agenda when it is not needed.
A society that takes away financial support from those authorities that face the greatest demand for mental ill health services indicates what value it places on those who suffer. And that is what is happening to local authorities in the areas where need is greatest.
A state that will cannot guarantee a child with mental ill health the support they need is not valuing their life. And even Jeremy Hunt has admitted he is failing woefully on this issue.
A state that does not support its own employees when they know things are going wrong at work is fostering the bullying that creates mental ill health and yet whistle-blowing in the NHS is nigh on impossible.
A state that denies choice creates a path to desperation. No wonder people are attracted to populist politics.
These are all issues the state can address when it comes to mental ill health. None of these are small issues. They are about fundamentally revaluing our society. But when we have so much mental ill health that is very clearly what we need to do. This sickness requires radical treatment and I heard nothing about that yesterday.
Instead I heard a debate diverted into meaningless discussion of four hour waiting times for those with minor physical ailments. Which says most of what really needs to be known.
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One small note of dissent:
When last week the reporting came out that there were particular areas of the NHS that were struggling to cope, the BBC noted two. One was mental health services – and there has been a tide of discussion about what is wrong with these.
THe other was services for people with learning disabilities – and on that subject the BBC, government and pretty well everyone else has been silent. It appears that even the commentariat don’t care about these people. They should.
Full disclosure: my stepdaughter has learning disabilities.
I am pleased you found them doing something right
I have to say yesterday’s coverage of this by the BBC was insipid. ITN did much better
And I agree with you on the issue of learning disabilities: they too are far too often ignored.
I had to laugh at Hunt on the news and his false veneer of concern for those with mental health problems.
Cuddly doe-eyed Jeremy – wheeled out to put a nice shine on a couldn’t-care-less Tory shock doctrine.
However, I stopped laughing when I heard of their latest innovations – to enable SCHOOLS to identify young people with mental health problems!!!
How novel! As I see that yet more teaching assistants are being flushed down the toilet up and down the country because education too is subject to austerity, how an earth is that going to work? Who is actually going to take the time yo deliver that service? My partner is meant to be a part-time teacher but is already doing full-time hours for a part-time wage! Her school keeps losing new teachers who decide they could have a life AND a job else where. Applications for new posts are down.
I do wonder just for how long the Tories can keep up this pretence of governing this country well. There is so much to make a meal of for the Opposition. It’s a shambles everywhere it seems.
I agree with everything you say
This is just ridiculous
School budgets are being cut and they demand yet more
I’m in total agreement with your post. These things need to be said as they are the only sane response to what is so obviously a symptom of an increasingly dysfunctional society.I have worked for many years in FE with students(16+) with mental health problems and also those with learning difficulties in a department that specialised in helping all those students who were unable to access, or had ‘failed ‘ in mainstream education. Over the past 5 years we experienced annual redundancies and budget cuts until last year when 12 out 15 lecturers left through redundancy, either forced or voluntary, or resigned as their jobs were no longer viable.
In 2015-16 the numbers on our course for students who’d experienced mental health problems almost doubled at the same time that all student services(mental health and welfare) were reduced. The much reduced courses left are now taught mainly by instuctors at much lower cost.
There is scarcely any provision for teenagers to bridge the gap between being an in patient in a psychiatric unit and going back into schools which are unable, understandably, to cope with the level of risk and support involved.
I had never thought I would see an FE college and so called liberal institution behaving as mine did but it became a microcosm of government to a shocking degree.
Leaving was a painful process, both seeing the withdrawal of provision for the most needy in our community and seeing experienced and committed colleagues so undervalued.
I have felt increasingly that the only solution is political and would put my energy there if I could only see a viable place for it. Like many on this blog my natural home has always been the Labour Party but of that I despair.
I am an avid reader of this very positive and contructive blog and only wish there was a viable party that would take your ideas forward.
Needles to say, after my experience I wouldn’t believe a word that this vindictive goverment utters on any matter of well being for the public at large.
Thanks for sharing Judith
I wish I had an answer
As a fairly recently retired teacher, I would have to point to the changes that have occurred in schools as a significant driver in causing mental health issues. Our young people are subject to an oppressive regime of assessment, beginning with the absurd and discredited tests in primary schools. Teachers are under such pressure from marking, data management, performance management and Ofsted that many cannot cope. They break down or leave the profession – I’ve seen this happen.
As you say, Richard, if the government was serious about improving mental health it would look at the root causes. This is just another example of its culpability.
I see that from both teacher and pupil sides of the equation
And it can be tragic
Yes I agree with Kevin too.
Knowing that you are part of a failing school or that OFSTED are in cannot help children to feel bad about themselves especially when the histrionics of a bad result follow on (incudentally OFSTED did an inspection of my partner’s school just before Xmas whilst all the staff had been busy doing nativity plays and carol concert performances – how considerate of them).
But I also think that one of the drivers of mental health issues in young folk is social media. It’s viscious out there as our expereince with our 13 year old daughter will testify.
I’ll add some weight to what you’ve written with personal experience, something I have never discussed publicly for fear of the negative reaction even people who I believe are otherwise close friends sometimes display.
I have a son who was diagnosed with ADHD when he was about 12. As far as I can tell, only 3 of teachers even recognised his difficulties in any meaningful way, for which I was, and am, eternally grateful because they were the only people for whom he studied enthusiastically and demonstrated what he could have achieved. Even now, 18 years later, he speaks kindly of them occasionally. There just weren’t enough teachers who, whether too busy, too unaware or too indifferent who took Tim’s difficulties into account.
The governments expressed intention to tackle mental health issues in schools is fine but, as others have pointed out, if it’s just a case of government passing the buck by asking demotivated and stressed teachers to add this to their role, it just won’t happen, in which case the fine words will be about as far as this initiative goes. The cynic in me believes this initiative is little more than propaganda to convince the peons that “we have a good government”.
As my son matured, his problems intensified significantly, to the point where anger took over and caused so many problems that he was excluded from school. We found our way to child mental health services where his first professional help came from a second, child specialist, psychiatrist who simply waited for my son to explain what his problems were, failing completely to recognise my son was unable to explain clearly what he was feeling.
At 18, my son was passed on to adult services where his first contact was with a senior psychiatrist who, after 2 or 3 meetings, simply walked away from my son without informing him. Since there have been two psychiatrists, both well meaning but both refusing to provide any fixed diagnosis on the basis that it would make no difference to his diagnosis and that there were no alternative treatments beyond CBT based interventions, which were tried but did nothing to help. At our last meeting with the second of these psychiatrists, we were told that he was moving to child services but that no replacement had yet been appointed. That meeting was 5 or 6 months ago, since when no more has been heard.
With only one or two notable exceptions, the people in Mental Health Services have tried to be helpful but it’s always been clear those services are dying; where are the people they need and the alternative treatments that some said they would have attempted had the funds only been available? That Mental Health Services have been vastly degraded and underfunded in our area is beyond question. For that to have been allowed to happen, or been caused, by incoherent austerity economics, is something of which this government and its predecessor should be ashamed.
But what happens, in my experience, is not the end of it in terms of discrimination against those with mental health needs.
As shameful as the underfunding of Mental Health Services is, the iniquities of the benefits system are far, far worse, in that they reinforce my son’s sense of worthlessness. The application forms for both ESA and PIP seem to have been designed specifically to trip up the unwary, of which my son is one, because they ask similar questions but in different ways. According to the Benefits and Work website, an outstanding support resource for those claiming benefits, information in both applications is passed freely between assessors for both benefits and what is said in one used to deny claims in the other, or both. The possibility that a second assessor might be minded simply to arrive at the same negative conclusion as his predecessor doesn’t appear to have been considered. Worse, it might have been the intention.
Capita operate the WCA in our area and, according to the Benefits and Work website, the vast majority of their assessors, 933, are physiotherapists. That the government allows its contractor to use a physiotherapist with little or no experience of mental health to assess mental health suggests a callous indifference on their part.
Because my son cannot cope with official documents, I, as his designated representative, have had to work my way through both a WCA questionnaire and a PIP application on his behalf. As I am my son’s sole carer, and, perhaps the only person he trusts, many of the responses in both documents have been based on my experiences alone.
In the WCA document, among everything else, I explained fully how my son’s explosive temper, which can erupt under the smallest provocation, can and does intimidate and threaten others, the point being that I believed he would pose an unpredictable potential threat to others if asked to do something he considered demeaning.
The “decision maker” decided that, despite what I had written, that my son had limited capability for work and placed him son in the WRAG group where precisely the circumstance I had described was likeliest to happen, eg “go and work unpaid in Tesco stacking shelves”. I asked for mandatory reconsideration but, predictably, there was no change. So I went to a Tribunal.
Having listened to what I had to say, the Tribunal moved my son into the Support group and recommended that he not be re-assessed. That Tribunal was in October last year; I have not to this day received written confirmation that my son is now in the Support Group, though his benefit says he is, or that, as they are entitled, DWP have set a 2 year re-assessment date.
The entire WCA process ran from January to October 2016. Although I am grateful that it was resolved in my son’s favour, the fact that DWP can reduce the Court’s recommendation of indefinite non re-assessment to 2 years, shows, in my opinion, how seriously they take a court’s recommendation. But then, they’ve got form on that point, as we all know.
Having concluded the ESA process, I was notified later in October that a PIP application was required. The questionnaire took about 10 hours to complete, spent largely on making sure I was consistent with the answers in the WCA and researching how best to express myself.
Add together the state of mental health services and the time spent assembling accurate questionnaires and challenging decisions from unqualified “decision makers, and the journey, I believe, will have proved to one that perhaps most people with mental health difficulties could not navigate alone. To me, that represents gross discrimination.
To supplement that discrimination with a pervasive narrative that, if you don’t work and don’t have money, you’re irrelevant and impoverishment through a clear policy to reduce benefits below subsistence level can only be described as hateful. And that’s exactly how I feel about the government since 2010.