After a shock narrow majority win, we are now facing five years under a Conservative government. So what does this mean for mental health?
To properly understand, we need to look at what has happened to mental health care and conditions after five years of the Conservative-Liberal Democrat coalition, in conjunction with what the Tories have promised to do. The zeitgeist surrounding mental health at the moment and public opinion will also have a part to play.
Firstly, one cold hard fact of the Coalition, is that as a direct result of their policies on health, welfare and mental health – people have died. Some, had pre-existing mental health conditions which were not properly tended to by the state. Others, were driven to psychological distress and eventual suicide by the government’s welfare policy. The Government’s Work and Pensions Select Committee announced in March that 40 people had committed suicide because of problems with welfare payments since 2012.
So too, people have died due to the policy of detaining those who are mentally ill in police cells due to a lack of hospital beds and facilities where patients can be admitted. Sadly, whilst incarcerated, some chose to take their own lives. These are people who needed proper specialist care, but were detained like criminals, ignored as they endured a personal crisis no one would wish on anyone else, and are now dead. Furthermore, for those who survived, they now face the stigma for the rest of their lives of having their conditions criminalised, as well as enduring the traumatic experience of having been put in prison – for the crime of having a mental health issue. Under great public pressure, the Conservative government to their credit have now outlawed this, but for these victims of the cuts and their families, it is too late.
In addition to this, the notorious ATOS fit-for-work scheme has been varied in the way it has killed people. Some, suffering from severe stress, have simply dropped dead having returned to work after having been declared fit to work, with their benefits being sanctioned to force them to undertake work which they clearly were not ready for. Others, upon losing the only crutch that supported them in their battle against an illness that gives no quarter, again chose to take their own lives. It is worthy of note that in May 2013, a three-judge tribunal panel ruled that the Department for Work and Pensions had failed to make reasonable adjustments to ensure people with mental health problems were treated fairly by the system. The fit-for-work scheme has carried on regardless.
This is the legacy of the Coalition on mental health. However, it would be narrow-minded to place the blame entirely on their shoulders. Public opinion towards mental health has only recently begun to turn, and the media should feel great guilt for this (The Sun’s ‘Bonker’s Bruno’ front page springs to mind). Also, and in particular with suicide, there remains somewhat a national taboo surrounding it, and one could argue the general public can to a very small extent be considered complicit in these individual tragedies by not talking about problems and maintaining the wall of silence surrounding mental health.
Despite this, since the Coalition came in to power, there has been an 8% decrease in the mental health budget, which has seen the closure of entire psychiatric wards. There have been at least seven suicides linked to problems accessing beds, where doctors often have to send home ‘critically unwell’ patients, or house them in places hundreds of miles from loved ones and their homes. Waiting lists for counselling, therapy and talk therapy have gotten longer and longer. A survey of 2,000 talking therapies patients published by MIND in 2014 found that 1 in 10 had waited more than a year to get help. 1 in 6 attempted to take their own life while waiting. Therefore, not only has the Coalition had policies that have punished people with existing conditions and exacerbated them, but it has been the direct cause of a mental health epidemic – all the while cutting the services which may have been able to help those people. It is at the feet of austerity measures that the blame must lie for these deaths. Indeed, in an open letter to The Guardian, 442 psychotherapists, counsellors and academics condemned austerity’s impact on the nation’s mental health. Yet austerity marches on, unflinching in the face of families torn apart by its policies.
This paints a worrying picture for the next five years. For all his faults, Nick Clegg has always been a champion of mental health, and in the weeks prior to the election, he has been at pains to express that the state of affairs in the country would be a lot harsher had the Lib Dems not been there to temper the rampant Conservatives, the good cop to the Tories bad cop. But are these the desperate words of a condemned man? His resignation earlier today may suggest so, and indeed the Lib Dems collapse can be attributed to an abandonment in their values, simply becoming Tory-Lite. Furthermore, the Lib Dem diaspora has shown itself to be more right wing than Left, so these could simply be empty words from Clegg. And yet, whether or not he actually got any results, it really isn’t in question as to whether or not the Lib Dems served as a dissenting voice against the austerity measures imposed on the public services of Britain and in particular mental health – the corner would have been fought, regardless of whether the fight lasted for the first ten seconds of the first round before the Lib Dems threw the towel in. Therefore the only conclusion that can be drawn is that in this Conservative government, regardless of whether it would even actually do any good or have any effect, there will be no opposition to the further cuts which are to be imposed – they will be deeper, and more hardly felt in the latter half of this decade than the former.
But what of the pledges and promises that have been made? It is has been noticeable how much attention mental health has been given in the run up to the election. Sadly, of the three main parties, the party which made the least noise on the subject is now currently celebrating in 10 Downing Street.
Nick Clegg had previously announced the Lib Dems were to launch initiatives to get the NHS to commit to a ‘zero suicide goal’. Currently 4,700 people a year commit suicide, mostly men, and this they hoped to reduce considerably. The plan was to adopt methods from a programme which had unmitigated success in Detroit, reducing suicides from 89 per 100,000 in 2001, to zero per 100,000 by 2011. The Lib Dems are now leaderless with just 8 MPs in Parliament.
Labour announced they were to ‘end the scandal of neglect’ of children’s mental health issues if they won in May’s general election. Having commissioned an independent taskforce to create a report to help devise a strategic plan for mental health, off the back of its findings Miliband in January announced ‘Taking action to improve mental health is essential if we are to thrive as a nation and ensure the NHS remains sustainable’. This came just a week after a separate report found that children’s mental health services had been cut by £50 million, falling by more than 6% since 2010, despite 54% of headteachers in the country believing that their pupils are being let down by the Child and Adolescent Mental Health Service (CAMHS), and a 20% rise in the number of 10 to 19 year olds being admitted to hospital for self-harming, which caused two teaching unions to announce they are ‘struggling to cope’ with students self-harming. Miliband like Clegg has now resigned, and Labour faces years of soul searching.
The Conservatives, and Health Secretary Jeremy Hunt, have publically declared mental health to be a priority. They have not particularly said how it will be a priority, what they will prioritise or indeed what they will do at all, but nonetheless, it shall be a priority. They have reaffirmed their commitment to put mental health services on a par with physical health, and in their manifesto, they said they would increase the budget for mental health care. They did not go into the finer details of just how much this would be increased by. In all likelihood this increase will be allocated to be part of the George Osbourne guaranteed £8 billion increase in spending per year above inflation by 2020. Whether this will only come about by letting the Tories ‘finish the job’ in the 2020 election remains to be seen. Chamali Fernando suggested that those who suffered with mental health issues should have wristbands in order to identify themselves. She did not say whether she would also like the LGBT community to wear pink triangles, and for the Jewish community to make themselves easily identifiable by wearing a yellow Star of David. Thankfully, she did not get elected in Cambridge. Whilst it can be argued that you could allow the Conservative’s a degree of vagueness in their mental health plans given it was more the Lib Dems remit to deal with that area in the Coalition, surely it would have been more reassuring to the thousands of NHS staff now concerned about the future of themselves, their colleagues, their patients and the institution itself to do more than just pay lip service to mental health.
This all paints a very bleak picture for those who care about mental health, and for those of us unfortunate enough to be suffering from a mental health problem.
It will therefore be the responsibility of the electorate to do what we can to keep the government in check and to monitor and prevent the culling of services which are keeping people alive and changing people’s lives for the better. It is a point of scant optimism that we as a society are more accepting of mental health issues. There is an incredible movement going on in society right now to reduce the stigma surrounding mental illness and to genuinely save lives. Wonderful organisations like MIND, Rethink Mental Illness and The Campaign Against Living Miserably (CALM) are making a tangible, positive change to so many people’s lives. It will unfairly fall on their shoulders, and the people’s shoulders to try and weather this storm, and react in constructive ways to ever more difficult circumstances. As more and more stories come out about exasperated and stretched NHS staff reaching breaking point, and services are unable to cope with increasing demand, something is going to have to give.
This country is in the grips of a mental health crisis, and there is no evidence to suggest that five years of a Conservative government will help to ease this strain, going by their track record and the promises they have made. Only time will tell if they have more blood on their hands at the end of their next term of government than the last.